Sample records for surgical work force

  1. Sensorization of a surgical robotic instrument for force sensing (United States)

    Shahzada, Kaspar S.; Yurkewich, Aaron; Xu, Ran; Patel, Rajni V.


    This paper presents the development and application of an approach for sensorizing a surgical robotic instrument for two degree-of-freedom (DOF) lateral force sensing. The sensorized instrument is compatible with the da Vinci® Surgical System and can be used for skills assessment and force control in specific surgical tasks. The sensing technology utilizes a novel layout of four fiber Bragg grating (FBG) sensors attached to the shaft of a da Vinci® surgical instrument. The two cross-section layout is insensitive to error caused by combined force and torque loads, and the orientation of the sensors minimizes the condition number of the instrument's compliance matrix. To evaluate the instrument's sensing capabilities, its performance was tested using a commercially available force-torque sensor, and showed a resolution of 0.05N at 1 kHz sampling rate. The performance of the sensorized instrument was evaluated by performing three surgical tasks on phantom tissue using the da Vinci® system with the da Vinci Research Kit (dVRK): tissue palpation, knot tightening during suturing and Hem-O-Lok® tightening during knotless suturing. The tasks were designed to demonstrate the robustness of the sensorized force measurement approach. The paper reports the results of further evaluation by a group of expert and novice surgeons performing the three tasks mentioned above.

  2. On the work of internal forces

    CERN Document Server

    Guemez, Julio; Brito, Lucilia


    We discuss the role of the internal forces and how their work changes the energy of a system. We illustrate the contribution of the internal work to the variation of the system's energy, using a pure mechanical example, a thermodynamical system and an example from electromagnetism. We emphasize that internal energy variations related to the work of the internal forces should be pinpointed in the classroom and placed on the same footing as other internal energy variations such as those caused by temperature changes or by chemical reactions.

  3. Does the electromotive force (always represent work?

    Directory of Open Access Journals (Sweden)

    C. J. Papachristou


    Full Text Available In the literature of Electromagnetism, the electromotive force of a "circuit" is often defined as work done on a unit charge during a complete tour of the latter around the circuit. We explain why this statement cannot be generally regarded as true, although it is indeed true in certain simple cases. Several examples are used to illustrate these points.

  4. Joining Forces: Working with Spirituality in Organisations. (United States)

    Snell, Robin; And Others


    Includes "Joining Forces" (Lindamood); "Spiritual Dimension of the Learning Organisation" (Hawkins); "Management--A 'Spiritual' Foundation?" (Nevard); "Hermit in Organisations" (Murray); "Towards a Spiritual Perspective on Behavior at Work" (Henson); "On Uncertainty" (Adlam); "Spirituality in Organisations" (Lee); "Ecological Organisation" (Conn);…

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

    LENUS (Irish Health Repository)

    Kelly, B D


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

  6. Employee satisfaction: creating a positive work force. (United States)

    Wright, M


    In the early 1990s, El Camino Hospital (ECH) streamlined its operations in order to remain competitive. In 1992, the hospital's District Board voted to turn the hospital's management over to a nonprofit company and it became an integrated delivery system (IDS). Hospital employees continued to suffer as their work and work schedules changed in ongoing efforts by the new administration to streamline. Finally, in early 1997, the IDS, Camino Healthcare, was dissolved. The director of radiology and radiation oncology services became aware of increasing employee problems, from high turnover rates and increased absenteeism, to morale and productivity issues. Employees also worried about job redesign, re-engineering and a lack of clear direction and expectations from department leadership. The director of the department created a task force to respond to the needs of staff members. With so much anger directed at department leadership, supervisory staff were not included in the task force. The task force worked first to identify rumors and innuendos and followed with a plan to resolve such issues. The second step was to agree to focus on issues that they could change and to let go of those they couldn't. They selected five priority issues or concerns. The group met weekly and made progress by replacing negative talk and attitudes with positive ones. Meanwhile, the director researched employee satisfaction issues so she would be prepared to discuss such issues and concerns with employees. She focused on a common theme, of having a personal mission or goal for one's self. She encouraged staff members to be aware of their own behavior when communicating with others. Although several informal surveys proved there was still much work to be done, there was positive response--a light at the end of the long tunnel.

  7. Telecommuters: the work force of the future. (United States)

    Yancer, D A; Moe, J K


    Telecommuters are the work force of the future. The dawning of the information age, with its explosion of telecommunication technology, presents new opportunities for healthcare agencies to extend their borders far beyond traditional physical boundaries. The virtual workplace can become a reality and position healthcare agencies to be geographically dispersed throughout their community. The authors describe a pioneering effort to use telecommunications to retain a valuable employee and create a healthcare agency's first virtual workplace. Strategies for success in telecommuting also are provided from both the telecommuter's and the manager's viewpoints.

  8. Estimating Tool-Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool. (United States)

    Zhao, Baoliang; Nelson, Carl A


    Robot-assisted minimally invasive surgery (MIS) has gained popularity due to its high dexterity and reduced invasiveness to the patient; however, due to the loss of direct touch of the surgical site, surgeons may be prone to exert larger forces and cause tissue damage. To quantify tool-tissue interaction forces, researchers have tried to attach different kinds of sensors on the surgical tools. This sensor attachment generally makes the tools bulky and/or unduly expensive and may hinder the normal function of the tools; it is also unlikely that these sensors can survive harsh sterilization processes. This paper investigates an alternative method by estimating tool-tissue interaction forces using driving motors' current, and validates this sensorless force estimation method on a 3-degree-of-freedom (DOF) robotic surgical grasper prototype. The results show that the performance of this method is acceptable with regard to latency and accuracy. With this tool-tissue interaction force estimation method, it is possible to implement force feedback on existing robotic surgical systems without any sensors. This may allow a haptic surgical robot which is compatible with existing sterilization methods and surgical procedures, so that the surgeon can obtain tool-tissue interaction forces in real time, thereby increasing surgical efficiency and safety.

  9. Annual report on contractor work force restructuring, fiscal year 1997

    Energy Technology Data Exchange (ETDEWEB)



    This report summarizes work force restructuring and community transition activities at all sites. It outlines work force restructuring activity for FY 1997, changing separation patterns, cost savings and separation costs, program assessment, activities to mitigate restructuring impacts, community transition activities, status of displaced workers, lessons learned, and emerging issues in worker and community transition. Work force restructuring and community transition activities for defense nuclear sites are summarized, as are work force restructuring activities at non-defense sites.

  10. [Investigating work, age, health and work participation in the ageing work force in Germany]. (United States)

    Ebener, M; Hasselhorn, H M


    Working life in Germany is changing. The work force is ageing and the number of people available to the labour market will - from now on - shrink considerably. Prospectively, people will have to work longer; but still today, most people leave employment long before reaching official retirement age. What are the reasons for this? In this report, a conceptual framework and the German lidA Cohort Study are presented. The "lidA conceptual framework on work, age, health and work participation" visualises determinants of employment (11 "domains") in higher working age, e. g., "work", "health", "social status" and "life style". The framework reveals 4 key characteristics of withdrawal from work: leaving working life is the result of an interplay of different domains (complexity); (early) retirement is a process with in part early determinants in the life course (processual character); retirement has a strong individual component (individuality); retirement is embedded in a strong structural frame (structure). On the basis of this framework, the "lidA Cohort Study on work, age, health and work participation" ( investigates long-term effects of work on health and work participation in the ageing work force in Germany. It is the only large study in Germany operationalising the concept of employability in a broad interdisciplinary approach. Employees subject to social security and born in 1959 or in 1965 will be interviewed (CAPI) every 3 years (N[wave 1]=6 585, N[wave 2]=4 244) and their data will be linked (where consented) with social security data covering employment history and with health insurance data. The study design ("Schaie's most efficient design") allows for a tri-factor model that isolates the impact of age, cohort and time. In 2014, the second wave was completed. In the coming years lidA will analyse the association of work, health and work participation, and identify age as well as generation differences. lidA will investigate the

  11. The assessment and management of older cancer patients : A SIOG surgical task force survey on surgeons' attitudes

    NARCIS (Netherlands)

    Ghignone, F; van Leeuwen, B. L.; Montroni, I; Huisman, M G; Somasundar, P; Cheung, K L; Audisio, R A; Ugolini, G

    Aim: The Surgical Task Force at SIOG (International Society of Geriatric Oncology) designed this survey to explore the surgical oncologists' approach toward elderly cancer patients. Methods: A web-based survey was sent to all members of ESSO (European Society of Surgical Oncology) and SSO (Society

  12. [Surgical and non-surgical management of primary hyperparathyroidism:How do calcimimetics work? (United States)

    Takeuchi, Yasuhiro


    Primary hyperparathyroidism is a common endocrine disease. The first line therapy for the disease is surgical removal of affected parathyroid gland(s). Other therapeutic options with medication are needed to be established, because many of patients with primary hyperparathyroidism have few or no symptoms and are expected to have a long life expectancy without surgery. Cinacalcet as a calcimimetic, bisphosphonates and denosumab are promising candidates for medical management of the disease. Effectiveness and efficiency of these drugs for patients with primary hyperparathyroidism is to be evaluated in comparison with surgical treatment.

  13. Children of Working Mothers. Special Labor Force Report. Bulletin 2158. (United States)

    Bureau of Labor Statistics (DOL), Washington, DC.

    Part of a Special Labor Force Report series, this bulletin on children of working mothers discusses the increase in the number of children with working mothers as of March 1981, and describes major reasons for this growth. The bulletin consists of an article first published February 1982 in the "Monthly Labor Review," additional tables providing…

  14. Surgical resident learning styles have changed with work hours. (United States)

    Quillin, Ralph C; Cortez, Alexander R; Pritts, Timothy A; Hanseman, Dennis J; Edwards, Michael J; Davis, Bradley R


    The Accreditation Council for Graduate Medical Education instituted the 80-h workweek for residency programs in 2003. This presented a unique challenge for surgery residents who must acquire a medical and technical knowledge base during training. Therefore, learning should be delivered in an environment congruent with an individual's learning style. In this study, we evaluated the learning styles of general surgery residents to determine how learning styles changed after the implementation to the 80-h workweek. Kolb learning style inventory was taken by general surgery residents at the University of Cincinnati's Department of Surgery, and results from 1999-2012 were analyzed. Statistical analysis was performed using the chi-squared, logistic regression and Wilcoxon rank-sum test. Significance was defined as a P value of learning styles after the institution of the 80-h workweek to converging (43.9%) and accommodating (40.4%, P learning. This change paralleled the transition to a more team-based approach to patient care with the implementation of the 80-h workweek. These findings are important for surgical educators to consider in the development of surgical resident curriculum. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Evaluation of bacterial contamination on surgical drapes following use of the Bair Hugger(®) forced air warming system. (United States)

    Occhipinti, Lindsay L; Hauptman, Joe G; Greco, Justin J; Mehler, Stephen J


    This pilot study determined the rate of bacterial contamination on surgical drapes of small animal patients warmed intra-operatively with the Bair Hugger(®) forced air warming system compared to a control method. Surgical drapes of 100 patients undergoing clean surgical procedures were swabbed with aerobic culturettes at the beginning and end of surgery. Samples were cultured on Trypticase soy agar. Contamination of the surgical drapes was identified in 6/98 cases (6.1%). There was no significant difference in the number of contaminated surgical drapes between the Bair Hugger(®) and control groups (P = 0.47).

  16. Helping Managers and Employees Cope with Work-Force Cutbacks. (United States)

    Morton, Gene L.


    Steps can be taken to reduce the need for work-force cutbacks and to prepare in advance by planning activities, defining severance awards, reducing anxiety, setting layoff criteria, providing outplacement services, and handling the timing, logistics, and aftermath of layoffs with sensitivity. (SK)

  17. Helping Managers and Employees Cope with Work-Force Cutbacks. (United States)

    Morton, Gene L.


    Steps can be taken to reduce the need for work-force cutbacks and to prepare in advance by planning activities, defining severance awards, reducing anxiety, setting layoff criteria, providing outplacement services, and handling the timing, logistics, and aftermath of layoffs with sensitivity. (SK)

  18. [Esthetic and social indications for the "redressement forcé" technic and the hazards of this surgical procedure]. (United States)

    Roykó, A; Razouk, G; Dénes, J


    The authors report on-, and evaluate the type of operation known as "redressement force" for the correction of retained upper canines. The risk of the surgical intervention is extremely high, but there are good reasons for the indications, too.

  19. European Working Time Directive: implications for surgical training.

    LENUS (Irish Health Repository)

    Donohoe, C L


    The forthcoming implementation of the European Working Time Directive (EWTD) for non-consultant hospital doctors (NCHDs) poses a number of challenges in the areas of patient care, training, service provision and quality of life for workers. Surgery, as a craft-based speciality, will face a greater impact on training of future surgeons as operating time could be lost to service provision. The EWTD acts a stimulus for reform of current working practices and re-configuration of services. It will necessitate transformation of the way in which surgeons are trained, if current standards are to be maintained.

  20. Occupational health for what were, a well work force

    Energy Technology Data Exchange (ETDEWEB)

    Spiller, Roger [MSF, Stowmarket (United Kingdom)


    This paper contrasts the offshore scene of 30 years ago with today, within the limits of inadequate monitoring, then and now. It identifies stress, bullying, change, long working hours and offshore trips and lifestyle as major factors that now have to be addressed if the health of the ageing work force is not to be compromised. Activity external to formal working hours such as travel to and from home and domestic and social relationships are all modified by the nature of offshore work but rarely acknowledged as the responsibility of the employer or operator. The development of a superior lifelong health tracking system is essential for long-term surveillance and epidemiological studies. The acceptance by operators of their long-term responsibilities for staff and the families of offshore workers needs to be better developed. (author)

  1. Force

    CERN Document Server

    Graybill, George


    Forces are at work all around us. Discover what a force is, and different kinds of forces that work on contact and at a distance. We use simple language and vocabulary to make this invisible world easy for students to ""see"" and understand. Examine how forces ""add up"" to create the total force on an object, and reinforce concepts and extend learning with sample problems.

  2. Power, muscular work, and external forces in cycling. (United States)

    de Groot, G; Welbergen, E; Clijsen, L; Clarijs, J; Cabri, J; Antonis, J


    Cycling performance is affected by the interaction of a number of variables, including environment, mechanical, and human factors. Engineers have focused on the development of more efficient bicycles. Kinesiologists have examined cycling performance from a human perspective. This paper summarizes only certain aspects of human ergonomics of cycling, especially those which are important for the recent current research in our departments. Power is a key to performance of physical work. During locomotion an imaginary flow of energy takes place from the metabolism to the environment, with some efficiency. The 'useful' mechanical muscle power output might be used to perform movements and to do work against the environment. The external power is defined as the sum of joint powers, each calculated as the product of the joint (net) moment and angular velocity. This definition of external power is closely related to the mean external power as applied to exercise physiology: the sum of joint powers reflects all mechanical power which in principle can be used to fulfil a certain task. In this paper, the flow of energy for cycling is traced quantitatively as far as possible. Studies on the total lower limb can give insight into the contribution of individual muscles to external power. The muscle velocity (positive or negative) is obtained from the positions and orientations of body segments and a bar linkage model of the lower limb. The muscle activity can be measured by electromyography. In this way, positive and negative work regions in individual muscles are identified. Synergy between active agonistic/antagonistic muscle groups occurs in order to deliver external power. Maximum power is influenced by body position, geometry of the bicycle and pedalling rate. This has to be interpreted in terms of the length-tension and force-velocity-power relationships of the involved muscles. Flat road and uphill cycling at different saddle-tube angles is simulated on an ergometer. The

  3. Work-energy theorem and friction forces: two experiments (United States)

    Bonanno, A.; Bozzo, G.; Grandinetti, M.; Sapia, P.


    Several studies have showed the subsistence, even in students enrolled in scientific degree courses, of spontaneous ideas regarding the motion of bodies that conflict with Newton’s laws. One of the causes is related to the intuitive preconceptions that students have about the role of friction as a force. In fact, in real world novices do not recognise friction as a force, and for this reason they may believe that a motion with a constant speed needs as a necessary condition the presence of a constant force in the same direction of the motion. In order to face these ‘intuitive ways of reasoning’, in this paper we propose two sequential experiments that can allow undergraduate students to clarify the role of friction forces through the use of the work-energy theorem. This is a necessary first step on the way to a deeper understanding of Newton’s second law. We have planned our experiments in order to strongly reduce quantitative difficult calculations and to facilitate qualitative comprehension of observed phenomena. Moreover, the proposed activities represent two examples of the recurring methodology used in experimental practices, since they offer the possibility to measure very small physical quantities in an indirect way with a higher accuracy than the direct measurements of the same quantities.

  4. Proactive changes in nursing work force development in Tennessee. (United States)

    Moody, N B; Smith, P L


    Problems to be addressed by the CIC grant have been identified and defined, and a coalition has been formalized to address nursing work force development in Tennessee. The THCN, composed of consumers, nursing educators, policy makers, healthcare providers, and representatives of professional organizations and regulatory boards, is enthusiastically tackling the implementation phase of the project. These members are demonstrating open communication, teamwork, and interdependent decision making. Results are being achieved through persuasion, negotiation, seeking input from others, showing political sensitivity, and a willingness to share rewards and recognition.

  5. The Finnish forward surgical team: lessons from the European Union Forces Operation République Démocratique du Congo. (United States)

    Lauri, Handolin; Olli, Kiviluoto


    The European Union Forces Operation République Démocratique du Congo in the Democratic Republic of the Congo in 2006 was the first operation planned and conducted solely by the European Union Forces. The Finnish forward surgical team (FST) was deployed for 4 months in Kinshasa, the capital of the Democratic Republic of the Congo. Because of the peacekeeping nature of the operation, the surgical workload was light and the total number of patients treated by the FST was 12. However, there is an obvious need to establish similar surgical assets in future operations. The lessons and experiences regarding the variables in the composition of the FST (mobility, surgical ability, staffing, patient care, physical stability, environmental adaptation, and independence) are discussed in the present article. The major future challenges are to resource the FST units optimally to remain light and easily deployable and to maintain the effectiveness of the unit during nonclinical periods.

  6. Forced-Air Warming Provides Better Control of Body Temperature in Porcine Surgical Patients

    Directory of Open Access Journals (Sweden)

    Brian T. Dent


    Full Text Available Background: Maintaining normothermia during porcine surgery is critical in ensuring subject welfare and recovery, reducing the risk of immune system compromise and surgical-site infection that can result from hypothermia. In humans, various methods of patient heating have been demonstrated to be useful, but less evaluation has been performed in techniques to prevent hypothermia perioperatively in pigs. Methods: We compared body temperature regulation during surgery before and after modification of the ambient temperature of the operating laboratories. Three different methods of heating were then compared; a standard circulating water mattress, a resistive fabric blanket, and a forced hot air system. The primary measure was percentage of temperature readings outside a specification range of 36.7–40.0 °C. Results: Tighter control of the ambient temperature while using a circulating water mattress reduced the occurrence of out-of-specification body temperature readings from 20.8% to 5.0%, with most of these the result of hypothermia. Use of a resistive fabric blanket further reduced out-of-specification readings to 1.5%, with a slight increase in the occurrence of hyperthermia. Use of a forced air system reduced out-of-specification readings to less 0.1%. Conclusions: Maintenance of normothermia perioperatively in pig can be improved by tightly controlling ambient temperatures. Use of a resistive blanket or a forced air system can lead to better control than a circulating water mattress, with the forced air system providing a faster response to temperature variations and less chance of hyperthermia.

  7. State of the practice for pediatric surgery--career satisfaction and concerns. A report from the American Pediatric Surgical Association Task Force on Family Issues. (United States)

    Katz, Aviva; Mallory, Baird; Gilbert, James C; Bethel, Colin; Hayes-Jordan, Andrea A; Saito, Jacqueline M; Tomita, Sandra S; Walsh, Danielle S; Shin, Cathy E; Wesley, John R; Farmer, Diana


    There has been increasing interest and concern raised in the surgical literature regarding changes in the culture of surgical training and practice, and the impact these changes may have on surgeon stress and the appeal of a career in surgery. We surveyed pediatric surgeons and their partners to collect information on career satisfaction and work-family balance. The American Pediatric Surgical Association Task Force on Family Issues developed separate survey instruments for both pediatric surgeons and their partners that requested demographic data and information regarding the impact of surgical training and practice on the surgeon's opportunity to be involved with his/her family. We found that 96% of pediatric surgeons were satisfied with their career choice. Of concern was the lack of balance, with little time available for family, noted by both pediatric surgeons and their partners. The issues of work-family balance and its impact on surgeon stress and burnout should be addressed in both pediatric surgery training and practice. The American Pediatric Surgical Association is positioned to play a leading role in this effort. Copyright © 2010 Elsevier Inc. All rights reserved.

  8. Work-family conflict and neck and back pain in surgical nurses. (United States)

    Baur, Heiner; Grebner, Simone; Blasimann, Angela; Hirschmüller, Anja; Kubosch, Eva Johanna; Elfering, Achim


    Surgical nurses' work is physically and mentally demanding, possibly leading to work-family conflict (WFC). The current study tests WFC to be a risk factor for neck and lower back pain (LBP). Job influence and social support are tested as resources that could buffer the detrimental impact of WFC. Forty-eight surgical nurses from two university hospitals in Germany and Switzerland were recruited. WFC was assessed with the Work-Family Conflict Scale. Job influence and social support were assessed with the Copenhagen Psychosocial Questionnaire, and back pain was assessed with the North American Spine Society Instrument. Multiple linear regression analyses confirmed WFC as a significant predictor of cervical pain (β = 0.45, p back pain in surgery nurses. Work-life interventions may have the potential to reduce WFC in surgery nurses.

  9. Individual and Work Factors Related to Perceived Work Ability and Labor Force Outcomes (United States)

    McGonagle, Alyssa K.; Fisher, Gwenith G.; Barnes-Farrell, Janet L.; Grosch, James W.


    Perceived work ability refers to a worker's assessment of his or her ability to continue working in his or her job, given characteristics of the job along with his or her personal resources. Perceived work ability is a critical variable to study in the U.S., given an aging workforce, trends to delay retirement, and U.S. policy considerations to delay the age at which full Social Security retirement benefits may be obtained. Based on the Job Demands-Resources Model, cognitive appraisal theory of stress and push/pull factors related to retirement, we proposed and tested a conceptual model of antecedents and outcomes of perceived work ability using three independent samples of U.S. working adults. Data regarding workers’ job characteristics were from self-report and O*NET measures. Results from relative importance analysis indicated that health and sense of control were consistently and most strongly related to work ability perceptions relative to other job demands and job resources when perceived work ability was measured concurrently or two weeks later in samples with varying occupations. Job demands (along with health and sense of control) were most strongly related to work ability perceptions when perceived work ability was measured in a manufacturing worker sample 1.6 years later. Perceived work ability also predicted lagged labor force outcomes (absence, retirement, and disability leave) while controlling for other known predictors of each. Consistent indirect effects were observed from health status and sense of control to all three of these outcomes via perceived work ability. PMID:25314364

  10. Individual and work factors related to perceived work ability and labor force outcomes. (United States)

    McGonagle, Alyssa K; Fisher, Gwenith G; Barnes-Farrell, Janet L; Grosch, James W


    Perceived work ability refers to a worker's assessment of his or her ability to continue working in his or her job, given characteristics of the job along with his or her resources. Perceived work ability is a critical variable to study in the United States, given an aging workforce, trends to delay retirement, and U.S. policy considerations to delay the age at which full Social Security retirement benefits may be obtained. Based on the job demands-resources model, cognitive appraisal theory of stress, and push/pull factors related to retirement, we proposed and tested a conceptual model of antecedents and outcomes of perceived work ability using 3 independent samples of U.S. working adults. Data regarding workers' job characteristics were from self-report and Occupational Information Network measures. Results from relative importance analysis indicated that health and sense of control were consistently and most strongly related to work ability perceptions relative to other job demands and job and personal resources when perceived work ability was measured concurrently or 2 weeks later in samples with varying occupations. Job demands (along with health and sense of control) were most strongly related to work ability perceptions when perceived work ability was measured in a manufacturing worker sample 1.6 years later. Perceived work ability also predicted lagged labor force outcomes (absence, retirement, and disability leave) while controlling for other known predictors of each. Consistent indirect effects were observed from health status and sense of control to all 3 of these outcomes via perceived work ability. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  11. Self-reported drug allergies and the diagnostic work-up in the surgical population


    Tamayo, E; Álvarez, FJ; Castrodeza, J.; Yánez, J.; Arnaiz, P.; Lajo, C.; Soria, S.


    Producción Científica Objective The diagnostic work-up of a drug hypersensitivity reaction is indeed difficult. In general, medical documentation of allergic reactions in medical reports is usually highly deficient or non-existent. The aim of this study was to analyse the prevalence of selfreported drug allergies in the surgical population as well as the criteria used in the diagnosis of drug hypersensitivity reactions. Methods A prospective study with the consecutive partic...

  12. The American Association for Thoracic Surgery 2016 ethics forum: Working virtues in surgical practice. (United States)

    Churchill, Larry R


    Moral virtues are the complement to ethical principles. They constitute the elements of character that drive habits and daily routines. Certain virtues are especially important in surgery, shaping surgical practice even when no big decisions are at hand. Eight virtues are described and the work they do is explored: trustworthiness, equanimity, empathy, advocacy, compassion, courage, humility, and hope. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  13. Reorganizing nursing work on surgical units: a time-and-motion study. (United States)

    Desjardins, France; Cardinal, Linda; Belzile, Eric; McCusker, Jane


    A time-and-motion study was conducted in response to perceptions that the surgical nursing staff at a Montreal hospital was spending an excessive amount of time on non-nursing care. A sample of 30 nurse shifts was observed by trained observers who timed nurses' activities for their entire working shift using a hand-held Personal Digital Assistant. Activities were grouped into four main categories: direct patient care, indirect patient care, non-nursing and personal activities. Break and meal times were excluded from the denominator of total worked hours. A total of 201 working hours were observed, an average of 6 hours, 42 minutes per nurse shift. The mean proportions of each nurse shift spent on the main activity categories were: direct care 32.8%, indirect care 55.7%, non-nursing tasks 9.0% and personal 2.5%. Three activities (communication among health professionals, medication verification/preparation and documentation) comprised 78.9% of indirect care time. Greater time on indirect care was associated with work on night shifts and on the short-stay surgical unit. Subsequent work reorganization focused on reducing time spent on communication and medications. The authors conclude that time-and-motion studies are a useful method of monitoring appropriate use of nursing staff, and may provide results that assist in restructuring nursing tasks.

  14. Resistance to change in surgical residency: an ethnographic study of work hours reform. (United States)

    Kellogg, Katherine C; Breen, Elizabeth; Ferzoco, Stephen J; Zinner, Michael J; Ashley, Stanley W


    Although the practical challenges to work hour restrictions have been the focus of much discussion, cultural resistance to such change has received less attention. Surgical residency has its own unique social structure, and we hypothesized that challenges to this would provide impediments to successful implementation of duty hours reform. We used ethnographic research methods to study the efforts at work hour restriction over a 15-month period before the introduction of the Accreditation Council for Graduate Medical Education regulations. These methods, validated for studying institutional change, build on intense periods of observation. Records of observations are then analyzed and coded to uncover cultural and political challenges. The frequency of successful hand-offs in sign-out situations between day and night float residents was measured as an objective index of success. Practical issues were addressed initially by scheduling adjustments including creating a night float system. The hand-offs that this system required, however, were successful only 14% of the time. Subsequent steps to address the challenge to resident identity by top-down support of a new definition of professionalism increased the number of successful hand-offs to 39%. Finally, a reduction in a noted hierarchy violation led to successful hand-offs 79% of the time. These results demonstrate that practical solutions alone may not be a sufficient basis for change in surgical residency. While we face other challenges to the traditional surgical culture, attention to social and political issues may enhance the success of our efforts.

  15. Design of a haptic device with grasp and push-pull force feedback for a master-slave surgical robot. (United States)

    Hu, Zhenkai; Yoon, Chae-Hyun; Park, Samuel Byeongjun; Jo, Yung-Ho


    We propose a portable haptic device providing grasp (kinesthetic) and push-pull (cutaneous) sensations for optical-motion-capture master interfaces. Although optical-motion-capture master interfaces for surgical robot systems can overcome the stiffness, friction, and coupling problems of mechanical master interfaces, it is difficult to add haptic feedback to an optical-motion-capture master interface without constraining the free motion of the operator's hands. Therefore, we utilized a Bowden cable-driven mechanism to provide the grasp and push-pull sensation while retaining the free hand motion of the optical-motion capture master interface. To evaluate the haptic device, we construct a 2-DOF force sensing/force feedback system. We compare the sensed force and the reproduced force of the haptic device. Finally, a needle insertion test was done to evaluate the performance of the haptic interface in the master-slave system. The results demonstrate that both the grasp force feedback and the push-pull force feedback provided by the haptic interface closely matched with the sensed forces of the slave robot. We successfully apply our haptic interface in the optical-motion-capture master-slave system. The results of the needle insertion test showed that our haptic feedback can provide more safety than merely visual observation. We develop a suitable haptic device to produce both kinesthetic grasp force feedback and cutaneous push-pull force feedback. Our future research will include further objective performance evaluations of the optical-motion-capture master-slave robot system with our haptic interface in surgical scenarios.

  16. University of Tennessee deploys force10 switch for CERN work

    CERN Multimedia


    "Force20 networks, the pioneer in building and securing reliable networks, today announced that the University of Tennessee physics department has deployed the C300 resilient switch to analyze data form CERN's Large Hadron Collider." (1/2 page)

  17. Assessing the performance characteristics and clinical forces in simulated shape memory bone staple surgical procedure: The significance of SMA material model. (United States)

    Saleeb, A F; Dhakal, B; Owusu-Danquah, J S


    This work is focused on the detailed computer simulation of the key stages involved in a shape memory alloy (SMA) osteosynthesis bone stapling procedure. To this end, a recently developed three-dimensional constitutive SMA material model was characterized from test data of three simple uniaxial-isothermal-tension experiments for powder metallurgically processed nickel-rich NiTi (PM/NiTi-P) material. The calibrated model was subsequently used under the complex, thermomechanical loading conditions involved in the surgical procedure using the body-temperature-activated PM/NiTi-P bone staple. Our aim here is to assess the immediate and post-surgical performance characteristics of the stapling operation using the material model. From this study: (1) it was found that adequate compressive forces were developed by the PM/NiTi-P bone staple, with the tendency of this force to even increase under sustained thermal loading due to the intrinsic "inverse relaxation phenomena" in the SMA material, (2) the simulation results correlated well with those from experimental measurements, (3) the body-temperature-activated PM/NiTi-P staple was proved to be clinically viable, providing a stable clamping force needed for speedy coaptation of the fractured bones, and (4) these realistic assessments crucially depend on the use of suitable and comprehensive SMA material models. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Evaluation of knee joint forces during kneeling work with different kneepads. (United States)

    Xu, Hang; Jampala, Sree; Bloswick, Donald; Zhao, Jie; Merryweather, Andrew


    The main purpose of this study is to determine knee joint forces resulting from kneeling work with and without kneepads to quantify how different kneepads redistribute force. Eleven healthy males simulated a tile setting task to different locations during six kneepad states (five different kneepad types and without kneepad). Peak and average forces on the anatomical landmarks of both knees were obtained by custom force sensors. The results revealed that kneepad design can significantly modify the forces on the knee joint through redistribution. The Professional Gel design was preferred among the five tested kneepads which was confirmed with both force measurements and participants' responses. The extreme reaching locations induced significantly higher joint forces on left knee or right knee depending on task. The conclusion of this study is that a properly selected kneepad for specific tasks and a more neutral working posture can modify the force distribution on the knees and likely decrease the risk of knee disorders from kneeling work.

  19. The Migrant Farm Work Force: Differences in Attachment to Farmwork. (United States)

    Whitener, Leslie A.


    Investigates extent of diversity and segmentation within United States migrant farm labor force by examining differences in migrants' attachment to farmwork. Finds three groups of migrants with differing levels of dependence on agriculture differentiated by demographic (age, minority status, region) and employment (earnings) variables. (NEC)

  20. Work-Energy Theorem and Friction Forces: Two Experiments (United States)

    Bonanno, A.; Bozzo, G.; Grandinetti, M.; Sapia, P.


    Several studies have showed the subsistence, even in students enrolled in scientific degree courses, of spontaneous ideas regarding the motion of bodies that conflict with Newton's laws. One of the causes is related to the intuitive preconceptions that students have about the role of friction as a force. In fact, in real world novices do not…

  1. Multicultural Group Work: A Force for Developing and Healing (United States)

    Anderson, Donald


    Multicultural group work represents a powerful tool for helping and healing in the context of human diversity. This article summarizes multicultural group work, including task, psychoeducational, counseling, and psychotherapy groups, and describes a group work model for multicultural assessment, diagnosis, and treatment planning. Group work…

  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.

  3. The Prediction of the Work of Friction Force on the Arbitrary Path (United States)

    Matehkolaee, Mehdi Jafari; Majidian, Kourosh


    In this paper we have calculated the work of friction force on the arbitrary path. In our method didn't use from energy conservative conceptions any way. The distinction of this procedure is that at least do decrease measurement on the path once. Thus we can forecast the amount of work of friction force without information about speed of…

  4. Managing Diversity: The New Multicultural Work Force Requires a Simpatico Style. (United States)

    Piturro, Marlene; Mahoney, Sarah S.


    Some companies are finding ways to manage a culturally diverse work force: analyzing work force composition, increasing awareness of attitudinal differences and diversity issues, thinking interculturally about problems, mentoring diverse employees, making standards fluid enough for all achievers, and rewarding successful managers of diverse…

  5. Better jobs, better care: building the home care work force. (United States)

    Surpin, R; Haslanger, K; Dawson, S


    This paper focuses on providing quality care in the paraprofessional home care industry. Despite government policies that have encouraged home-based care for 20 years, home health care still remains relegated to second-class status by the rest of the health care industry. Home care is unique because it relies primarily on paraprofessional care delivered by a home care aide working alone, essentially as a guest in the client's home. The resulting interpersonal dynamic between patient and caregiver--which develops far from the eyes of the primary physician, regulators, and third-party payers--is one unlike any other patient-caregiver relationship in the health care system. The quality of care received by the client is linked directly to the quality of the paraprofessional's job: "good jobs" are prerequisite for "good service." Good jobs, however, are not enough. They must be supported by paraprofessional agencies that add real value to the home care service. Part I We define quality home care as meeting the client's needs. Unfortunately, since home care is provided in dispersed, minimally supervised settings, measuring quality of service is very difficult. For this reason, we suggest that it is the front-line employee--the home care aide who is present for hours every visit--who can best determine if the client's needs are being met, and who is best positioned to respond accordingly. Part II To best meet client needs, paraprofessional home care must be built around the home care aide. This requires that home care aides (1) be carefully selected during the hiring process, (2) be well trained, and (3) be empowered with considerable responsibility and capacity to respond to the daily needs of the clients. This Model, one that emphasizes the front-line employee, is in full keeping with the "total quality management" innovations that are currently reorganizing America's service industries. Unfortunately this model is not typically reflected in current paraprofessional

  6. Extrinsic Motivation as Correlates of Work Attitude of the Nigerian Police Force: Implications for Counselling (United States)

    Igun, Sylvester Nosakhare


    The study examined Extrinsic motivation as correlates of work attitude of the Nigeria Police Force and its implications for counselling. 300 Police personnel were selected by random sampling technique from six departments that make up police force Headquarters, Abuja. The personnel were selected from each department using simple sampling…

  7. 3 CFR - White House Task Force on Middle-Class Working Families (United States)


    ... 3 The President 1 2010-01-01 2010-01-01 false White House Task Force on Middle-Class Working Families Presidential Documents Other Presidential Documents Memorandum of January 30, 2009 White House... times. To these ends, I hereby direct the following: Section 1. White House Task Force on...

  8. Exploring Work and Development Options to Reduce Early Labour Force Exit of Mature Aged Australians (United States)

    Pillay, Hitendra; Kelly, Kathy; Tones, Megan


    Early labour force exit is a significant challenge associated with the ageing workforce in Australia and many other developed countries. A reduction and increased flexibility of work hours has been suggested to improve labour force participation of the mature aged cohort. However, little is known about mature aged workers' aspirations for…

  9. A robot-assisted surgical system using a force-image control method for pedicle screw insertion.

    Directory of Open Access Journals (Sweden)

    Wei Tian

    Full Text Available OBJECTIVE: To introduce a robot-assisted surgical system for spinal posterior fixation that can automatically recognize the drilling state and stop potential cortical penetration with force and image information and to further evaluate the accuracy and safety of the robot for sheep vertebra pedicle screw placement. METHODS: The Robotic Spinal Surgery System (RSSS was composed of an optical tracking system, a navigation and planning system, and a surgical robot equipped with a 6-DOF force/torque sensor. The robot used the image message and force signals to sense the different operation states and to prevent potential cortical penetration in the pedicle screw insertion operation. To evaluate the accuracy and safety of the RSSS, 32 screw insertions were conducted. Furthermore, six trajectories were deliberately planned incorrectly to explore whether the robot could recognize the different drilling states and immediately prevent cortical penetration. RESULTS: All 32 pedicle screws were placed in the pedicle without any broken pedicle walls. Compared with the preoperative planning, the average deviations of the entry points in the axial and sagittal views were 0.50 ± 0.33 and 0.65 ± 0.40 mm, and the average deviations of the angles in the axial and sagittal views were 1.9 ± 0.82° and 1.48 ± 1.2°. The robot successfully recognized the different drilling states and prevented potential cortical penetration. In the deliberately incorrectly planned trajectory experiments, the robot successfully prevented the cortical penetration. CONCLUSION: These results verified the RSSS's accuracy and safety, which supported its potential use for the spinal surgery.

  10. A robot-assisted surgical system using a force-image control method for pedicle screw insertion. (United States)

    Tian, Wei; Han, Xiaoguang; Liu, Bo; Liu, Yajun; Hu, Ying; Han, Xiao; Xu, Yunfeng; Fan, Mingxing; Jin, Haiyang


    To introduce a robot-assisted surgical system for spinal posterior fixation that can automatically recognize the drilling state and stop potential cortical penetration with force and image information and to further evaluate the accuracy and safety of the robot for sheep vertebra pedicle screw placement. The Robotic Spinal Surgery System (RSSS) was composed of an optical tracking system, a navigation and planning system, and a surgical robot equipped with a 6-DOF force/torque sensor. The robot used the image message and force signals to sense the different operation states and to prevent potential cortical penetration in the pedicle screw insertion operation. To evaluate the accuracy and safety of the RSSS, 32 screw insertions were conducted. Furthermore, six trajectories were deliberately planned incorrectly to explore whether the robot could recognize the different drilling states and immediately prevent cortical penetration. All 32 pedicle screws were placed in the pedicle without any broken pedicle walls. Compared with the preoperative planning, the average deviations of the entry points in the axial and sagittal views were 0.50 ± 0.33 and 0.65 ± 0.40 mm, and the average deviations of the angles in the axial and sagittal views were 1.9 ± 0.82° and 1.48 ± 1.2°. The robot successfully recognized the different drilling states and prevented potential cortical penetration. In the deliberately incorrectly planned trajectory experiments, the robot successfully prevented the cortical penetration. These results verified the RSSS's accuracy and safety, which supported its potential use for the spinal surgery.


    Economic Research Service (USDA), Washington, DC.


  12. Children of Working Mothers, March 1973. Special Labor Force Report No. 165. (United States)

    Waldman, Elizabeth; Whitmore, Robert

    A special labor force report, the pamphlet provides statistics related to the children of working mothers: type of family, number of children under 18, race, number of children in broken families, work experience of family head, and family income. Although the number of children in the population has declined, the number of children with working…

  13. Children of Working Mothers, March 1977. Special Labor Force Report 217. (United States)

    Grossman, Allyson Sherman


    This special labor force report, focusing on children of working mothers, summarizes findings from the 1977 annual survey of marital and family characteristics of workers in the population who are 16 years old and over. Data are given on: the numbers of children of various ages with working mothers, the percentages of black and white children…

  14. The effects of arts-in-medicine programming on the medical-surgical work environment (United States)

    Sonke, Jill; Pesata, Virginia; Arce, Lauren; Carytsas, Ferol P.; Zemina, Kristen; Jokisch, Christine


    Background: Arts in medicine programs have significant impacts on patients and staff in long-term care environments, but the literature lacks evidence of effectiveness on hospital units with shorter average lengths of stay. Methods: The qualitative study used individual structured interviews to assess the impacts of arts programming on job satisfaction, stress, unit culture, support, quality of care, and patient outcomes on a short-term medical-surgical unit, and used a qualitative cross comparison grounded theory methodology to analyze data. Results: The study confirmed that arts programming can positively affect unit culture, nursing practice, and quality of care on short-stay medical-surgical units. Significant insights related to nursing practice and the art program were found, including that music can cause negative distraction for staff. Conclusions: While positive impacts of arts programming on the medical-surgical environment are clear, potential negative effects also need to be considered in the development of practice protocols for artists. PMID:25544861

  15. Foreign students and foreign-born scientists and engineers in the US work force

    Energy Technology Data Exchange (ETDEWEB)

    Finn, M.G.


    This paper summarizes some earlier findings regarding the stay rate of foreign students and then addresses two questions about which we have scant information at present. One question is concerning the geographic origin of foreign nationals working in the United States. The second is related to the stay rate of foreign students: What is the emigration rate of foreign-born scientists and engineers once they have become a part of the US work force.

  16. Children of Working Mothers, March 1976. Special Labor Force Report 205. (United States)

    Grossman, Allyson Sherman


    This paper presents a survey of the number of mothers with children under age 17 who were in the work force in 1976. The paper surveys various factors which influence these statistics: age of children, socioeconomic factors, ethnic and racial characteristics, family size, family income and the availability of child care services. The statistics…

  17. Small Wars 2.0: A Working Paper on Land Force Planning After Iraq and Afghanistan (United States)


    specific brand of small war — i.e., neo-classical COIN in the Near East and South Asia. This move relies on four questionable assumptions: 1...Afghanistan Small Wars 2.0: A Working Paper on Land Force Planning After Iraq and Afghanistan indefinitely. While the current full-spectrum mantra cham

  18. Non-surgical and non-chemical attempts to treat echinococcosis: do they work?

    Directory of Open Access Journals (Sweden)

    Tamarozzi Francesca


    Full Text Available Cystic echinococcosis (CE and alveolar echinococcosis (AE are chronic, complex and neglected diseases. Their treatment depends on a number of factors related to the lesion, setting and patient. We performed a literature review of curative or palliative non-surgical, non-chemical interventions in CE and AE. In CE, some of these techniques, like radiofrequency thermal ablation (RFA, were shelved after initial attempts, while others, such as High-Intensity Focused Ultrasound, appear promising but are still in a pre-clinical phase. In AE, RFA has never been tested, however, radiotherapy or heavy-ion therapies have been attempted in experimental models. Still, application to humans is questionable. In CE, although prospective clinical studies are still lacking, therapeutic, non-surgical drainage techniques, such as PAIR (puncture, aspiration, injection, re-aspiration and its derivatives, are now considered a useful option in selected cases. Finally, palliative, non-surgical drainage techniques such as US- or CT-guided percutaneous biliary drainage, centro-parasitic abscesses drainage, or vascular stenting were performed successfully. Recently, endoscopic retrograde cholangiopancreatography (ERCP-associated techniques have become increasingly used to manage biliary fistulas in CE and biliary obstructions in AE. Development of pre-clinical animal models would allow testing for AE techniques developed for other indications, e.g. cancer. Prospective trials are required to determine the best use of PAIR, and associated procedures, and the indications and techniques of palliative drainage.

  19. Adjuvant Teriparatide Therapy for Surgical Treatment of Femoral Fractures; Does It Work? (United States)

    Kim, Jung Taek; Jeong, Hyung Jun; Lee, Soong Joon; Kim, Hee Joong


    Purpose Atypical femoral fracture (AFF), periprosthetic femoral fracture (PPFF) and femoral nonunion (FNU) are recalcitrant challenges for orthopedic surgeons. Teriparatide (TPTD) had been demonstrated to have anabolic effects on bone in various studies. We postulated that adjuvant TPTD after operation would enhance biologic stimulation for bone formation. We investigated (1) whether the adjuvant TPTD could achieve satisfactory union rate of surgically challenging cases such as displaced AFF, PPFF and FNU; (2) whether the adjuvant TPTD could promote development of abundant callus after surgical fixation; (3) whether the adjuvant TPTD had medically serious adverse effects. Materials and Methods Thirteen patients who agreed to off label use of TPTD in combination of operation were included in this retrospective case series. Median patients' age was 68.7 years, and there were three male and ten female patients. Their diagnoses were nonunion in six patients and acute fracture in seven. Medical records and radiographic images were reviewed. Results Twelve of thirteen fractures were united both clinically and radiologically within a year after adjuvant TPTD. Union completed radiologically median 5.4 months and clinically 5.7 months after the medication, respectively. Callus appeared abundantly showing median 1.4 of fracture healing response postoperatively. There was no serious adverse reaction of medication other than itching, muscle cramp, or nausea. Conclusion Even appropriate surgical treatment is a mainstay of treatment for AFF, PPFF, and FNU, the current report suggested that adjuvant TPTD combined with stable fixation results in satisfactory outcome for the challenging fractures of femur. PMID:27777917

  20. Control of repulsive force in a virtual environment using an electrorheological haptic master for a surgical robot application (United States)

    Oh, Jong-Seok; Choi, Seung-Hyun; Choi, Seung-Bok


    This paper presents control performances of a new type of four-degrees-of-freedom (4-DOF) haptic master that can be used for robot-assisted minimally invasive surgery (RMIS). By adopting a controllable electrorheological (ER) fluid, the function of the proposed master is realized as a haptic feedback as well as remote manipulation. In order to verify the efficacy of the proposed master and method, an experiment is conducted with deformable objects featuring human organs. Since the use of real human organs is difficult for control due to high cost and moral hazard, an excellent alternative method, the virtual reality environment, is used for control in this work. In order to embody a human organ in the virtual space, the experiment adopts a volumetric deformable object represented by a shape-retaining chain linked (S-chain) model which has salient properties such as fast and realistic deformation of elastic objects. In haptic architecture for RMIS, the desired torque/force and desired position originating from the object of the virtual slave and operator of the haptic master are transferred to each other. In order to achieve the desired torque/force trajectories, a sliding mode controller (SMC) which is known to be robust to uncertainties is designed and empirically implemented. Tracking control performances for various torque/force trajectories from the virtual slave are evaluated and presented in the time domain.

  1. Effect of reciprocating motions around working points on levitation force of superconductor-magnet system (United States)

    Xu, Jimin; Zhang, Fei; Sun, Tao; Yuan, Xiaoyang; Zhang, Cuiping


    In order to simulate vibration around working points in practical operation of superconducting levitation system, magnet in a simple superconductor-magnet system are conducted reciprocating motions around static height in this study. Two YBCO cylindrical samples with different grain orientations are used to investigate the effect of reciprocating motions of magnet on superconducting magnetic force. The c-axis of sample S1 is perpendicular to the top surface while sample S2 is parallel to the top surface. The initial cooling processes for the superconductors include zero-field-cooled (ZFC) and filed-cooled (FC). Compared to the levitation force before reciprocating motions, the ZFC levitation force at static height becomes smaller after reciprocating while the FC force presents opposite phenomenon. It is found that levitation force at static height tends to be stable after several times of reciprocating under ZFC and FC conditions and its time-decay phenomenon is suppressed in some extent, which is meaningful for the practical application of superconducting levitation system. Based on vortex dynamic, some physical discussions are presented to the experimental results.


    Directory of Open Access Journals (Sweden)

    M. Avksientiev


    Full Text Available Highly qualified working force is a central element of intensive development model in modern society. The article surveys the experience of countries that managed to transform their economy to the innovative one. Ukrainian economy cannot stand aside processes that dominate the world economy trends, thus we are to use this experience to succeed in future. Today any government of the world is facing challenges that occur due to transformation of the economy into informational one. This type of economy causes its transformation form extensive to intensive one. The main reasons under that is limitation of nature resources, material factors of production. Thus this approach depends much on the quality of working force. Unfortunately in Ukraine there is a misbalance in specialist preparation. This puts additional pressure on the educational sphere also. In order to avoid this pressure we are to conduct reforms in education sphere. Nowadays, in the world views and concepts of governmental role in the social development are changing. This why, even at times of economic recession educational costs are not reduced under the new economical doctrine in the EU. Highly qualified specialists, while creating new products and services play role of engineers in XXI century. They are to lead their industries to world leading positions. From economic point of view, highly qualified specialists benefit society with higher income rates, taxation and thus, increasing the living standards in society. Thus, the majority if modern scientists prove the importance of highly trained working force for more effective economic development.

  3. Work function of few layer graphene covered nickel thin films measured with Kelvin probe force microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Eren, B. [Department of Physics, University of Basel, Klingelbergstrasse 82, CH-4056 Basel (Switzerland); Material Sciences Division, Lawrence Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, California 94720 (United States); Gysin, U.; Marot, L., E-mail:; Glatzel, Th.; Steiner, R.; Meyer, E. [Department of Physics, University of Basel, Klingelbergstrasse 82, CH-4056 Basel (Switzerland)


    Few layer graphene and graphite are simultaneously grown on a ∼100 nm thick polycrystalline nickel film. The work function of few layer graphene/Ni is found to be 4.15 eV with a variation of 50 meV by local measurements with Kelvin probe force microscopy. This value is lower than the work function of free standing graphene due to peculiar electronic structure resulting from metal 3d-carbon 2p(π) hybridization.

  4. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    NARCIS (Netherlands)

    Tan, P.H.; Cheng, L.; Srigley, J.R.; Griffiths, D.; Humphrey, P.A.; Kwast, T.H. van der; Montironi, R.; Wheeler, T.M.; Delahunt, B.; Egevad, L.; Epstein, J.I.; Hulsbergen- van de Kaa, C.A.


    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed

  5. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    NARCIS (Netherlands)

    Tan, P.H.; Cheng, L.; Srigley, J.R.; Griffiths, D.; Humphrey, P.A.; Kwast, T.H. van der; Montironi, R.; Wheeler, T.M.; Delahunt, B.; Egevad, L.; Epstein, J.I.; Hulsbergen- van de Kaa, C.A.


    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed


    Directory of Open Access Journals (Sweden)

    T. A. Kuchmenko


    Full Text Available Innovations in Education are based on the use of new effective educational and information technologies, introduction of progressive forms of organization of educational process, active learning methods. The significant role in the educational system is the development and implementation of virtual labs. For the development of the contemporary science section as bioinformatics, it is necessary to extend the possibility of using computers for processing the information received with the use of modern devices. These research methods include atomic force microscopy. For Students of the specialty 06.05.01 "Bioengineering and Bioinformatics" in the SD "Basics of Nanobiotechnology" it has been developed a virtual laboratory work on "Processing of nanostructured images of biomolecules." The basis for the development of laboratory work was the handbook modified for affordable performance. Laboratory workshop allows you to briefly find out the theory of atomic force microscopy, the organization and the principle of operation of the device. It allows Students to quickly learn the using the program at the AFM image processing Nova In the laboratory work for the tasks solution the biological objects are selected from the images catalog, and to study and describe of these objects the software is used. Students work with images of biomolecules in the program: change them (increasing, selection of separate areas, evaluate the geometrical parameters, work with 3D-image, writing a description and compare objects with each other. The results are summarized in a table and conclusion. The effectiveness and usefulness of the created laboratory work are proved by the results of Student’s survey and tested in the final and interim certification. This kind of work is suitable for distance learning, to provide a laboratory practicum in SD "Nanotechnology", "Modern methods of analysis" for other specialties as an educational and methodological materials.

  7. The seventh penis: towards effective psychoanalytic work with pre-surgical transsexuals. (United States)

    Withers, Robert


    The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind-body dissociation to transsexualism. © 2015, The Society of Analytical Psychology.

  8. Theoretical and numerical analysis of coal dust separated by centrifugal force for working and heading faces

    Institute of Scientific and Technical Information of China (English)

    Shiqiang Chen; Haiqiao Wang; Yiqun Li; Haijiao Cui; Jie Zhao; Xiaowei Zhang


    In order to meet engineering needs of Chinese underground coal mines, a new dust-collecting fan, a device of dust separated by centrifugal force in driven cyclone passageway (DCCP) was designed. In centrifugal dust removal section (CDRS) of DCCP, a general equation is derived from the principle of force equilibrium. According to CDRS structure parameters and fan running parameters, the general equation is simplified, and the simplest equation is calculated numerically by MATLAB. The calculation results illustrate that increasing quantity of air current is against dust removal, but it is beneficial to dust removal by increasing the radius of driven spiral blade and increasing the particle diameter of coal dust. The conclusions show that the dust-collecting structure parameters coupled with the fan running parameters is a novel optimization approach to dust-collection fan for working and heading faces, which is especially suitable for Chinese underground mines.

  9. Estimation of intrinsic work function of multilayer graphene by probing with electrostatic force microscopy (United States)

    Singh, Anshika; Guha, Puspendu; Panwar, Amrish K.; Tyagi, Pawan K.


    In present study, electrostatic force microscopy (EFM) is used to estimate the intrinsic work function of few layer graphene (FLG) transferred on SiO2 (300 nm)/Si (500 μm) substrate. This FLG has been prepared by using the mechanical exfoliation technique. In exfoliated FLG, adhesive residues are always left from scotch tape on its surface. These residues as well as SiO2 substrate could modify the work function due to the formation of dipoles on the surface. Taking the effect of adhesive into account, FLG is pre-charged and then scanned with a tip biased with dc voltage. Intrinsic work function of FLG is determined and found to be 4.52 ± 0.1 eV.

  10. Audit of work force restructuring at the Fernald Environmental Management Project

    Energy Technology Data Exchange (ETDEWEB)



    The Department of Energy (Department) restructured its work force at the Fernald Environmental Management Project (Fernald Project) to reduce staffing levels and to modify the mix of workers` skills in response to budget cuts, facility closures, and changes in the Fernald Project`s mission. The objective of this audit was to determine whether the work force restructurings were effective in reducing staffing levels and in changing the mix of workers` skills. As of September 30, 1995, the restructurings were not effective in reducing staffing levels or in improving the mix of workers` skills. The Fernald Environmental Restoration Management Corporation (FERMCO) spent $2.9 million to separate 255 employees in October 1993. However, by September 30, 1994, all but 14 of the employees separated were either rehired or replaced by new employees with similar skills. The second restructuring began in October 1994 and is not expected to be completed until May 1996. The Department expects the second restructuring to reduce FERMCO`s work force by 476 employees at a cost of $12.9 million. However, since the second restructuring began, FERMCO has hired 265 new employees and at September 30, 1995, had open job announcements seeking 82 additional employees. Many of these new employees have essentially the same skills as employees who separated under the two restructurings. The Department`s objectives were not met because the Fernald Area Office did not (1) require FERMCO to perform the skills analysis necessary to identify which employees were needed to perform the Fernald Project`s current mission, and (2) effectively monitor FERMCO`s restructuring efforts to ensure that the Department`s objectives were met.

  11. Stress and burnout in colorectal and vascular surgical consultants working in the UK National Health Service. (United States)

    Sharma, A; Sharp, D M; Walker, L G; Monson, J R T


    It has been suggested that dealing with cancer is associated with increased stress and burnout in health-care professionals. The aim of this study is to examine the prevalence of psychiatric morbidity and burnout in surgeons working in the National Health Service (NHS), and the putative relationship between psychiatric morbidity, burnout and the amount of cancer-related work. All consultant colorectal and vascular surgeons identified from their professional societies were sent a booklet consisting of questions about cancer-related and specialty-specific work load, job satisfaction and socio-demographics. It also included the General Health Questionnaire (GHQ-12), the Maslach Burnout Inventory (MBI) and the Coping Questionnaire. Logistic regression analysis was used to identify independent predictors of psychiatric morbidity (GHQ), burnout (MBI) and retirement intentions. Five hundred and one questionnaire booklets were completed and returned (response rate 58.7%). The mean age of respondents was 47 years (range 31-65). The majority of the surgeons were male (460, 92%). One hundred and sixty-three (33%) surgeons scored in the positive range of the GHQ, and 154 (32%) had high burnout on at least one subscale of the MBI. Three hundred and eighty-three (77%) surgeons stated that they intended to retire before the statutory retirement age. Level of work satisfaction and perceived adequacy of training in communication and management skills were significantly negatively correlated with GHQ and MBI scores. Surgeons who planned to take early retirement or wished to retire as soon as they could afford to were more likely to have psychiatric morbidity and/or burnout. Surgeons who were married or cohabiting were less likely to have psychiatric morbidity, and younger surgeons were more likely to have higher levels of depersonalization (DP). Work satisfaction was negatively correlated with psychiatric morbidity and all three burnout scales. Colorectal surgeons had a greater

  12. New Forces at Work in Mining: Industry View of Critical Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, D. J. [Science and Technology Policy Inst., Arlington, VA (United States); LaTourrette, Tom [Science and Technology Policy Inst., Arlington, VA (United States); Bartis, James T. [Science and Technology Policy Inst., Arlington, VA (United States)


    RAND has just published a report entitled, "New Forces at Work in Mining: Industry Views of Critical Technologies," by D. J. Peterson, Tom LaTourrette, and James T. Bartis. The report presents the results of a series of in-depth discussions with leading mining industry representatives selected for their prominent position and their ability to think broadly about technology trends. The discussions highlighted the importance of collaborative technology research, development, and implementation strategies and the increasingly critical role of mine personnel in the utilization of new technologies.


    Directory of Open Access Journals (Sweden)

    Grażyna Nowak-Starz


    Full Text Available Nursing is one of the professions where chronic stress is an inseparable characteristic and stems from the very nature of the profession itself. The job of a nurse involves particular mental burdens. The source of these is another person, one who has most often found themselves in an extreme situation. A nurse carries out her/his duties in a state of strong and long-lasting emotional strain. Inappropriate coping with stress and a lack of support from others in difficult situations leads to the development of burnout syndrome. This syndrome not only lowers, to a great extent, the quality of performed work but also prevents nurses from further professional development. Aims : The aim of the following paper is to evaluate the influence of stress connected with the professional work of a nurse on the occurrence of burnout syndrome. Material and methodology : Research was conducted on a group of 103 nurses working at eight hospital wards (surgical and medical treatment at the District Hospital in Lipsko. The research tool was a questionnaire of the author’s own devise, which contained 34 questions. Results : Among the examined nurses, 90% concluded that their professional work has a negative impact on their family life and they pointed to their own occupational burnout. Nurses who carried negative emotions over from work to their homes significantly more often showed a lack of satisfaction from their job and signs of occupational burnout. A substantial percentage of the participants considered shift-work and the professional position held to be a detrimental factor in the process of occupational burnout. Conclusion : The nurses were to a large extent exposed to mental burdens having a negative impact on their work. The vast majority of the respondents felt satisfaction from their job but a significant percentage of the respondents admitted to suffering from symptoms of chronic stress and exhaustion, which may indicate a lack of any support from co

  14. Applying Mobile and Pervasive Computer Technology to Enhance Coordination of Work in a Surgical Ward

    DEFF Research Database (Denmark)

    Hansen, Thomas Riisgaard; Bardram, Jakob


    , and unnecessary stress. To accommodate this situation and to increase the quality of work in operating wards, we have designed a set of pervasive computer systems which supports what we call context-mediated communication and awareness. These systems use large interactive displays, video streaming from key...... locations, tracking systems, and mobile devices to support social awareness and different types of communication modalities relevant to the current context. In this paper we report qualitative data from a one-year deployment of the system in a local hospital. Overall, this study shows that 75......Collaboration, coordination, and communication are crucial in maintaining an efficient and smooth flow of work in an operating ward. This coordination, however, often comes at a high price in terms of unsuccessfully trying to get hold of people, disturbing telephone calls, looking for people...

  15. Applying mobile and pervasive computer technology to enhance coordination of work in a surgical ward

    DEFF Research Database (Denmark)

    Hansen, Thomas Riisgaard; Bardram, Jakob Eyvind


    , and unnecessary stress. To accommodate this situation and to increase the quality of work in operating wards, we have designed a set of pervasive computer systems which supports what we call context-mediated communication and awareness. These systems use large interactive displays, video streaming from key...... locations, tracking systems, and mobile devices to support social awareness and different types of communication modalities relevant to the current context. In this paper we report qualitative data from a one-year deployment of the system in a local hospital. Overall, this study shows that 75......Collaboration, coordination, and communication are crucial in maintaining an efficient and smooth flow of work in an operating ward. This coordination, however, often comes at a high price in terms of unsuccessfully trying to get hold of people, disturbing telephone calls, looking for people...

  16. Optimal work-rest cycles for an isometric intermittent gripping task as a function of force, posture and grip span. (United States)

    Eksioglu, Mahmut


    The aim of this study was to investigate the maximum acceptable contraction frequencies (i.e. work-rest cycles) for an isometric-intermittent handgrip task as a function of grip span, applied force and shoulder posture using psychophysical and physiological approaches. Twelve healthy males served as subjects. The three grip spans investigated were the optimal, 2 cm narrower than the optimal, and 2 cm wider than the optimal. The grip force levels studied were 15% and 30% of maximum voluntary grip force and the two shoulder postures were 25 degrees flexion and 30 degrees abduction. The psychophysical results indicate that subjects work faster with the narrower grip span at 15% of maximum voluntary grip force level in comparison to working with the optimal and the wider spans. However, when the task required 30% of maximum grip force level, the subjects worked faster with the optimal grip span. These findings were supported by the results of electromyography, heart rate, blood pressure and perceived discomfort. The study suggests that grip span of a tool is an important factor to be considered in predicting optimal work-rest cycles for hand grip tasks, and the optimum setting of grip span of the hand-tool depends on the required task force level. That is, the optimality is relative rather than absolute. In addition, it appears that weaker subjects can work at a higher rate than stronger ones at the same relative force level.

  17. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study. (United States)

    Mason, Virginia M; Leslie, Gail; Clark, Kathleen; Lyons, Pat; Walke, Erica; Butler, Christina; Griffin, Martha


    Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. Nurses' experience of moral distress has been measured in medical intensive care units but not in surgical trauma care units, where nurses are exposed to patients and families faced with sudden life-threatening, life-changing patient consequences.This pilot study is a nonexperimental, descriptive, correlational design to examine the effect of compassion satisfaction, compassion fatigue, moral distress, and level of nursing education on critical care nurses' work engagement. This is a partial replication of Lawrence's dissertation. The study also asked nurses to describe sources of moral distress and self-care strategies for coping with stress. This was used to identify qualitative themes about the nurse experiences. Jean Watson's theory of human caring serves as a framework to bring meaning and focus to the nursing-patient caring relationship.A convenience sample of 26 of 34 eligible experienced surgical intensive care unit trauma nurses responded to this survey, indicating a 77% response rate. Twenty-seven percent of the nurses scored high, and 73% scored average on compassion satisfaction. On compassion fatigue, 58% scored average on burnout and 42% scored low. On the secondary traumatic stress subscale, 38% scored average, and 62% scored low. The mean moral distress situations subscale score was 3.4, which is elevated. The mean 9-item Utrecht Work Engagement Scale total score, measuring work engagement, was 3.8, which is considered low

  18. The 88-hour family: effects of the 80-hour work week on marriage and childbirth in a surgical residency. (United States)

    Jones, Arden M; Jones, Kevin B


    The restriction of the resident physician work week to 80 hours has had dramatic affects on resident education and life-style. While effects on mood, psychological distress, and burn-out have been studied, the resultant changes in tangible quality of life have received little attention. Birth rate was considered a measurable, relevant outcome. The resident marital and parental status by duty month was collected from a single orthopaedic surgical residency program for the four academic years preceding and following the implementation of the 80-hour work week. The number of births to residents during these periods were also tallied. The relative prevalence of positive marital status changed very little between residents in the two time durations from 66 to 71 percent, but parental status increased from 27 to 43 percent. The number of births per married resident duty year also increased from 0.23 pre-restrictions to 0.32 post-restrictions. While the individual decisions involved in generating these observed changes are complex and difficult to entirely decipher, it is thought that an increased perception of life-control within the work-hour restrictions may have prompted the dramatic changes in birth rate among resident families.

  19. Progressive surgical dissection for tendon transposition affects length-force characteristics of rat flexor carpi ulnaris muscle

    NARCIS (Netherlands)

    Smeulders, Mark J.C.; Kreulen, Michiel; Hage, J. Joris; Baan, Guus C.; Huijing, P.A.J.B.M.


    Extramuscular connective tissue and muscular fascia have been suggested to form a myo-fascial pathway for transmission of forces over a joint that is additional to the generally accepted myo-tendinous pathway. The consequences of myo-fascial force transmission for the outcome of conventional muscle

  20. Keyboard reaction force and finger flexor electromyograms during computer keyboard work. (United States)

    Martin, B J; Armstrong, T J; Foulke, J A; Natarajan, S; Klinenberg, E; Serina, E; Rempel, D


    This study examines the relationship between forearm EMGs and keyboard reaction forces in 10 people during keyboard tasks performed at a comfortable speed. A linear fit of EMG force data for each person and finger was calculated during static fingertip loading. An average r2 of .71 was observed for forces below 50% of the maximal voluntary contraction (MVC). These regressions were used to characterize EMG data in force units during the typing task. Averaged peak reaction forces measured during typing ranged from 3.33 N (thumb) to 1.84 N (little finger), with an overall average of 2.54 N, which represents about 10% MVC and 5.4 times the key switch make force (0.47 N). Individual peak or mean finger forces obtained from EMG were greater (1.2 to 3.2 times) than force measurements; hence the range of r2 for EMG force was .10 to .46. A closer correspondence between EMG and peak force was obtained using EMG averaged across all fingers. For 5 of the participants the force computed from EMG was within +/-20% of the reaction force. For the other 5 participants forces were overestimated. For 9 participants the difference between EMG estimated force and the reaction force was less than 13% MVC. It is suggested that the difference between EMG and finger force partly results from the amount of muscle load not captured by the measured applied force.

  1. Correlates of Injury-forced Work Reduction for Massage Therapists and Bodywork Practitioners. (United States)

    Blau, Gary; Monos, Christopher; Boyer, Ed; Davis, Kathleen; Flanagan, Richard; Lopez, Andrea; Tatum, Donna S


    Injury-forced work reduction (IFWR) has been acknowledged as an all-too-common occurrence for massage therapists and bodywork practitioners (M & Bs). However, little prior research has specifically investigated demographic, work attitude, and perceptual correlates of IFWR among M & Bs. To test two hypotheses, H1 and H2. H1 is that the accumulated cost variables set ( e.g., accumulated costs, continuing education costs) will account for a significant amount of IFWR variance beyond control/demographic (e.g., social desirability response bias, gender, years in practice, highest education level) and work attitude/perception variables (e.g., job satisfaction, affective occupation commitment, occupation identification, limited occupation alternatives) sets. H2 is that the two exhaustion variables (i.e., physical exhaustion, work exhaustion) set will account for significant IFWR variance beyond control/demographic, work attitude/perception, and accumulated cost variables sets. An online survey sample of 2,079 complete-data M & Bs was collected. Stepwise regression analysis was used to test the study hypotheses. The research design first controlled for control/demographic (Step1) and work attitude/perception variables sets (Step 2), before then testing for the successive incremental impact of two variable sets, accumulated costs (Step 3) and exhaustion variables (Step 4) for explaining IFWR. RESULTS SUPPORTED BOTH STUDY HYPOTHESES: accumulated cost variables set (H1) and exhaustion variables set (H2) each significantly explained IFWR after the control/demographic and work attitude/perception variables sets. The most important correlate for explaining IFWR was higher physical exhaustion, but work exhaustion was also significant. It is not just physical "wear and tear", but also "mental fatigue", that can lead to IFWR for M & Bs. Being female, having more years in practice, and having higher continuing education costs were also significant correlates of IFWR. Lower overall

  2. Care of critically ill surgical patients using the 80-hour Accreditation Council of Graduate Medical Education work-week guidelines: a survey of current strategies. (United States)

    Gordon, Chad R; Axelrad, Alex; Alexander, James B; Dellinger, R Phillip; Ross, Steven E


    As a result of the recently mandated work-hour restrictions, it has become more difficult to provide 24-hour intensive care unit (ICU) in-house coverage by the general surgical residents. To assess the current state of providing appropriate continuous care to surgical critical care patients during the era of resident work-hour constraints, a national survey was conducted by the Association of Program Directors of Surgery. The results revealed that 37 per cent of programs surveyed have residents other than general surgery housestaff providing cross-coverage and writing orders for surgical ICU patients. Residents in emergency medicine, anesthesia, family medicine, otorhinolaryngology, obstetrics/gynecology, internal medicine, urology, and orthopedic surgery have provided this cross-coverage. Some found it necessary to use physician extenders (i.e., nurse practitioners or physician assistants), thereby decreasing the burden of surgical housestaff coverage. The results indicated that 30 per cent use physician extenders to help cover the ICU during daytime hours and 11 per cent used them during nighttime hours. In addition, 24 per cent used a "night-float" system in an attempt to maintain continuous care, yet still adhere to the mandated guidelines. In conclusion, our survey found multiple strategies, including the use of physician extenders, a "night-float" system, and the use of nongeneral surgical residents in an attempt to provide continuous coverage for surgical ICU patients. The overall outcome of these new strategies still needs to be assessed before any beneficial results can be demonstrated.

  3. Preparedness and Practice Management Skills of Graduating Dental Students Entering the Work Force

    Directory of Open Access Journals (Sweden)

    Jane Manakil


    Full Text Available Dental education aims to produce competent graduates with the ability to provide quality care to the patients and facilitate the smooth integration into professional practice. The objective of this study was to explore the overall preparedness of graduands for integrating into professional practice. The survey was tested for reliability and analysed the career paths, learning preferences, overall knowledge, and confidence amongst graduating dentists in integrating and managing a dental practice on graduation. Sixty-nine students (89.6% in age group of 20–50 years participated in the study. Students indicated a high level of confidence in their skills and ability to work in a team in a practice or collaboratively with other colleagues and specialists but expressed some reservation on their practice management skills (73.1%. Challenges in gaining employment and pressures to repay educational debts are amongst the reasons for graduands preferring a paid job immediately on graduation regardless of demographics. Students indicated that an increase in speciality training and clinical/outreach placements could enhance employability. This study explores the students’ perception of their confidences, knowledge, learning preferences, and practice management skills as a method of evaluating their preparedness to practice on graduation and provides a base line for curriculum structuring to prepare graduands to enter the competitive dental work force.

  4. Becoming a member of the work force: perceptions of adults with Asperger Syndrome. (United States)

    Krieger, Beate; Kinébanian, Astrid; Prodinger, Birgit; Heigl, Franziska


    Research has shown that comparatively few adults with Asperger Syndrome (AS) participate in the competitive work force. The purpose of this study was to gain in-depth knowledge about contextual factors, which contribute to successful labor market participation in some adults with AS. This study was conducted by indepth-interviewing six adults with AS working in the competitive job market in Switzerland. A developmental and hermeneutic narrative approach was used for data collection and analysis. Two in-depth narrative interviews were conducted with each participant. A narrative analysis according to the theories of Paul Ricoeur was performed. Results showed that participants received pre-vocational requisites during their childhood through parents and friends that provided a feeling of security in social contexts. For participants, a supportive school setting resulted in academic achievements. The narratives reveal participants' capacities for understanding and adapting to social norms. Participants' understanding of their own needs was essential to the successful labor market participation. However, disclosure is rare and social stigma is still present. This study showed that successful labor participation of adults with AS can be enhanced through adequate social support already in the early stages of an individual's lifetime.

  5. Extramuscular myofascial force transmission alters substantially the acute effects of surgical aponeurotomy: assessment by finite element modeling

    NARCIS (Netherlands)

    Yucesoy, Can; Koopman, Bart; Grootenboer, Henk; Huijing, Peter


    Effects of extramuscular myofascial force transmission on the acute effects of aponeurotomy were studied using finite element modeling and implications of such effects on surgery were discussed. Aponeurotomized EDL muscle of the rat was modeled in two conditions: (1) fully isolated (2) with intact

  6. Exploring the relation between work domains and work-related learning: the case of the Dutch police force

    NARCIS (Netherlands)

    A. Doornbos; E. Denessen; Dr. S. Bolhuis


    The principal aim of this study is to explore the relations between work domains and the work-related learning of workers. The article is intended to provide insight into the learning experiences of Dutch police officers during the course of their daily work. Interviews regarding actual learning

  7. Exploring the Relation between Work Domains and Work-Related Learning: The Case of the Dutch Police Force (United States)

    Doornbos, Anja J.; Bolhuis, S.; Denessen, E.


    The principal aim of this study is to explore the relations between work domains and the work-related learning of workers. The article is intended to provide insight into the learning experiences of Dutch police officers during the course of their daily work. Interviews regarding actual learning events and subsequent changes in knowledge, skills…

  8. Work function measurement of multilayer electrodes using Kelvin probe force microscopy (United States)

    Peres, L.; Bou, A.; Cornille, C.; Barakel, D.; Torchio, P.


    The workfunction of dielectric|metal|dielectric transparent and conductive electrodes, promising candidates for replacing ITO in thin film solar cells, is measured by Kelvin probe force microscopy (KPFM). Measurement on commercial ITO gives a workfunction of 4.74 eV, which is in agreement with the values reported in the literature. Measurements are then performed on optically optimised multilayer electrodes fabricated on glass by e-beam evaporation, using three different dielectrics. For TiO2(37 nm)|Ag(13 nm)|TiO2(42 nm), SnO x (45 nm)|Ag(10 nm)|SnO x (45 nm), and ZnS(47 nm)|Ag(12 nm)|ZnS(42 nm), workfunctions of 4.83 eV, 4.75 eV, and 4.48 eV are measured respectively. These values suggest that these transparent and conductive electrodes are well adapted to extract photo-generated charge carriers in photovoltaic devices in which ITO is normally used. Furthermore, the KPFM technique proves to be an efficient and relatively fast way to determine the work function values of such electrodes.

  9. “Do the Germans Really Work Six Weeks More than the French?” – Measuring Working Time with the Labour Force Survey in France and Germany

    Directory of Open Access Journals (Sweden)

    Körner Thomas


    Full Text Available Measuring working time is not only an important objective of the EU Labour Force Survey (LFS, but also a highly demanding task in terms of methodology. Against the background of a recent debate on the comparability of working time estimates in France and Germany, this article presents a comparative assessment of the measurement of working time in the Labour Force Survey obtained in both countries. It focuses on the measurement of the hours actually worked, the key working-time concept for short-term economic analysis and the National Accounts. The contribution systematically analyses the differences in the measurement approaches used in France and Germany in order to identify the methodological effects that hinder comparability. It comes to the conclusion that the LFS overstates the difference in hours actually worked in France and Germany and identifies question comprehension, rounding, editing effects, as well as certain aspects of the sampling design, as crucial factors of a reliable measurement in particular of absences from work during the reference week. We recommend continuing the work started in the European Statistical System towards the development of a model questionnaire in order to improve cross-national harmonisation of key variables such as hours actually worked.

  10. Application of response surface methodology for determining cutting force model in turning hardened AISI H11 hot work tool steel

    Indian Academy of Sciences (India)

    B Fnides; M A Yallese; T Mabrouki; J-F Rigal


    This experimental study is conducted to determine statistical models of cutting forces in hard turning of AISI H11 hot work tool steel (∼ 50 HRC). This steel is free from tungsten on Cr–Mo–V basis, insensitive to temperature changes and having a high wear resistance. It is employed for the manufacture of highly stressed diecasting moulds and inserts with high tool life expectancy, plastic moulds subject to high stress, helicopter rotor blades and forging dies. The workpiece is machined by a mixed ceramic tool (insert CC650 of chemical composition 70%Al23+30%TiC) under dry conditions. Based on 33 full factorial design, a total of 27 tests were carried out. The range of each parameter is set at three different levels, namely low, medium and high. Mathematical models were deduced by software Minitab (multiple linear regression and response surface methodology) in order to express the influence degree of the main cutting variables such as cutting speed, feed rate and depth of cut on cutting force components. These models would be helpful in selecting cutting variables for optimization of hard cutting process. The results indicate that the depth of cut is the dominant factor affecting cutting force components. The feed rate influences tangential cutting force more than radial and axial forces. The cutting speed affects radial force more than tangential and axial forces.

  11. Force, Velocity, and Work: The Effects of Different Contexts on Students' Understanding of Vector Concepts Using Isomorphic Problems (United States)

    Barniol, Pablo; Zavala, Genaro


    In this article we compare students' understanding of vector concepts in problems with no physical context, and with three mechanics contexts: force, velocity, and work. Based on our "Test of Understanding of Vectors," a multiple-choice test presented elsewhere, we designed two isomorphic shorter versions of 12 items each: a test with no…

  12. Aligning the Work of Two U.S. Task Forces on Behavioral Counseling Recommendations (United States)

    Grossman, David C.; Elder, Randy W.


    This paper highlights the collaboration and alignment between topics and recommendations related to behavioral counseling interventions from the U.S. Preventive Services Task Force (USPSTF) and Community Preventive Services Task Force (CPSTF). Although the scope and mandates of the USPSTF and CPSTF differ, there are many similarities in the methods and approaches used to select topics and make recommendations to their key stakeholders. Behavioral counseling recommendations represent an important domain for both Task Forces, given the importance of behavior change in promoting healthful lifestyles. This paper explores opportunities for greater alignment between the two Task Forces and compares and contrasts the groups and their current approaches to making recommendations that involve behavioral counseling interventions. Opportunities to enhance behavioral counseling preventive services through closer coordination when developing and disseminating recommendations as well as future collaboration between the USPSTF and CPSTF are discussed. PMID:26296552

  13. Do Skyrme forces that fit nuclear matter work well in finite nuclei?

    CERN Document Server

    Stevenson, P D; Stone, J R; Dutra, M


    A shortlist of Skyrme force parameterizations, recently found to have passed a series of constraints relating to nuclear matter properties is analyzed for their ability to reproduce data in finite nuclei. We analyse binding energies, isotope shifts and fission barriers. We find that the subset of forces have no common ability to reproduce (or otherwise) properties of finite nuclei, despite passing the extensive range of nuclear matter constraints.

  14. Numerical Simulation of a Grinding Process for the Spatial Work-pieces: Modeling of Grinding Forces and System Dynamics

    Directory of Open Access Journals (Sweden)

    I. A. Kiselev


    Full Text Available The paper describes a computation-experimental technique to determine model coefficients of grinding forces using a Nelder-Mead algorithm. As an error function, the paper offers a deviation measure of calculating and experimental grinding forces averaged for a single-pass of the grinding wheel. As an example of cutting forces model coefficients calculation for linear model, in which the grinding forces depend on uncut chip thickness is analyzed. The coefficients vary on abrasive grain geometric parameters and are determined applying the authors-developed method based on Nelder-Mead technique. The measured forces while plane grinding of test work-piece are used to determine the coefficients. Model coefficients are identified if compare the measured data with the results of modeling for grinding by tool with the uniformly distributed abrasive grains with the triangular shape of cutting edge.Grinding dynamics simulation applying the determined coefficients was carried out for the processing of cantilever plane work-piece as a test example. The work-piece was processed by grinding wheel transverse passages made at different distances from the fixation. A selfoscillating process accompanied by vibration of high level was observed for some selected technological parameters of grinding. The simulation has shown qualitative and quantitative compliance with the experiment. It was shown that the intensity of the self-oscillating process arising during the processing depends on the work-piece rigidity and cutting conditions. The results of modeling can be applied in practice in developing the technology process of grinding the spatial work-pieces.

  15. Work-related health complaints in surgical residents and the influence of social support and job-related autonomy.

    NARCIS (Netherlands)

    Boerjan, M.; Bluyssen, S.J.; Bleichrodt, R.P.; Weel-Baumgarten, E.M. van; Goor, H. van


    OBJECTIVES: The aim of this cross-sectional study was to investigate the influence of job-related autonomy and social support provided by consultants and colleagues on the stress-related health complaints of surgical residents in the Netherlands. METHODS: All (n = 400) Dutch residents in training in

  16. Electron work functions of ferrite and austenite phases in a duplex stainless steel and their adhesive forces with AFM silicon probe. (United States)

    Guo, Liqiu; Hua, Guomin; Yang, Binjie; Lu, Hao; Qiao, Lijie; Yan, Xianguo; Li, Dongyang


    Local electron work function, adhesive force, modulus and deformation of ferrite and austenite phases in a duplex stainless steel were analyzed by scanning force microscopy. It is demonstrated that the austenite has a higher electron work function than the ferrite, corresponding to higher modulus, smaller deformation and larger adhesive force. Relevant first-principles calculations were conducted to elucidate the mechanism behind. It is demonstrated that the difference in the properties between austenite and ferrite is intrinsically related to their electron work functions.

  17. Working women worldwide. Age effects in female labor force participation in 117 countries

    NARCIS (Netherlands)

    Besamusca, J.; Tijdens, K.; Keune, M.; Steinmetz, S.


    In this article, we investigate the effects of economic conditions, families, education, and gender ideologies on the labor force participation rates of women in eleven age groups in 117 countries. We find that participation rates of young and older women are partly explained by sector sizes and the

  18. Safety management within Task Force Uruzgan: A report of working with Unmanned Aerial Vehicles

    NARCIS (Netherlands)

    Moorkamp, M.; Kramer, E.H.; Van Gulijk, C.; Ale, B.J.M.


    In this paper we present a conceptualization of safety management that is based on the cybernetic concepts of “controllability” and “control capacity”. In particular, we explore what this conceptualization means for safety management of the Dutch Army’s UAV unit that was part of Task Force Uruzgan (

  19. Wives' Relative Wages, Husbands' Paid Work Hours, and Wives' Labor-Force Exit (United States)

    Shafer, Emily Fitzgibbons


    Economic theories predict that women are more likely to exit the labor force if their partners' earnings are higher and if their own wage rate is lower. In this article, I use the National Longitudinal Survey of Youth (N = 2,254) and discrete-time event-history analysis to show that wives' relative wages are more predictive of their exit than are…

  20. Wives' Relative Wages, Husbands' Paid Work Hours, and Wives' Labor-Force Exit (United States)

    Shafer, Emily Fitzgibbons


    Economic theories predict that women are more likely to exit the labor force if their partners' earnings are higher and if their own wage rate is lower. In this article, I use the National Longitudinal Survey of Youth (N = 2,254) and discrete-time event-history analysis to show that wives' relative wages are more predictive of their exit than are…

  1. Does the United States Air Force Academy’s Training Philosophy Really Work (United States)


    and the supervisor’s: (1) "goal emphasis", (2) " positive motivation " expressed, and (3) the absence of "harsh treatment". Significant (ja < .01...Abstracts International. Rosebush, M.A., & Bryant, C. (1984). Implementation of the positive motivation model. United States Air Force Academy: Department of Behavioral Sciences and Leadership. 35

  2. Work-Family Conflict: The Effects of Religious Context on Married Women’s Participation in the Labor Force

    Directory of Open Access Journals (Sweden)

    Jenna Griebel Rogers


    Full Text Available Past work shows religion’s effect on women’s career decisions, particularly when these decisions involve work-family conflict. This study argues that the religious context of a geographic area also influences women’s solutions to work-family conflict through more or less pervasive normative expectations within the community regarding women’s roles and responsibilities to the family. We use the American Community Survey linked with community-level religious proportions to test the relationship between religious contexts and women’s participation in the labor force in the contiguous United States–2054 census geographic areas. Using spatial analysis, we find that community religious concentration is related to the proportion of women who choose not to work. Communities with a higher proportion of the population belonging to conservative religious traditions also have a greater proportion of married women choosing not to work outside the home.

  3. Report of the Task Force on the Impact of the Research, Development and Field Activities of The Ontario Institute for Studies in Education. Working Papers. (United States)

    Gage, N. L.; And Others

    The Ontario Institute for Studies in Education (OISE) established a task force to investigate the impact of its activities in two areas, research and development and field development. In the first part of this report, the task force and its work are discussed, and the central issues that the task force is concerned with are defined. In Part Two,…

  4. 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. ...

  5. Cellular Tug-of-War: Forces at Work and DNA Stretching in Mitosis (United States)

    Griffin, Brian; Kilfoil, Maria L.


    In the microscopic world of the cell dominated by thermal noise, a cell must be able to successfully segregate its DNA with high fidelity in order to pass its genetic information on to its progeny. In this process of mitosis in eukaryotes, driving forces act on the cytoskeleton-based architecture called the mitotic spindle to promote this division. Our preliminary data demonstrates that the dynamics of this process in yeast cells is universal. Moreover, the dynamics suggest an increasing load as the chromosomes are pulled apart. To investigate this, we use three-dimensional imaging to track the dynamics of the poles of this architecture and the points of attachment to chromosomes simultaneously and with high spatial resolution. We analyze the relative motions of chromosomes as they are organized before segregation and as they are pulled apart, using this data to investigate the force-response behavior of this cytoskeleton-chromosome polymer system.

  6. The training value of working with armed forces inpatients in psychiatry. (United States)

    de Burgh, H Thomas


    Over the last 10 years, the UK armed forces (UKAF) have been involved in operations worldwide. Mental health in the armed forces (AF) has been the subject of considerable interest in part because of a perceived added risk of psychological distress in this population. Inpatient psychiatric services are provided through partnerships with NHS hospitals. The Cavell Centre, Peterborough's acute inpatient psychiatric unit has up to four beds for service personnel, under the care of a civilian consultant psychiatrist and his AF Foundation Year 2 doctor (F2). This was the only Ministry of Defence (MoD) inpatient unit which had a training post for an AF doctor, but the post ended in August 2014 with the closure of MoD Hospital Unit Peterborough (MDHU(P)). This article outlines the differences in civilian and AF inpatient care and discusses the training value of AF doctors managing service personnel who are psychiatric inpatients.

  7. An Investigative Study of Air Force Acquisition Management Work with the Intent of Identifying Its Nature and Required Tools (United States)


    11. Air Force Business Research Management Center, WPAFB OH, 1983 (AD-A37700). Fayol , Henri . ’The Importance of the Administrative Factor,’ Readings...Kotter, Stewart, Fayol . Daft, Luthans, Beer, Boulding and several others. We students struggle to climb up to their shoulders for just an instant to...Subject.............. 19 The Role of the Computer ....................... 22 The Research of Management Work.................. 23 Henry Mintzberg

  8. A Study of the Job Satisfaction of Professional Air Force Social Work Officers. (United States)


    easily be replaced. This forms the basis for the professionalization process. Freidson (1973) defines it as follows: .a process by which an organized...other professional groups is also part of this process. ( Freidson , 1970) The policy-makers and managers of organizations which rely heavily on...Psychology. 1966, 19, (2), 165-183. 35. Freeman, F. The army as a social structure. Social Forces. 1948, 27, 78-83. 36. Freidson , E. Profession of medicine

  9. The work of the Spanish Armed Forces and the Culture of Defence


    Fernández Vargas, Valentina


    The world is currently experiencing a process of globalisation. The resulting political strife can lead to civil wars or new threats inconceivable in the past, such as the terrorist attack on the Twin Towers in New York in 2001 or the 2004 Madrid train bombings. International interventions have consequently taken place whenever they have been considered necessary. Therefore (always complying with the international agreements), the Spanish Armed Forces have been deployed in various territories...

  10. Children of Working Mothers, March 1975: Summary, Special Labor Force Report. (United States)

    Bureau of Labor Statistics (DOL), Washington, DC.

    The following are some of the findings based on the results of the annual survey of marital and family characteristics of workers: (1) about 27.6 million of 62.7 million children had mothers in the labor force (over 2 million more than in March 1970); (2) 1.1 million of 6.5 million children under six were in families headed by women (71 percent…

  11. The Influence of Oblique Angle Forced Exercise in Surgically Destabilized Stifle Joints Is Synergistic with Bone, but Antagonistic with Cartilage in an Ovine Model of Osteoarthritis. (United States)

    Hill, Rachel J; Mason, Holly M; Yeip, Gavin; Merchant, Samer S; Olsen, Aaron L; Stott, Rusty D; Van Wettere, Arnaud J; Bressel, Eadric; Mason, Jeffrey B


    Large animal models of osteoarthritis are a necessary testing ground for FDA approval of human medicine applications. Sheep models have advantages over other available large animals, but development and progression of osteoarthritis in sheep is exceedingly slow, which handicaps progress in development of potential treatments. We combined oblique angle forced exercise to increase stress on the stifle, with surgical destabilization to hasten the development of osteoarthritis in ewes. Methods for early detection of clinical signs included radiography, urine, and serum biomarker assays and gait analysis and ex vivo we used microcomputed tomography and macroscopic joint analysis. Our model was able to produce clinically detectable signs of osteoarthritis in a relatively short period (14 weeks). Changes in bone were highly correlated between microcomputed tomography and radiographic analysis and changes in cartilage correlated well between urinary glycosaminoglycan levels and serum aggrecanase analyses. Exercise improved the negative effects of destabilization in bone but exacerbated the negative effects of destabilization in cartilage. These observations suggest that we may need to consider treatments for bone and cartilage separately. These results represent an improved large animal model of osteoarthritis with rapid onset of disease and superior detection of bone and soft tissue changes.

  12. Stress dependence of the suspended graphene work function: Vacuum Kelvin probe force microscopy and density functional theory (United States)

    Volodin, A.; Van Haesendonck, C.; Leenaerts, O.; Partoens, B.; Peeters, F. M.


    We report on work function measurements on graphene, which is exfoliated over a predefined array of wells in silicon oxide, by Kelvin probe force microscopy operating in a vacuum. The obtained graphene sealed microchambers can support large pressure differences, providing controllable stretching of the nearly impermeable graphene membranes. These measurements allow detecting variations of the work function induced by the mechanical stresses in the suspended graphene where the work function varies linearly with the strain and changes by 62 ± 2 meV for 1 percent of strain. Our related ab initio calculations result in a work function variation that is a factor of 1.4 larger than the experimental value. The limited discrepancy between the theory and the experiment can be accounted for by a charge transfer from the unstrained to the strained graphene regions.

  13. Investigating shoulder muscle loading and exerted forces during wall painting tasks: influence of gender, work height and paint tool design. (United States)

    Rosati, Patricia M; Chopp, Jaclyn N; Dickerson, Clark R


    The task of wall painting produces considerable risk to the workers, both male and female, primarily in the development of upper extremity musculoskeletal disorders. Insufficient information is currently available regarding the potential benefits of using different paint roller designs or the possible adverse effects of painting at different work heights. The aim of this study was to investigate the influence of gender, work height, and paint tool design on shoulder muscle activity and exerted forces during wall painting. Ten young adults, five male and five female, were recruited to perform simulated wall painting at three different work heights with three different paint roller designs while upper extremity muscle activity and horizontal push force were recorded. Results demonstrated that for female participants, significantly greater total average (p = 0.007) and integrated (p = 0.047) muscle activity was present while using the conventional and curly flex paint roller designs compared to the proposed design in which the load was distributed between both hands. Additionally, for both genders, the high working height imposed greater muscular demands compared to middle and low heights. These findings suggest that, if possible, avoid painting at extreme heights (low or high) and that for female painters, consider a roller that requires the use of two hands; this will reduce fatigue onset and subsequently mitigate potential musculoskeletal shoulder injury risks.

  14. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins. (United States)

    Tan, Puay Hoon; Cheng, Liang; Srigley, John R; Griffiths, David; Humphrey, Peter A; van der Kwast, Theodore H; Montironi, Rodolfo; Wheeler, Thomas M; Delahunt, Brett; Egevad, Lars; Epstein, Jonathan I


    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed that tumor extending close to the 'capsular' margin, yet not to it, should be reported as a negative margin, and that locations of positive margins should be indicated as either posterior, posterolateral, lateral, anterior at the prostatic apex, mid-prostate or base. Other items of consensus included specifying the extent of any positive margin as millimeters of involvement; tumor in skeletal muscle at the apical perpendicular margin section, in the absence of accompanying benign glands, to be considered organ confined; and that proximal and distal margins be uniformly referred to as bladder neck and prostatic apex, respectively. Grading of tumor at positive margins was to be left to the discretion of the reporting pathologists. There was no consensus as to how the surgical margin should be regarded when tumor is present at the inked edge of the tissue, in the absence of transected benign glands at the apical margin. Pathologists also did not achieve agreement on the reporting approach to benign prostatic glands at an inked surgical margin in which no carcinoma is present.

  15. Effects of Inertial Setting on Power, Force, Work, and Eccentric Overload During Flywheel Resistance Exercise in Women and Men. (United States)

    Martinez-Aranda, Luis M; Fernandez-Gonzalo, Rodrigo


    Exercise load is a key component in determining end-point adaptations to resistance exercise. Yet, there is no information regarding the use of different inertia (i.e., loads) during isoinertial flywheel resistance exercise, a very popular high-intensity training model. Thus, this study examined power, work, force, and eccentric overload produced during flywheel resistance exercise with different inertial settings in men and women. Twenty-two women (n = 11) and men (n = 11) performed unilateral (in both legs) isolated concentric (CON) and coupled CON and eccentric (ECC) exercise in a flywheel knee extension device employing 6 inertias (0.0125, 0.025, 0.0375, 0.05, 0.075, 0.1 kg·m). Power decreased as higher inertias were used, with men showing greater (p ≤ 0.05) decrements than women (-36 vs. -29% from lowest to highest inertia). In contrast, work increased as higher inertias were employed, independent of sex (p ≤ 0.05; ∼48% from lowest to highest inertia). Women increased CON and ECC mean force (46-55%, respectively) more (p ≤ 0.05) than men (34-50%, respectively) from the lowest to the highest inertia evaluated, although the opposite was found for peak force data (i.e., peak force increased more in men than in women as inertia was increased). Men, but not women, increased ECC overload from inertia 0.0125 to 0.0375 kg·m2. Although estimated stretch-shorting cycle use during flywheel exercise was higher (p ≤ 0.05) in men (6.6%) than women (4.9%), values were greater for both sexes when using low-to-medium inertias. The information gained in this study could help athletes and sport and health professionals to better understand the impact of different inertial settings on skeletal muscle responses to flywheel resistance exercise.

  16. Work Force Education: Beyond Technical Skills. Trends and Issues Alert No. 1. (United States)

    Imel, Susan

    This brief suggests that during the past 2 decades, the skills needed to succeed in the workplace have changed significantly. Technical skills remain important, but, increasingly, employers recognize another category of skills crucial to a worker's ability to work "smarter, not harder." These "soft,""core,""nontechnical,""essential,""generic," and…

  17. Gaining Control of Occupational Injury and Illness in the U.S. Navy Civilian Work Force (United States)


    plans and ongoing medical care. Other endeavors include participation in mandatory job placement, job search, outplacement , and rehabilitation efforts...RESPONSIBILITIES: Continuing Endeavors " Mandatory Job Placement, Job Search, and Outplacement " Create-A-Returned-Employee (Care) Program...34 Rehabilitation 14 h. Mandatory Job Placement. Job Search. and Outplacement . Another role of the case manager is to work with supervisors and the Personnel

  18. Do body weight and gender shape the work force? The case of Iceland. (United States)

    Asgeirsdottir, Tinna Laufey


    Most studies of the relationship between body weight - as well as its corollary, beauty - and labor-market outcomes have indicated that it is a function of a gender bias, the negative relationship between excess weight or obesity and labor-market outcomes being greater for women than for men. Iceland offers an exceptional opportunity to examine this hypothesis, given that it scores relatively well on an index of gender equality comprising economic, political, educational, labor-market, and health-based criteria. Equipped with an advanced level of educational attainment, on average, women are well represented in Iceland's labor force. When it comes to women's presence in the political sphere, Iceland is out of the ordinary as well; that Icelanders were the first in the world to elect a woman to be president may suggest a relatively gender-blind assessment in the labor market. In the current study, survey data collected by Gallup Iceland in 2002 are used to examine the relationship between weight and employment within this political and social setting. Point estimates indicate that, despite apparently lesser gender discrimination in Iceland than elsewhere, the bias against excess weight and obesity remains gender-based, showing a slightly negative relationship between weight and the employment rate of women, whereas a slightly positive relationship was found for men.

  19. Maximal strength training improves work economy, rate of force development and maximal strength more than conventional strength training. (United States)

    Heggelund, Jørn; Fimland, Marius S; Helgerud, Jan; Hoff, Jan


    This study compared maximal strength training (MST) with equal training volume (kg × sets × repetitions) of conventional strength training (CON) primarily with regard to work economy, and second one repetition maximum (1RM) and rate of force development (RFD) of single leg knee extension. In an intra-individual design, one leg was randomized to knee-extension MST (4 or 5RM) and the other leg to CON (3 × 10RM) three times per week for 8 weeks. MST was performed with maximal concentric mobilization of force while CON was performed with moderate velocity. Eight untrained or moderately trained men (26 ± 1 years) completed the study. The improvement in gross work economy was -0.10 ± 0.08 L min(-1) larger after MST (P = 0.011, between groups). From pre- to post-test the MST and CON improved net work economy with 31 % (P < 0.001) and 18 % (P = 0.01), respectively. Compared with CON, the improvement in 1RM and dynamic RFD was 13.7 ± 8.4 kg (P = 0.002) and 587 ± 679 N s(-1) (P = 0.044) larger after MST, whereas isometric RFD was of borderline significance 3,028 ± 3,674 N s(-1) (P = 0.053). From pre- to post-test, MST improved 1RM and isometric RFD with 50 % (P < 0.001) and 155 % (P < 0.001), respectively whereas CON improved 1RM and isometric RFD with 35 % (P < 0.001) and 83 % (P = 0.028), respectively. Anthropometric measures of quadriceps femoris muscle mass and peak oxygen uptake did not change. In conclusion, 8 weeks of MST was more effective than CON for improving work economy, 1RM and RFD in untrained and moderately trained men. The advantageous effect of MST to improve work economy could be due to larger improvements in 1RM and RFD.

  20. Work-related acute injuries from mandatory fitness training in the Swedish Police Force. (United States)

    de Loës, M; Jansson, B


    Acute injuries in the Swedish Police Force from on-duty fitness training were selected retrospectively from the Information System of Occupational Injuries (ISA) at the National Board of Occupational Safety and Health and, if having caused a sick-leave exceeding 2 weeks, to the Labour Market Insurance (AMF Insurance). The latter included injuries from 1995 only. During the seven-year period 1992 to 1998, 920 injuries (80 % in males) from fitness training involving police officers were reported to the ISA-register. The total incidence was 1.6 for policemen per 10 000 hours of exposure and 2.2 for policewomen, which is 1.4 times higher than in men. Around 50 % of the injuries occurred in team and contact sports, with a slightly higher percentage for males, 54 % versus 49 % in females. The percentage of injuries from self-defense training was twice as high as in women than in men, 29 % versus 15 %. In 1995, 42 of the 72 injuries in males and 6 of the 21 injuries in females caused more than 14 days of sick-leave and were announced to the Occupational No Fault Liability Insurance. The major part, 32 of 48 injuries, came from team or contact sports (mainly floorball and soccer). Six policemen incurred injuries that were classified with a degree of disability ranging from 2 to 5 %. The total cost for medical treatment and production loss for the 48 injuries was Euro 248 448 and 99 336, respectively. Team and contact sports accounted for 89 % of the costs and 77 % of the production loss through sick-leave.

  1. Surgical Assisting (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  2. Telecommuters: the stay-at-home work force of the future

    Energy Technology Data Exchange (ETDEWEB)

    Eder, P.F.


    The spread of teleworkers who commute via telecommunications from their home offices will depend, despite the energy-saving and tax advantages of self-employment, on how fast the social climate accepts teleworking, whether software can be made friendlier, and whether legal issues of database networks are resolved. The societal changes associated with home offices can be either a positive reemphasis on the home or a negative electronic sweatshop and a way to export office work to low-wage areas. The author, who sees a gradual adoption of teleworking while these technological, societal, and marketing barriers are dealt with, develops a scenario for an information society of the future. (DCK)

  3. A comparative ergonomic study of work-related upper extremity musculo skeletal disorder among the unskilled and skilled surgical blacksmiths in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Tirthankar Ghosh


    Full Text Available Objective: The main aim of the study was to determine the nature and extent of work-related upper extremity musculoskeletal disorders (MSDs and physiological stress among the blacksmiths involved in surgical instrument industry. Materials and Methods: In the present investigation, 50 male blacksmiths of each skilled and unskilled groups of the forging section had been selected. For the symptom survey, a questionnaire on discomfort symptoms was performed. Repetitiveness of work and hand grip strength of both the groups were measured. Results: It was revealed that upper limb MSD was a major problem among both group of blacksmith, primarily involving the hand, wrist, fingers, and shoulder. From this study it was found that 66% (33 skilled and 80% (40 unskilled blacksmith workers are feeling discomfort. The most commonly affected regions among the skilled and unskilled blacksmith workers were lower back (skilled 65% and unskilled 80%, neck (skilled 60% and unskilled 80%, and hand (skilled 50% and unskilled.

  4. Labor market work and home care's unpaid caregivers: a systematic review of labor force participation rates, predictors of labor market withdrawal, and hours of work. (United States)

    Lilly, Meredith B; Laporte, Audrey; Coyte, Peter C


    As people continue to age and receive complex health care services at home, concern has arisen about the availability of family caregivers and their ability to combine employment with caregiving. This article evaluates the international research on unpaid caregivers and their labor market choices, highlighting three conclusions: first, caregivers in general are equally as likely to be in the labor force as noncaregivers; second, caregivers are more likely to work fewer hours in the labor market than noncaregivers, particularly if their caring commitments are heavy; and finally, only those heavily involved in caregiving are significantly more likely to withdraw from the labor market than noncaregivers. Policy recommendations are targeting greater access to formal care for "intensive" caregivers and developing workplace policies for employed caregivers.

  5. New respirator fit test panels representing the current U.S. civilian work force. (United States)

    Zhuang, Ziqing; Bradtmiller, Bruce; Shaffer, Ronald E


    The fit test panels currently used for respirator research, design, and certification are 25-subject panels developed by Los Alamos National Laboratory (LANL) and are based on data from the 1967 and 1968 anthropometric surveys of U.S. Air Force personnel. Military data do not represent the great diversity in face size and shape seen in civilian populations. In addition, the demographics of the U.S. population have changed over the last 30 years. Thus, it is necessary to assess and refine the LANL fit test panels. This paper presents the development of new respirator fit test panels representative of current U.S. civilian workers based on an anthropometric survey of 3,997 respirator users conducted in 2003. One panel was developed using face length and face width (bivariate approach) and weighting subjects to match the age and race distribution of the U.S. population as determined from the 2000 census. Another panel was developed using the first two principal components obtained from a set of 10 facial dimensions (age and race adjusted). These 10 dimensions are associated with respirator fit and leakage and can predict the remaining face dimensions well. Respirators designed to fit these panels are expected to accommodate more than 95% of the current U.S. civilian workers. Both panels are more representative of the U.S. population than the existing LANL panel and may be appropriate for testing both half-masks and full-face piece respirators. Respirator manufacturers, standards development organizations, and government respirator certification bodies need to select the appropriate fit test panel for their particular needs. The bivariate panel is simpler to use than the principal component analysis (PCA) panel and is most similar to the LANL panel currently used. The inclusion of the eight additional facial measurements allows the PCA panel to provide better criteria for excluding extreme face sizes from being used. Because the boundaries of the two new panels are

  6. Many flaked particles generated by electric field stress working as an impulsive force in mass-production plasma etching equipment (United States)

    Kasashima, Yuji; Uesugi, Fumihiko


    Particles generated in plasma etching significantly lower production yield. In plasma etching, etching reaction products adhere to the inner chamber walls, gradually forming films, and particles are generated by flaking of the deposited films due to electric field stress that acts boundary between the inner wall and the film. In this study, we have investigated the mechanism of instantaneous generation of many flaked particles using the mass-production reactive ion etching equipment. Particles, which flake off from the films on the ground electrode, are detected by the in-situ particle monitoring system using a sheet-shaped laser beam. The results indicate that the deposited films are severely damaged and flake off as numerous particles when the floating potential at the inner wall suddenly changes. This is because the rapid change in floating potential, observed when unusual wafer movement and micro-arc discharge occur, causes electric field stress working as an impulsive force. The films are easily detached by the impulsive force and many flaked particles are instantaneously generated. This mechanism can occur on not only a ground electrode but a chamber walls, and cause serious contamination in mass-production line. This work was partially supported by JSPS KAKENHI Grant Number B 26870903.

  7. Work. (United States)

    Haines, Annette M.


    Draws upon Maria Montessori's writings to examine work as a universal human tendency throughout life. Discusses the work of adaptation of the infant, work of "psycho-muscular organism" for the preschooler, work of the imagination for the elementary child, community work of the adolescent, and work of the adult. Asserts that…

  8. [Documentation of the surgical report with graphic statistical data analysis--a simplification of daily routine work]. (United States)

    Schramm, W; Wierrani, F; Grünberger, W


    A data collection system on microcomputer connected with an automatic medical report system for operations, was developed to facilitate both medical report as well as documentation. Linking different commercial software products by use of a Pascal programme, we were able to speed up daily routine work as well as establish efficient graphical statistics of patient data.

  9. The Joint Commission has provided a tool to change your work force: are you paying attention? (United States)

    Decker, P J; Strader, M K


    Most health care managers wonder how to change employee "attitudes" so that their staff will be more accountable for patient satisfaction, cost reduction, and quality of care. Employees were trained to function in an industry where the power players were the physician and the administrator and now it is exceedingly difficult to get them to switch their attention to the patient and the payer in a market-driven economy. For hospital managers, the answer may be right at their fingertips: The Joint Commission on Accreditation of Healthcare Organizations' standards demanding that employee competence be objectively measured, proven, tracked & trended, improved, and age specific. A comprehensive competence assessment system can save the health care manager enormous work in measuring fewer things, focusing performance assessment on the 20 percent of things that are true problems, and helping to specifically define certain competencies such as customer focus and cost consciousness so that coaching, training, and giving performance feedback is easier. Developing a comprehensive competence assessment system is a powerful tool to change the culture of organizations. Consequently, it is important that managers be aware of those possibilities before they embark on developing "competencies" or before their organizations get too carried away on redesigning systems to satisfy standards.

  10. Women of Hispanic Origin in the Labor Force. Facts on Working Women No. 89-1 = La mujer de origen hispano en la fuerza laboral. Facts on Working Women Num. 89-1S. (United States)

    Women's Bureau (DOL), Washington, DC.

    Data on Hispanic women in the labor force between 1978 and 1988 show the following: (1) 6.5 percent of the women in the work force in 1988 were of Hispanic origin (3.6 million); (2) the median age of Hispanic women was 26.1 years, 2-5 years younger than Black or White women; (3) 66 percent of Hispanic women participate in the labor force, a higher…

  11. Abolishment of 24-hour continuous medical call duty in quebec: a quality of life survey of general surgical residents following implementation of the new work-hour restrictions. (United States)

    Hamadani, Fadi T; Deckelbaum, Dan; Sauve, Alexandre; Khwaja, Kosar; Razek, Tarek; Fata, Paola


    The implementation of work hour restrictions across North America have resulted in decreased levels of self injury and medical errors for Residents. An arbitration ruling in Quebec has led to further curtailment of work hours beyond that proposed by the ACGME. This may threaten Resident quality of life and in turn decrease the educational quality of surgical residency training. We administered a quality of life questionnaire with an integrated education quality assessment tool to all General Surgery residents training at McGill 6 months after the work hour restrictions. Across several strata respondents reveal a decreased sense of educational quality and quality of life. The arbitration argued that work- hour restrictions would be necessary to improve quality of life for trainees and hence improve patient safety. Results from this study demonstrate the exact opposite in a large majority of respondents, who report a poorer quality of life and a self-reported inability on their part to provide continuous and safe patient care. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Labor Force (United States)

    Occupational Outlook Quarterly, 2012


    The labor force is the number of people ages 16 or older who are either working or looking for work. It does not include active-duty military personnel or the institutionalized population, such as prison inmates. Determining the size of the labor force is a way of determining how big the economy can get. The size of the labor force depends on two…

  13. Field-induced doping-mediated tunability in work function of Al-doped ZnO: Kelvin probe force microscopy and first-principle theory (United States)

    Kumar, Mohit; Mookerjee, Sumit; Som, Tapobrata


    We demonstrate that the work function of Al-doped ZnO (AZO) can be tuned externally by applying an electric field. Our experimental investigations using Kelvin probe force microscopy show that by applying a positive or negative tip bias, the work function of AZO film can be enhanced or reduced, which corroborates well with the observed charge transport using conductive atomic force microscopy. These findings are further confirmed by calculations based on first-principles theory. Tuning the work function of AZO by applying an external electric field is not only important to control the charge transport across it, but also to design an Ohmic contact for advanced functional devices.

  14. Field-induced doping-mediated tunability in work function of Al-doped ZnO: Kelvin probe force microscopy and first-principle theory. (United States)

    Kumar, Mohit; Mookerjee, Sumit; Som, Tapobrata


    We demonstrate that the work function of Al-doped ZnO (AZO) can be tuned externally by applying an electric field. Our experimental investigations using Kelvin probe force microscopy show that by applying a positive or negative tip bias, the work function of AZO film can be enhanced or reduced, which corroborates well with the observed charge transport using conductive atomic force microscopy. These findings are further confirmed by calculations based on first-principles theory. Tuning the work function of AZO by applying an external electric field is not only important to control the charge transport across it, but also to design an Ohmic contact for advanced functional devices.

  15. Applying Failure Modes, Effects, And Criticality Analysis And Human Reliability Analysis Techniques To Improve Safety Design Of Work Process In Singapore Armed Forces (United States)


    interactions from a purely mechanical standpoint. However, SAF does not apply FMECA to work processes that are typical of SAF training and operational...take considerable effort to complete. Therefore, it should be applied to work processes or activities that are generally static in nature ...AND CRITICALITY ANALYSIS AND HUMAN RELIABILITY ANALYSIS TECHNIQUES TO IMPROVE SAFETY DESIGN OF WORK PROCESS IN SINGAPORE ARMED FORCES by Weihao K

  16. Force, velocity, and work: The effects of different contexts on students' understanding of vector concepts using isomorphic problems (United States)

    Barniol, Pablo; Zavala, Genaro


    In this article we compare students' understanding of vector concepts in problems with no physical context, and with three mechanics contexts: force, velocity, and work. Based on our "Test of Understanding of Vectors," a multiple-choice test presented elsewhere, we designed two isomorphic shorter versions of 12 items each: a test with no physical context, and a test with mechanics contexts. For this study, we administered the items twice to students who were finishing an introductory mechanics course at a large private university in Mexico. The first time, we administered the two 12-item tests to 608 students. In the second, we only tested the items for which we had found differences in students' performances that were difficult to explain, and in this case, we asked them to show their reasoning in written form. In the first administration, we detected no significant difference between the medians obtained in the tests; however, we did identify significant differences in some of the items. For each item we analyze the type of difference found between the tests in the selection of the correct answer, the most common error on each of the tests, and the differences in the selection of incorrect answers. We also investigate the causes of the different context effects. Based on these analyses, we establish specific recommendations for the instruction of vector concepts in an introductory mechanics course. In the Supplemental Material we include both tests for other researchers studying vector learning, and for physics teachers who teach this material.

  17. 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.

  18. McClellan Air Force Base operable unit B, two-phase extraction system demonstration test, work implementation plan for McClellan AFB, California. Final report

    Energy Technology Data Exchange (ETDEWEB)


    This document is an integrated demonstration and work plan that presents the technical approach for design, implementation, and testing of two-phase extraction as compared with pump and treat technology in Operable Unit B, investigative cluster IC1 at the McClellan Air Force Base. This work is being coordinated with Clean Sites under a cooperative agreement with EPA's Technology Innovation Office and Superfund Innovative Technology Evaluation Program.

  19. Rheumatic patients at work : a study of labour force participations and its determinants in rheumatoid arthritis, ankylosing spondylitis, and juvenile chronic arthritis

    NARCIS (Netherlands)

    Chorus, A.M.J.


    This thesis at the University of Maastricht, defended at May 7, 2004, yields several important and new findings with regard to work related quality of life, participation in the labour force and its determinants of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and juvenile chr

  20. Rights of Passage. Final Report of the Task Force on the Transition from School to Work for Montgomery County Students with Disabilites. (United States)

    Montgomery County Public Schools, Rockville, MD.

    A task force was created to establish a collaborative relationship among government, education, private agencies, and employers for transition services for special education students. Findings were that unemployment and underemployment were extremely high for special education graduates who lacked adequate basic, job-seeking, and work skills. Few…

  1. Post-surgical hypocortisolism after removal of an adrenal incidentaloma: is it predictable by an accurate endocrinological work-up before surgery? (United States)

    Eller-Vainicher, Cristina; Morelli, Valentina; Salcuni, Antonio Stefano; Torlontano, Massimo; Coletti, Francesca; Iorio, Laura; Cuttitta, Antonello; Ambrosio, Angelo; Vicentini, Leonardo; Carnevale, Vincenzo; Beck-Peccoz, Paolo; Arosio, Maura; Ambrosi, Bruno; Scillitani, Alfredo; Chiodini, Iacopo


    Few data are available regarding the need of steroid substitutive therapy after unilateral adrenalectomy for adrenal incidentaloma (AI). It is unknown whether, before surgery, the hypothalamic-pituitary-adrenal (HPA) axis secretion parameters can predict post-surgical hypocortisolism. This study aimed to evaluate whether, in AI patients undergoing unilateral adrenalectomy, post-surgical hypocortisolism could be predicted by the parameters of HPA axis function. Prospective, multicenter. A total of 60 patients underwent surgical removal of AI (surgical indication: 29 subclinical hypercortisolism (SH); 31 AI dimension). Before surgery, SH was diagnosed in patients presenting at least three criteria out of urinary free cortisol (UFC) levels>60 microg/24 h, cortisol after 1-mg dexamethasone suppression test (1 mg-DST)>3.0 microg/dl, ACTH levels5.4 microg/dl. Two months after surgery, HPA axis function was assessed by low dose ACTH stimulation test or insulin tolerance test when needed: 39 patients were affected (Group B) and 21 were not affected (Group A) with hypocortisolism. The accuracy in predicting hypocortisolism of pre-surgical HPA axis parameters or their combinations was evaluated. The presence of >2 alterations among 1 mg-DST>5.0 microg/dl, ACTHhypocortisolism (OR 10.45, 95% confidence interval, CI 2.54-42.95, P=0.001). Post-surgical hypocortisolism was predicted with 100% probability by elevated UFC plus MSC levels, but not ruled out even in the presence of the normality of all HPA axis parameters. Post-surgical hypocortisolism cannot be pre-surgically ruled out. A steroid substitutive therapy is indicated after unilateral adrenalectomy for SH or size of the adenoma.

  2. Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. (United States)

    Davenport, Daniel L; Henderson, William G; Mosca, Cecilia L; Khuri, Shukri F; Mentzer, Robert M


    Since the Institute of Medicine patient safety reports, a number of survey-based measures of organizational climate safety factors (OCSFs) have been developed. The goal of this study was to measure the impact of OCSFs on risk-adjusted surgical morbidity and mortality. Surveys were administered to staff on general/vascular surgery services during a year. Surveys included multiitem scales measuring OCSFs. Additionally, perceived levels of communication and collaboration with coworkers were assessed. The National Surgical Quality Improvement Program was used to assess risk-adjusted morbidity and mortality. Correlations between outcomes and OCSFs were calculated and between outcomes and communication/collaboration with attending and resident doctors, nurses, and other providers. Fifty-two sites participated in the survey: 44 Veterans Affairs and 8 academic medical centers. A total of 6,083 surveys were returned, for a response rate of 52%. The OCSF measures of teamwork climate, safety climate, working conditions, recognition of stress effects, job satisfaction, and burnout demonstrated internal validity but did not correlate with risk-adjusted outcomes. Reported levels of communication/collaboration with attending and resident doctors correlated with risk-adjusted morbidity. Survey-based teamwork, safety climate, and working conditions scales are not confirmed to measure organizational factors that influence risk-adjusted surgical outcomes. Reported communication/collaboration with attending and resident doctors on surgical services influenced patient morbidity. This suggests the importance of doctors' coordination and decision-making roles on surgical teams in providing high-quality and safe care. We propose risk-adjusted morbidity as an effective measure of surgical patient safety.

  3. Twenty-year outcome in young adults with childhood hydrocephalus: assessment of surgical outcome, work participation, and health-related quality of life. (United States)

    Paulsen, A Henriette; Lundar, Tryggve; Lindegaard, Karl-Fredrik


    Shunting of CSF is one of the most commonly performed operations in the pediatric neurosurgeon's repertoire. The 1st decade after initial shunt insertion has been addressed in several previous reports. The goals of the authors' study, therefore, were to determine 20-year outcomes in young adults with childhood hydrocephalus and to assess their health-related quality of life (HRQOL). Patients younger than 15 years of age, in whom a first-time shunt insertion was performed for hydrocephalus in the calendar years 1985-1988, were included in a retrospective study on surgical morbidity, mortality rates, academic achievement, and/or work participation. Information concerning perceived health and functional status was assessed using the 36-Item Short Form Health Survey (SF-36) and Barthel Index, which were completed by patients still alive by September 1, 2009. Overall, 138 patients participated, no patient being lost to follow-up. For the 20-year period, the overall mortality rate was 21.7%. The mortality rate was not significantly higher in the 1st decade after initial shunt insertion than in the 2nd decade (p = 0.10). Ten percent of the patients surviving still live with their primary shunt in place, whereas 81% required at least one revision, and among these individual the mean number of revisions was 4.2 (median 3, range 0-26). There was a significantly higher revision rate during the 1st decade after initial shunt insertion compared with the 2nd decade (p = 0.027). The majority of patients live lives comparable with those of their peers. At follow-up, 56% were employed in open-market jobs or were still students, 23% had sheltered employment, and 21% were unemployed. The HRQOL was slightly lower in the hydrocephalic cohort than in the normative population. A significant difference was found in 2 of 8 SF-36 domains-Physical Functioning and General Health. During the 20-year follow-up period, 81% of the patients required at least one revision of the CSF shunt. The

  4. Mountains of Work: NACUBO TRA97 Task Force Takes Proactive Stance in Developing Processes, Recommending Changes, and Offering Advice. (United States)

    Gross, Anne C.; Bachinger, Mary M.; Whalen, Edward L.


    A National Association of College and University Business Officers (NACUBO) task force has developed a process guide, list of policy issues and unsolved questions, and recommendations for colleges and universities to use in complying with the reporting requirements of the Tax Relief Act of 1997, which provides parents of college students with tax…

  5. Dynamic transmission modeling: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force Working Group-5.

    NARCIS (Netherlands)

    Pitman, Richard; Fisman, David; Zaric, Gregory S; Postma, Maarten; Kretzschmar, Mirjam; Edmunds, John; Brisson, Marc; ISPOR-SMDM Modeling Good Research Practices Task Force, [No Value


    The transmissible nature of communicable diseases is what sets them apart from other diseases modeled by health economists. The probability of a susceptible individual becoming infected at any one point in time (the force of infection) is related to the number of infectious individuals in the popula

  6. Dynamic transmission modeling: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force Working Group-5.

    NARCIS (Netherlands)

    Pitman, Richard; Fisman, David; Zaric, Gregory S; Postma, Maarten; Kretzschmar, Mirjam; Edmunds, John; Brisson, Marc; ISPOR-SMDM Modeling Good Research Practices Task Force, [No Value


    The transmissible nature of communicable diseases is what sets them apart from other diseases modeled by health economists. The probability of a susceptible individual becoming infected at any one point in time (the force of infection) is related to the number of infectious individuals in the popula

  7. Dynamic transmission modeling: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force Working Group-5.

    NARCIS (Netherlands)

    Pitman, Richard; Fisman, David; Zaric, Gregory S; Postma, Maarten; Kretzschmar, Mirjam; Edmunds, John; Brisson, Marc; ISPOR-SMDM Modeling Good Research Practices Task Force, [No Value


    The transmissible nature of communicable diseases is what sets them apart from other diseases modeled by health economists. The probability of a susceptible individual becoming infected at any one point in time (the force of infection) is related to the number of infectious individuals in the

  8. Surgical Navigation

    DEFF Research Database (Denmark)

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


    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  9. Work force retention: Role of work environment, organization commitment, supervisor support and training & development in ceramic sanitary ware industries in India

    Energy Technology Data Exchange (ETDEWEB)

    Umamaheswari S, Jayasree Krishnan


    Although retention of employees has become hot topic in this career turbulent era, practically no empirical research is carried out in the fast growing ceramic sector till now and this research fills the gap in the literature. The literatures surveys reported that organization commitment is an important determinant of retention and work environment, supervisor support and training and development are the most relevant antecedents increasing commitment towards organization. This paper examines the impact of the above factors over organization commitment and explores the effects of organization commitment on retention, and verifies the mediating effect of organization commitment on the relationship between proposed factors and retention. Design/methodology/approach: A survey was completed by 416 employees working in five ceramic sanitary ware factories located at different places in India. Questionnaire consisting of items adopted from previous researches were used to collect data. The selection of respondents was based on the simple random sampling. Findings: Findings reveals that organization commitment influences retention and all the above factors enhances it. Moreover organization commitment partially mediates the relationship between proposed factors and retention. However multiple regression analysis indicated that training and development did not have any notable influence on retention. Limitations: This study was conducted in a particular country and also in a particular sector of manufacturing industry, which limits generalization .Possibility of bias towards their organization and assumption that respondents know about their organization are other limitations. Implications: This paper offers recommendations to HR(Human resource) managers that they should extend their support to work environment, supervisor support and training and development in order to generate better relationship with employees and to reduce their likelihood of leaving the company

  10. Work force retention: Role of work environment, organization commitment, supervisor support and training & development in ceramic sanitary ware industries in India

    Directory of Open Access Journals (Sweden)

    Umamaheswari S


    Full Text Available Purpose: Although retention of employees has become hot topic in this career turbulent era, practically no empirical research is carried out in the fast growing ceramic sector till now and this research fills the gap in the literature. The literatures surveys reported that organization commitment is an important determinant of retention and work environment, supervisor support and training and development are the most relevant antecedents increasing commitment towards organization. This paper examines the impact of the above factors over organization commitment and explores the effects of organization commitment on retention, and verifies the mediating effect of organization commitment on the relationship between proposed factors and retention. Design/methodology/approach: A survey was completed by 416 employees working in five ceramic sanitary ware factories located at different places in India. Questionnaire consisting of items adopted from previous researches were used to collect data. The selection of respondents was based on the simple random sampling. Findings: Findings reveals that organization commitment influences retention and all the above factors enhances it. Moreover organization commitment partially mediates the relationship between proposed factors and retention. However multiple regression analysis indicated that training and development did not have any notable   influence on retention. Limitations: This study was conducted in a particular country and also in a particular sector of manufacturing industry, which limits generalization .Possibility of bias towards their organization and assumption that respondents know about their organization are other limitations. Implications: This paper offers recommendations to HR(Human resource managers that they should extend their support to work environment, supervisor support and training and development in order to generate better relationship with employees and to reduce their

  11. Hispanic and Anglo Males in the Navy’s Blue-Collar Civilian Work Force: A Comparison of New Hirees (United States)


    package that includes accountability, rewards, and evaluation. 22 REFERENCES Ash, R. A., Levine, E. L., & Edgell , S. L. (1979). Exploratory study of a...30. Office work ...................... 31. Sales or store ... .................32. Restaurant ....... ........... ... 33. Janitor or cleaning

  12. Perceptions of gender equality in work-life balance, salary, promotion, and harassment: results of the NASPGHAN task force survey. (United States)

    Tomer, Gitit; Xanthakos, Stavra; Kim, Sandra; Rao, Meenakshi; Book, Linda; Litman, Heather J; Fishman, Laurie N


    Gender equality in the workplace has not been described in pediatric gastroenterology. An electronic survey that explored perceptions of career parity, work-life balance, and workplace harassment was sent to all members of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Reponses were anonymous. Of the 303 respondents (21%), there was an even distribution across geographic region, age, and gender (54% men). Gender affected perception of salary and promotion; 46% of men but only 9% of women feel that "women earn the same as men" (P work-life balance for either gender. Overall, women are more likely to be dissatisfied with work-life balance than men (P = 0.046). Satisfaction with work-life balance is lower among women versus men pediatric gastroenterologists, but does not correlate with flexibility of spouse's job or caring for young children. Gender-divergent perception of promotion, parity of compensation, and mentoring requires further investigation.

  13. 外科护士在工作中的危险因素和安全防护%Risk Factors of Surgical Nurses in the Work and Safety Protection

    Institute of Scientific and Technical Information of China (English)

    张丽; 侯晓丽; 张慧培


    The hospital environment is special, there are many safe hidden trouble, the nurse unique working environment and service objectdetermines the nurses often faced all kinds of danger in the work process, in order to improve the nurses' knowledge of the work of risk factors, reduce the occurrence of accident, has very important significance to do the safety protection. The au-thor will study the dangerfactors in the work environment of surgical nurses, and combined with the personal point of view, puts forward some measures of safety protection, the aim is to enhance the ability of identification and protection of surgical nurses' a-bility of risk factors, the surgical nurses in their daily work, from the dangerous factors of poison.%医院环境特殊,存在诸多安全隐患,护士独特的工作环境及服务对象决定了护士在工作过程中常常面临各种各样的危险,为提高护士对工作中危险因素的认识,降低意外事故的发生,做好安全防护具有非常重要的意义。该研究将对外科护士工作环境中存在的危险因素进行研究,并结合个人观点,提出几点安全防护措施,旨在增强外科护士对危险因素的鉴别能力与防护能力,使外科护士在日常工作中,免遭危险因素的荼毒。

  14. Analysis of surgical intervention populations using generic surgical process models. (United States)

    Neumuth, Thomas; Jannin, Pierre; Schlomberg, Juliane; Meixensberger, Jürgen; Wiedemann, Peter; Burgert, Oliver


    According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical 'mean' surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making. Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical 'mean' intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical 'mean' procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis. Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models. The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.

  15. Personality traits of the Five-Factor Model are associated with work-related stress in special force police officers. (United States)

    Garbarino, S; Chiorri, C; Magnavita, N


    The police work is particularly stressful. The aim of this work was to clarify whether the personality factors are associated with perceived stress levels or reactivity to environmental stressors in a special body of police. The police officers in charge of guaranteeing public order at the L'Aquila G8 meeting were subjected to a control of their levels of work-related stress in anticipation of the event. Personality was assessed by the Italian version of the Five-Factor Model questionnaire, while stress was measured three times (during routine work in January 2009, preparation and imminence of the event, in April and July 2009, respectively) with the demand/control/support model of Karasek and the effort/reward imbalance model of Siegrist. A total of 289 of 294 officers took part in the survey. Some personality traits of the Five-Factor Model were associated with stress levels and stress reactivity. Neuroticism (low emotional stability) showed the strongest associations with job strain (demand/control ratio) (β = 0.115, p Personality factors may mitigate or increase the strain induced by environmental stressors.

  16. The Work-to-College Transition: Postsecondary Expectations and Enrolment for Young Men and Women in the US Labour Force (United States)

    Wells, Ryan S.; Bills, David B.; Devlin, Maura E.


    This paper investigates early employment influences on postsecondary expectations and enrolment for working men and women who have recently completed high school in the United States. We find that young workers still have very high expectations for postsecondary education, but that women are more likely to enrol. However, this difference is…

  17. [Trends of work force participation of patients with rheumatic diseases : results from German social insurance data and the national database of the German collaborative arthritis centers]. (United States)

    Mau, W; Thiele, K; Lamprecht, J


    Positive therapeutic effects on the work force participation derived from international clinical trials may not be directly transferable to the community based care in Germany. Therefore recent changes of data regarding sick leave (SL), work disability pension (WDP) and employment from the social insurance and from the national database of the German collaborative arthritis centers were analyzed covering a time period of at least 10 years. Health insurance data showed a steeper decline in the average duration of SL caused by rheumatoid arthritis (RA), ankylosing spondylitis (AS) and systemic lupus erythematosus (SLE) compared with all other diseases. In RA patients from the collaborative arthritis centers the mean duration of SL was much more reduced than the average duration of SL for members of the compulsory health insurance. The proportion of gainfully employed RA patients in collaborative arthritis centers has particularly increased in women. According to data from the pension insurance fund less incident cases of WDP due to RA, AS, and SLE have been observed than WDP caused by all other diseases. Thus different nationwide data show positive changes of the work force participation of individuals suffering from inflammatory rheumatic diseases in Germany.

  18. Energy-related scientists and engineers: a statistical profile of recent entrants into the work force, 1978

    Energy Technology Data Exchange (ETDEWEB)

    Bell, Sharon E.


    This report examines the educational and employment characteristics of scientists and engineers who graduated during the years 1972, 1974, 1975, and 1976, with special attention to those whose work involves energy. The characteristics of energy-related graduates are also compared to those of more experienced scientists and engineers involved in energy activities. Information is based on the results of the 1976 and 1978 National Surveys of Recent Science and Engineering Graduates, and the 1976 National Survey of Natural and Social Scientists and Engineers, sponsored by the National Science Foundation and the US Department of Energy. Tabulations are included for the first time on employment involving specific energy sources and activities. Other characteristics discussed include educational level, salary, primary work activity, type of employer, and the proportion of graduates who found employment in their major field.

  19. Theoretical Analysis of Unit Friction Force Working on the Metal Contact Surface with the Roll Change during Feedstock with Non-Uniform Temperature Distribution Rolling Process

    Directory of Open Access Journals (Sweden)

    Sygut P.


    Full Text Available The paper presents the results of theoretical studies influence of non-uniform temperature distribution along the feedstock length to the unit friction force working on the metal contact surface with the roll change during the round bars 70 mm in diameter continuous rolling process. This value is one of the major factors affecting the grooves wear during the rolling process. The studies were carried out based on the actual engineering data for 160 × 160 mm square cross-section feedstock of steel S355J0. Numerical modelling of the rolling process was performed using Forge2008®, a finite-element based computer program.

  20. [24-hour work: the interaction of stress and changes in the sleep-wake cycle in the police force]. (United States)

    Garbarino, Sergio


    Disruption in police officers. In recent years there has been a widespread growth in services, available regardless of time or day organization (24/7 service) and a diffuse increase in their use, both in work and private lives, generally ignoring the importance of a regular sleep organization. Police officers - often need to work extended shifts and long hours under highly stressful conditions, which results in reduced levels of safety and operational effectiveness. In numerous studies, perceived stress has been found to correlate with both subjective and objective disturbances in sleep. Consequently, excessive daytime sleepiness is one of the most frequent health and safety hazards that police officers have to deal with. Sleep deprivation affects performance outcomes through a wide range of cognitive domains. Sleepiness and fatigue, caused by sleep loss, extended work and wakefulness, circadian misalignment and sleep disorders are major causes of workplace human errors, incidents, and accidents. Therefore, prevention of sleep loss, high levels of stress and fatigue is a key factor to consider when assessing emergency intervention. In order to combat fatigue and sleepiness, a 30-90 minutes nap before night shift could be a viable option.

  1. [Chronic psychotropic drugs use in the Canadian labor force: what are the contributions of occupation and work organization conditions?]. (United States)

    Marchand, A; Blanc, M-E


    This study aims to better understand the contributions of occupation and work organization conditions to the development of chronic psychotropic drugs use among workers in Canada. The study is based on a secondary analysis of the longitudinal data of the National Population Health Survey (NPHS) of Statistics Canada which includes five cycles from 1994-1995 to 2002-2003. A panel of 6585 people from 15 to 55 years old and employed at cycle 1 and nested in 1413 neighbourhoods was selected. Multilevel models of regression were estimated on three levels: repeated measures (level 1=24,785 observations) were nested in the individuals (level 2=6585 individuals) and the individuals nested in the local communities (level 3=1413 neighborhoods). The prevalence of multiple episodes (two episodes and more between cycle 1 and cycle 5) of psychotropic drugs use was 6.7% (95%CI=6.0-7.4%). Only occupation and the number of working hours showed a significant contribution. Family and individual variables like marital status and personality traits (locus of control and sense of coherence) had a significant contribution, in addition to time, gender, age, physical health, number of cigarettes and stressful childhood events. Work contributes weakly to the risk of chronic psychotropic drugs use, whereas individual characteristics make a much more important contribution to the phenomenon.

  2. A single magnetic nanocomposite cilia force sensor

    KAUST Repository

    Alfadhel, Ahmed


    The advancements in fields like robotics and medicine continuously require improvements of sensor devices and more engagement of cooperative sensing technologies. For example, instruments such as tweezers with sensitive force sensory heads could provide the ability to sense a variety of physical quantities in real time, such as the amount and direction of the force applied or the texture of the gripped object. Force sensors with such abilities could be great solutions toward the development of smart surgical tools. In this work, a unique force sensor that can be integrated at the tips of robotic arms or surgical tools is reported. The force sensor consists of a single bioinspired, permanent magnetic and highly elastic nanocomposite cilia integrated on a magnetic field sensing element. The nanocomposite is prepared from permanent magnetic nanowires incorporated into the highly elastic polydimethylsiloxane. We demonstrate the potential of this concept by performing several experiments to show the performance of the force sensor. The developed sensor element has a 200 μm in diameter single cilium with 1:5 aspect ratio and shows a detection range up to 1 mN with a sensitivity of 1.6 Ω/mN and a resolution of 31 μN. The simple fabrication process of the sensor allows easy optimization of the sensor performance to meet the needs of different applications.

  3. Forced-Choice Assessment of Work-Related Maladaptive Personality Traits: Preliminary Evidence From an Application of Thurstonian Item Response Modeling. (United States)

    Guenole, Nigel; Brown, Anna A; Cooper, Andrew J


    This article describes an investigation of whether Thurstonian item response modeling is a viable method for assessment of maladaptive traits. Forced-choice responses from 420 working adults to a broad-range personality inventory assessing six maladaptive traits were considered. The Thurstonian item response model's fit to the forced-choice data was adequate, while the fit of a counterpart item response model to responses to the same items but arranged in a single-stimulus design was poor. Monotrait heteromethod correlations indicated corresponding traits in the two formats overlapped substantially, although they did not measure equivalent constructs. A better goodness of fit and higher factor loadings for the Thurstonian item response model, coupled with a clearer conceptual alignment to the theoretical trait definitions, suggested that the single-stimulus item responses were influenced by biases that the independent clusters measurement model did not account for. Researchers may wish to consider forced-choice designs and appropriate item response modeling techniques such as Thurstonian item response modeling for personality questionnaire applications in industrial psychology, especially when assessing maladaptive traits. We recommend further investigation of this approach in actual selection situations and with different assessment instruments. © The Author(s) 2016.

  4. Do they care too much to work? The influence of caregiving intensity on the labour force participation of unpaid caregivers in Canada. (United States)

    Lilly, Meredith B; Laporte, Audrey; Coyte, Peter C


    The recent growth of the home care sector combined with societal and demographic changes have given rise to concerns about the adequacy of the supply of family and friend caregivers. Potential caregivers face competing time pressures that pull them in the direction of the labour market on one hand, and towards unpaid caregiving duties on the other. This paper examines the influence of unpaid caregiving on the labour supply of a cohort of working-aged caregivers in Canada, with particular emphasis on caregiving intensity. Results suggest that caregivers are heterogeneous in both their caregiving inputs and associated labour market responses, thereby underscoring the importance of controlling for caregiving intensity when measuring labour supply. The negative influence of primary caregiving on labour supply appears to be at the level of labour force participation, rather than on hours of work or wages.

  5. Complex myograph allows the examination of complex muscle contractions for the assessment of muscle force, shortening, velocity, and work in vivo

    Directory of Open Access Journals (Sweden)

    Ruhschulte Hainer


    Full Text Available Abstract Background The devices used for in vivo examination of muscle contractions assess only pure force contractions and the so-called isokinetic contractions. In isokinetic experiments, the extremity and its muscle are artificially moved with constant velocity by the measuring device, while a tetanic contraction is induced in the muscle, either by electrical stimulation or by maximal voluntary activation. With these systems, experiments cannot be performed at pre-defined, constant muscle length, single contractions cannot be evaluated individually and the separate examination of the isometric and the isotonic components of single contractions is not possible. Methods The myograph presented in our study has two newly developed technical units, i.e. a. a counterforce unit which can load the muscle with an adjustable, but constant force and b. a length-adjusting unit which allows for both the stretching and the contraction length to be infinitely adjustable independently of one another. The two units support the examination of complex types of contraction and store the counterforce and length-adjusting settings, so that these conditions may be accurately reapplied in later sessions. Results The measurement examples presented show that the muscle can be brought to every possible pre-stretching length and that single isotonic or complex isometric-isotonic contractions may be performed at every length. The applied forces act during different phases of contraction, resulting into different pre- and after-loads that can be kept constant – uninfluenced by the contraction. Maximal values for force, shortening, velocity and work may be obtained for individual muscles. This offers the possibility to obtain information on the muscle status and to monitor its changes under non-invasive measurement conditions. Conclusion With the Complex Myograph, the whole spectrum of a muscle's mechanical characteristics may be assessed.

  6. A single group follow-up study of non-surgical patients seen by physiotherapists working in expanded roles in orthopaedic departments: recall of recommendations, change in exercise and self-efficacy

    Directory of Open Access Journals (Sweden)

    MacKay Crystal


    Full Text Available Abstract Background Specially trained physiotherapists (advanced practice physiotherapists (APP are working in orthopaedic clinics to improve access to orthopaedic services and support chronic disease management. Little attention has been paid to the impact APPs may have on non-surgical patients. In non-surgical patients with hip or knee arthritis consulting an APP in an orthopaedic clinic, the objectives were to: 1 describe patients’ recall of APP recommendations, use of self-management strategies, and barriers to management six weeks following consultation; and, 2 compare exercise behaviour and self-efficacy at baseline and six weeks. Findings This was a single group pre-and post-intervention study of patients who saw an APP when consulting the orthopaedic departments of two hospitals. At baseline and six weeks participants completed the adapted Stanford Exercise Behaviour Scale (response options: none,  3 hours/week, and the Chronic Disease Self-efficacy Scale (range 1–10; higher scores indicate higher self-efficacy. At follow-up participants completed questions on recall of APP recommendations, use of self-management strategies and barriers to management. Seventy three non-surgical patients with hip or knee arthritis participated, a response rate of 89% at follow-up. Seventy one percent of patients reported that the APP recommended exercise, of whom 83% reported exercising to manage their arthritis since the visit. Almost 50% reported an increase in time spent stretching; over 40% reported an increase in time spent walking or doing strengthening exercises at follow-up. Common barriers to arthritis management were time, cost and other health problems. Mean chronic disease self-efficacy scores significantly improved from 6.3 to 7.2 (p  Conclusions This pilot study of an APP intervention for non-surgical patients referred for orthopaedic consultation showed promising results, particularly for enhancing use of conservative management

  7. Analysis of Active Force and Constraint Force of Parallel Manipulator Based on Virtual Work Theory%基于虚功原理的并联机构驱动力和约束力分析

    Institute of Scientific and Technical Information of China (English)



    Based on the virtual work theory, the active and constraint forces of each limb of the parallel manipulator are solved. Taking the 2SPS + 2UPU spatial parallel manipulator as research object, a simulation mechanism of the parallel manipulator with Euler angles was created firstly. Then the force/torque simulation mechanisms were created. When modifying the driving dimension, the configuration of the simulation mechanisms were varied correspondingly, and the active and constraint forces were solved automatically and visualized dynamically. The results show that the CAD variation geometry is fairly quick and straightforward, and is also advantageous from viewpoint of accuracy and reliability.%以虚功原理为基础,利用CAD变量几何法,求解空间并联机构各分支的驱动力和约束力.以一种空间2SPS+ 2UPU并联机构为例,首先构造含有欧拉角的该机构的模拟机构,在此基础上进一步构造F/T(力/力矩)模拟机构,得到其驱动力和约束力解.当改变驱动参数时,F/T(力/力矩)模拟机构随之变化,驱动力和约束力自动求解和动态显示.结果表明CAD变量几何法不仅快速直观,而且准确可靠.

  8. External force estimation and implementation in robotically assisted minimally invasive surgery. (United States)

    Sang, Hongqiang; Yun, Jintian; Monfaredi, Reza; Wilson, Emmanuel; Fooladi, Hadi; Cleary, Kevin


    Robotically assisted minimally invasive surgery can offer many benefits over open surgery and laparoscopic minimally invasive surgery. However, currently, there is no force sensing and force feedback. This research was implemented using the da Vinci research kit. An external force estimation and implementation method was proposed based on dynamics and motor currents. The dynamics of the Patient Side Manipulator was modeled. The dynamic model was linearly parameterized. The estimation principle of external force was derived. The dynamic parameters were experimentally identified using a least squares method. Several experiments including dynamic parameter identification, joint torque estimation, and external force estimation were performed. The results showed that the proposed method could implement force estimation without using a force sensor. The force estimation method was proposed and implemented and experimental results showed the method worked and was feasible. This method could be used for force sensing in minimally invasive surgical robotics in the future. Copyright © 2017 John Wiley & Sons, Ltd.

  9. Visit of Peters Higgs at Point 2 ALICE Experiment - British theoretical physicist, He worked on proposals to unify the weak and the electromagnetic forces into a single electroweak theory, The Boson of Higgs.

    CERN Multimedia

    Mona Schweizer


    Visit of Peters Higgs at Point 2 ALICE Experiment - British theoretical physicist, He worked on proposals to unify the weak and the electromagnetic forces into a single electroweak theory, The Boson of Higgs.

  10. Signature of the CERN GoldenBook at CERN by Peters Higgs British theoretical physicist - He worked on proposals to unify the weak and the electromagnetic forces into a single electroweak theory, The Boson of Higgs.

    CERN Multimedia

    Claudia Marcelloni


    Signature of the CERN GoldenBook at CERN by Peters Higgs British theoretical physicist - He worked on proposals to unify the weak and the electromagnetic forces into a single electroweak theory, The Boson of Higgs.

  11. Effects of specific resistance training program on force-velocity relationship, power consumption and work production of quadrics muscle during eccentric actions in elite athletes

    Directory of Open Access Journals (Sweden)



    Full Text Available Aim: Resistance training is the most famous method for the prevention, rehabilitation of myotendinous injuries and especially for the development of muscle’s ability in competitive and recreational sports. The purpose of the present study was to examine the average exerted force ( , the mean power consumption (Pmean and the work production on Quadriceps Femoris Muscle of elite athletes, in accordance with joint’s knee movement velocity, during eccentric contractions, before and after the application of a specific resistance training program. Methods: 14 elite athletes participated in this study. Seven of them (training group performed isometric and eccentric contractions on isokinetic dynamometer before and after the application of specific resistance training program. The other seven athletes (control group followed the training program of their team and they have participated only to the procedure of measurements. Results: The results showed, that after the application of the specific training program, the subjects improved significantly (P<.05 , Pmean (P<.05 at high angular velocities of joint’s knee movement and maximal isometric exerted force ( , P<.05. Conlusion: This study suggests that the application of the specific training program creates adaptations to the subject muscles’ which concerns the power consumption ability and the maximal effort activation.

  12. Regression Modeling Of Cutting Parameters' Effect To Cutting Forces And Hole Surface Qualities In Drilling Of Dievar Hot Work Tool Steel

    Directory of Open Access Journals (Sweden)

    İskender Özkul


    Full Text Available In this study, cutting moments, surface roughness, dimensional accuracy and circularity deviation values were investigated during drilling on Dievar degree of hot work tool steels with various drill bits. The experiments, was completed with Ø16 mm diameter uncoated carbide drill bits and TiAlN coated self-reamed carbide drill bits using coolant fluid on vertical machining center. In experiments, feed rate 0,16 mm/rev and the cutting speed 36, 40, 44, 48 m/min rates were used. The results were modeled by the method of linear regression and polynomial regression curve. Then they were compared with values equal significance. At the same time by analysis of variance, the cutting speed and drill type were investigated on the results of axial feed force, cutting torque, surface roughness, dimensional accuracy and circularity the deviation.

  13. Progress in research and work of psychological health in U.S.Armed Forces%美军心理健康维护进展

    Institute of Scientific and Technical Information of China (English)

    苏文娜; 楼铁柱; 刁天喜; 吴东


    With the United States still involved in military operations in Afghanistan and Iraq, psychological and cognitive injuries among those deployed are of growing concern, such as traumatic brain injury ( TBI ), suicide and post-traumatic stress disorder ( PTSD ). This paper reviews the main progress in the research and work of psychological health in the U. S. Armed Forces.%美军自2001年参加阿富汗战争和2003年参加伊拉克战争以来,创伤性脑损伤、自杀、创伤后应激障碍等成为其日益关注的问题.本文围绕目前美军心理健康维护的工作重点,介绍了其在心理健康维护方面的科研和工作进展.

  14. 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. PMID:26090737

  15. Surgical education through video broadcasting. (United States)

    Nagengast, Eric S; Ramos, Margarita S; Sarma, Hiteswar; Deshpande, Gaurav; Hatcher, Kristin; Magee, William P; Campbell, Alex


    Surgical training is facing new obstacles. As advancements in medicine are made, surgeons are expected to know more and to be able to perform more procedures. In the western world, increasing restrictions on residency work hours are adding a new hurdle to surgical training. In low-resource settings, a low attending-to-resident ratio results in limited operative experience for residents. Advances in telemedicine may offer new methods for surgical training. In this article, the authors share their unique experience using live video broadcasting of surgery for educational purposes at a comprehensive cleft care center in Guwahati, India.

  16. WORK FORCE OPTIMIZATION FOR 2025 (United States)


    promote overall fitness and continue researching the human dimension for additional improvements . The deciding factor on future battlefields will not...Since DOD funds a significant amount of the medical cost for the civilian employees, improvements in the overall health and fitness of the workforce... Agriculture . n.d. Health and Wellness. Accessed January 23, 2016. 51 Vaughn, Robert. 2010

  17. High-intensity stress elicits robust cortisol increases, and impairs working memory and visuo-spatial declarative memory in Special Forces candidates: A field experiment. (United States)

    Taverniers, John; Van Ruysseveldt, Joris; Smeets, Tom; von Grumbkow, Jasper


    While running a selection procedure, 27 male Belgian Special Forces candidates, with a mean age of 27.4 years (SD = 5.1), were randomly assigned to a no-stress control (n = 14) or a high-intensity stress group (n = 13). Participants in the latter group were exposed to an extremely strenuous mock prisoner of war (POW) exercise. Immediately after stress or control treatment, working memory and visuo-spatial declarative memory performances were measured by the digit span (DS) test and the Rey-Osterrieth complex figure (ROCF), respectively. Concurrently, stress levels were assessed by obtaining salivary cortisol measurements and subjectively by the NASA Task Load Index (TLX). As expected, exposure to high-intensity stress led to both robust cortisol increases and significant differences in TLX scores. Stress induction also significantly impaired DS and ROCF performances. Moreover, delta cortisol increases and ROCF performance in the POW stress group showed a significant negative correlation, while DS performances followed the same tendency. Summarizing, the current findings complement and extend previous work on hormonal stress effects, and the subsequent performance deterioration on two memory tests in a unique high-intensity stress environment.

  18. Labor Force Participation Rate (United States)

    City and County of Durham, North Carolina — This thematic map presents the labor force participation rate of working-age people in the United States in 2010. The 2010 Labor Force Participation Rate shows the...

  19. Searle's Conditions and the Determination of Illocutionary Force. Centrum: Working Papers of the Minnesota Center for Advanced Studies in Language, Style and Literary Theory, Vol. 1, No. 2. (United States)

    Hammer, Katherine

    Two approaches to the problem of determining the illocutionary force(s) of a sentence are examined: Gordon and Lakoff's (1971) "Conversational Postulates," and Fraser's (1973) "On Accounting for Illocutionary Forces"; their relation to Searle's conditions is discussed. It is argued that Gordon and Lakoff's analysis can be…

  20. Charge injection in thin dielectric layers by atomic force microscopy: influence of geometry and material work function of the AFM tip on the injection process. (United States)

    Villeneuve-Faure, C; Makasheva, K; Boudou, L; Teyssedre, G


    Charge injection and retention in thin dielectric layers remain critical issues for the reliability of many electronic devices because of their association with a large number of failure mechanisms. To overcome this drawback, a deep understanding of the mechanisms leading to charge injection close to the injection area is needed. Even though the charge injection is extensively studied and reported in the literature to characterize the charge storage capability of dielectric materials, questions about charge injection mechanisms when using atomic force microscopy (AFM) remain open. In this paper, a thorough study of charge injection by using AFM in thin plasma-processed amorphous silicon oxynitride layers with properties close to that of thermal silica layers is presented. The study considers the impact of applied voltage polarity, work function of the AFM tip coating and tip curvature radius. A simple theoretical model was developed and used to analyze the obtained experimental results. The electric field distribution is computed as a function of tip geometry. The obtained experimental results highlight that after injection in the dielectric layer the charge lateral spreading is mainly controlled by the radial electric field component independently of the carrier polarity. The injected charge density is influenced by the nature of electrode metal coating (work function) and its geometry (tip curvature radius). The electron injection is mainly ruled by the Schottky injection barrier through the field electron emission mechanism enhanced by thermionic electron emission. The hole injection mechanism seems to differ from the electron one depending on the work function of the metal coating. Based on the performed analysis, it is suggested that for hole injection by AFM, pinning of the metal Fermi level with the metal-induced gap states in the studied silicon oxynitride layers starts playing a role in the injection mechanisms.

  1. Charge injection in thin dielectric layers by atomic force microscopy: influence of geometry and material work function of the AFM tip on the injection process (United States)

    Villeneuve-Faure, C.; Makasheva, K.; Boudou, L.; Teyssedre, G.


    Charge injection and retention in thin dielectric layers remain critical issues for the reliability of many electronic devices because of their association with a large number of failure mechanisms. To overcome this drawback, a deep understanding of the mechanisms leading to charge injection close to the injection area is needed. Even though the charge injection is extensively studied and reported in the literature to characterize the charge storage capability of dielectric materials, questions about charge injection mechanisms when using atomic force microscopy (AFM) remain open. In this paper, a thorough study of charge injection by using AFM in thin plasma-processed amorphous silicon oxynitride layers with properties close to that of thermal silica layers is presented. The study considers the impact of applied voltage polarity, work function of the AFM tip coating and tip curvature radius. A simple theoretical model was developed and used to analyze the obtained experimental results. The electric field distribution is computed as a function of tip geometry. The obtained experimental results highlight that after injection in the dielectric layer the charge lateral spreading is mainly controlled by the radial electric field component independently of the carrier polarity. The injected charge density is influenced by the nature of electrode metal coating (work function) and its geometry (tip curvature radius). The electron injection is mainly ruled by the Schottky injection barrier through the field electron emission mechanism enhanced by thermionic electron emission. The hole injection mechanism seems to differ from the electron one depending on the work function of the metal coating. Based on the performed analysis, it is suggested that for hole injection by AFM, pinning of the metal Fermi level with the metal-induced gap states in the studied silicon oxynitride layers starts playing a role in the injection mechanisms.

  2. CT-guided infiltration saves surgical intervention and fastens return to work compared to anatomical landmark-guided infiltration in patients with lumbosciatica. (United States)

    Deml, Moritz C; Buhr, Michael; Wimmer, Matthias D; Pflugmacher, Robert; Riedel, Rainer; Rommelspacher, Yorck; Kabir, Koroush


    Infiltration procedures are a common treatment of lumbar radiculopathy. There is a wide variety of infiltration techniques without an established gold standard. Therefore, we compared the effectiveness of CT-guided transforaminal infiltrations versus anatomical landmark-guided transforaminal infiltrations at the lower lumbar spine in case of acute sciatica at L3-L5. A retrospective chart review was conducted of 107 outpatients treated between 2009 and 2011. All patients were diagnosed with lumbar radiculopathic pain secondary to disc herniation in L3-L5. A total of 52 patients received CT-guided transforaminal infiltrations; 55 patients received non-imaging-guided nerve root infiltrations. The therapeutic success was evaluated regarding number of physician contacts, duration of treatment, type of analgesics used and loss of work days. Defined endpoint was surgery at the lower lumbar spine. In the CT group, patients needed significantly less oral analgesics (p lumbosciatica caused by intervertebral disc herniation is significantly superior to non-imaging, anatomical landmark-guided infiltration, regarding the parameters investigated. The high number of treatment failures in the non-imaging group underlines the inferiority of this treatment concept.

  3. Surgical Technologists (United States)

    ... Contact & Help Economic Releases Latest Releases » Major Economic Indicators » Schedules for news Releases » By Month By News ... vocational schools, as well as some universities and hospitals, have accredited programs in ... Stress-management skills. Working in an operating room can be ...

  4. Tophi - surgical treatment. (United States)

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  5. Tophi – surgical treatment (United States)

    Słowińska, Iwona; Słowiński, Radosław


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A “clinical mask” suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient’s life improved significantly. PMID:27994273

  6. Undergraduate Studies in Earthquake Information Technology (UseIT): Preparing Students for the Twenty-First Century Work Force via a Multidisciplinary and Collaborative Learning Experience (United States)

    Degroot, R. M.; Jordan, T. H.; Benthien, M. L.; Ihrig, M.; Berti, R.


    UseIT is one of the three undergraduate research programs sponsored by the Southern California Earthquake Center (SCEC). The program allows students to work in multi-disciplinary collaborative teams to tackle a scientific “Grand Challenge.” The topic varies each year but it always entails performing computer science research that is needed by earthquake scientists, educators, and other target audiences. The program allows undergraduates to use the advanced tools of information technology to solve important problems in interdisciplinary earthquake research. Since the program began in 2002, 145 students have participated in UseIT. The program stresses problem solving and interdisciplinary cross training. A key aspect of the UseIT program is its flexible, yet structured, team approach. Students share their diverse skills and interests, creating a powerful synergy through this peer mentoring. The majority of UseIT interns have considerable computer science skill or aptitude, but successful UseIT interns have hailed from nearly three-dozen disciplines, all class levels, and all skill levels. Successful UseIT interns have in common a willingness to step outside their comfort zones and try new things. During the 2009 internship the focus of the program was to deliver SCEC Virtual Display of Objects (VDO) images and animations of faults and earthquake sequences to SCEC, the Earthquake Country Alliance, and other virtual organizations via a content management system that captures the metadata and guides the user. SCEC-VDO is the SCEC intern-developed visualization software that allows the user to see earthquake related phenomena in three and four dimensions. The 2009 Grand Challenge had special relevance for the interns because the products they created were used for The Great California ShakeOut. This talk will discuss lessons learned from this program, how it addresses the needs of the 21st century STEM work force, and highlights of the 2009 internship.

  7. The Impact of Complex Forcing on the Viscous Torsional Vibration Damper’s Work in the Crankshaft of the Rotating Combustion Engine

    Directory of Open Access Journals (Sweden)

    Jagiełowicz-Ryznar C.


    Full Text Available The numerical calculations results of torsional vibration of the multi-cylinder crankshaft in the serial combustion engine (MC, including a viscous damper (VD, at complex forcing, were shown. In fact, in the MC case the crankshaft rotation forcings spectrum is the sum of harmonic forcing whose amplitude can be compared with the amplitude of the 1st harmonic. A significant impact, in the engine operational velocity, on the vibration damping process of MC, may be the amplitude of the 2nd harmonic of a forcing moment. The calculations results of MC vibration, depending on the amplitude of the 2nd harmonic of the forcing moment, for the first form of the torsional vibration, were shown. Higher forms of torsional vibrations have no practical significance. The calculations assume the optimum damping coefficient VD, when the simple harmonic forcing is equal to the base critical velocity of the MC crankshaft.

  8. Surgical Management of Fractures and Tendons. (United States)

    Pentecost, Rebecca; Niehaus, Andrew J; Anderson, David E


    Long bone fractures and disorders of tendons and ligaments represent a significant proportion of surgical orthopedic cases presented to ruminant veterinarians. The presentation of these patients, their diagnostic work-up, surgical treatment, and expected outcome will be discussed. The outcome of these cases depends largely on the presenting problem; however, accurate diagnosis and prompt surgical intervention can greatly improve the outcome of many of these cases.

  9. Evolution of surgical skills training

    Institute of Scientific and Technical Information of China (English)

    Kurt E Roberts; Robert L Bell; Andrew J Duffy


    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced,virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery.An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training,ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

  10. 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

  11. Design, Implementation and Testing of Master Slave Robotic Surgical System

    Directory of Open Access Journals (Sweden)

    Syed Amjad Ali


    Full Text Available The autonomous manipulation of the medical robotics is needed to draw up a complete surgical plan in development. The autonomy of the robot comes from the fact that once the plan is drawn up off-line, it is the servo loops, and only these, that control the actions of the robot online, based on instantaneous control signals and measurements provided by the vision or force sensors. Using only these autonomous techniques in medical and surgical robotics remain relatively limited for two main reasons: Predicting complexity of the gestures, and human Safety. Therefore, Modern research in haptic force feedback in medical robotics is aimed to develop medical robots capable of performing remotely, what a surgeon does by himself. These medical robots are supposed to work exactly in the manner that a surgeon does in daily routine. In this paper the master slave tele-robotic system is designed and implemented with accuracy and stability by using 6DOF (Six Degree of Freedom haptic force feedback devices. The master slave control strategy, haptic devices integration, application software designing using Visual C++ and experimental setup are considered. Finally, results are presented the stability, accuracy and repeatability of the system

  12. 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.

  13. Surgical innovation as sui generis surgical research. (United States)

    Lotz, Mianna


    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.


    Directory of Open Access Journals (Sweden)



    Full Text Available This paper discusses about the Natural Fiber Reinforced Composite Materials contribution as bone implants. Biomaterial science is an interdisciplinary field that represents one of the most sophisticated trends in worldwide medical practice. In the last decades, researchers have developed new materials to improve the quality of human life. Owing to the frequent occurrence of bone fractures, it is important to develop a plate material for fixation on the fractured bone. These plate materials have to be lightweight, allow stiffness, and be biocompatible with humans. Drilling is the most frequently employed operation of secondary machining for fiber-reinforced materials, owing to the need for joining fractured bone by means of plate material in the field of orthopedics. An effort to utilize theadvantages offered by renewable resources for the development of biocomposite materials based on biopolymers and natural fibers has been made through fabrication of Natural fiber powdered material (Sisal (Agave sisalana, Banana (Musa sepientum, and Roselle (Hibiscus sabdariffa reinforced polymer composite plate material by using bio epoxy resin Grade 3554A and Hardner 3554B. Instead of orthopedics alloys such as Titanium, Cobalt chrome, Stainless steel, and Zirconium, this plate material can be used for internal fixationand aso external fixation on human body for fractured bone. The present work focuses on the prediction of thrust force and torque of the natural fiber reinforced polymer composite materials, and the values, compared with the Regression model and the Scheme of Delamination factor / zone using machine vision system, also discussed with the help of Scanning Electron Microscope [SEM].

  15. Research on the Personal Safety Work for Female Nurs-ing Interns through Joint Forces%形成合力做好护理专业实习女生人身安全工作研究

    Institute of Scientific and Technical Information of China (English)

    万英; 冉丽; 李志强; 姚本丽


    从恩格斯的“历史合力论”原理出发,引申出护理专业实习女生人身安全工作需要学校、实习单位、家长、实习生、其他力量、辅导员等形成合力,并且减少合力中的消极因素,确保护理专业实习女生人身安全得到有效保障。%According to Engels' history with joint forces theory, this paper extends the meaning that the personal safety work for female nursing interns needs the joint forces of the college, prac-tice sites, parents, interns themselves, counselors and other forces, and negative factors in the joint forces should be reduced, in order to effectively ensure the personal safety of female nursing interns.

  16. Surgical Lasers In Veterinary Medicine (United States)

    Newman, H. C.


    Veterinary medicine is a latecomer in benefiting from the advent of surgical lasers. It is ironic that although most of the basic work in lasers is carried out in animal species with which we are most conversant, veterinary medicine as a profession has not been very extensively involved.

  17. Surgical management of tubal pregnancy

    NARCIS (Netherlands)

    Mol, F.


    The work presented in this thesis first addresses the magnitude of the clinical problem of surgically treated tubal pregnancy in The Netherlands. Next, we studied the adherence to recommendations from the Dutch guideline on diagnosis and management of ectopic pregnancy. A systematic review and meta-

  18. Surgical Treatment of Mirizzi Syndrome

    Directory of Open Access Journals (Sweden)

    Е.М. Goch


    Full Text Available The results of treatment of 53 patients with Mirizzi syndrome are presented in the work. The article focuses on the modern classification of syndrome, diagnostics and surgical approach according to the severity of duct damage. Mirizzi syndrome proves to be the complication of cholelithiasis. It is one of the most complicated problems of biliary surgery


    Energy Technology Data Exchange (ETDEWEB)



    challengers are described. Many of the challenges to the D&D work at PFP were met with innovative approaches based on new science and/or technology and many were also based on the creativity and motivation of the work force personnel.

  20. Multimodal strategies to improve surgical outcome

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Wilmore, Douglas W


    surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...... track" surgery programs represents the major challenge for the medical professionals working to achieve a "pain and risk free" perioperative course....

  1. Mi Primer Libro de Maquinas Simples: Trabajo y Fuerza. Escuela Intermedia Grados 7, 8 y 9 (My First Book of Simple Machines: Work and Force. Intermediate School Grades 7, 8, and 9). (United States)

    Alvarado, Patricio R.; Montalvo, Luis

    This is the first book in a five-book physical science series on simple machines. The books are designed for Spanish-speaking junior high school students. This volume defines force and work by suggesting experiments and posing questions concerning drawings in the book which illustrate scientific principles. Answers to the questions are provided;…

  2. Use of structural components of specific work of internal forces for estimating the strength of viscoelastic structures in local stress concentration regions (United States)

    Bykov, D. L.; Konovalov, D. N.


    Material fracture experiments on specimens and structures testify that materials can resist greater stresses in local stress concentration regions than in regions with a nearly homogeneous stress state. Taking this fact into account in design stress analysis permits one to reveal additional structure loading and/or service life margins. One approach aimed at taking into account the increased strength in local stress concentration regions is to use averaged limit characteristics parametrically depending on the characteristic size L of the averaging region. One version of this approach is the concept of "elementary block" of a material [1, 2]. The averaged limit characteristics are determined by an experiment-calculation method involving the analysis of the stress-strain state of a material specimen with a stress concentrator at the time when the specimen attains the limit state preceding macrofracture. In [3], the dependence of the averaged limit separation stresses on the size of the averaging region was determined on the basis of numerical analysis of the singular stress state of the specimen used to determine the standard characteristics of the adhesion strength of a filled polymer material. In the present paper, we generalize the above approach to the case of a viscoelastic material. For the limit characteristics of the material in the local stress concentration region we take the volume-averaged components of the specific work of internal forces [4, 5] (the averaged specific absorbed energy and the averaged specific instantaneously reversible energy). The introduction of two limit energies originates from the fact that, to initiate the process of macrofracture, it is necessary to satisfy the following two conditions simultaneously: the material must be "damaged" sufficiently strongly by the preceding loading, and the "damaged" material must be loaded sufficiently strongly. As an example of determining the material averaged limit energy characteristics in a

  3. Hernia Surgical Mesh Implants (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  4. Urogynecologic Surgical Mesh Implants (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  5. 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 / ...

  6. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin


    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  7. 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 ...

  8. Disparities between industrial and surgical ergonomics. (United States)

    Seagull, F Jacob


    A surgeon's work environment and working conditions are often harsher than those of an industrial worker. Accepted principles and regulations of ergonomics in manufacturing are largely ignored or absent in the medical/surgical domain. Examples include poor surgical tool handle design, awkward and stressful surgical postures, and prolonged standing without breaks and without a foot mat. In these and other areas, there are documented "best practices" for industrial hygiene and ergonomics that are not yet widely accepted for surgery. There is support in the literature for innovations in surgical ergonomics, yet adoption is not widespread. In the absence of these ergonomic principles, surgical repetitive strain injuries in minimally invasive surgery are reaching epidemic levels. As ergonomists, it falls upon us to understand why current solutions have not been widely adopted within this domain, and to derive solutions to the unique challenges of surgery.

  9. A novel linear elastic actuator for minimally invasive surgery: development of a surgical gripper (United States)

    Gerboni, G.; Brancadoro, M.; Tortora, G.; Diodato, A.; Cianchetti, M.; Menciassi, A.


    Minimally invasive surgery (MIS) applications require lightweight actuators that can generate a high force in a limited volume. Among pressure driven actuators, fluid elastic actuators demonstrate high potential for use in the medical field. They are characterized by nearly no friction and wear and they can be made of low-cost biocompatible elastomers. However, when compared to traditional piston-cylinder fluid actuators, fluid elastic actuators often result in smaller output forces as well as weaker return forces. This work is about the design of a linear elastic actuator (LEA) which is able to develop relevant pulling-pushing force in one direction. The LEA is composed of entirely disposable materials and it requires a simple manufacturing process. Thanks to its design, the LEA can be compared to traditional piston-cylinders actuators in terms of output forces (up to 7 N) with the advantage of using relative low working pressures (0, 2 MPa). The actuator has been used for the actuation of a gripper for MIS, as a case study. The whole range of gripping forces developed by the tool actated by the LEA has been evaluated, thus verifying that the gripping device, is able to meet the force requirements for accomplishing typical surgical tasks.

  10. Surgical infection in art. (United States)

    Meakins, J L


    The earliest images of medicine and surgery in Western art are from the late Middle Ages. Although often attractive, at that time they were illustrative and mirrored the text on how to diagnose or treat a specific condition. These drawings in medieval manuscripts represent management of abscesses, perianal infection and fistulas, amputation, and wound dressings. With the Renaissance, art in all its forms flourished, and surgeons were represented at work draining carbuncles, infected bursae, and mastoiditis; managing ulcers, scrofula, and skin infections; and performing amputations. Specific diagnosis can be made, such as streptococcal infection in the discarded leg of the miraculous transplantation performed by Saints Cosmas and Damian and in the works of Rembrandt van Rijn and Frederic Bazille. Evocations of cytokine activity are evident in works by Albrecht Dürer, Edvard Munch, and James Tissot. The iconography of society's view of a surgeon is apparent and often not complimentary. The surgeon's art is a visual art. Astute observation leads to early diagnosis and better results in surgical infection and the septic state. Learning to see what we look at enhances our appreciation of the world around us but, quite specifically, makes us better clinicians.

  11. [Financing and control of surgical training]. (United States)

    Schröder, W; Welcker, K


    The present analyses of different surgical training systems show that training of surgical residents significantly contributes to hospital costs. These are predominantly caused by prolonged operation times of residents with increased work load for other staff members in the operating room. In addition, the productivity of surgical residents is less compared to experienced surgeons. On the other hand, hospital managements save money by the lower standard wages paid to the residents. The amount of educational costs is difficult to determine because surgical training takes place as on the job training. Therefore, from an economic point of view, the two products patient care and surgical training are difficult to separate. There are no reliable cost analyses available for the German training system. At present surgical training is indirectly financed by the DRG (diagnosis-related groups) flat rates of the health insurance. Possible options of financing the surgical training are additional funding from the health department or redistribution with supplemental payment for those surgical departments which contribute significantly more to the residents' training. Statements of medical associations, health departments and health insurances demonstrate the difficulty to come to an agreement concerning the finances of the training system. Despite this controversial discussion it should be taken into consideration that there is no alternative to a high quality surgical training as this is the basis for an effective health system.

  12. Surgical Lasers In Gynecology (United States)

    Schellhas, Helmut F.; Barnes, Alfonso E.


    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  13. Workflow-based Context-aware Control of Surgical Robots


    Beyl, Tim


    Surgical assistance system such as medical robots enhanced the capabilities of medical procedures in the last decades. This work presents a new perspective on the use of workflows with surgical robots in order to improve the technical capabilities and the ease of use of such systems. This is accomplished by a 3D perception system for the supervision of the surgical operating room and a workflow-based controller, that allows to monitor the surgical process using workflow-tracking techniques.

  14. [Surgical managment of retinal detachment]. (United States)

    Haritoglou, C; Wolf, A


    The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90 % can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. Georg Thieme Verlag KG Stuttgart · New York.

  15. [Surgical education has its price]. (United States)

    Schröder, W; Krones, C J


    The radical economisation of the German health-care system has caused an increasing cost awareness. Following this trend, medical education has been identified as a possible expense factor. The theoretical and practical training of young doctors needs time and costs money. However, a detailed cost analysis is still not available, since the complex daily work schedule of young professionals only allows the calculation of single cost factors. Investigations in the USA estimate the costs of surgical training at US$ 80 000 per year and per resident. At present in Germany, surgical training is indirectly financed by the DRG flat rates of the health insurance companies. Possible alternatives include the implementation of a "training fond" which is financed by a percentage fee of the DRG's as well as an on-top funding by the federal government. This "training fond" would support only those surgical units that offer a structured and certified training to surgical residents. However, a systematic cost analysis of such a structured curriculum is necessary for any further discussion.

  16. Visual force feedback in laparoscopic training

    NARCIS (Netherlands)

    Horeman, T.; Rodrigues, S.P.; Van den Dobbelsteen, J.J.; Jansen, F.W.; Dankelman, J.


    Background - To improve endoscopic surgical skills, an increasing number of surgical residents practice on box or virtual reality (VR) trainers. Current training is focused mainly on hand–eye coordination. Training methods that focus on applying the right amount of force are not yet available. Metho

  17. Force modeling for incisions into various tissues with MRF haptic master (United States)

    Kim, Pyunghwa; Kim, Soomin; Park, Young-Dai; Choi, Seung-Bok


    This study proposes a new model to predict the reaction force that occurs in incisions during robot-assisted minimally invasive surgery. The reaction force is fed back to the manipulator by a magneto-rheological fluid (MRF) haptic master, which is featured by a bi-directional clutch actuator. The reaction force feedback provides similar sensations to laparotomy that cannot be provided by a conventional master for surgery. This advantage shortens the training period for robot-assisted minimally invasive surgery and can improve the accuracy of operations. The reaction force modeling of incisions can be utilized in a surgical simulator that provides a virtual reaction force. In this work, in order to model the reaction force during incisions, the energy aspect of the incision process is adopted and analyzed. Each mode of the incision process is classified by the tendency of the energy change, and modeled for realistic real-time application. The reaction force model uses actual reaction force information with three types of actual tissues: hard tissue, medium tissue, and soft tissue. This modeled force is realized by the MRF haptic master through an algorithm based on the position and velocity of a scalpel using two different control methods: an open-loop algorithm and a closed-loop algorithm. The reaction forces obtained from the proposed model are compared with a desired force in time domain.

  18. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría


    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  19. The role of the surgical care practitioner within the surgical team. (United States)

    Quick, Julie

    Changes to the surgical workforce and the continued development of health policy have perpetuated the requirement for innovative perioperative roles. The surgical care practitioner is a nurse or allied health professional who works within a surgical team and has advanced perioperative skills, including the ability to undertake surgical interventions.With only limited literature evaluating this role, any benefits of their inclusion to a surgical team are largely anecdotal. This article presents the findings of an autoethnographic inquiry that explored the experiences of surgical team members who worked with the nurse researcher in her role as surgical care practitioner. Surgeons identified the provision of a knowledgeable, competent assistant and operator who enhanced patient care, helped maintain surgical services and supported the training of junior doctors. The professional, ethical and legal obligations of advanced perioperative practice were upheld. Interprofessional collaboration was improved, as was service provision. This further enhanced the patient experience. The traditional viewpoint that nurses who undertake tasks previously associated with medicine should be working to the standard of a doctor is challenged but requires further examination.

  20. 维和警队思想政治工作体系构建研究%A Study of Peace - keeping Force Ideological and Political Working System Construction

    Institute of Scientific and Technical Information of China (English)

    冯跃民; 孙梅; 王洪海; 于志刚; 郝大卫


    在维和任务区承担雏和任务的中国维和警队具有工作政治性强、形势复杂、工作任务艰巨、队员素质高等特点。思想政治工作是维和警队不辱使命、圆满完成任务的保障,维和警队思想政治工作应明确目标任务。加强组织领导,从党组织建设、思想政治教育、思想骨干队伍建设、经常性思想工作、外宣工作、联络工作、心理服务工作等几个方面充实思想政治工作内容,完善工作方法,注重思想政治工作效益的评估和经验的应用。%Chinese Peace -keeping Forces in the peace -keeping areas are characterized by having strong political will, facing a complex situation, performing their tasks arduously and with high personal quality. Ideological and political work is a key factor to guarantee that peacekeepers could fulfill their mission and accomplish their tasks suecessfully. Ideological and political work in peacekeeping forces should clarify goals and tasks, strengthen the organization and leadership construction, enrich the political working content and improve the working method from the perspectives of an organizational construction of the Party, an ideological and political education, an ideological con- struction of team hardcores, a regular ideological work, a publicity work, a liaison work, psychological services and so on. Both results evaluation and experience application should be placed on equal emphasis.

  1. Surgical ethics and the challenge of surgical innovation. (United States)

    Angelos, Peter


    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  2. Compact teleoperated laparoendoscopic single-site robotic surgical system: Kinematics, control, and operation. (United States)

    Isaac-Lowry, Oran Jacob; Okamoto, Steele; Pedram, Sahba Aghajani; Woo, Russell; Berkelman, Peter


    To date a variety of teleoperated surgical robotic systems have been developed to improve a surgeon's ability to perform demanding single-port procedures. However typical large systems are bulky, expensive, and afford limited angular motion, while smaller designs suffer complications arising from limited motion range, speed, and force generation. This work was to develop and validate a simple, compact, low cost single site teleoperated laparoendoscopic surgical robotic system, with demonstrated capability to carry out basic surgical procedures. This system builds upon previous work done at the University of Hawaii at Manoa and includes instrument and endoscope manipulators as well as compact articulated instruments designed to overcome single incision geometry complications. A robotic endoscope holder was used for the base, with an added support frame for teleoperated manipulators and instruments fabricated mostly from 3D printed parts. Kinematics and control methods were formulated for the novel manipulator configuration. Trajectory following results from an optical motion tracker and sample task performance results are presented. Results indicate that the system has successfully met the goal of basic surgical functionality while minimizing physical size, complexity, and cost. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Inspiration from Victorian times in Ultrasonic Surgical Tool Design (United States)

    Ganilova, O. A.; Lucas, M.; Pan, Z.; Y Muir, A.; Simpson, H.


    This work is devoted to the investigation of performance of surgical tools used in orthopaedics in terms of the occurrence of signs of necrosis, the accuracy of the cut and cutting tool design. For the comparison of the surgical tool performance different types of cutting devices were studied in a series of experiments. A Victorian surgical saw, its copy, a contemporary surgical saw, a surgical scalpel and an ultrasonic blade designed for a surgical application were chosen for the performance assessment. Such geometrical parameters as cutting edge shape, angle of teeth inclination, and sharpness of the cutting tools were analysed in terms of the quality of the cut and signs of necrosis. As a result of the analysis of experimental data obtained and theoretical insight the authors have come up with a creative solution for a novel design for a surgical ultrasonic blade which benefits from the design advantages of each of the analysed surgical tools and eliminates their drawbacks.

  4. 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

  5. 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...

  6. The Theory of Subjunctive Work and the Analysis of the Solution to the Restrict Anti-force%关于虚功原理及用其求解约束反力的分析

    Institute of Scientific and Technical Information of China (English)



    从虚功原理的定义入手,分析了在理想约束下以及在光滑约束下的虚功原理的运用,并且运用虚功原理对解决有非理想约束存在时约束反力的求法问题进行了探讨分析。%This paper analyses the definition of virtual work principle based on the application of the virtual work under condition of the ideal restriction and the smooth restriction. And it also applies the virtual work principle to searching the method of solving the restriction of the anti-force under the non-ideal restriction condition.

  7. Sushruta: Foundation for Surgical Practice

    Directory of Open Access Journals (Sweden)

    Siddharth P. Dubhashi


    Full Text Available Sushruta was an ancient Indian surgeon (600 B.C. who resided in Varanasi.The teachings and work of Sushruta is compiled in a treatise called Sushruta Samhita (Sushruta's compendium, which is believed to be a part of Atharvaveda. It contains 184 chapters, descriptions of 1,120 illnesses, 300 surgical procedures, classification of human surgery in 8 categories, over 120 surgical instruments and around 700 drugs of animal, plant and mineral origin. Sushruta was one of the earliest exponents of surgery as an art and science. Sushruta's principles and teachings took surgery in ancient India to a noteworthy pedestal, making it the Golden Age of Surgery. He is truly the “Father of Surgery” and “Father of Plastic Surgery”. It is extremely essential that we put his principles into practice, and preserve the dignity of our noble profession. That would be the ideal tribute to this legendary figure.

  8. 改良Miccoli模式内镜手术的工作腔室:WSM-I型建腔器成腔的力学特征研究%Working space establishment with Miccoli's approach: characteristics of the lifting force produced by a working space marker ln the proesss of its cavity-forming

    Institute of Scientific and Technical Information of China (English)

    陈高翔; 高力; 宋春轶


    force produced by a working space marker in process of its cavity-forming. Methods 37 patients were successively operated with the surgical mode of minimally invasive video-assisted thyroidectomy (22/37 cases received a lobotomy and others un derwent a partial thyroidectomy) from January to August, 2010. Instead of hand-retraction, a mechanical armworking space marker type I ( WSM-I, MIEO Medinstr Co. Ltd, China) was applied to establish a working space. After pathway making, an interlayer-cavity above the lobe was created by the space maker and endoscopic view was properly built. Following all these steps, a simulated space making procedure was performed in a way of stepwise hook-lifting (5 mm rising per time). The lifting force ( LF)was measured during the process with a modflied force-measure device (FB-50, DESIK company, Germen). Then recorded data were assessed and analyzed statistically. Results ①Ascending scope of LF in the process of entire space-forming was 0-27.5 Newton (N).②Along with hook rising, LF ascended correspondingly and 2 specific values emerged: One was 11. 2 ±3.5 N,as the lifting height approached 1.5 cm ( also a approximate position of essential space-forming ( Pe), at which the musculo-cutaneous tissue just became tight) ; the other was 17.5 ± 4.3 N , as the lifting height approached 1.75 cm ( also a approximate position of maximal space-forming (Pmax), at which the musculo-cutaneous tissue appeared real tight, but not in a status of extreme tightness). ③Two types of LF ascending were found when the values transferred to a curve diagram : a palliative linearity increasing while lifting height varied from 0 to 1.5 cm (PO to Pe) and a rapid exponent-like increasing while lifting height varied from 1.5 to 1.75cm ( Pe to Pmax). ④ Dependability analyses yielded a diverse statistical outcome: negative significance of the comparison between incision length and LF value ( P > 0. 05 ), and positive significance of the comparison between skin

  9. 维和警队思想政治工作地位与作用探析%A Tentative Study on the Role of Ideological and Political Work for Peacekeeping Police Force

    Institute of Scientific and Technical Information of China (English)



    The ideological and political work is the lifeblood for peacekeeping police force, is fundamental to maintain the political life of the force. The important role that the ideological and political work plays for peacekeeping police force are as follows: it is the fundamental guarantee of a firm political direction for the peacekeeping police force; it is an important factor to enhance the combat effectiveness; it is an intrinsic moti- vation to solve various problems and to accomplish various tasks; it is the foundation to give full play to the temporary party organizations in combat; it is the inevitable requirement to fully develop the leadership and de- cision-making ability of the "squad leader".%内思想政治工作是维和警队的生命线,是维系维和警队政治生命的根本因素。思想政治工作对维和警队的地位和作用,体现在:思想政治工作是维和警队坚定政治方向的根本保证,是提升战斗力的重要因素;是解决各种问题、完成各项任务的内在动力;是充分发挥临时党组织战斗堡垒作用的基础;是全面培养“班长”的组织领导和决策能力的必然要求。

  10. Effects of Degree of Surgical Correction for Flatfoot Deformity in Patient-Specific Computational Models. (United States)

    Spratley, E M; Matheis, E A; Hayes, C W; Adelaar, R S; Wayne, J S


    A cohort of adult acquired flatfoot deformity rigid-body models was developed to investigate the effects of isolated tendon transfer with successive levels of medializing calcaneal osteotomy (MCO). Following IRB approval, six diagnosed flatfoot sufferers were subjected to magnetic resonance imaging (MRI) and their scans used to derive patient-specific models. Single-leg stance was modeled, constrained solely through physiologic joint contact, passive soft-tissue tension, extrinsic muscle force, body weight, and without assumptions of idealized mechanical joints. Surgical effect was quantified using simulated mediolateral (ML) and anteroposterior (AP) X-rays, pedobarography, soft-tissue strains, and joint contact force. Radiographic changes varied across states with the largest average improvements for the tendon transfer (TT) + 10 mm MCO state evidenced through ML and AP talo-1st metatarsal angles. Interestingly, 12 of 14 measures showed increased deformity following TT-only, though all increases disappeared with inclusion of MCO. Plantar force distributions showed medial forefoot offloading concomitant with increases laterally such that the most corrected state had 9.0% greater lateral load. Predicted alterations in spring, deltoid, and plantar fascia soft-tissue strain agreed with prior cadaveric and computational works suggesting decreased strain medially with successive surgical repair. Finally, joint contact force demonstrated consistent medial offloading concomitant with variable increases laterally. Rigid-body modeling thus offers novel advantages for the investigation of foot/ankle biomechanics not easily measured in vivo.

  11. Nonlinear Dynamic Force Spectroscopy

    CERN Document Server

    Björnham, Oscar


    Dynamic force spectroscopy (DFS) is an experimental technique that is commonly used to assess information of the strength, energy landscape, and lifetime of noncovalent bio-molecular interactions. DFS traditionally requires an applied force that increases linearly with time so that the bio-complex under investigation is exposed to a constant loading rate. However, tethers or polymers can modulate the applied force in a nonlinear regime. For example, bacterial adhesion pili and polymers with worm-like chain properties are examples of structures that show nonlinear force responses. In these situations, the theory for traditional DFS cannot be readily applied. In this work we expand the theory for DFS to also include nonlinear external forces while still maintaining compatibility with the linear DFS theory. To validate the theory we modeled a bio-complex expressed on a stiff, an elastic and a worm-like chain polymer, using Monte Carlo methods, and assessed the corresponding rupture force spectra. It was found th...

  12. An Examination and Comparative Study of Job Characteristics Levels and Internal Work Motivation Among U.S. Air Force Navigators Based on Aircraft and Type of Mission Flown (United States)


    the onset of the Great Depression, a second school of thought called Human Relations Theory began to evolve. Associated with Elton Mayo and his...Maslow’s theory and some of the wo;rks of Elton Mayo , Douglas McGregor developed the well-known "Theory X-Theory Y" framework of motivational behavior

  13. Working out of generalized dynamic model of cargo fixation with cargo pads jointly with flexible and thrust elements under the action spatial force system

    Directory of Open Access Journals (Sweden)

    Khabibulla TURANOV


    Full Text Available The article gives an account of the results of working out a generalized dynamic model of fixation of cargo with pads jointly with flexible and thrust elements. Working out a generalized dynamic model of cargo fixation is rather a complicated problem not in the sense of solving differential equations systems but in the sense of presenting them as a complex mechanical system “cargo – pads – flexible elements – thrust bars”. Generalized dynamic model of cargo with pads observed that this model represents technology of joint work of flexible and thrust fastening means of cargo on rolling stock. In particular, on the basis of this model there can be obtained the technology models of joint work of flexible and elastic fastening means of cargo without pads of fastening flexible elements of cargo with pads without thrust bars and also flexible fastening elements of cargo without pads and thrust bars at asymmetrical and/or symmetrical allocation of cargo in the wagon. A specific feature (novelty feature of the proposed dynamic model is inclusion into the model of both cargo pads and thrust bars which are nailed to the wagon floor close to the butt and lateral sides of cargo.

  14. Joint Inflammation and Early Degeneration Induced by High-Force Reaching Are Attenuated by Ibuprofen in an Animal Model of Work-Related Musculoskeletal Disorder

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Driban


    Full Text Available We used our voluntary rat model of reaching and grasping to study the effect of performing a high-repetition and high-force (HRHF task for 12 weeks on wrist joints. We also studied the effectiveness of ibuprofen, administered in the last 8 weeks, in attenuating HRHF-induced changes in these joints. With HRHF task performance, ED1+ and COX2+ cells were present in subchondral radius, carpal bones and synovium; IL-1alpha and TNF-alpha increased in distal radius/ulna/carpal bones; chondrocytes stained with Terminal deoxynucleotidyl Transferase- (TDT- mediated dUTP-biotin nick end-labeling (TUNEL increased in wrist articular cartilages; superficial structural changes (e.g., pannus and reduced proteoglycan staining were observed in wrist articular cartilages. These changes were not present in normal controls or ibuprofen treated rats, although IL-1alpha was increased in reach limbs of trained controls. HRHF-induced increases in serum C1,2C (a biomarker of collagen I and II degradation, and the ratio of collagen degradation to synthesis (C1,2C/CPII; the latter a biomarker of collage type II synthesis were also attenuated by ibuprofen. Thus, ibuprofen treatment was effective in attenuating HRHF-induced inflammation and early articular cartilage degeneration.

  15. The Inventory Revaluation Method and General Ledger Accounting Treatment Used in Compiling the FY 1997 Air Force Working Capital Fund Financial Statements. (United States)


    stratification reports are prepared semiannually, data from the latest available report will be used until a new report is received. Net Realizable Value . On...Working Capital Funds (DCWF) Supply Management Inventory Values." The memorandum stated that the net realizable value of inventory identified as EOBR...Regulation states that the difference between the value of the inventory before identification as EOBR and its expected net realizable value after

  16. 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.

  17. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L


    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  18. Dispersion Forces

    CERN Document Server

    Buhmann, Stefan Yoshi


    In this book, a modern unified theory of dispersion forces on atoms and bodies is presented which covers a broad range of advanced aspects and scenarios. Macroscopic quantum electrodynamics is shown to provide a powerful framework for dispersion forces which allows for discussing general properties like their non-additivity and the relation between microscopic and macroscopic interactions. It is demonstrated how the general results can be used to obtain dispersion forces on atoms in the presence of bodies of various shapes and materials. Starting with a brief recapitulation of volume I, this volume II deals especially with bodies of irregular shapes, universal scaling laws, dynamical forces on excited atoms, enhanced forces in cavity quantum electrodynamics, non-equilibrium forces in thermal environments and quantum friction. The book gives both the specialist and those new to the field a thorough overview over recent results in the field. It provides a toolbox for studying dispersion forces in various contex...

  19. A flexure-based wrist for needle-sized surgical robots (United States)

    Losey, Dylan P.; York, Peter A.; Swaney, Philip J.; Burgner, Jessica; Webster, Robert J.


    We present a novel flexure-based wrist design intended for use with needle-sized robotic manipulators. It is designed to be mounted at the tip of a traditional surgical needle, deployed through an endoscope working channel, or attached to the tip of a concentric tube robot. In all these applications, the wrist enables dexterity in small spaces. The wrist consists of two stacked flexure joints that are actuated by thin pull wires. In this paper we present the design of the wrist, its kinematics, and an experimental evaluation of the relationship between actuation force and tip displacement conducted using a scale model.

  20. Decision making in surgical oncology. (United States)

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N


    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients.

  1. Career satisfaction of surgical specialties. (United States)

    Deshpande, Satish P; Deshpande, Sagar S


    To examine the factors that impact career satisfaction for various surgical specialties. An acute shortage of surgeons is anticipated in the future. Career dissatisfaction can make this already difficult situation worse. It is important to understand and address factors that influence career satisfaction of surgeons to prolong tenure of existing surgeons and understand anticipated needs of future surgeons. The Center for Studying Health System Change 2008 Health Tracking Physician Survey data were used in this study. Regression analysis was done to examine the impact of various practice-related factors, compensation-related factors, practice location, extent of minority patient, and various demographics on career satisfaction of various surgical specialties (n = 762). Among practice related factors, although threat of malpractice had a significant negative impact on career satisfaction, ability to provide quality care to patients and time with patients had a significant positive impact on career satisfaction of surgical specialists. Among compensation related factors, income and financial incentives to expand services had a significant positive impact on career satisfaction. Among practice location factors, those who primarily worked in medical schools were significantly more satisfied with their careers than others. Among minority factors, those treating a large proportion of Hispanic patients were significantly less likely to be satisfied with their careers. Ability to provide quality care, time with patients, income, and financial incentives had a significant positive impact on career satisfaction. Similarly, threat of malpractice and high proportion of Hispanic patients had a negative impact on career satisfaction.

  2. Miniature 6-axis force/torque sensor for force feedback in robot-assisted minimally invasive surgery

    Institute of Scientific and Technical Information of China (English)

    李坤; 潘博; 高文朋; 封海波; 付宜利; 王树国


    In order to restore force sensation to robot-assisted minimally invasive surgery (RMIS), design and performance evaluation of a miniature 6-axis force/torque sensor for force feedback is presented. Based on the resistive sensing method, a flexural-hinged Stewart platform is designed as the flexible structure, and a straightforward optimization method considering the force and sensitivity isotropy of the sensor is proposed to determine geometric parameters which are best suited for the given external loads. The accuracy of this method is preliminarily discussed by finite element methods (FEMs). The sensor prototype is fabricated with the development of the electronic system. Calibration and dynamic loading tests for this sensor prototype are carried out. The working ranges of this sensor prototype are 30 N and 300 N·mm, and resolutions are 0.08 N in radial directions, 0.25 N in axial direction, and 2.4 N·mm in rotational directions. It also exhibits a good capability for a typical dynamic force sensing at a frequency close to the normal heart rate of an adult. The sensor is compatible with surgical instruments for force feedback in RMIS.

  3. Non-surgical therapy of Peyronie's disease

    Institute of Scientific and Technical Information of China (English)

    Frederick L. Taylor; Laurence A. Levine


    The present paper provides a review of the available non-surgical treatments for Peyronie's disease (PD). A review of published literature on oral, intralesional, external energy and iontophoresis therapies for PD was performed,and the published results of available treatment options reviewed. The authors' recommendations for appropriate non-surgical management of PD are provided. Although there are many published reports that show the efficacy of non-surgical therapies for PD, there is a lack of large scale, multicenter controlled clinical trials, which makes treatment recommendations difficult. Careful review of the literature does suggest that there are treatment options that make scientific sense and appear to stabilize the disease process, reduce deformity, and improve function. Offering no treatment at all will encourage our patients to pursue alternative treatments, which might do harm, and misses the opportunity to do some good. Clearly further work is necessary to develop safe and effective non-surgical treatments for PD.

  4. Guide to Surgical Specialists (United States)

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  5. 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....

  6. Ambulatory Surgical Measures - National (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...

  7. 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...

  8. Surgical site infections

    African Journals Online (AJOL)

    and mortality as well as significant financial implications. Worldwide it has ... common nosocomial infection amongst surgical patients with up to 38% .... antibiotics as soon as the sensitivity results are available. ... Breast surgery. Staph Aureus/ ...

  9. 公安消防部队群众工作机制建设的思考%The Reflection on the Constructing Mechanism of Masses Work by Fire Force of Public Security

    Institute of Scientific and Technical Information of China (English)



    The masses work by public security fire force should define a clear responsibility, and strengthen the organization and leadership of the masses. Fire departments should strive to organize and do the fire protection publicity and education and political organs should focus on the organization to support the government and cherish the people work.%公安消防部队群众工作机制建设,应从明确责任,加强对群众工作的组织领导入手;防火部门应着力组织做好消防宣传教育工作;政治机关应着重组织做好拥政爱民工作。

  10. Lesson plans in surgical training. (United States)

    Lester, S E; Robson, A K R


    Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

  11. Social Networks, the ‘Work’ and Work Force of Chronic Illness Self-Management: A Survey Analysis of Personal Communities (United States)

    Vassilev, Ivaylo; Rogers, Anne; Blickem, Christian; Brooks, Helen; Kapadia, Dharmi; Kennedy, Anne; Sanders, Caroline; Kirk, Sue; Reeves, David


    Self-management support forms a central aspect of chronic Illness management nationally and globally. Evidence for the success of self-management support has mainly focussed on individually-centred outcomes of behavioural change. While it is recognised that social network members play an important role there is currently a gap in knowledge regarding who provides what type of support and under what circumstances. This is relevant for understanding the division of labour and the meeting of needs for those living with a long-term condition. We therefore took a network approach to explore self-management support conceptualising it as types of illness ‘work’ undertaken within peoples’ social networks. 300 people from deprived areas and with chronic illnesses took part in a survey conducted in 2010 in the North West of England. A concentric circles diagram was used as a research tool with which participants identified 2,544 network members who contributed to illness management. The results provide an articulation of how social network members are substantially involved in illness management. Whilst partners and close family make the highest contributions there is evidence of inputs from a wide range of relationships. Network member characteristics (type of relationship, proximity, frequency of contact) impact on the amount of illness work undertaken in peoples’ networks. In networks with ‘no partner’ other people tend to contribute more in the way of illness related work than in networks with a partner. This indicates a degree of substitutability between differently constituted networks, and that the level and type of input by different members of a network might change according to circumstances. A network perspective offers an opportunity to redress the balance of an exclusively individual focus on self-management because it addresses the broader set of contributions and resources available to people in need of chronic illness management and support. PMID

  12. Travail, force vive et fatigue dans l'oeuvre de Daniel Bernoulli: vers l'optimisation du fait biologique (1738-1753) / Work, vis viva and tiredness in Daniel Bernoulli's works: towards the optimization of the biological fact (1738-1753)

    CERN Document Server

    Fonteneau, Yannick


    The concept of mechanical work is inherited from the concepts of potentia absoluta and men's work, both implemented in the Section IX of Daniel Bernoulli's Hydrodynamica in 1738. Nonetheless, Bernoulli did not confuse those two entities: he defined a link from gender to species between the former, general, and the latter, organic. Besides, Bernoulli clearly distinguished vis viva and potentia absoluta (or work). Their mutual conversions are rarely explicitly mentionned in this book, except once, in the Section X of his work, from vis viva to work, and subordinated to the mediation of a machine, in a driving forces substitution problem. His attitude significantly evolved in a text in 1753, in which work and vis viva were unambiguously connected, while the concept of potentia absoluta was reduced to the one of men's work, and the expression itself was abandoned. It was then accepted that work can be converted into vis viva, but the opposite is true in only one case, the intra-organic one. The concept of tiredne...

  13. Development of a High Resolution 3D Infant Stomach Model for Surgical Planning (United States)

    Chaudry, Qaiser; Raza, S. Hussain; Lee, Jeonggyu; Xu, Yan; Wulkan, Mark; Wang, May D.

    Medical surgical procedures have not changed much during the past century due to the lack of accurate low-cost workbench for testing any new improvement. The increasingly cheaper and powerful computer technologies have made computer-based surgery planning and training feasible. In our work, we have developed an accurate 3D stomach model, which aims to improve the surgical procedure that treats the infant pediatric and neonatal gastro-esophageal reflux disease (GERD). We generate the 3-D infant stomach model based on in vivo computer tomography (CT) scans of an infant. CT is a widely used clinical imaging modality that is cheap, but with low spatial resolution. To improve the model accuracy, we use the high resolution Visible Human Project (VHP) in model building. Next, we add soft muscle material properties to make the 3D model deformable. Then we use virtual reality techniques such as haptic devices to make the 3D stomach model deform upon touching force. This accurate 3D stomach model provides a workbench for testing new GERD treatment surgical procedures. It has the potential to reduce or eliminate the extensive cost associated with animal testing when improving any surgical procedure, and ultimately, to reduce the risk associated with infant GERD surgery.

  14. "There is hunger in my community": a qualitative study of food security as a cyclical force in sex work in Swaziland. (United States)

    Fielding-Miller, Rebecca; Mnisi, Zandile; Adams, Darrin; Baral, Stefan; Kennedy, Caitlin


    Swaziland has the highest HIV prevalence in the world - 32% of adults are currently living with HIV - and many Swazis are chronically food insecure - in 2011 one in four Swazis required food aid from the World Food Programme. In southern Africa, food insecurity has been linked to high-risk sexual behaviors, difficulty with antiretroviral therapy (ART) adherence, higher rates of mother-to-child HIV transmission, and more rapid HIV progression. Sex workers in Swaziland are a population that is most at risk of HIV. Little is known about the context and needs of sex workers in Swaziland who are living with HIV, nor how food insecurity may affect these needs. In-depth interviews were conducted with 20 female sex workers who are living with HIV in Swaziland. Interviews took place in four different regions of the country, and were designed to learn about context, experiences, and health service needs of Swazi sex workers. Hunger was a major and consistent theme in our informants' lives. Women cited their own hunger or that of their children as the impetus to begin sex work, and as a primary motivation to continue to sell sex. Informants used good nutrition and the ability to access "healthy" foods as a strategy to manage their HIV infection. Informants discussed difficulty in adhering to ART when faced with the prospect of taking pills on an empty stomach. Across interviews, discussions of CD4 counts and ART adherence intertwined with discussions of poverty, hunger and healthy foods. Some sex workers felt that they had greater trouble accessing food through social networks as result of both their HIV status and profession. Informants described a risk cycle of hunger, sex work, and HIV infection. The two latter drive an increased need for 'healthy foods' and an alienation from social networks that offer material and emotional support against hunger. Services and interventions for sex workers which address the pathways through which food insecurity generates vulnerability

  15. Computer-Assisted Technique for Surgical Tooth Extraction. (United States)

    Hamza, Hosamuddin


    Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut). Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome). In addition, the conventional surgical cutting tools (surgical burs) are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  16. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza


    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  17. Seven Important Labor Force Trends. (United States)

    Bailey, John A.


    Presents statistics on the changing human resources mix in the labor force, which vocational counselors should be aware of. Trends include higher percentages of women working, and older men and married men leaving the work force. One result is an increasing number of persons are able to retire earlier. (JAC)

  18. [Surgical research in Germany. Organization, quality and international competitiveness]. (United States)

    Menger, M D; Laschke, M W


    Surgical research in Germany is performed within surgical clinics by individual working groups or in surgical research divisions. Additionally, a few independent institutes and departments of surgical research have been established at medical faculties. The number of these institutions, however, is too small. To increase productivity in surgical research, structural changes are necessary, including additional establishment of further institutes and professorships. The quality of clinical research in surgery in Germany is critically discussed. International comparison shows that Germany has a low ranking with respect to the number of clinical studies published in leading surgical journals. However, there has been some improvement in the quality of clinical studies performed in surgical departments during the last 15 years. The establishment of the study center of the German Society of Surgery shows that excellent clinical studies with adequate numbers of patients can also be performed in Germany and can be published in leading journals. Accordingly, there is need to distribute the structures and the competence necessary to perform clinical studies in a standardized manner to all surgical departments involved in clinical research. The experimental surgical research in Germany is not adequately visible, although over the last 10 years the most relevant publications from institutions for surgical research have been placed in journals with a mean impact factor of 8. This may be due to the fact that 85% of these top publications are published in non-surgical journals. The aim for the future must therefore be to increase the impact factor and, thus, the attractiveness of surgical journals. This may be achieved by publishing the highest quality results from experimental surgical research not in non-surgical but in surgical journals.

  19. 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


    Directory of Open Access Journals (Sweden)

    Singh R.K


    Full Text Available The Sushruta Samhita is an Ayurvedic text, by the legendary Sushruta, foundational to Ayurvedic medicine (Indian traditional medicine, with innovative chapters mainly on surgery. There is a general impression that Sushruta Samhita is only an ancient Indian Ayurvedic text book of surgery. Sushruta Samhita contains 184 chapters and description of 1120 illnesses, 700 medicinal plants, a detailed study on anatomy, 64 preparations from mineral sources and 57 preparations based on animal sources. It still retains the land mark position in the field of surgical texts. In addition to his worldwide known work of historical significance on plastic surgery, he also made similar unique contributions on numerous aspects of medicine, such as fracture and dislocations, urinary stones, skin diseases including leprosy, Pancha Karma (Purification procedures, toxicology, pediatrics, eye diseases, psychiatry, obstetrics and gynaecology, etc. A very limited conceptual work has been performed on the selected chapters of Sushruta Samhita. Therefore a review conceptual study has been carried out on the various surgical concepts of Sushruta Samhita. Outcome of this study shows, Sushruta Samhita is written in the aphorism form and the techniques described in it are eminently in line with technical abilities of the times. It is need of the hour to explore the hidden truth by decoding the versions of the texts.

  1. 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...

  2. Strong Force

    CERN Document Server

    Without the strong force, there could be no life. The carbon in living matter is synthesised in stars via the strong force. Lighter atomic nuclei become bound together in a process called nuclear fusion. A minor change in this interaction would make life impossible. As its name suggests, the strong force is the most powerful of the 4 forces, yet its sphere of influence is limited to within the atomic nucleus. Indeed it is the strong force that holds together the quarks inside the positively charged protons. Without this glue, the quarks would fly apart repulsed by electromagnetism. In fact, it is impossible to separate 2 quarks : so much energy is needed, that a second pair of quarks is produced. Text for the interactive: Can you pull apart the quarks inside a proton?

  3. Surgical bleeding in microgravity (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd


    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  4. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA


    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  5. Force Feedback Control of Robotic Forceps for Minimally Invasive Surgery (United States)

    Ishii, Chiharu; Kamei, Yusuke


    Recently, the robotic surgical support systems are in clinical use for minimally invasive surgery. For improvement in operativity and safety of minimally invasive surgery, the development of haptic forceps manipulator is in demand to help surgeon's immersion and dexterity. We have developed a multi-DOF robotic forceps manipulator using a novel omni-directional bending mechanism, so far. In this paper, in order to control the developed robotic forceps as a slave manipulator, joy-stick type master manipulator with force feedback mechanism for remote control is designed and built, and force feedback bilateral control system was constructed for grasping and bending motions of the robotic forceps. Experimental works were carried out and experimental results showed the effectiveness of the proposed control system.

  6. Haptic feedback and control of a flexible surgical endoscopic robot. (United States)

    Wang, Zheng; Sun, Zhenglong; Phee, Soo Jay


    A flexible endoscope could reach the potential surgical site via a single small incision on the patient or even through natural orifices, making it a very promising platform for surgical procedures. However, endoscopic surgery has strict spatial constraints on both tool-channel size and surgical site volume. It is therefore very challenging to deploy and control dexterous robotic instruments to conduct surgical procedures endoscopically. Pioneering endoscopic surgical robots have already been introduced, but the performance is limited by the flexible neck of the robot that passes through the endoscope tool channel. In this article we present a series of new developments to improve the performance of the robot: a force transmission model to address flexibility, elongation study for precise position control, and tissue property modeling for haptic feedback. Validation experiment results are presented for each sector. An integrated control architecture of the robot system is given in the end. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  7. 基于 SolidWorks 与 ANSYS Workbench 的膨化机螺杆受力分析%Force Analysis of Extruder Screw Based on SolidWorks and ANSYS Workbench

    Institute of Scientific and Technical Information of China (English)

    孟祥凯; 刘文生


    Because of its unique way of processing and the output ,extruder is gaining popular in feed pro-cessing industry and food manufacturing .Screw is the main component of the extruder , it should bear a huge extrusion pressure in high temperature and high humidity environment .During to the complex curved surface and the shape ,for the moment there is not a particularly good way to the stress analysis or optimization design for it.So it requires us to propose workable solutions to improve the extruder .In this article the screw 3D model is based on SolidWorks then imported it into ANSYS Workbench and stress analysis was performed for different pitch and helix different cross-sections of the screw by ANSYS .This analysis give out the relatively optimum range of sizes about screw pitch ,and it lays the foundation for screw ’ s optimization in the future .%膨化机因其独特的加工方式和输出结果,目前越来越受到饲料加工业和食品制造业的重视。螺杆是膨化机里面的主要零部件,在高温高湿的加工腔环境中要受到巨大的挤压力,但是受其复杂曲面和形状影响,目前对其受力分析、优化设计还没有特别好的办法,这就要求我们提出可行的解决办法进行改进。本文基于SolidWorks的三维螺杆模型,导入到ANSYS Workbench界面中分别对不同螺距和螺旋横截面的螺杆进行受力分析。分析出螺杆螺距相对较优的尺寸范围,为以后螺杆的优化奠定了基础。

  8. Virtual reality simulation in endovascular surgical training.

    LENUS (Irish Health Repository)

    Tsang, J S


    Shortened trainingtimes duetothe European Working Time Directive (EWTD) and increased public scrutiny of surgical competency have led to a move away from the traditional apprenticeship model of training. Virtual reality (VR) simulation is a fascinating innovation allowing surgeons to develop without the need to practice on real patients and it may be a solution to achieve competency within a shortened training period.

  9. ¿Inserción laboral de las mujeres en América Latina: una fuerza de trabajo secundaria? Women's participation in the labor market in Latin America: a secondary work force?

    Directory of Open Access Journals (Sweden)

    Laís Abramo


    Full Text Available El objetivo principal de este texto es discutir la aplicación de la noción de "fuerza de trabajo secundaria" para caracterizar la fuerza da trabajo femenina en América Latina. Esa caracterización, hecha con frecuencia en forma mecánica por un lado corresponde, cada vez menos a la realidad de los hechos, ya que es creciente la participación femenina en el mercado de trabajo, así como la continuidad de sus trayectorias laborales, el número de horas dedicadas al trabajo remunerado, así como su aporte al ingreso familiar y a la superación de la situación de pobreza de un porcentaje importante de hogares. Por otro lado, el texto argumenta que esa caracterización es uno de los elementos centrales en la estructuración de los patrones de discriminación de género que persisten y se reproducen en el mercado de trabajo latinoamericano.This article aims to discuss the concept of "secondary labor force" to characterize female workforce in Latin America. Such characterization corresponds increasingly less to reality, as women's participation in the labor force and the hours dedicated to their paid work continues to grow, as well as their contribution to household income. The article argues that such characterization is one of the core elements of the gender discriminating patterns that persist in Latin American labor market.

  10. Hand-tool-tissue interaction forces in neurosurgery for haptic rendering. (United States)

    Aggravi, Marco; De Momi, Elena; DiMeco, Francesco; Cardinale, Francesco; Casaceli, Giuseppe; Riva, Marco; Ferrigno, Giancarlo; Prattichizzo, Domenico


    Haptics provides sensory stimuli that represent the interaction with a virtual or tele-manipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user. Such a technique guarantees a stable haptic feedback loop, while it keeps the transparency of the tele-operation system high, which means that the system faithfully replicates and render back the user's directives. This work focuses on checking whether the interaction forces during a bench model neurosurgery operation can lie in the solely cutaneous perception of the human finger pads. If this assumption is found true, it would be possible to exploit sensory subtraction techniques for providing surgeons with feedback from neurosurgery. We measured the forces exerted to surgical tools by three neurosurgeons performing typical actions on a brain phantom, using contact force sensors, while the forces exerted by the tools to the phantom tissue were recorded using a load cell placed under the brain phantom box. The measured surgeon-tool contact forces were 0.01-3.49 N for the thumb and 0.01-6.6 N for index and middle finger, whereas the measured tool-tissue interaction forces were from six to 11 times smaller than the contact forces, i.e., 0.01-0.59 N. The measurements for the contact forces fit the range of the cutaneous sensitivity for the human finger pad; thus, we can say that, in a tele-operated robotic neurosurgery scenario, it would possible to render forces at the fingertip level by conveying haptic cues solely through the cutaneous channel of the surgeon's finger pads. This approach would allow high transparency and high stability of the haptic feedback loop in a tele-operation system.

  11. Weak Force

    CERN Multimedia

    Without the weak force, the sun wouldn't shine. The weak force causes beta decay, a form of radioactivity that triggers nuclear fusion in the heart of the sun. The weak force is unlike other forces: it is characterised by disintegration. In beta decay, a down quark transforms into an up quark and an electron is emitted. Some materials are more radioactive than others because the delicate balance between the strong force and the weak force varies depending on the number of particles in the atomic nucleus. We live in the midst of a natural radioactive background that varies from region to region. For example, in Cornwall where there is a lot of granite, levels of background radiation are much higher than in the Geneva region. Text for the interactive: Move the Geiger counter to find out which samples are radioactive - you may be surprised. It is the weak force that is responsible for the Beta radioactivity here. The electrons emitted do not cross the plastic cover. Why do you think there is some detected radioa...

  12. Working Influence of Organizing Field of Force under the Environment of AMT on Workers%组织“力场”对AMT环境下员工行为的影响

    Institute of Scientific and Technical Information of China (English)

    陈业华; 田子州


    在先进制造技术(AMT)的环境下,有效的人力资源管理(HRM)对于员工行为绩效的提升和组织目标的实现有着十分重要的作用。基于勒温场论,针对AMT环境下传统的组织系统对员工行为的影响和约束,提出一种员工一般工作环境下的组织"力场"概念,定义了员工行为影响力的各种组织"力场"因素。在此基础上分析了组织"力场"环境与AMT环境之间的异同以及相互影响,进一步使用结构方程分析了在AMT环境下组织"力场"因素与AMT环境对员工行为的影响度,为能够更好完善组织在AMT环境下实施员工行为管理提供理论依据,并给出相应政策建议。%Under the circumstance of advanced manufacturing technology(AMT),the effective human resource management(HRM) plays an important role in promoting the performance of the employees and achieving the organizational goals.Regarding to the traditional organizational system having influenced and constrained the employees' behaviors under AMT environment,this paper,using K· Lewin's Environmental Theory,proposes a conception of organizational force field under the ordinary working environment,and defines the factors of organizational force field which influences the employees' behaviors.On this basis,this paper analyzes the similarities,differences and interactive influences between the organizational force field and the AMT environment.Furthermore,it uses the structure equation to analyze influential degree of the employees' behaviors,which affected by both the factors of organizational force field under AMT environment and the AMT environment.This provides scientific basis and advices to organize and improve the employees' behaviors management under AMT environment.

  13. A student surgical society – the Cape Town experience

    African Journals Online (AJOL)

    The UCT Surgical Society is a student-managed academic society that promotes ... curricular surgical lectures and clinical activities for their medical students, all with the ... accommodate all in attendance (talks regularly attract 200 - 300 attendees). ... at any institution: all that is needed is a group of motivated, hard- working ...

  14. Orthodontic microsurgery: a new surgically guided technique for dental movement. (United States)

    Vercellotti, Tomaso; Podesta, Andrea


    Eight patients with malocclusions were treated with a new orthodontic-surgical technique that reduces the duration of treatment compared to conventional techniques. The monocortical tooth dislocation and ligament distraction (MTDLD) technique combines two different dental movements that work separately but simultaneously on opposite root surfaces. On the root surface corresponding to the direction of movement, vertical and horizontal microsurgical corticotomies are performed around each tooth root with a piezosurgical microsaw to eliminate cortical bone resistance. The immediate application of strong biomechanical forces produces rapid dislocation of the root and the cortical bone together. On the root surface opposite the direction of movement, the force of dislocation produces rapid distraction of ligament fibers. During the osteogenic process that follows, application of normal orthodontic biomechanics achieves the final tooth movement. All eight patients underwent periodontal and radiologic examinations for more than 1 year after treatment. No periodontal defects were observed in any of the patients, including one with a severe malocclusion and a thin periodontal tissue biotype. Compared to traditional orthodontic therapy, the average treatment time with the MTDLD technique in the mandible and maxilla was reduced by 60% and 70%, respectively.

  15. [Optimizing surgical hand disinfection]. (United States)

    Kampf, G; Kramer, A; Rotter, M; Widmer, A


    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  16. Paul of Aegina's surgical instruments: a complete surgical instrumentarium in the seventh century AD. (United States)

    Papadakis, Marios; de Bree, Eelco; Trompoukis, Constantinos; Manios, Andreas


    Although current progress in surgical instruments is oriented towards stapler devices, minimally invasive instrumentation and advanced cautery tools, it definitely seems intriguing to determine what instruments were used in antiquity and to appraise their use. Most adequate information can be retrieved from manuscripts of early medical authors, of whom Paul of Aegina (AD 625-690), also being a most important surgeon, is the most recent. The aim of this study is to present surgical instruments used in his practice. Surgical instruments mentioned in the original Greek text of his monumental work named Epitome of Medicine were sought using computer software. Further, similar research was performed on other significant manuscripts of earlier Greek medical writers to determine whether some of the instruments were exclusively mentioned by Paul of Aegina. In total, 121 different surgical instruments were identified and described in detail in the Epitome of Medicine. Thirty-three instruments (27%) were exclusively reported by Paul of Aegina. In antiquity a large number of surgical instruments were already being used. Paul of Aegina described in detail a large variety of fine, as well as a substantial number of, original surgical instruments, which he himself used in a wide spectrum of surgical operations. © 2015 Royal Australasian College of Surgeons.

  17. Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model

    Directory of Open Access Journals (Sweden)

    M. Erol Demirseren


    Full Text Available Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating rooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient population, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training. There are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and the evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures is an easily obtainable real human tissue which could be used as a training model in plastic surgery.

  18. [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.

  19. Treatment of Glioma Using neuroArm Surgical System

    Directory of Open Access Journals (Sweden)

    Yaser Maddahi


    Full Text Available The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases. neuroArm is equipped with force sensors at the end-effector allowing quantification of tool-tissue interaction forces and transmits force of dissection to the surgeon sited at a remote workstation that includes a haptic interface. Interaction forces between the tool tips and the brain tissue were measured for each procedure, and the peak forces were quantified. Results showed maximum and minimum peak force values of 2.89 N (anaplastic astrocytoma, WHO grade III and 0.50 N (anaplastic oligodendroglioma, WHO grade III, respectively, with the mean of peak forces varying from case to case, depending on type of the glioma. Mean values of the peak forces varied in range of 1.27 N (anaplastic astrocytoma, WHO grade III to 1.89 N (glioblastoma with oligodendroglial component, WHO grade IV. In some cases, ANOVA test failed to reject the null hypothesis of equality in means of the peak forces measured. However, we could not find a relationship between forces exerted to the pathological tissue and its size, type, or location.

  20. Isokinetic muscle assessment after treatment of pectoralis major muscle rupture using surgical or non-surgical procedures

    Directory of Open Access Journals (Sweden)

    Anna Maria Fleury


    Full Text Available INTRODUCTION: Rupture of the pectoralis major muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for pectoralis major muscle rupture. METHODS: We assessed 33 pectoralis major muscle ruptures (18 treated non-surgically and 15 treated surgically. Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20% for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively. The peak torque ratio revealed that the horizontal adduction muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%. CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for pectoralis major muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of muscle strength and balance.

  1. Working Collaboratively

    DEFF Research Database (Denmark)

    Holder, Anna; Lovett, George


    Working collaboratively is arguably an essential skill in architectural practice as the complexity of contemporary projects involves multiple agents in the conception, construction and use of architecture. This has been emphasised by recent government rhetoric. Mass collaboration has been...... identified as a transformative global force of the last decade, most notably in knowledge and information publishing, communication and creation. This paper presents a structured conversation on changing understandings of collaboration, and the realities of collaborative methodology in architectural work....... Ideas of the platforms and structures necessary to support ‘creative’ collaborations are advanced and tested, and a vocabulary of key terms is developed. The conversation extends to reflect on the role of the architecture profession in supporting or enabling collaboration in architectural works....

  2. Perfecting patient flow in the surgical setting. (United States)

    Amato-Vealey, Elaine J; Fountain, Patricia; Coppola, Deborah


    Reduced surgical efficiency and productivity, delayed patient discharges, and prolonged use of hospital resources are the results of an OR that is unable to move patients to the postanesthesia care unit or other patient units. A primary reason for perioperative patient flow delay is the lack of hospital beds to accommodate surgical patients, which consequently causes backups of patients currently in the surgical suite. In one facility, implementing Six Sigma methodology helped to improve OR patient flow by identifying ways that frontline staff members could work more intelligently and more efficiently, and with less stress to streamline workflow and eliminate redundancy and waste in ways that did not necessitate reducing the number of employees. The results were improved employee morale, job satisfaction and safety, and an enhanced patient experience.

  3. Surgical procedures in pinniped and cetacean species. (United States)

    Higgins, Jennifer L; Hendrickson, Dean A


    Significant advances in veterinary diagnostic and surgical techniques have been made over the past several decades. Many of these advances, however, have not reached the field of marine mammal medicine. A number of limitations exist: risks of anesthesia, anatomical challenges, difficulties with wound closure, environmental constraints, equipment limitations, and perceived risks. Despite these limitations, surgical treatments have been successfully utilized in marine mammals. While surgery is performed in pinnipeds more frequently than in cetaceans, studies conducted in the 1960s and 1970s on dolphin sleep and hearing demonstrated that general anesthesia can be successfully induced in cetaceans. Since this pioneering work, a small number of successful surgeries have been performed in dolphins under both general anesthesia and heavy sedation. While these surgical procedures in pinnipeds and cetaceans have typically been limited to wound management, dentistry, ophthalmic procedures, fracture repair, and superficial biopsy, a number of abdominal surgeries have also been performed. Recently there have been pioneering successes in the application of minimally invasive surgery in marine mammals. Many of the anatomical challenges that almost prohibit traditional laparotomies in cetacean species and present challenges in pinnipeds can be overcome through the use of laparoscopic techniques. Due to the limited number of pinnipeds and cetaceans in captivity and, thus, the limited case load for veterinarians serving marine mammal species, it is vital for knowledge of surgical procedures to be shared among those in the field. This paper reviews case reports of surgical procedures, both traditional and laparoscopic, in pinnipeds and cetaceans. Limitations to performing surgical procedures in marine mammals are discussed and surgical case reports analyzed in an effort to determine challenges that must be overcome in order to make surgery a more feasible diagnostic and treatment

  4. Allegiance: Egypt Security Forces (United States)


    square, the very definition of political jiu-jitsu.124 The CSF commanders continued to press protestors, often using lethal force.125 The battle on...incident France 2 had a crew of four arrested and held for 10 hours on August while Jared Malsin, who works for Time Magazine and freelance photographer

  5. OOTW Force Design Tools

    Energy Technology Data Exchange (ETDEWEB)

    Bell, R.E.; Hartley, D.S.III; Packard, S.L.


    This report documents refined requirements for tools to aid the process of force design in Operations Other Than War (OOTWs). It recommends actions for the creation of one tool and work on other tools relating to mission planning. It also identifies the governmental agencies and commands with interests in each tool, from whom should come the user advisory groups overseeing the respective tool development activities. The understanding of OOTWs and their analytical support requirements has matured to the point where action can be taken in three areas: force design, collaborative analysis, and impact analysis. While the nature of the action and the length of time before complete results can be expected depends on the area, in each case the action should begin immediately. Force design for OOTWs is not a technically difficult process. Like force design for combat operations, it is a process of matching the capabilities of forces against the specified and implied tasks of the operation, considering the constraints of logistics, transport and force availabilities. However, there is a critical difference that restricts the usefulness of combat force design tools for OOTWs: the combat tools are built to infer non-combat capability requirements from combat capability requirements and cannot reverse the direction of the inference, as is required for OOTWs. Recently, OOTWs have played a larger role in force assessment, system effectiveness and tradeoff analysis, and concept and doctrine development and analysis. In the first Quadrennial Defense Review (QDR), each of the Services created its own OOTW force design tool. Unfortunately, the tools address different parts of the problem and do not coordinate the use of competing capabilities. These tools satisfied the immediate requirements of the QDR, but do not provide a long-term cost-effective solution.

  6. Forced Snaking (United States)

    Ponedel, Benjamin; Knobloch, Edgar


    We study spatial localization in the real subcritical Ginzburg-Landau equation ut =m0 u +m1 cos2/π l x u +uxx +d | u | 2 u -| u | 4 u with spatially periodic forcing. When d > 0 and m1 = 0 this equation exhibits bistability between the trivial state u = 0 and a homogeneous nontrivial state u =u0 with stationary localized structures which accumulate at the Maxwell point m0 = - 3d2 / 16 . When spatial forcing is included its wavelength is imprinted on u0 creating conditions favorable to front pinning and hence spatial localization. We use numerical continuation to show that under appropriate conditions such forcing generates a sequence of localized states organized within a snakes-and-ladders structure centered on the Maxwell point, and refer to this phenomenon as forced snaking. We determine the stability properties of these states and show that longer lengthscale forcing leads to stationary trains consisting of a finite number of strongly localized, weakly interacting pulses exhibiting foliated snaking.

  7. [Surgical management of animal bites in children]. (United States)

    Touzet-Roumazeille, S; Jayyosi, L; Plenier, Y; Guyot, E; Guillard, T; François, C


    Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities. Animal bites require psychological, anesthetic and surgical treatment, adapted to the child, in a specialized structure. Hospitalization and general anesthesia are more frequent in children. Any suspicion of mistreatment (and/or abuse) should lead to the child's hospitalization, even if wounds do not justify monitoring in a surgical environment. Emergency surgery is essential to limit functional and aesthetic consequences. The healing capacities of the child and the frequent lack of co-morbidity allow a conservative surgical treatment with suture, repositioning skin flaps and controlled healing in the first place. Immobilization, drainage, and antibiotics will complete the surgery. The healing process, however, leads to a specific management during scar remodeling phase and growth. Psychological care of the child and parents should not be forgotten, and has to start at the same time as surgical treatment at in acute phase.

  8. Vitiligo- A surgical approach

    Directory of Open Access Journals (Sweden)

    Deepti Ghia


    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  9. Spacecraft surgical scrub system (United States)

    Abbate, M.


    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  10. Gossypiboma—Retained Surgical Sponge

    Directory of Open Access Journals (Sweden)

    Hung-Shun Sun


    Full Text Available Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.

  11. Hepatic surgical anatomy. (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros


    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  12. Design of teleoperated surgical instruments for minimally invasive surgery (United States)

    Madhani, Akhil Jiten


    Minimally invasive surgery (MIS) is performed today using hand held instruments passed through small incisions into the body. The internal surgical site and instruments are viewed remotely on a monitor using images obtained with an endoscopic camera. It is well recognized that the marked therapeutic benefits of MIS must be weighed against the increased technical difficulty for the surgeon and the ensuing risk of surgical errors. Here I describe the design, construction, and operation of teleoperated surgical instruments that solve several key problems in current minimally invasive surgical practice. These improvements are primarily achieved through (1) an increase in dexterity and degrees of freedom, (2) force feedback to allow surgeons to feel instrument-tissue interactions, and (3) the elimination of geometrical discrepancies between actual and observed tool motions. I present the design of two teleoperator slave manipulators for minimally invasive surgery, the seven- degree-of-freedom Silver Falcon and the eight-degree-of- freedom Black Falcon. Both systems were tested using an existing PHANToM TM haptic interface which was modified for use as a master manipulator. Position based bilateral force-reflecting teleoperation was implemented using sound cable design principles, without force sensors. Through the design of system dynamics that accommodate a macro-micro control scheme, a substantial reduction was achieved in slave endpoint inertia and friction reflected to the user. The Black Falcon was successfully used to drive surgical sutures along arbitrarily oriented paths, a task which is rarely feasible using today's instruments. This test demonstrates successful kinematic design and range of motion, although the quality of force reflection was not sufficient to be helpful when suturing soft tissue. Force reflection was found to be more useful during rigid contact tasks where force information is not already available to the operator via visual cues. (Copies

  13. Louis Pasteur surgical revolution. (United States)

    Toledo-Pereyra, Luis H


    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  14. Guideline implementation: Surgical attire. (United States)

    Cowperthwaite, Liz; Holm, Rebecca L


    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  15. Intermolecular forces. (United States)

    Buckingham, A D


    The nature of molecular interactions is examined. Intermolecular forces are divided into long-range and short-range components; the former operate at distances where the effects of electron exchange are negligible and decrease as an inverse power of the separation. The long-range interactions may be subdividied into electrostatic, induction and dispersion contributions, where the electrostatic component is the interaction of the permanent charge distributions and the others originate in the fluctuations in the distributions. Typical magnitudes of the various contributions are given. The forces between macroscopic bodies are briefly considered, as are the effects of a medium. Some of the manifestations of molecular interactions are discussed.

  16. Debridement for surgical wounds. (United States)

    Dryburgh, Nancy; Smith, Fiona; Donaldson, Jayne; Mitchell, Melloney


    Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register (searched 3/3/08) , Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2008, issue 1), MEDLINE (1950 to February Week 3 2008 ), EMBASE (1980 to 2008 Week 09) and CINHAL (1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. We included relevant randomised controlled trials (RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (Streptokinase/streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator

  17. Mao Zedong' s Experience on the Armed Forces Being Also a Working Team%解放战争后期毛泽东工作队的经验及其启示

    Institute of Scientific and Technical Information of China (English)



    解放战争后期,尤其是辽沈、淮海、平津三大战役胜利结束以后,毛泽东审时度势,及时地提出了军队不仅是战斗队而且是工作队,要求军队干部应当学会接收、管理城市和新区工作,对促进当时新解放区干部问题的解决和革命事业的顺利发展起到了巨大的促进作用。在新世纪新阶段,我军要借鉴毛泽东的工作队经验。努力做到突出核心军事能力建设,注重非战争军事行动能力建设,注重培养“学习型”高素质复合型军事人才,为维护国家安全、社会稳定和经济发展作贡献。%In the later stage of War of Liberation,especially after Liaoxi-Shenyang,Huai-Hai and Beiping-Tianjing Campaigns, Mao Zedong, correctly appraising the situations, presented the thinking that the armed forces were not only a fighting team but also a working team,requiring that cadres should learn to take over and manage cities and new areas.That has played an important role in developing the cause of the revolution. In the new era,our armed forces should draw lessons from Mao Zedong's experience on the working team,strive to give prominence to improving the core military capacity, focus on the improvement of their unmilitary capacity, try hard to train "learning-oriented" high-quality composite type personnel, safeguard China's security and contribute to economic and social development.

  18. Considerações sobre a terceira revolução industrial e a força de trabalho em saúde em Natal Considerations on the third industrial revolution and the health work force in Natal

    Directory of Open Access Journals (Sweden)

    Soraya Maria de Medeiros


    Full Text Available A articulação entre modo de produção, políticas sociais e práticas de saúde constitui-se o fio condutor desta investigação: trabalho e trabalhadores em saúde. A Terceira Revolução Industrial desencadeou novas articulações de processos econômicos, políticos e sociais, projetos de sociedade, formas de organização de poder e de atores sociais em proporções mundiais. A conformação definida pela nova divisão mundial do trabalho mantém uma relação de força desigual entre o grupo dos países desenvolvidos e em desenvolvimento. O Brasil também vivencia esse processo de transformação e vem implantando políticas sociais com características do modelo neoliberal. Tais políticas têm causado dificuldades, injustiças e instabilidade social, constituindo desafios aos direitos sociais e desencadeando processos que envolvem os âmbitos público e o privado, em termos organizativos e de subjetividade. Este estudo trata de um recorte de periferia do capitalismo tardio, tendo o Brasil como exemplo, e mais especificamente a região Nordeste.The articulation among production mode, social politics and health practices is established as conducting wire of our inquiry press cutting: the work and the workers in health. The Third Industrial Revolution unchained new articulations with the economical, political and social processes in world-wide ratios, the society projects, forms of organization, power and the social actors. This conformation defined by the new world-wide work division keeps a relation of unequal force between developed countries group and developing countries. Brazil lives this transformation process and has been implanting social politics with the neoliberal model characteristics. Such politcs have been motivating difficulties, injustices and social instability, constituting challenges to the question of the social rights and unchaining processes that involve the public and the private of the Brazilian citizens, in their

  19. Fundamental Ethical Issues in Unnecessary Surgical Procedures. (United States)

    Tayade, Motilal Chandu; Dalvi, Shashank D


    In clinical practice performing any surgical procedure is inconsistent because all surgical procedures carry definitely some degree of risk. Worldwide every year millions of patients go under knife, but many of them are enduring great pain and shelling out thousands and dollars for surgeries they don't really need. This review work was planned with an intention to focus attention towards it with reporting cited evidences of unnecessary surgical operations and discuss ethical issues concern with it. In present review the references search included standard citations Google scholar, MEDLINE and PUBMED. We also used Google search engine for screening various news concern with highlighting this topic in community and online media. For articles we go through more than 60 articles from worldwide and 12 news media views from Google search in last one year. We used following quotes for their search-unnecessary surgeries, second opinion, ethical issues in unnecessary surgeries. Geographical variations were also kept in view. Our intension was highlighting ethical issues concern with unnecessary surgical operations. Henceforth we excluded such work that does not concern with ethical issues. Unnecessary surgery is that which is medically unjustifiable when the risks and costs are more than the likely therapeutic benefits or relief to the patient based on the patient's lifestyle requirements. To avoid or minimize such interventions basic seeding of ethics in curriculum and strict laws will definitely helpful in clinical practice. In conclusion, our aim was to highlight this major issue and underline need of competency based medical bioethics education in Indian scenario.

  20. Force measurement platform for training and assessment of laparoscopic skills

    NARCIS (Netherlands)

    Horeman, T.; Rodrigues, S.P.; Jansen, F.W.; Dankelman, J.; Van den Dobbelsteen, J.J.


    Background - To improve endoscopic surgical skills, an increasing number of surgical residents practice on box or virtual-reality (VR) trainers. Current training is mainly focused on hand–eye coordination. Training methods that focus on applying the right amount of force are not yet available. Metho

  1. Good experiences with interactive temporal bone surgical simulator

    DEFF Research Database (Denmark)

    Andersen, Steven A W; Mikkelsen, Peter Trier; Noe, Karsten Ostergaard;


    The Visible Ear Simulator (VES) is a freeware temporal bone surgical simulator utilizing a high-fidelity haptic and graphical voxel model compiled from segmented digital images of fresh frozen sections. A haptic device provides the 3-dimensional handling and drilling with force-feedback in real...

  2. New Frontiers in Surgical Innovation. (United States)

    Jackson, Ryan S; Schmalbach, Cecelia E


    It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. How Does Force Affect Motion? (United States)

    Darling, Gerald


    Whether playing soccer at recess, walking to lunch, or sitting at their desk, children encounter forces every moment of their lives. The connection between force and motion is absolutely amazing to children, so anyone working with them better be prepared for the battery of tough questions they ask: "What made the ball move that way? Why does a…

  4. Acute surgical unit: The consultant experience

    Directory of Open Access Journals (Sweden)

    Patrick J Stokes


    Full Text Available Background Establishment of the Acute Surgical Unit (ASU has redefined the approach to emergency surgery in Australia with quantitative data showing improvement in patient outcomes. However, as qualitative data regarding the ASU remains scarce, we sought to determine the impact of the ASU on overall surgeon job satisfaction. Aims The aim of this paper was to specifically address the impact of the ASU on consultant surgeons overall job satisfaction. Methods We designed a 34 – item questionnaire with consultant general surgeons addressing important aspects of the ASU. Themes included on – call rostering and workload, academic pursuits, surgical training, work – life balance and overall job satisfaction. Results We received responses from 88 surgeons currently working on ASU units, responding correctly and in full to the survey. Overall, our surveyed cohort reported better on – call rostering, improved surgical training and higher levels of job satisfaction and overall work – life balance with ASU implementation. Conclusion Preliminary qualitative results indicate that the ASU may improve on – call rostering, work – life balance and overall job satisfaction.

  5. The surgical management of elderly cancer patients : recommendations of the SIOG surgical task force

    NARCIS (Netherlands)

    Audisio, RA; Bozzetti, F; Gennari, R; Jaklitsch, MT; Koperna, T; Longo, WE; Wiggers, T; Zbar, AP


    Although cancer in the elderly is extremely common, few health professionals in oncology are familiar with caring for series of oncogeriatric patients. Surgery is at present the first choice, but is frequently delivered suboptimally: under-treatment is justified by concerns about unsustainable toxic

  6. An Augmented Reality-Based Approach for Surgical Telementoring in Austere Environments. (United States)

    Andersen, Dan; Popescu, Voicu; Cabrera, Maria Eugenia; Shanghavi, Aditya; Mullis, Brian; Marley, Sherri; Gomez, Gerardo; Wachs, Juan P


    Telementoring can improve treatment of combat trauma injuries by connecting remote experienced surgeons with local less-experienced surgeons in an austere environment. Current surgical telementoring systems force the local surgeon to regularly shift focus away from the operating field to receive expert guidance, which can lead to surgery delays or even errors. The System for Telementoring with Augmented Reality (STAR) integrates expert-created annotations directly into the local surgeon's field of view. The local surgeon views the operating field by looking at a tablet display suspended between the patient and the surgeon that captures video of the surgical field. The remote surgeon remotely adds graphical annotations to the video. The annotations are sent back and displayed to the local surgeon while being automatically anchored to the operating field elements they describe. A technical evaluation demonstrates that STAR robustly anchors annotations despite tablet repositioning and occlusions. In a user study, participants used either STAR or a conventional telementoring system to precisely mark locations on a surgical simulator under a remote surgeon's guidance. Participants who used STAR completed the task with fewer focus shifts and with greater accuracy. The STAR reduces the local surgeon's need to shift attention during surgery, allowing him or her to continuously work while looking "through" the tablet screen.

  7. Development of a Cognitive Robotic System for Simple Surgical Tasks

    Directory of Open Access Journals (Sweden)

    Riccardo Muradore


    Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

  8. Development of a Cognitive Robotic System for Simple Surgical Tasks

    Directory of Open Access Journals (Sweden)

    Riccardo Muradore


    Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

  9. Does Leave Work?

    NARCIS (Netherlands)

    Heleen van Luijn; Saskia Keuzenkamp


    More and more people have to combine work and care responsibilities, and work part-time or use daycare and after-school care facilities to help them do so. The Work and Care Act, which came into force on 1 December 2001, combined all the existing schemes - such as parental and maternity leave -

  10. Force, motion & simple machines big book

    CERN Document Server

    Graybill, George


    Our Combined resource includes all the required fundamentals for teaching Force, Motion & Simple Machines. Give your students a kick start on learning with our resource that has simplified language and vocabulary. We begin with a look at force, motion and work, with examples of simple machines in daily life. Discover what a force is, and different kinds of forces that work on contact and at a distance.

  11. The role of preoperative pulmonary function tests in the surgical treatment of extremely severe scoliosis


    Lao, Lifeng; Weng, Xisheng; Qiu, Guixing; Shen, Jianxiong


    Background The patients with extremely severe spinal deformity are commonly considered high-risk candidates for surgical treatment because of their underlying lung disease. Currently, little has been reported about the postoperative pulmonary complication events in this population. This retrospective study sought to evaluate preoperative pulmonary function tests in the surgical treatment of extremely severe scoliosis. Methods Preoperative forced vital capacity (FVC), FVC ratio, forced expirat...

  12. [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.

  13. Diverticulitis: selective surgical management. (United States)

    Rugtiv, G M


    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  14. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona


    neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while...... neuromuscular block suctioning the lungs elicited brief periods of abdominal EMG activity. No difference was found in the force needed to close the fascia when comparing no neuromuscular block with intense neuromuscular block. Furthermore, no significant differences were found in the width of the diastase...... not influence the force needed to close the fascia....

  15. An End to Forced Labor

    Institute of Scientific and Technical Information of China (English)


    China is working on an improved drug rehabilitation regulation that drops work as a form of treatment China is going to release a new regulation soon to give detail to the rules for forced-and-isolated rehab treatment,a new measure replac- ing forced drug treatment through labor, according to an official with the China Narcotics Control Foundation(CNCF). Chen Xingyou,Secretary General of the

  16. Surgical education and training in an outer metropolitan hospital: a qualitative study of surgical trainers and trainees. (United States)

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


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

  17. Forces in strategy formation

    DEFF Research Database (Denmark)

    Steensen, Elmer Fly


    This chapter proposes that organizational strategy formation should be characterized theoretically as a process that is subject to several interacting forces, rather than represented by separate discrete decisionmodels or theoretic perspectives, as is commonly done in the strategic management...... literature. Based on an extensive review of relevant theory and empirical work in strategic decision-making, organizational change theory, cognitive and social psychology, and strategy processes, seven kinds of ''forces'' - rational, imposed, teleological, learning, political, heuristic, and social...... - are identified as interacting in and having significant influence on the strategy formation process. It is further argued that by applying a holistic ''forces-view'' of the significant and interacting influences on strategy formation, we can better understand the dynamics and challenges in managing the process...

  18. Surgical Team Stability and Risk of Sharps-Related Blood and Body Fluid Exposures During Surgical Procedures. (United States)

    Myers, Douglas J; Lipscomb, Hester J; Epling, Carol; Hunt, Debra; Richardson, William; Smith-Lovin, Lynn; Dement, John M


    To explore whether surgical teams with greater stability among their members (ie, members have worked together more in the past) experience lower rates of sharps-related percutaneous blood and body fluid exposures (BBFE) during surgical procedures. A 10-year retrospective cohort study. A single large academic teaching hospital. Surgical teams participating in surgical procedures (n=333,073) performed during 2001-2010 and 2,113 reported percutaneous BBFE were analyzed. A social network measure (referred to as the team stability index) was used to quantify the extent to which surgical team members worked together in the previous 6 months. Poisson regression was used to examine the effect of team stability on the risk of BBFE while controlling for procedure characteristics and accounting for procedure duration. Separate regression models were generated for percutaneous BBFE involving suture needles and those involving other surgical devices. RESULTS The team stability index was associated with the risk of percutaneous BBFE (adjusted rate ratio, 0.93 [95% CI, 0.88-0.97]). However, the association was stronger for percutaneous BBFE involving devices other than suture needles (adjusted rate ratio, 0.92 [95% CI, 0.85-0.99]) than for exposures involving suture needles (0.96 [0.88-1.04]). Greater team stability may reduce the risk of percutaneous BBFE during surgical procedures, particularly for exposures involving devices other than suture needles. Additional research should be conducted on the basis of primary data gathered specifically to measure qualities of relationships among surgical team personnel.

  19. Force decomposition in robot force control (United States)

    Murphy, Steve H.; Wen, John T.


    The unit inconsistency in force decomposition has motivated an investigation into the force control problem in multiple-arm manipulation. Based on physical considerations, it is argued that the force that should be controlled is the internal force at the specified frame in the payload. This force contains contributions due to both applied forces from the arms and the inertial force from the payload and the arms. A least-squares scheme free of unit inconsistency for finding this internal force is presented. The force control issue is analyzed, and an integral force feedback controller is proposed.

  20. Retinal Changes Induced by Epiretinal Tangential Forces

    Directory of Open Access Journals (Sweden)

    Mario R. Romano


    Full Text Available Two kinds of forces are active in vitreoretinal traction diseases: tangential and anterior-posterior forces. However, tangential forces are less characterized and classified in literature compared to the anterior-posterior ones. Tangential epiretinal forces are mainly due to anomalous posterior vitreous detachment (PVD, vitreoschisis, vitreopapillary adhesion (VPA, and epiretinal membranes (ERMs. Anomalous PVD plays a key role in the formation of the tangential vectorial forces on the retinal surface as consequence of gel liquefaction (synchysis without sufficient and fast vitreous dehiscence at the vitreoretinal interface. The anomalous and persistent adherence of the posterior hyaloid to the retina can lead to vitreomacular/vitreopapillary adhesion or to a formation of avascular fibrocellular tissue (ERM resulting from the proliferation and transdifferentiation of hyalocytes resident in the cortical vitreous remnants after vitreoschisis. The right interpretation of the forces involved in the epiretinal tangential tractions helps in a better definition of diagnosis, progression, prognosis, and surgical outcomes of vitreomacular interfaces.

  1. Aspects of computer vision in surgical endoscopy (United States)

    Rodin, Vincent; Ayache, Alain; Berreni, N.


    This work is related to a project of medical robotics applied to surgical endoscopy, led in collaboration with Doctor Berreni from the Saint Roch nursing-home in Perpignan, France). After taking what Doctor Berreni advises, two aspects of endoscopic color image processing have been brought out: (1) The help to the diagnosis by the automatic detection of the sick areas after a learning phase. (2) The 3D reconstruction of the analyzed cavity by using a zoom.

  2. Dynamic virtual simulation of the occurrence and severity of edge loading in hip replacements associated with variation in the rotational and translational surgical position. (United States)

    Leng, Joanna; Al-Hajjar, Mazen; Wilcox, Ruth; Jones, Alison; Barton, David; Fisher, John


    Variation in the surgical positioning of total hip replacement can result in edge loading of the femoral head on the rim of the acetabular cup. Previous work has reported the effect of edge loading on the wear of hip replacement bearings with a fixed level of dynamic biomechanical hip separation. Variations in both rotational and translational surgical positioning of the hip joint replacement combine to influence both the biomechanics and the tribology including the severity of edge loading, the amount of dynamic separation, the force acting on the rim of the cup and the resultant wear and torque acting on the cup. In this study, a virtual model of a hip joint simulator has been developed to predict the effect of variations in some surgical positioning (inclination and medial-lateral offset) on the level of dynamic separation and the contact force of the head acting on the rim as a measure of severity of edge loading. The level of dynamic separation and force acting on the rim increased with increased translational mismatch between the centres of the femoral head and the acetabular cup from 0 to 4 mm and with increased cup inclination angle from 45° to 65°. The virtual model closely replicated the dynamics of the experimental hip simulator previously reported, which showed similar dynamic biomechanical trends, with the highest level of separation being found with a mismatch of 4 mm between the centres of the femoral head and acetabular cup and 65° cup inclination angle.

  3. Minimally invasive surgical technique for tethered surgical drains

    Directory of Open Access Journals (Sweden)

    Shane R Hess


    Full Text Available A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  4. Support Process of Surgical Block: Patient safety strategies

    Directory of Open Access Journals (Sweden)

    Rosa Martos Moreno


    Full Text Available Second edition of Guide of designe and continues improvement of the Care Integrated Procedures identifies us indispensable elements, among others, the ones related with the dimension patient safety. Objetive of this work has been the elaboration of a Surgical patient path document which contains those elements. The result has been a document in the shape of a indivisible triptych, continent of a lot of safety barrier ( pre surgical and assist surgical check-lists, clinic guides, etc that should avoid the appearance of adverse events. For its suitable employment it would be necessary introducing the document before the movement of the patient to the Surgical Block, during the pre surgical preparation at the Hospitalization Unit. It would be moved forward a step at the third level of the Process Architecture, to guarantee the Cares continuity and the Safety.

  5. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg


    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  6. Concepts of force

    CERN Document Server

    Jammer, Max


    Both historical treatment and critical analysis, this work by a noted physicist takes a fascinating look at a fundamental of physics, tracing its development from ancient to modern times. Kepler's initiation of scientific conceptualization, Newton's definition, post-Newtonian reinterpretation - contrasting concepts of Leibniz, Boscovich, Kant with those of Mach, Kirchhoff, Hertz. In-depth analysis of contemporary trend toward eliminating force from conceptual scheme of physics. ""An excellent presentation."" - Science. 1962 edition.

  7. Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and Swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment. (United States)

    Rosenow, Felix; Bast, Thomas; Czech, Thomas; Feucht, Martha; Hans, Volkmar H; Helmstaedter, Christoph; Huppertz, Hans-Jürgen; Noachtar, Soheyl; Oltmanns, Frank; Polster, Tilman; Seeck, Margitta; Trinka, Eugen; Wagner, Kathrin; Strzelczyk, Adam


    The definition of minimal standards remains pivotal as a basis for a high standard of care and as a basis for staff allocation or reimbursement. Only limited publications are available regarding the required staffing or methodologic expertise in epilepsy centers. The executive board of the working group (WG) on presurgical epilepsy diagnosis and operative epilepsy treatment published the first guidelines in 2000 for Austria, Germany, and Switzerland. In 2014, revised guidelines were published and the WG decided to publish an unaltered English translation in this report. Because epilepsy surgery is an elective procedure, quality standards are particularly high. As detailed in the first edition of these guidelines, quality control relates to seven different domains: (1) establishing centers with a sufficient number of sufficiently and specifically trained personnel, (2) minimum technical standards and equipment, (3) continuous medical education of employees, (4) surveillance by trained personnel during video electroencephalography (EEG) monitoring (VEM), (5) systematic acquisition of clinical and outcome data, (6) the minimum number of preoperative evaluations and epilepsy surgery procedures, and (7) the cooperation of epilepsy centers. These standards required the certification of the different professions involved and minimum numbers of procedures. In the subsequent decade, quite a number of colleagues were certified by the trinational WG; therefore, the executive board of the WG decided in 2013 to make these standards obligatory. This revised version is particularly relevant given that the German procedure classification explicitly refers to the guidelines of the WG with regard to noninvasive/invasive preoperative video-EEG monitoring and invasive intraoperative diagnostics in epilepsy. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

  8. Neuronavigation. Principles. Surgical technique. (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad


    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  9. Surgical education in Mexico. (United States)

    Cervantes, Jorge


    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital.

  10. O quadro de trabalhadores federais em saúde no Brasil: uma análise no contexto dos anos 2000 The federal health work force in Brazil: an analysis in the context of the 2000's

    Directory of Open Access Journals (Sweden)

    Luciane Galdino Alberto


    Full Text Available O artigo analisa o quadro de trabalhadores do Ministério da Saúde e entidades vinculadas - agências reguladoras da saúde e Fundação Oswaldo Cruz - de 2000 a 2008, relacionando a evolução quantitativa e o perfil dos vínculos dos trabalhadores federais da saúde com os condicionantes históricos e as políticas para o funcionalismo. As estratégias metodológicas da pesquisa foram: revisão bibliográfica, análise documental e de dados primários e secundários. Os resultados sugerem que a partir de 2003 houve uma recomposição parcial de quadros na administração pública federal, por meio de concursos públicos. Tal movimento foi heterogêneo entre áreas, sendo que a saúde apresentou um aumento de servidores ativos inferior à média federal. Observaram-se diferenças na situação do quadro de trabalhadores do Ministério da Saúde e entidades vinculadas. O nível central do Ministério foi pouco beneficiado com a realização de concursos, mantendo baixa proporção de servidores e alta dependência de consultores, terceirizados e contratos temporários. As agências reguladoras da saúde receberam servidores concursados a partir de 2005, mas em 2008 ainda apresentavam trabalhadores com outros tipos de vínculos. Na Fiocruz, observou-se um incremento do número de servidores, porém um aumento maior dos terceirizados. Por fim, discutem-se os desafios de conformação de uma adequada força de trabalho no Ministério da Saúde e entidades vinculadas, visto que no Brasil a esfera federal mantém um papel estratégico para a consolidação do Sistema Único de Saúde.This paper analyzes the work force of the Brazilian Ministry of Health and associated entities -the health regulatory agencies and the Oswaldo Cruz Foundation -from 2000 to 2008, focusing on the quantitative evolution and types of employment relation. The methods involved a bibliographical review, documental analysis and analysis of primary and secondary data. The

  11. Acceptance of the WHO Surgical Safety Checklist among surgical personnel in hospitals in Guatemala city

    Directory of Open Access Journals (Sweden)

    Hurtado Juan J


    Full Text Available Abstract Background Studies have highlighted the effects the use of the WHO Surgical Safety Checklist can have on lowering mortality and surgical complications. Implementation of the checklist is not easy and several barriers have been identified. Few studies have addressed personnel’s acceptance and attitudes toward the WHO Surgical Safety Checklist. Determining personnel’s acceptance might reflect their intention to use the checklist while their awareness and knowledge of the checklist might assess the effectiveness of the training process. Methods Through an anonymous self- responded questionnaire, general characteristics of the respondents (age, gender, profession and years spent studying or working at the hospital, knowledge of the WHO Surgical Safety Checklist (awareness of existence, knowledge of objectives, knowledge of correct use, acceptance of the checklist and its implementation (including personal belief of benefits of using the checklist, current use, teamwork and safety climate appreciation were determined. Results Of the 147 surgical personnel who answered the questionnaire, 93.8% were aware of the existence of the WHO Surgical Safety Checklist and 88.8% of them reported knowing its objectives. More nurses than other personnel knew the checklist had to be used before the induction of anesthesia, skin incision, and before the patient leaves the operating room. Most personnel thought using the WHO Surgical Safety Checklist is beneficial and that its implementation was a good decision. Between 73.7% and 100% of nurses in public and private hospitals, respectively, reported the checklist had been used either always or almost always in the general elective surgeries they had participated in during the current year. Conclusions Despite high acceptance of the checklist among personnel, gaps in knowledge about when the checklist should be used still exist. This can jeopardize effective implementation and correct use of the checklist

  12. WHO Surgical Checklist and Its Practical Application in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Shady Abdel-Rehim


    Full Text Available The WHO surgical checklist was introduced to most UK surgical units following the WHO “Safe Surgery Saves Lives” initiative. The aim of this audit was to review patient's safety in the delivery of surgical care and to evaluate the practical application of the new WHO surgical checklist. We conducted a retrospective audit of patients who received operative treatment under general anaesthesia at our Plastic Surgery Department, involving a total number of 90 patients. The WHO form was compared to its former equivalents. Complications or incidents occurring during or after surgery were recorded. Using the department's previous surgical checklist, “Time out” was only performed in only 30% of cases. One patient arrived at theatre reception without a completed consent form, and two clinical incidents were reported without patients suffering harm. Following introduction of current WHO surgical checklist, “Time out” was recorded in 80% of cases. In all cases, the new WHO surgical checklist was used and no incidents were reported. The WHO surgical checklist provides a structured frame work that standardizes the delivery of care across hospitals and specialized units; however, it will take some time and practice for teams to learn to use the checklist effectively and reliably.

  13. [The organization of surgical care in Russian army during 1812 Great Patriotic War]. (United States)

    Gliantsev, S P


    The article considers the characteristics of surgical care to warriors of Russian army during 1812 Great Patriotic War. Such conditions are analyzed as damaging action of French weapons, types of combat wounds, organization and forces of military sanitary service of Russian troops, surgeons' support with means of supplying surgical care to the wounded and arsenal of surgical aids. On the basis of given materials analysis a preliminary conclusion is made that surgical care in Russian army in 1812 not only was on the sufficiently high level but it played a specified role in the victory of Russian weapon.

  14. Recent in vivo surgical robot and mechanism developments. (United States)

    Rentschler, M E; Oleynikov, D


    The surgical landscape is quickly changing because of the major driving force of robotics. Well-established technology that provides robotic assistance from outside the patient may soon give way to alternative approaches that place the robotic mechanisms inside the patient, whether through traditional laparoscopic ports or through other, natural orifices. While some of this technology is still being developed, other concepts are being evaluated through clinical trials. This article examines the state of the art in surgical robots and mechanisms by providing an overview of the ex vivo robotic systems that are commercially available to in vivo mechanisms, and robotic assistants that are being tested in animal models.

  15. Design, Implementation and Testing of Master Slave Robotic Surgical System


    Syed Amjad Ali; Amir Mahmood Soomro; Arbab Nighat Khizer


    The autonomous manipulation of the medical robotics is needed to draw up a complete surgical plan in development. The autonomy of the robot comes from the fact that once the plan is drawn up off-line, it is the servo loops, and only these, that control the actions of the robot online, based on instantaneous control signals and measurements provided by the vision or force sensors. Using only these autonomous techniques in medical and surgical robotics remain relatively limited for two main rea...

  16. Imaging in Lung Transplantation: Surgical Considerations of Donor and Recipient. (United States)

    Backhus, Leah M; Mulligan, Michael S; Ha, Richard; Shriki, Jabi E; Mohammed, Tan-Lucien H


    Modifications in recipient and donor criteria and innovations in donor management hold promise for increasing rates of lung transplantation, yet availability of donors remains a limiting resource. Imaging is critical in the work-up of donor and recipient including identification of conditions that may portend to poor posttransplant outcomes or necessitate modifications in surgical technique. This article describes the radiologic principles that guide selection of patients and surgical procedures in lung transplantation.

  17. Does "grief work" work?

    NARCIS (Netherlands)

    Stroebe, M; Stroebe, W


    This article challenges the long-standing belief in the necessity of "grief work" for adjustment to bereavement. Evidence is offered from a prospective study of 30 widows and 30 widowers that indicates that grief work is not always as essential for adjustment to bereavement as theorists and clinicia

  18. Interaction Force Estimation During Manipulation of Microparticles

    NARCIS (Netherlands)

    Khalil, I.S.M.; Metz, R.M.P.; Abelmann, L.; Misra, S.


    This work investigates the utilization of microparticles for the wireless sensing of interaction forces in magneticbased manipulation systems. The proposed force estimation approach allows for using microparticles in sensing the interaction forces at hard-to-reach regions to avoid the mechanical and

  19. Interaction Force Estimation During Manipulation of Microparticles

    NARCIS (Netherlands)

    Khalil, I.S.M.; Metz, R.M.P.; Abelmann, Leon; Misra, Sarthak


    This work investigates the utilization of microparticles for the wireless sensing of interaction forces in magneticbased manipulation systems. The proposed force estimation approach allows for using microparticles in sensing the interaction forces at hard-to-reach regions to avoid the mechanical and

  20. Cluster forcing

    DEFF Research Database (Denmark)

    Christensen, Thomas Budde

    .g. sustainability or quality of life. The purpose of this paper is to explore how and to what extent public sector interventions that aim at forcing cluster development in industries can support sustainable development as defined in the Brundtland tradition and more recently elaborated in such concepts as eco......, Portugal and New Zealand have adopted the concept. Public sector interventions that aim to support cluster development in industries most often focus upon economic policy goals such as enhanced employment and improved productivity, but rarely emphasise broader societal policy goals relating to e...... to the automotive sector in Wales. Specifically, the paper evaluates the "Accelerates" programme initiated by the Welsh Development Agency and elaborates on how and to what extent the Accelerate programme supports the development of a sustainable automotive industry cluster. The Accelerate programme was set up...

  1. Coriolis Force (United States)

    Marciuc, Daly; Solschi, Viorel


    Understanding the Coriolis effect is essential for explaining the movement of air masses and ocean currents. The lesson we propose aims to familiarize students with the manifestation of the Coriolis effect. Students are guided to build, using the GeoGebra software, a simulation of the motion of a body, related to a rotating reference system. The mathematical expression of the Coriolis force is deduced, for particular cases, and the Foucault's pendulum is presented and explained. Students have the opportunity to deepen the subject, by developing materials related to topics such as: • Global Wind Pattern • Ocean Currents • Coriolis Effect in Long Range Shooting • Finding the latitude with a Foucault Pendulum

  2. 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.

  3. 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 n

  4. Surgical treatment of acquired tracheocele. (United States)

    Porubsky, Edward A; Gourin, Christine G


    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  5. 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 n

  6. Importance of Ethics in Surgical Practice

    Directory of Open Access Journals (Sweden)

    Vedat Menderes Özçiftçi


    Full Text Available The field of ethics, also called moral philosophy, involves systematizing, defending, and recommending concepts of right and wrong behavior. Ethics is an established system of moral principles that govern the rules of conduct. Medical ethics define what the physician ought to do and how he or she should behave. Some of us may think that ethics are unimportant in surgery, however, we should be aware that surgeons operate daily in the theater of moral choice. Ethical considerations, such as diagnosis and treatment, are essential features of the surgical care for each patient (1. Surgeons working in surgical units increasingly face ethical problems owing to growth in scientific knowledge and technology, and the availability of new diagnostic equipment and treatment opportunities. The applications become more complex and the decisions more difficult as advancing technology provides greater opportunities to save lives and relieve pain and suffering. More and more surgical procedures are now carried out in older patients who have multiple and more serious diseases than ever before (2. Doctors often face with ethical dilemmas related to providing care that maintains patients’ dignity while attending their advanced medical treatment. Organizational and financial constraints in hospitals, and professional relationships with colleagues and other healthcare providers also create ethical problems for surgeons as they try to act appropriately towards patients and relatives (3. Studies have shown, however, that physicians often are in doubt about the best and correct actions to take for the patients in specific situations (2-4. In fact, the majority of surgeons with little or no education in bioethics face many ethical challenges in daily practice. The overall aim of this article was to analyze surgeons’ experiences of living with ethical difficulties in their work, and highlight the importance of ethical requirements in surgical practice.

  7. Origin of Knudsen forces on heated microbeams

    KAUST Repository

    Zhu, Taishan


    The presented work probes the fundamentals of Knudsen forces. Using the direct simulation Monte Carlo (DSMC) method, the flows induced by temperature inhomogeneity within a representative configuration and the Knudsen force acting on a heated microbeam are captured as functions of Knudsen number in the entire flow regime. Both flow strength and Knudsen force peak in the transition regime and negative Knudsen force absent in experimental data is observed. The mechanisms of the thermally induced flows and Knudsen forces are studied. It has been found that thermal edge flow is the main driven source for the formation of the Knudsen force on microbeams and domain configuration plays an important role in the process.

  8. Stress-Related Job Analysis for Medical Students on Surgical Wards in Germany. (United States)

    Chiapponi, Costanza; Meyer, Christine Y; Heinemann, Silvia; Meyer, Frank; Biberthaler, Peter; Bruns, Christiane J; Kanz, Karl-Georg

    Working conditions in hospitals generate stress within all professional groups. The aim of this study was to find out how German medical students during their senior student clerkship in surgery perceive their own stress and the stress of surgical residents. This was measured using "Instrument zur stressbezogenen Arbeitsanalyse bei KlinikÃrztInnen (ISAK-K)," a validated questionnaire of the German statutory occupational accident insurance system (BGW). This bi-institutional paper-and-pencil survey was performed on 52 medical students in their sixth year, who had been working in a surgical department for 4 months. Data were compared with those of the BGW on the stress perceived by physicians working in German surgical departments. The stress levels measured with the ISAK-K were similar in students and in physicians working in surgery. Students believe that surgical residents experience a higher time pressure (p students planning a surgical career feel to be more exposed to time pressure (p students, students interested in surgery believe that surgical residents have more possibilities to learn at work (p students believe that surgical residents commonly need to take decisions without having enough information (p students overestimate the stress of surgical residents. Students overestimate time pressure and uncertainty of surgical residents. A possible way to increase their interest in surgery is offering a better insight in surgeons' work and strategies to deal with these stressors. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Key Tenets of Effective Surgery Leadership: Perspectives From the Society of Surgical Chairs Mentorship Sessions. (United States)

    Rosengart, Todd K; Kent, K Craig; Bland, Kirby I; Britt, L D; Eberlein, Timothy J; Gewertz, Bruce Labe; Hunter, John G; Lillemoe, Keith D; Pellegrini, Carlos A; Schulick, Richard D; Stain, Steven Charles; Weigel, Ronald J


    This Special Communication summarizes the key points raised at the Society of Surgical Chairs mentorship panel sessions held at the 2014 and 2015 annual meetings of the society. Highlights of these expert panel discussions include senior chairs' insights into successfully dealing with increasingly complex academic medical organizations and horizontal department management expectations in the context of the arrival of the Millennial Generation into the work force. Three key tenets of effective surgery leadership that arose from these sessions deal with the importance of (1) collaboration and cooperativity, (2) humanized relationships and mentorship, and (3) operational efficiency. Overall, the panel consensus for the future of surgery leadership was optimistic while recognizing that the demands of chairmanship are considerable.

  10. Accelerating surgical training and reducing the burden of surgical disease in Haiti before and after the earthquake. (United States)

    DeGennaro, Vincent A; DeGennaro, Vincent A; Kochhar, Amit; Nathan, Nirmal; Low, Christopher; Avashia, Yash J; Thaller, Seth R


    In general, university-based global health initiatives have tended to focus on expanding access to primary care. In the past, surgical programs may have been characterized by sporadic participation with little educational focus. However, there have been some notable exceptions with plastic surgery volunteer missions. We offer another model of regularly scheduled surgical trips to rural Haiti in plastic and general surgery. The goal of these trips is to reduce the burden of surgical disease and ultimately repair every cleft lip/palate in Haiti. Another principal objective is to accelerate the training of American residents through increased case load and personal interaction with attending surgeons in a concentrated period. Diversity of the case load and the overall number of surgeries performed by residents in a typical surgical trip outpaces the experiences available during a typical week in an American hospital setting. More importantly, we continue to provide ongoing training to Haitian nurses and surgeons in surgical techniques and postoperative care. Our postoperative complication rate has been relatively low. Our follow-up rates have been lower than 70% despite intensive attempts to maintain continued communication with our patients. Through our experiences in surgical care in rural Haiti, we were able to quickly ramp up our trauma and orthopedic surgical care immediately after the earthquake. Project Medishare and the University of Miami continue to operate a trauma and acute care hospital in Port au Prince. The hospital provides ongoing orthopedic, trauma, and neurosurgical expertise from the rotating teams of American surgeons and training of Haitian surgeons in modern surgical techniques. We believe that surgical residencies in the United States can improve their training programs and reduce global surgical burden of disease through consistent trips and working closely with country partners.

  11. The Surgical Treatment of Mycetoma. (United States)

    Suleiman, Suleiman Hussein; Wadaella, El Sammani; Fahal, Ahmed Hassan


    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors' experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan.

  12. The Surgical Treatment of Mycetoma.

    Directory of Open Access Journals (Sweden)

    Suleiman Hussein Suleiman


    Full Text Available Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors' experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan.

  13. Joining Forces

    Institute of Scientific and Technical Information of China (English)


    The Chinese and U.S. navies are bound to work together for the common good of the international community Sino-U.S. military relations recently received another boost. The Japan-Ibased U.S. destroyer USS Fitzgerald joined Chinese and foreign naval vessels in a grand international fleet review to celebrate the 60th anniversary of the founding of the Navy of the People’s Liberation Army (PLA) in the coastal city of Qingdao

  14. Surgical treatment of pediatric rhinosinusitis. (United States)

    Isaacson, G


    Pediatric rhinosinusitis is a common sequela of upper respiratory infections in children. It is usually a self-limited disease, sometimes requiring antibiotic therapy. Surgery may be indicated in children who suffer complication of acute rhinosinusitis, severe recurrent acute rhinosinusitis, rhinosinusitis in cystic fibrosis with or without polyposis, chronic rhinosinusitis refractory to maximal medical management, allergic fungal sinusitis, and paranasal sinus mucoceles. Surgical options include, adenoidectomy, sinus puncture and lavage, open surgical approaches, endoscopic sinus surgery, balloon sinuplasty, and turbinectomy or turbinate reduction. This paper reviews the anatomy and physiology of rhinosinusitis in children and current knowledge of the indications and best methods of surgical treatment.

  15. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael


    A proof of safety is paramount for an autonomous robotic surgical system to ensure that it does not cause trauma to patients. However, a proof of safety is rarely constructed, as surgical systems are too complex to be dealt with by most formal verification methods. In this paper, we design...... a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...

  16. Retained surgical sponge: An enigma

    Directory of Open Access Journals (Sweden)

    Gurjit Singh


    Full Text Available Retained surgical sponge in the body following a surgery is called "gossypiboma". A 27-year-old female who had undergone lower segment cesarean section 4 months earlier was admitted with complaints of pain abdomen with a palpable mass in left iliac fossa. X-ray, ultrasonography, and CT scan findings were suggestive of retained surgical sponge. Surgical sponge was removed following laparotomy. Surgeons must be aware of the risk factors that lead to gossypiboma, and measures should be taken to prevent it. Besides increasing morbidity and possible mortality, it may result in libel suit for compensation.

  17. Surgical research using national databases. (United States)

    Alluri, Ram K; Leland, Hyuma; Heckmann, Nathanael


    Recent changes in healthcare and advances in technology have increased the use of large-volume national databases in surgical research. These databases have been used to develop perioperative risk stratification tools, assess postoperative complications, calculate costs, and investigate numerous other topics across multiple surgical specialties. The results of these studies contain variable information but are subject to unique limitations. The use of large-volume national databases is increasing in popularity, and thorough understanding of these databases will allow for a more sophisticated and better educated interpretation of studies that utilize such databases. This review will highlight the composition, strengths, and weaknesses of commonly used national databases in surgical research.

  18. Surgical Templates for Dental Implant Positioning; Current ...

    African Journals Online (AJOL)

    applied scientifically based research techniques to develop an endosseous implant that forms ... KEYWORDS: Dental implants, surgical templates, surgical procedure, stent .... during the surgical stage for single implant therapy.[24] Afterward,.

  19. Application of the FlexiForce contact surface force sensor to continuous extraocular compression monitoring during craniotomy for cerebral aneurysms. (United States)

    Mutoh, Tatsushi; Ishikawa, Tatsuya; Nishimura, Hiromi; Yasui, Nobuyuki


    The aims of this study were to introduce our newly developed device equipped with a contact surface force sensor (FlexiForce) for monitoring extraocular compression continuously, and to illustrate its potential clinical application using this device in patients undergoing uncomplicated frontotemporal or bifrontal craniotomy for surgical clipping of unruptured anterior circulation aneurysms. In a pilot study with volunteers, we determined the critical force of 100 gf to cause painful ocular sensation. Then we performed the bilateral extraocular force measurements in 15 patients undergoing uncomplicated frontotemporal or bifrontal craniotomy for surgical clipping of unruptured anterior circulation aneurysms. Extraocular force increased immediately after retraction of the flap, increased to 144+/-26 gf (mean+/-SD) during lower craniotomy close to the orbit, was maintained at 91+/-18 gf during microsurgery, and returned close to baseline at 24+/-14 gf after restoration of skin flap retraction. Such changes were observed only on the surgical side in frontotemporal craniotomy. Abnormal increase in extraocular force was effectively reduced by placing a real-time digital panel meter to warn surgeons to avoid excessive skin flap retraction during the surgical procedure. In conclusion, this new tool may allow us to monitor the external forces that can be applied intraoperatively to the ocular globe in the supine position.

  20. Evidence-based surgical wound care on surgical wound infection. (United States)

    Reilly, Jaqueline


    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  1. Surgical wound care - closed (United States)

    ... before touching the dressing. Wash your hands with soap and warm water. Also clean under your nails. Rinse, then dry your hands with a clean towel . Make sure you have all the supplies handy. Have a clean work surface. Remove the old dressing. Put on clean ...

  2. 3D Printed Surgical Instruments: The Design and Fabrication Process. (United States)

    George, Mitchell; Aroom, Kevin R; Hawes, Harvey G; Gill, Brijesh S; Love, Joseph


    3D printing is an additive manufacturing process allowing the creation of solid objects directly from a digital file. We believe recent advances in additive manufacturing may be applicable to surgical instrument design. This study investigates the feasibility, design and fabrication process of usable 3D printed surgical instruments. The computer-aided design package SolidWorks (Dassault Systemes SolidWorks Corp., Waltham MA) was used to design a surgical set including hemostats, needle driver, scalpel handle, retractors and forceps. These designs were then printed on a selective laser sintering (SLS) Sinterstation HiQ (3D Systems, Rock Hill SC) using DuraForm EX plastic. The final printed products were evaluated by practicing general surgeons for ergonomic functionality and performance, this included simulated surgery and inguinal hernia repairs on human cadavers. Improvements were identified and addressed by adjusting design and build metrics. Repeated manufacturing processes and redesigns led to the creation of multiple functional and fully reproducible surgical sets utilizing the user feedback of surgeons. Iterative cycles including design, production and testing took an average of 3 days. Each surgical set was built using the SLS Sinterstation HiQ with an average build time of 6 h per set. Functional 3D printed surgical instruments are feasible. Advantages compared to traditional manufacturing methods include no increase in cost for increased complexity, accelerated design to production times and surgeon specific modifications.

  3. 关于做好海军高山海岛部队官兵心理工作的几点思考%Reflections on How to Implement Soldiers' Psychological Work in Alpine Island Naval Forces

    Institute of Scientific and Technical Information of China (English)



    Based on the real situation of a certain alpine island naval forces, through individual counseling, questionnaire and discussion, the writer deeply enters the forces to learn soldiers' psychological conditions, discovering problems and researches targeted countermeasures and suggestions.%  基于海军某高山海岛部队的实际情况,笔者通过个体咨询、问卷调查、座谈讨论等方式,深入该部队了解官兵心理状况,查找问题,研究针对性的对策建议。

  4. Measurements of the contact force from myenteric contractions on a solid bolus. (United States)

    Terry, Benjamin S; Schoen, Jonathan A; Rentschler, Mark E


    The development of robotic capsule endoscopes (RCEs) is one avenue presently investigated by multiple research groups to minimize invasiveness and enhance outcomes of enteroscopic procedures. Understanding the biomechanical response of the small bowel to RCEs is needed for design optimization of these devices. In previous work, the authors developed, characterized, and tested the migrating motor complex force sensor (MFS), a novel sensor for quantifying the contact forces per unit of axial length exerted by the myenteron on a solid bolus. This work is a continuation, in which the MFS is used to quantify the contractile strength in the small intestine proximal, middle, and distal regions of five live porcine models. The MFSs are surgically implanted in a generally anesthetized animal, and force data from 5 min of dwell time are analyzed. The mean myenteric contact force from all porcine models and locations within the bowel is 1.9 ± 1.0 N cm(-1). Examining the results based on the small bowel region shows a statistically significant strengthening trend in the contractile force from proximal to middle to distal with mean forces of 1.2 ± 0.5, 1.9 ± 0.9, and 2.3 ± 1.0 N cm(-1), respectively (mean ± one standard deviation). Quantification of the contact force against a solid bolus provides developers of RCEs with a valuable, experimentally derived parameter of the intraluminal environment.

  5. Preventing surgical site infection. Where now?

    LENUS (Irish Health Repository)

    Humphreys, H


    Surgical site infection (SSI) is increasingly recognised as a measure of the quality of patient care by surgeons, infection control practitioners, health planners and the public. There is increasing pressure to compare SSI rates between surgeons, institutions and countries. For this to be meaningful, data must be standardised and must include post-discharge surveillance (PDS) as many superficial SSIs do not present to the original institution. Further work is required to determine the best method of conducting PDS. In 2008 two important documents on SSI were published from the Society for Healthcare Epidemiology of America\\/The Infectious Disease Society of America and the National Institute for Health and Clincal Excellence, UK. Both emphasise key aspects during the preoperative, operative and postoperative phases of patient care. In addition to effective interventions known to be important for some time, e.g. not shaving the surgical site until the day of the procedure, there is increasing emphasis on physiological parameters, e.g. blood glucose concentrations, oxygen tensions and body temperature. Laparoscopic procedures are increasingly associated with reduced SSI rates, and the screening and decontamination of meticillin-resistant Staphylococcus aureus carriers is effective for certain surgical procedures but has to be balanced by cost and the risk of mupirocin resistance. Finally, there is a need to convert theory into practice by the rigorous application of SSI healthcare bundles. Recent studies suggest that, with a multidisciplinary approach, simple measures can be effective in reducing SSI rates.

  6. Needle Path Planning for Autonomous Robotic Surgical Suturing. (United States)

    Jackson, Russell C; Cavuşoğlu, M Cenk


    This paper develops a path plan for suture needles used with solid tissue volumes in endoscopic surgery. The path trajectory is based on the best practices that are used by surgeons. The path attempts to minimize the interaction forces between the tissue and the needle. Using surgical guides as a basis, two different techniques for driving a suture needle are developed. The two techniques are compared in hardware experiments by robotically driving the suture needle using both of the motion plans.

  7. Module based training improves and sustains surgical skills

    DEFF Research Database (Denmark)

    Carlsen, C G; Lindorff-Larsen, K; Funch-Jensen, P


    PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills. METHODS......: A randomised controlled trial concerning supervised hernia repair in eight training hospitals in Denmark was performed. The participants were 18 registrars [Post graduate year (PGY) 3 or more] in their first year of surgical specialist training. The intervention consisted of different modules with a skills......-lab course followed by 20 supervised Lichtenstein hernia repairs. Operative performance was video recorded and blindly rated by two consultants using a previously validated skills rating scale (8-40 points). Outcome measures were change in the ratings of operative skills and operative time. RESULTS...

  8. Surgical Treatment of Winged Scapula

    National Research Council Canada - National Science Library

    Galano, Gregory J; Bigliani, Louis U; Ahmad, Christopher S; Levine, William N


    .... Although nonoperative treatment is successful in some patients, failures have led to the evolution of surgical techniques involving various combinations of fascial graft and/or transfer of adjacent muscles...

  9. Essential Tremor (ET): Surgical Options (United States)

    ... t respond to propranolol, primidone, or other common ET medications and whose tremor has become debilitating, there ... treatments were first introduced. Current surgical options for ET include Deep Brain Stimulation (DBS) , Focused Ultrasound Thalamotomy , ...

  10. Surgical treatment of cranial neuralgias. (United States)

    Franzini, Angelo; Ferroli, Paolo; Messina, Giuseppe; Broggi, Giovanni


    The most common types of cranial neuralgias amenable to surgical therapeutic options are trigeminal neuralgia and glossopharyngeal neuralgia, the former having an approximate incidence of 5/100000 cases per year and the latter of 0.05/100000 cases per year. Surgical therapy of these pathological conditions encompasses several strategies, going from ablative procedures to neurovascular decompression, to radiosurgery. The choice of the most appropriate surgical option (which must be taken into account when all conservative treatments have proven to be unsuccessful) has to take into account many factors, the most important ones being neuroradiological evidence of a neurovascular conflict, severity of symptoms, the age and clinical history of the patient, and the patient's overall medical condition. In this chapter we report our experience with the treatment of trigeminal and glossopharyngeal neuralgia, describing the surgical procedures performed and reviewing the most recent aspects on this subject in the past literature.

  11. Surgical trainees and trauma emergencies. (United States)

    Wybaillie, E; Broos, P L O


    An accident and emergency (A&E) training has been suggested as an essential part of the basic surgical training. The A&E curriculum should be divided into three sections: a critical curriculum, a core curriculum and a comprehensive curriculum. For instance, the critical curriculum contains topics that provide the opportunity to translate the ABCDE principles of trauma management into practice. Furthermore, a post in the A&E department provides the surgical trainee with significant exposure to the management of the polytrauma patient and to the management of other acute general surgical, urological and orthopaedic conditions. By presenting better educational programs and by reducing the non-medical tasks a trainee has to deal with, the education of surgical trainees during A&E attachment can be improved.

  12. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    to reduce the global burden of disease (GBD), it is ... global players have supported efforts to improve access and safety of surgery ... (i) strengthening surgical services at district hospitals ... of the surrounding community and a model for other.

  13. Intermittent exotropia: Surgical treatment strategies

    Directory of Open Access Journals (Sweden)

    Jai Aditya Kelkar


    Full Text Available Surgical management of intermittent exotropias (IXTs is ambiguous, with techniques of management varying widely between institutions. This review aims to examine available literature on the surgical management of IXT. A literature search was performed using PubMed, Web of Knowledge, LILACS, and the University of Liverpool Orthoptic Journals and Conference Transactions Database. All English-language papers published between 1958 and the present day were considered.

  14. Aesthetic Surgical Crown Lengthening Procedure. (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria


    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  15. Aesthetic Surgical Crown Lengthening Procedure (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria


    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  16. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira


    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  17. Surgical Treatment of Facial Paralysis


    Mehta, Ritvik P.


    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (2 yr). For acute facial paralysis, the main surgi...

  18. Innovation in pediatric surgical education. (United States)

    Clifton, Matthew S; Wulkan, Mark L


    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  19. Surgical management of hepatic hydatid disease

    Directory of Open Access Journals (Sweden)

    Ketan Vagholkar


    Full Text Available Hydatidosis is strictly a zoonosis. Humans are an accidental host. The disease is endemic in rural agricultural areas. However if acquired by humans, it can cause extensive spread affecting a wide range of organs with predilection for the liver. Managing such cases requires a sound fundamental knowledge of the parasite and its pathogenicity. It is essential that surgeons who deal with such cases have a good working knowledge of the disease. The approaches to hepatic hydatids with respect to the principles of surgical treatment are presented in this article. [Int J Res Med Sci 2016; 4(6.000: 1834-1837

  20. [Surgical managment of colorectal liver metastasis]. (United States)

    Prot, Thomas; Halkic, Nermin; Demartines, Nicolas


    Surgery offer the only curative treatment for colorectal hepatic metastasis. Nowadays, five-year survival increases up to 58% in selected cases, due to the improvement and combination of chemotherapy, surgery and ablative treatment like embolisation, radio-frequency or cryoablation. Surgery should be integrated in a multi disciplinary approach and initial work-up must take in account patient general conditions, tumor location, and possible extra hepatic extension. Thus, a surgical resection may be performed immediately or after preparation with chemotherapy or selective portal embolization. Management of liver metastasis should be carried out in oncological hepato-biliary centre.

  1. Assessment of technical needs for surgical equipment by surgical process models. (United States)

    Neumuth, Thomas; Trantakis, Christos; Riffaud, Laurent; Strauss, Gero; Meixensberger, Jürgen; Burgert, Oliver


    The presented approach introduces a method for estimating the potential benefit of a surgical assist system prior to its actual development or clinical use. The central research question is: What minimal requirements must a future system meet so that its use would be more advantageous than a conventional or already existent method or system, and how can these requirements be obtained from routine clinical data? Forty-three cases of lumbar discectomies were analyzed with regard to activities related to bone ablation in order to predict the temporal requirements for an alternative strategy of using a surgical assist system for bone ablation. The study recorded and analyzed surgical process models (SPM), which are progression models with detailed and exact-to-the-second representations of surgical work steps, as a sensible means for the detailed quantification of the temporal needs of the system. The presented methods can be used for a systematic analysis of such requirements. Implementation of these methods will prove very useful in the future from a medical, technical, and administrative point of view. Manufacturers can use this analytical procedure to derive parameters for their systems that indicate success criteria. Additionally, hospitals can decide, before making actual capital expenditure decisions, if the system of interest is superior to the conventional strategy and therefore worth the investment.

  2. Análisis cuantitativo de la evolución post-quirúrgica de la rotura de ligamento cruzado anterior mediante el uso de la plataforma de fuerza - Quantitative analysis of the evolution of post-surgical anterior cruciate ligament rupture using force platform

    Directory of Open Access Journals (Sweden)

    Vilar, JM


    Full Text Available ResumenEl analisis cinético mediante plataforma de fuerza es un método objetivo de cuantificar el apoyo de los miembros en los animales domésticos.SummaryKinetic análisis by jeans of force platforms is an objetive method to measure weight - bearing or ground reaction force (GRF.

  3. An Analysis of Section 529 College Savings and Prepaid Tuition Plans. A Report Prepared by the Department of Treasury for the White House Task Force on Middle Class Working Families (United States)

    US Department of the Treasury, 2009


    Making college education more affordable is a central goal of the Obama Administration and has been a focus of Vice-President Biden's Taskforce on the Middle Class. To that end, the Task Force asked U.S. Treasury Department to prepare this report on how to make Section 529 college savings plans a more effective and reliable tool for families to…

  4. Cutting for a Career; a Discussion of the Domains of Surgical Competence Using Expert Bespoke Tailoring as a Metaphor for Surgical Practice (United States)

    Rees-Lee, Jacqueline; Kneebone, Roger


    Competency based surgical training uses proficiency of technical skills to quantify surgical competency. We believe this is an over simplification of what is required to be a competent surgeon. This work aims to illuminate the attributes of a mature, competent, thinking surgeon. A bespoke (or custom) tailor is highly trained craftsman who produces…

  5. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter


    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  6. A downward buoyant force experiment


    Lima, F. M. S.; Venceslau,G.M.; Brasil,G.T.


    In hydrostatics, the Archimedes principle predicts an upward force whenever a body is submerged in a liquid. In contrast to common sense, this physical law is not free of exceptions, as for example when the body touches the container. This is more evident when a rectangular block less dense than the liquid rests on the bottom, with no liquid underneath it, a case in which a downward force is expected, according to a recent work by the first author. In the present work, we describe a simple, l...

  7. [Surgical service at the Central Military Hospital of People's Commissariat of Defence shortly before the Great Patriotic War]. (United States)

    Krainyukov, P E; Efimenko, N A; Abashin, V G


    Authors present the article historical data on the foundation and development of surgical service at the 1st Therapeutic Red Cross Hospital (Central Military Hospital of People's Commissariat. of Defense) since its organization. The structure of the hospital surgical service and organization of surgical activity during the pre-war years is presented. Provided information about outstanding surgeons who was working in the hospital.

  8. Implementing Force-Feedback in a Telesurgery Environment, Using Parameter Estimation

    DEFF Research Database (Denmark)

    Hansen, Thomas; Henningsen, Claus; Nielsen, Jens;


    During minimal invasive telesurgery with surgical robots, surgeons rely on their vision to determine the forces applied to tissue. A force-feedback control system has been developed, in order to reduce the unnecessary forces applied by the surgeon. To avoid adding any additional hardware...

  9. A Novel Device for Measuring Forces in Endoluminal Procedures

    Directory of Open Access Journals (Sweden)

    Tommaso Ranzani


    Full Text Available In this paper a simple but effective measuring system for endoluminal procedures is presented. The device allows measuring forces during the endoluminal manipulation of tissues with a standard surgical instrument for laparoscopic procedures. The force measurement is performed by recording both the forces applied directly by the surgeon at the instrument handle and the reaction forces on the access port. The measuring system was used to measure the forces necessary for appropriate surgical manipulation of tissues during transanal endoscopic microsurgery (TEM. Ex-vivo and in-vivo measurements were performed, reported and discussed. The obtained data can be used for developing and appropriately dimensioning novel dedicated instrumentation for TEM procedures.

  10. A Novel Device for Measuring Forces in Endoluminal Procedures

    Directory of Open Access Journals (Sweden)

    Tommaso Ranzani


    Full Text Available In this paper a simple but effective measuring system for endoluminal procedures is presented. The device allows measuring forces during the endoluminal manipulation of tissues with a standard surgical instrument for laparoscopic procedures. The force measurement is performed by recording both the forces applied directly by the surgeon at the instrument handle and the reaction forces on the access port. The measuring system was used to measure the forces necessary for appropriate surgical manipulation of tissues during transanal endoscopic microsurgery (TEM. Ex-vivo and in-vivo measurements were performed, reported and discussed. The obtained data can be used for developing and appropriately dimensioning novel dedicated instrumentation for TEM procedures.

  11. Phase Segmentation Methods for an Automatic Surgical Workflow Analysis (United States)

    Sakurai, Ryuhei; Yamazoe, Hirotake


    In this paper, we present robust methods for automatically segmenting phases in a specified surgical workflow by using latent Dirichlet allocation (LDA) and hidden Markov model (HMM) approaches. More specifically, our goal is to output an appropriate phase label for each given time point of a surgical workflow in an operating room. The fundamental idea behind our work lies in constructing an HMM based on observed values obtained via an LDA topic model covering optical flow motion features of general working contexts, including medical staff, equipment, and materials. We have an awareness of such working contexts by using multiple synchronized cameras to capture the surgical workflow. Further, we validate the robustness of our methods by conducting experiments involving up to 12 phases of surgical workflows with the average length of each surgical workflow being 12.8 minutes. The maximum average accuracy achieved after applying leave-one-out cross-validation was 84.4%, which we found to be a very promising result. PMID:28408921

  12. Surgical versus non-surgical treatment of congenital hyperinsulinism. (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David


    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  13. The Radiation Magnetic Force (FmR) (United States)

    Yousif, Mahmoud


    The detection of Circular Magnetic Field (CMF), associated with electrons movement, not incorporated in theoretical works; is introduced as elements of attraction and repulsion for magnetic force between two conductors carrying electric currents; it also created magnetic force between charged particles and magnetic field, or Lorentz force; CMF contain energy of Electromagnetic Radiation (EM-R); a relationship has been established between the magnetic part of the EM-R, and radiation force, showing the magnetic force as a frequency controlled entity, in which a Radiation Magnetic Force formula is derived, the force embedded EM-Wave, similar to Electromagnetic Radiation Energy given by Planck's formula; the force is accountable for electron removal from atom in the Photoelectric Effects, stabilizing orbital atoms, excitation and ionization atoms, initiating production of secondary EM-R in Compton Effect mechanism; the paper aimed at reviving the wave nature of EM-R, which could reflects in a better understanding of the microscopic-world.

  14. Bacterial adhesion force quantification by fluidic force microscopy (United States)

    Potthoff, Eva; Ossola, Dario; Zambelli, Tomaso; Vorholt, Julia A.


    cells. The contact time and setpoint dependence of the adhesion forces of E. coli and Streptococcus pyogenes, as well as the sequential detachment of bacteria out of a chain, are shown, revealing distinct force patterns in the detachment curves. This study demonstrates the potential of the FluidFM technology for quantitative bacterial adhesion measurements of cell-substrate and cell-cell interactions that are relevant in biofilms and infection biology. Electronic supplementary information (ESI) available: Video S1. Detachment of a S. pyogenes cell chain from glass substrate. The cantilever is approached on the outermost adherent cell of a chain and four bacteria were then sequentially detached. The sequential cell detachment suddenly stopped after four bacteria. This possibly occurred because bacteria-glass interactions became too strong or the maximal probe retraction was reached. The cells spontaneously detached from the cantilever flipping back on the surface. Fig. S1. (A) Adhesion force-distance and (B) adhesion force-detaching work correlation of E.coli on PLL for setpoints of 1 and 10 nN. Circle: 1 nN setpoint, square: 10 nN. See DOI: 10.1039/c4nr06495j

  15. Elastic deformation due to tangential capillary forces

    CERN Document Server

    Das, Siddhartha; Andreotti, Bruno; Snoeijer, Jacco H


    A sessile liquid drop can deform the substrate on which it rests if the solid is sufficiently "soft". In this paper we compute the detailed spatial structure of the capillary forces exerted by the drop on the solid substrate using a model based on Density Functional Theory. We show that, in addition to the normal forces, the drop exerts a previously unaccounted tangential force. The resultant effect on the solid is a pulling force near the contact line directed towards the interior of the drop, i.e. not along the interface. The resulting elastic deformations of the solid are worked out and illustrate the importance of the tangential forces.

  16. Transcription Against an Applied Force (United States)

    Yin, Hong; Wang, Michelle D.; Svoboda, Karel; Landick, Robert; Block, Steven M.; Gelles, Jeff


    The force produced by a single molecule of Escherichia coli RNA polymerase during transcription was measured optically. Polymerase immobilized on a surface was used to transcribe a DNA template attached to a polystyrene bead 0.5 micrometer in diameter. The bead position was measured by interferometry while a force opposing translocation of the polymerase along the DNA was applied with an optical trap. At saturating nucleoside triphosphate concentrations, polymerase molecules stalled reversibly at a mean applied force estimated to be 14 piconewtons. This force is substantially larger than those measured for the cytoskeletal motors kinesin and myosin and exceeds mechanical loads that are estimated to oppose transcriptional elongation in vivo. The data are consistent with efficient conversion of the free energy liberated by RNA synthesis into mechanical work.

  17. Towards an in vivo wireless mobile robot for surgical assistance. (United States)

    Hawks, Jeff A; Rentschler, Mark E; Redden, Lee; Infanger, Roger; Dumpert, Jason; Farritor, Shane; Oleynikov, Dmitry; Platt, Stephen R


    The use of miniature in vivo robots that fit entirely inside the peritoneal cavity represents a novel approach to laparoscopic surgery. Previous work has demonstrated that mobile and fixed-base in vivo robots can be used to improve visualization of the surgical field and perform surgical tasks such as collecting biopsy tissue samples. All of these robots used tethers to provide for power and data transmission. This paper describes recent work focused on developing a modular wireless mobile platform that could be used for in vivo robotic sensing and manipulation applications. One vision for these types of self-contained in vivo robotic devices is that they could be easily carried and deployed by non-medical personnel at the site of an injury. Such wireless in vivo robots are much more transportable and lower cost than current robotic surgical assistants, and could ultimately allow a surgeon to become a remote first responder irrespective of the location of the patient.

  18. Using dummies for surgical skills training

    DEFF Research Database (Denmark)

    Langebæk, Rikke


    teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...... this a relatively low budget solution with a big ethical benefit....

  19. 21 CFR 878.4040 - Surgical apparel. (United States)


    ... known as scrub suits, are excluded. (b) Classification. (1) Class II (special controls) for surgical... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical apparel. 878.4040 Section 878.4040 Food... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4040 Surgical apparel....

  20. Surgical treatment for male prolactinoma (United States)

    Song, Yi-Jun; Chen, Mei-Ting; Lian, Wei; Xing, Bing; Yao, Yong; Feng, Ming; Wang, Ren-Zhi


    Abstract A total of 184 cases of surgically treated male prolactinoma were analyzed retrospectively to summarize the outcome of this surgical intervention. We analyzed the general characteristics, clinical manifestations, hormone levels, imaging features, preoperative treatments, surgical outcomes, pathology results, and follow-up records for all included patients. The most common clinical manifestations included sexual dysfunction (47.4%), headache (55.9%), and visual disturbance (46.7%). Serum prolactin levels ranged from 150 to 204,952 ng/mL. Tumor size varied from 6 to 70 mm. Pituitary adenomas grew in a parasellar pattern with visual deficits occurring 40.7% of the time. After surgical therapy, 88.6% of patients achieved symptom relief, and 98.4% experienced an immediate postoperative decline in prolactin level. Fifty-seven patients (31.0%) achieved initial remission, and 26 patients (45.6%) experienced recurrence. Hence, our results suggest that in male prolactinoma characterized by a large pituitary diameter and high serum prolactin level, tumor size predicts the degree of gross resection. The prognostic predictors included preoperative tumor growth pattern and Ki-67 index. Citation: Yi-jun S, Mei-ting C, Wei L, Bing X, Yong Y, Ming F, Ren-zhi W. (2016) Surgical treatment for male prolactinoma: a retrospective study of 184 cases PMID:28079813

  1. Can we measure surgical resilience? (United States)

    Graham, David; Becerril-Martinez, Guillermo; Quinto, Lena; Zhao, Dong Fang


    Surgical resilience describes psychological resilience within a surgical setting. Within a surgical setting, psychologically resilient patients have improved recovery and wound-healing. The search for biological correlates in resilient patients has led to the hypothesis that certain endogenous biomarkers (namely neuropeptide Y (NPY), testosterone, and dehydroepiandrosterone (DHEA)) are altered in resilient patients. The concept of surgical resilience raises the question of whether enhanced recovery following surgery can be demonstrated in patients with high titres of resilience biomarkers as compared to patients with low titres of resilience biomarkers. To determine the prognostic value of resilience biomarkers in surgical recovery, a cohort of patients undergoing major surgery should initially be psychometrically tested for their resilience levels before and after surgery so that biomarker levels of NPY, testosterone and DHEA can be compared to a validated psychometric test of resilience. The primary outcome would be length of hospital stay with and without an enhanced recovery program. Secondary outcome measures such as complications, time in rehabilitation and readmission could also be included. If the hypothesis is upheld, resilience biomarkers could be used to support more individualised perioperative management and lead to more efficient and effective allocation of healthcare resources.

  2. [Optimization of working in the operating room by minimizing losses and improving flow]. (United States)

    Leppikangas, Heli; Puolakka, Pia; Korppi, Anssi; Heikki-Jussi, Laine


    The need for development of practices within the Finnish healthcare system is immense. Economic threats will force the system to streamline treatment processes without sacrificing quality. Surgical operations bind resources and represent one of the most expensive units in the hospital. By developing the respective procedures it is possible to achieve significant changes in the patient's entire care pathway. Lean is a practical management philosophy involving fairly expedient and structured methods of work development. On the basis of available research results and practical experiences Lean is very well suited for a method of development of practices within healthcare.

  3. Surgical-orthodontic management of bilateral multiple impactions in non-syndromic patient


    Agrawal, Jiwanasha Manish; Agrawal, Manish Suresh; Nanjannawar, Lalita Girish


    Several surgical and orthodontic treatment options are available to disimpact the impacted teeth. But the closed eruption technique has the best long-term prognosis. The tooth is surgically exposed, an attachment is bonded to it, flap is resutured over it and an orthodontic extrusive force is delivered to bring the tooth into occlusion. This case report presents a case with multiple impacted teeth in which no syndrome or systemic conditions were detected. A 20-year-old female patient reported...

  4. Malaysia and forced migration

    National Research Council Canada - National Science Library

    Arzura Idris


    This paper analyzes the phenomenon of "forced migration" in Malaysia. It examines the nature of forced migration, the challenges faced by Malaysia, the policy responses and their impact on the country and upon the forced migrants...

  5. Statistical Mechanics of Entropic Forces: Disassembling a Toy (United States)

    Sokolov, Igor M.


    The notion of entropic forces often stays mysterious to students, especially to ones coming from outside physics. Although thermodynamics works perfectly in all cases when the notion of entropic force is used, no effort is typically made to explain the mechanical nature of the forces. In this paper we discuss the nature of entropic forces as…

  6. Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection. (United States)

    Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien


    Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  7. Handbook of force transducers

    CERN Document Server

    Stefanescu, Dan Mihai


    Part I introduces the basic ""Principles and Methods of Force Measurement"" acording to a classification into a dozen of force transducers types: resistive, inductive, capacitive, piezoelectric, electromagnetic, electrodynamic, magnetoelastic, galvanomagnetic (Hall-effect), vibrating wires, (micro)resonators, acoustic and gyroscopic. Two special chapters refer to force balance techniques and to combined methods in force measurement. Part II discusses the ""(Strain Gauge) Force Transducers Components"", evolving from the classical force transducer to the digital / intelligent one, with the inco

  8. Malaysia and forced migration


    Arzura Idris


    This paper analyzes the phenomenon of “forced migration” in Malaysia. It examines the nature of forced migration, the challenges faced by Malaysia, the policy responses and their impact on the country and upon the forced migrants. It considers forced migration as an event hosting multifaceted issues related and relevant to forced migrants and suggests that Malaysia has been preoccupied with the issue of forced migration movements. This is largely seen in various responses invoked from Malaysi...

  9. Outcome of surgical treatment of arthrofibrosis following ligament reconstruction. (United States)

    Said, Sinan; Christainsen, Svend Erik; Faunoe, Peter; Lund, Bent; Lind, Martin


    Clinical outcome following surgical treatment and intensive physiotherapy was evaluated in patients with arthrofibrosis as a complication to varying knee-ligament reconstructions. From 2003 to 2007, 31 patients underwent surgery for arthrofibrosis as a postoperative complication following knee-ligament reconstruction. Treatment for reduced range of motion consisted of forced manipulation or arthroscopic arthrolysis followed by intensive physiotherapy. Twenty-seven patients (12 men and 15 women; median age 35(12-70) years) were followed up. Objective examination, Pain, KOOS and Tegner scores were used to evaluate the clinical outcome at follow-up. Fourteen patients were treated with forced manipulation alone, and the remaining thirteen were treated with forced manipulation and arthroscopic arthrolysis. The patients' median follow-up was 51 months (19-73 months). Median interval between primary surgery and surgical release was 4 (1-32) months. Median range of motion (ROM) improved from -0°(0 to 20) to 0°(+2-9) in extension deficit and from 90°(40-145) to 130°(90-155) in flexion. Mean KOOS score were symptoms 63, pain 72, ADL 77, sport 42, QOL 45. Median Tegner score was 4 (2-9). Surgical arthrolysis combined with intensive physiotherapy improved range of motion to nearly normal values. Subjective outcome scores revealed relatively poor outcome levels compared to uncomplicated knee-ligament reconstruction. Predictors of poor outcome were global arthrofibrosis and greater than 6-month time interval from primary reconstruction and surgical release. Retrospective clinical case series, Level IV.

  10. Surgical treatment of facial paralysis. (United States)

    Mehta, Ritvik P


    The management of facial paralysis is one of the most complex areas of reconstructive surgery. Given the wide variety of functional and cosmetic deficits in the facial paralysis patient, the reconstructive surgeon requires a thorough understanding of the surgical techniques available to treat this condition. This review article will focus on surgical management of facial paralysis and the treatment options available for acute facial paralysis (facial paralysis (3 weeks to 2 yr) and chronic facial paralysis (>2 yr). For acute facial paralysis, the main surgical therapies are facial nerve decompression and facial nerve repair. For facial paralysis of intermediate duration, nerve transfer procedures are appropriate. For chronic facial paralysis, treatment typically requires regional or free muscle transfer. Static techniques of facial reanimation can be used for acute, intermediate, or chronic facial paralysis as these techniques are often important adjuncts to the overall management strategy.


    Directory of Open Access Journals (Sweden)

    Andonovska Biljana J.


    Full Text Available The term 'malnutrition' is a broad term used to describe any imbalance in the diet. In 2009 it was confirmed that malnutrition is an urgent health problem. The reasons for which malnutrition may develop are different. Loss on cellular, physical and physiological level happens as a consequence of malnutrition. Studies show that in surgical practice there is malnutrition in 50% of patients and that there is an association between inadequate nutritional status and surgical result. It leads to prolonged treatment, increasing of the level of morbidity and mortality, increased hospital costs, etc. Sometimes malnutrition is unrecognised, untreated and worsened in hospitals. For this reason this paper will elaborate: nutrition and a surgical patient, assessment of a nutritional status, assessment of energy requirements, and enteral and parenteral nutrition in order to determine the conditions and procedures that affect the appearance, recognition and treatment of malnutrition.

  12. Surgical Complications of Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Basir Hashemi


    Full Text Available Cochlear implantation is a method used for the treatment ofpatients with profound hearing loss. This procedure may theaccompanied by some major or minor complications. Weevaluated the surgical complications of cochlear implantationin Fars province (south of Iran. A total of 150 patients withcochlear implantation were enrolled in the present study. Mostof the patients were pre-lingual children and most of our deviceswere nucleus prosthesis. We had three device failuresand four major complications, including one misplaced electrode,one case of meningitis, one case of foreign body reactionto suture and one case with extensive hematoma. Thesecomplications were managed successfully by surgical interventionor re-implantation. Facial nerve damage or woundbreakdown was not seen. Minor complications including smallhematoma, edema, stitch infection and dizziness were found in15 cases, which were managed medically. In our center, therate of minor complications was comparable to other centersin the world. But the rate of major surgical complications waslower than other centers.

  13. Nutrition support in surgical oncology. (United States)

    Huhmann, Maureen B; August, David A


    This review article, the second in a series of articles to examine the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients, evaluates the evidence related to the use of nutrition support in surgical oncology patients. Cancer patients develop complex nutrition issues. Nutrition support may be indicated in malnourished cancer patients undergoing surgery, depending on individual patient characteristics. As with the first article in this series, this article provides background concerning nutrition issues in cancer patients, as well as discusses the role of nutrition support in the care of surgical cancer patients. The goal of this review is to enrich the discussion contained in the clinical guidelines as they relate to recommendations made for surgical patients, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequently published studies.

  14. [Surgical adrenal approaches: learned experiences]. (United States)

    Bravo-Lázaro, Santos; Hernandis-Villalba, Juan; Meroño-Carbajosa, Emilio; Navío-Perales, Juan; Marzal-Felici, Vicente


    Laparoscopic surgery is the standard approach for surgical adrenal gland pathology. However, the open procedure still has its role. Our intention is to report our results and experience using different techniques. A retrospective study of 40 patients was carried out. Demographic and surgical data were analyzed. Thirty two patients had benign pathology and eight had malignant tumors. Laparotomy was performed in 18 patients: seven patients with malignant tumors and 11 with benign pathology. Young's approach was indicated in four patients. Laparoscopic aproach was indicated in 25 patients with seven patients requiring conversion to laparotomy. The conversion rate was 28% In most cases, the laparoscopic approach is the standard technique. Appropriate case selection is of primary importance. Other surgical techniques should be considered if necessary.

  15. Coffee Cup Atomic Force Microscopy (United States)

    Ashkenaz, David E.; Hall, W. Paige; Haynes, Christy L.; Hicks, Erin M.; McFarland, Adam D.; Sherry, Leif J.; Stuart, Douglas A.; Wheeler, Korin E.; Yonzon, Chanda R.; Zhao, Jing; Godwin, Hilary A.; Van Duyne, Richard P.


    In this activity, students use a model created from a coffee cup or cardstock cutout to explore the working principle of an atomic force microscope (AFM). Students manipulate a model of an AFM, using it to examine various objects to retrieve topographic data and then graph and interpret results. The students observe that movement of the AFM…

  16. Coffee Cup Atomic Force Microscopy (United States)

    Ashkenaz, David E.; Hall, W. Paige; Haynes, Christy L.; Hicks, Erin M.; McFarland, Adam D.; Sherry, Leif J.; Stuart, Douglas A.; Wheeler, Korin E.; Yonzon, Chanda R.; Zhao, Jing; Godwin, Hilary A.; Van Duyne, Richard P.


    In this activity, students use a model created from a coffee cup or cardstock cutout to explore the working principle of an atomic force microscope (AFM). Students manipulate a model of an AFM, using it to examine various objects to retrieve topographic data and then graph and interpret results. The students observe that movement of the AFM…

  17. Surgical teams: role perspectives and role dynamics in the operating room. (United States)

    Leach, Linda Searle; Myrtle, Robert C; Weaver, Fred A


    Observations of surgical teams in the operating room (OR) and interviews with surgeons, circulating registered nurses (RNs), anaesthesiologists and surgical technicians reveal the importance of leadership, team member competencies and an enacted environment that encourages feelings of competence and cooperation. Surgical teams are more loosely coupled than intact and bounded. Team members tend to rely on expected role behaviours to bridge lack of familiarity. While members of the surgical team identified technical competence and preparation as critical factors affecting team performance, they had differing views over the role behaviours of other members of the surgical team that lead to surgical team performance. Observations revealed that the work climate in the OR can shape interpersonal relations and begins to be established when the room is being set up for the surgical case, and evolves as the surgical procedure progresses. The leadership and supervisory competencies of the circulating RNs establish the initial work environment. Both influenced the degree of cooperation and support that was observed, which had an effect on the interactions and relationships between other members of the surgical team. As the surgery unfolds, the surgeon's behaviours and interpersonal relations modify this environment and ultimately influence the degree of team work, team satisfaction and team performance.

  18. Work pressure is major cause of accidents at work

    NARCIS (Netherlands)

    Smulders, P.


    The work-related accident rate in the Netherlands is 6.4%. The highest rates were found in the construction and agricultural sectors and in the police force. Workers subject to heavy work and work pressure are shown to have an accident rate up to five times greater than for workers who seldom or nev

  19. The quality of work : The work-family interface

    NARCIS (Netherlands)

    Schouteten, RLJ; de Witte, M C; Isaksson, K; Hogstedt, C; Eriksson, C; Theorell, T


    Since the early years of this century the characteristics of work and work circumstances in the Netherlands, like in other European countries, changed dramatically. The development of a 24 hour economy, the flexibilisation of work, and a greater participation of women in the labour force are

  20. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard


    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...

  1. Caring for migrant farm workers on medical-surgical units. (United States)

    Anthony, Maureen J


    Over 3 million migrant farm workers are employed in the United States. Many factors place them at risk for work-related disease and injury. Knowledge of workers' health issues can prepare medical-surgical nurses to anticipate and meet the needs of this underserved population.

  2. Exploring the Changing Landscape of Surgical Residency Training

    NARCIS (Netherlands)

    C.J. Hopmans (Niels)


    textabstractWithin the past decade, the structure and format of surgical residency training has changed radically by the introduction of competency-based training programs, the progressive fragmentation of general surgery into subspecialties, and the implementation of stringent work hour restriction

  3. [Wound prevention in the surgical intensive care unit]. (United States)

    Le Moel, Carole; Mounier, Roman; Ardic-Pulas, Taline


    Literature reports a high prevalence of wounds in the hospital environment. A study devoted to wounds encountered in post-surgical intensive care has been carried out in a university hospital. This work highlighted the diversity of acute wounds mainly observed in intensive care and the difficulties nurses have in managing them.

  4. Managing a surgical unit using google drive - a feasibility study

    Directory of Open Access Journals (Sweden)

    Ashley Solomon C.


    Conclusions: It is feasible to use google drive as a patient management system by a surgical unit to organise work. This system is efficient, secure and cost effective. [Int J Res Med Sci 2016; 4(10.000: 4365-4369

  5. Aeromobility and work

    DEFF Research Database (Denmark)

    Lassen, Claus


    In this paper, the hypothesis is that there is a connection between international aeromobility, knowledge organisations, and environmental impacts. The object is therefore to examine the driving forces, mechanisms, and patterns of meaning behind the increase in international long-distance work...

  6. Royal Danish Air Force. Air Operations Doctrine

    DEFF Research Database (Denmark)

    Nørby, Søren

    This brief examines the development of the first Danish Air Force Air Operations Doctrine, which was officially commissioned in October 1997 and remained in effect until 2010. The development of a Danish air power doctrine was heavily influenced by the work of Colonel John Warden (USAF), both...... through his book ”The Air Campaign” and his subsequent planning of the air campaign against Iraq in 1990-1991. Warden’s ideas came to Denmark and the Danish Air Force by way of Danish Air Force students attending the United States Air Force Air University in Alabama, USA. Back in Denmark, graduates from...... the Air University inspired a small number of passionate airmen, who then wrote the Danish Air Operations Doctrine. The process was supported by the Air Force Tactical Command, which found that the work dovetailed perfectly with the transformation process that the Danish Air Force was in the midst...

  7. Providing surgical care in Somalia: A model of task shifting

    Directory of Open Access Journals (Sweden)

    Ford Nathan P


    Full Text Available Abstract Background Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. Methods In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Results Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65% were male and the median age was 22 (interquartile range, 17-30. 1460 (70% of interventions were emergent. Trauma accounted for 76% (1585 of all surgical pathology; gunshot wounds accounted for 89% (584 of violent injuries. Operative mortality (0.5% of all surgical interventions was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. Conclusions The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully


    Directory of Open Access Journals (Sweden)

    E. V. Prozorenko


    Full Text Available Cerebral metastases occur with 10 to 30 % of all oncological patients. Hemorrhages into cerebral metastases are one of the most dangerous complications of the metastatic process. With that, cerebral metastases of such widespread solid malignant tumors as melanoma, kidney cancer, germ cell tumors, less frequently, lung cancer and breast cancer are prone to hemorrhages. The purpose of the work is to improve the results of surgical treatment of patients with brain metastases complicated with hemorrhages.Materials  and  methods. Surgical  treatment  of  69  patients  with  brain  metastases complicated  with  hemorrhages was  performed in N.N. Blokhin Russian Cancer Research Center. Hemorrhage on the macroscopic level was confirmed intraoperatively and in accordance with the results of the morphological study of surgical drugs. Total microsurgical resection of one or several cerebral metastases with hemor rhages was performed regarding all patients studied. The time interval of observation of patients after the surgical treatment comprises 1 to 72 months. There were 27 women and 42 men. The age range was from 18 to 74 y.o. Besides, the state of veins of lower extremities and the state of the coagulation blood system in accordance with the data of coagulograms was studies. The analysis of the macrostructure and the microstructure of metastases with hemorrhages as well as the morphological study of the brain tissue adjacent to hematomas was performed with a morphological study and histological techniques. The patients were distributed in accordance with the RPA (recursive partitioning analysis classes: I class (n = 7, II class (n = 39, III class (n = 23; in accordance with the hemorrhage type: intratumoral type (26 metastases, perifocal type (20, mixed type (32; in accordance with the histological principle: melanoma (n = 25, lung cancer (n = 13, kidney cancer (n = 17, breast cancer (n = 4, colorectal cancer (n = 1, soft tissue sarcoma (n

  9. Attainment and retention of force moderation following laparoscopic resection training with visual force feedback. (United States)

    Hernandez, Rafael; Onar-Thomas, Arzu; Travascio, Francesco; Asfour, Shihab


    Laparoscopic training with visual force feedback can lead to immediate improvements in force moderation. However, the long-term retention of this kind of learning and its potential decay are yet unclear. A laparoscopic resection task and force sensing apparatus were designed to assess the benefits of visual force feedback training. Twenty-two male university students with no previous experience in laparoscopy underwent relevant FLS proficiency training. Participants were randomly assigned to either a control or treatment group. Both groups trained on the task for 2 weeks as follows: initial baseline, sixteen training trials, and post-test immediately after. The treatment group had visual force feedback during training, whereas the control group did not. Participants then performed four weekly test trials to assess long-term retention of training. Outcomes recorded were maximum pulling and pushing forces, completion time, and rated task difficulty. Extreme maximum pulling force values were tapered throughout both the training and retention periods. Average maximum pushing forces were significantly lowered towards the end of training and during retention period. No significant decay of applied force learning was found during the 4-week retention period. Completion time and rated task difficulty were higher during training, but results indicate that the difference eventually fades during the retention period. Significant differences in aptitude across participants were found. Visual force feedback training improves on certain aspects of force moderation in a laparoscopic resection task. Results suggest that with enough training there is no significant decay of learning within the first month of the retention period. It is essential to account for differences in aptitude between individuals in this type of longitudinal research. This study shows how an inexpensive force measuring system can be used with an FLS Trainer System after some retrofitting. Surgical

  10. Towards robotic heart surgery: introduction of autonomous procedures into an experimental surgical telemanipulator system. (United States)

    Bauernschmitt, R; Schirmbeck, E U; Knoll, A; Mayer, H; Nagy, I; Wessel, N; Wildhirt, S M; Lange, R


    The introduction of telemanipulator systems into cardiac surgery enabled the heart surgeon to perform minimally invasive procedures with high precision and stereoscopic view. For further improvement and especially for inclusion of autonomous action sequences, implementation of force-feedback is necessary. The aim of our study was to provide a robotic scenario giving the surgeon an impression very similar to open procedures (high immersion) and to enable autonomous surgical knot tying with delicate suture material. In this experimental set-up the feasibility of autonomous surgical knot tying is demonstrated for the first time using stereoscopic view and force feedback. Copyright 2005 John Wiley & Sons, Ltd.

  11. From theater to the world wide web--a new online era for surgical education.

    LENUS (Irish Health Repository)

    O'Leary, D Peter


    Traditionally, surgical education has been confined to operating and lecture theaters. Access to the World Wide Web and services, such as YouTube and iTunes has expanded enormously. Each week throughout Ireland, nonconsultant hospital doctors work hard to create presentations for surgical teaching. Once presented, these valuable presentations are often never used again.

  12. A career in surgical oncology: finding meaning, balance, and personal satisfaction. (United States)

    Shanafelt, Tait


    The practice of surgical oncology provides opportunities for both personal distress as well as personal satisfaction. While many surgical oncologists experience career burnout, others derive great meaning and satisfaction from their work. In this article, we review the literature on surgeon burnout, discuss potential personal and professional consequences, and consider steps individual surgeons can take to promote personal and professional satisfaction.

  13. Tan Zheng,s On the Problems of Army Political Work and the Maturity and Development of Party Building Theory for the Armed Forces%谭政《关于军队政治工作问题》的报告与军队党建理论成熟与发展

    Institute of Scientific and Technical Information of China (English)



    Delegated by the Party Central and Mao Zedong, Tan Zheng made the report On the Problems of Ar-my Political Work at the Northwestern Senior Cadres, Meeting to elaborate a series of theoretical principles for party building in the armed forces. The report expounded the status and effects of party building in the armed forces, clarified the fundamental tasks of party building in the armed forces, revealed the essential relationship between party building and military building in the armed forces, raised a series of principles for party ideological building in the armed forces, and proposed important arguments such as necessity of scientification and continuous institu-tional innovation for party building in armed forces. The Tan Zheng Report is an important part of Mao Zedong Thought on party building, a programmatic document to guide party building in the armed forces, and still has e-normous guiding significance for party building in the armed forces under the new historical situations.%谭政受党中央、毛泽东同志的委托,在西北局高干会上做的《关于军队政治工作问题》的报告,阐述了军队党的建设一系列重大理论原则:阐明了军队党的建设的地位作用,明确了军队党的建设的根本任务,揭示了军队党的建设与军队建设的本质联系,提出了军队党的思想建设的一系列原则,提出了军队党的建设要科学化和不断进行制度创新等重要观点。《谭政报告》是毛泽东建党思想的重要组成部分,是指导军队党的建设的纲领性文件,对新的历史条件下军队党建仍具有巨大的指导意义。

  14. Non-linear finite element simulations of injuries with free boundaries: application to surgical wounds (United States)

    Valero, C.; Javierre, E.; García-Aznar, J. M.; Gómez-Benito, M. J.


    SUMMARY Wound healing is a process driven by biochemical and mechanical variables in which new tissue is synthesised to recover original tissue functionality. Wound morphology plays a crucial role in this process, as the skin behaviour is not uniform along different directions. In this work we simulate the contraction of surgical wounds, which can be characterised as elongated and deep wounds. Due to the regularity of this morphology, we approximate the evolution of the wound through its cross-section, adopting a plane strain hypothesis. This simplification reduces the complexity of the computational problem while maintaining allows for a thorough analysis of the role of wound depth in the healing process, an aspect of medical and computational relevance that has not yet been addressed. To reproduce wound contraction we consider the role of fibroblasts, myofibroblasts, collagen and a generic growth factor. The contraction phenomenon is driven by cell-generated forces. We postulate that these forces are adjusted to the mechanical environment of the tissue where cells are embedded through a mechanosensing and mechanotransduction mechanism. To solve the non-linear problem we use the Finite Element Method and an updated Lagrangian approach to represent the change in the geometry. To elucidate the role of wound depth and width on the contraction pattern and evolution of the involved species, we analyse different wound geometries with the same wound area. We find that deeper wounds contract less and reach a maximum contraction rate earlier than superficial wounds. PMID:24443355

  15. Nonlinear finite element simulations of injuries with free boundaries: application to surgical wounds. (United States)

    Valero, C; Javierre, E; García-Aznar, J M; Gómez-Benito, M J


    Wound healing is a process driven by biochemical and mechanical variables in which a new tissue is synthesised to recover original tissue functionality. Wound morphology plays a crucial role in this process, as the skin behaviour is not uniform along different directions. In this work, we simulate the contraction of surgical wounds, which can be characterised as elongated and deep wounds. Because of the regularity of this morphology, we approximate the evolution of the wound through its cross section, adopting a plane strain hypothesis. This simplification reduces the complexity of the computational problem; while allows for a thorough analysis of the role of wound depth in the healing process, an aspect of medical and computational relevance that has not yet been addressed. To reproduce wound contraction, we consider the role of fibroblasts, myofibroblasts, collagen and a generic growth factor. The contraction phenomenon is driven by cell-generated forces. We postulate that these forces are adjusted to the mechanical environment of the tissue where cells are embedded through a mechanosensing and mechanotransduction mechanism. To solve the nonlinear problem, we use the finite element method (FEM) and an updated Lagrangian approach to represent the change in the geometry. To elucidate the role of wound depth and width on the contraction pattern and evolution of the involved species, we analyse different wound geometries with the same wound area. We find that deeper wounds contract less and reach a maximum contraction rate earlier than superficial wounds. Copyright © 2014 John Wiley & Sons, Ltd.

  16. The surgical treatment of cloaca. (United States)

    Bischoff, Andrea


    Similar to other anorectal malformations, cloaca also represents a spectrum of defects that goes from "benign" cloaca with a good functional prognosis that can be repaired with a relatively simple surgical technique, to very complex malformations with many anatomic variations that require different surgical maneuvers to be able to successfully reconstruct those patients. The group of patients born with a "benign" type of cloaca will have bowel and urinary control, will become sexually active and may get pregnant and deliver by cesarean section. All this is possible, provided the malformation is repaired with a meticulous and delicate technique. Fortunately this represents more than 50% of all cloacas. Our belief is that the surgical technique to repair this group of defects is reproducible and can be taught to pediatric surgical trainees. On the other hand, complex cloaca with a common channel longer than 3 cm should be repaired by surgeons fully dedicated to repair these malformations. The experience reported in this paper is based on 570 patients with cloaca operated by Dr. Alberto Peña and the author in the last 8 years. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Surgical treatment of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Brasso, K; Karstrup, S; Lundby, C M


    One hundred and two patients with primary hyperparathyroidism underwent a total of 108 bilateral neck explorations with attempted identification and biopsy of all four glands. Hypercalcaemia was surgically eliminated in 97 of 102 patients (95%). Of the remaining hypercalcaemic patients one was cu......--including bilateral neck exploration and attempted biopsies of all parathyroid glands--is safe with a high cure rate....

  18. Surgical Training in the Netherlands

    NARCIS (Netherlands)

    Borel Rinkes, I.H.M.; Gouma, D.J.; Hamming, J.F.


    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nat

  19. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.


    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  20. Posterior fossa meningioma (surgical experiences)

    African Journals Online (AJOL)

    Wael M. Moussa


    Aug 27, 2012 ... Morbidity included decreased level of consciousness, cranial nerve palsy and wound infection. ..... (10 cases), trigeminal nerve compression (6 cases), facial nerve .... and magnetic resonance imaging for surgical planning for menin- ... anatomy scanning in the operation of intracranial parasagittal.

  1. Surgical pearl: the temporary assistant. (United States)

    Jacobs, Aleda A; Orengo, Ida F


    A simple maneuver is presented which simultaneously facilitates both adequate surgical site exposure and sufficient traction. A single suture with high tensile strength can be utilized to this end. This technique is especially helpful when the cutaneous surgeon is operating alone.

  2. Surgical options after Fontan failure

    DEFF Research Database (Denmark)

    van Melle, Joost P; Wolff, Djoeke; Hörer, Jürgen;


    OBJECTIVE: The objective of this European multicenter study was to report surgical outcomes of Fontan takedown, Fontan conversion and heart transplantation (HTX) for failing Fontan patients in terms of all-cause mortality and (re-)HTX. METHODS: A retrospective international study was conducted by...

  3. Pseudothrombocytopenia in cardiac surgical practice. (United States)

    Nair, Sukumaran K; Shah, Roma; Petko, Matus; Keogh, Bruce E


    Pseudothrombocytopenia is observed occasionally in post-cardiac surgical patients. It is commonly due to EDTA-mediated immunological mechanisms, which lead to agglutination of functionally intact platelets. This condition is harmless and does not warrant platelet transfusion. We describe an instance of pseudothrombocytopenia in our practice and discuss its clinical relevance.

  4. Surgical smoke and infection control.

    NARCIS (Netherlands)

    Alp, E.; Bijl, D.; Bleichrodt, R.P.; Hansson, B.M.; Voss, A.


    Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as 'surgical smoke'. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of

  5. Smart surgical needle actuated by shape memory alloys for percutaneous procedures (United States)

    Konh, Bardia

    Background: Majority of cancer interventions today are performed percutaneously using needle-based procedures, i.e. through the skin and soft tissue. Insufficient accuracy using conventional surgical needles motivated researchers to provide actuation forces to the needle's body for compensating the possible errors of surgeons/physicians. Therefore, active needles were proposed recently where actuation forces provided by shape memory alloys (SMAs) are utilized to assist the maneuverability and accuracy of surgical needles. This work also aims to introduce a novel needle insertion simulation to predict the deflection of a bevel tip needle inside the tissue. Methods: In this work first, the actuation capability of a single SMA wire was studied. The complex response of SMAs was investigated via a MATLAB implementation of the Brinson model and verified via experimental tests. The material characteristics of SMAs were simulated by defining multilinear elastic isothermal stress-strain curves. Rigorous experiments with SMA wires were performed to determine the material properties as well as to show the capability of the code to predict a stabilized SMA transformation behavior with sufficient accuracy. The isothermal stress-strain curves of SMAs were simulated and defined as a material model for the Finite Element Analysis of the active needle. In the second part of this work, a three-dimensional finite element (FE) model of the active steerable needle was developed to demonstrate the feasibility of using SMA wires as actuators to bend the surgical needle. In the FE model, birth and death method of defining boundary conditions, available in ANSYS, was used to achieve the pre-strain condition on SMA wire prior to actuation. This numerical model was validated with needle deflection experiments with developed prototypes of the active needle. The third part of this work describes the design optimization of the active using genetic algorithm aiming for its maximum flexibility

  6. Surgical treatment of post-infarction left ventricular pseudoaneurysm: Case series highlighting various surgical strategies

    Directory of Open Access Journals (Sweden)

    Edvin Prifti, MD, PhD


    Conclusion: In conclusion, this study revealed that surgical repair of post infarct left ventricular pseudoaneurysm was associated with an acceptable surgical mortality rate, that cardiac rupture did not occur in surgically treated patients.

  7. Between two roles - Experiences of newly trained nurse practitioners in surgical care in Sweden: A qualitative study using repeated interviews. (United States)

    Jangland, Eva; Yngman Uhlin, Pia; Arakelian, Erebouni


    The position of Nurse Practitioner is a new role in Nordic countries. The transition from a registered nurse to the Nurse Practitioner role has been reported to be a personal challenge. This study, guided by the Nordic theoretical model for use in the education of advanced practice nurses, represents a unique opportunity to describe this transition for newly graduated Nurse Practitioners in an interprofessional surgical care team in Sweden. The aim was to explore how the first Nurse Practitioners in surgical care experienced the transition into a new role and what competences they used in the team. Eight new Nurse Practitioners with parallel work in clinical practice were interviewed twice around the time of their graduation. The qualitative analyses show that the participants integrated several central competences, but the focus in this early stage in their new role was on direct clinical praxis, consultation, cooperation, case management, and coaching. Transition from the role of clinical nurse specialist to nurse practitioner was a challenging process in which the positive response from patients was a driving force for the new Nurse Practitioners. The participants felt prepared for and determined to solve the challenging situations they approached working in the interprofessional team.

  8. Surgical management of chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Stavros Gourgiotis; Stylianos Germanos; Marco Pericoli Ridolifni


    BACKGROUND:Treatment of chronic pancreatitis (CP) is a challenging condition for surgeons. During the last decades, increasing knowledge about pathophysiology of CP, improved results of major pancreatic resections, and integration of sophisticated diagnostic methods in clinical practice have resulted in signiifcant changes in surgery for CP. DATA SOURCES:To detail the indications for CP surgery, the surgical procedures, and outcome, a Pubmed database search was performed. The abstracts of searched articles about surgical management of CP were reviewed. The articles could be identiifed and further scrutinized. Further references were extracted by cross-referencing. RESULTS: Main indications of CP for surgery are intractable pain, suspicion of malignancy, and involvement of adjacent organs. The goal of surgical treatment is to improve the quality of life of patients. The surgical approach to CP should be individualized according to pancreatic anatomy, pain characteristics, baseline exocrine and endocrine function, and medical co-morbidity. The approach usually involves pancreatic duct drainage and resection including longitudinal pancreatojejunostomy, pancreatoduodenectomy (Whipple's procedure), pylorus-preserving pancreatoduodenectomy, distal pancreatectomy, total pancreatectomy, duodenum-preserving pancreatic head resection (Beger's procedure), and local resection of the pancreatic head with longitudinal pancreatojejunostomy (Frey's procedure). Non-pancreatic and endoscopic management of pain has also been advocated. CONCLUSIONS:Surgical procedures provide long-term pain relief, a good postoperative quality of life with preservation of endocrine and exocrine pancreatic function, and are associated with low early and late mortality and morbidity. In addition to available results from randomized controlled trials, new studies are needed to determine which procedure is the most effective for the management of patients with CP.

  9. A brief history of the Coriolis force

    NARCIS (Netherlands)

    Gerkema, T.; Gostiaux, L.


    In 1835, Gustave Coriolis derived the expression of a force acting in rotating systems, now known as the Coriolis force. His work was inspired by rotating devices such as waterwheels. However, the onerotating device that has always been with us is the Earth itself. Indeed, the earliest studies on ho

  10. Homosexuality in the Dutch Armed Forces 2006

    NARCIS (Netherlands)

    Anna Adolfsen; Saskia Keuzenkamp; m.m.v. Linda Mans


    Original title: Uniform uit de kast. This study looks at the attitudes of defence personnel to homosexuality. How do members of the military view homosexual colleagues? Can gays and lesbians working in the armed forces be open about their sexual preferences? Do they regard the armed forces as a gay

  11. modelingthe effect the effect of contact and seepage forces of ...

    African Journals Online (AJOL)


    NIGERIA. 2 DEPARTMENT OF CIVIL ENGINEERING, UNIVERSITY OF NIGERIA, NSUKKA. ... This research work has investigated the contribution of contact force and seepage force to the .... iii Operational and maintenance failures. With the ...

  12. Estimation of Coriolis Force and Torque Acting on Ares-1 (United States)

    Mackey, Ryan M.; Kulikov, Igor K.; Smelyanskiy, Vadim; Luchinsky, Dmitry; Orr, Jeb


    A document describes work on the origin of Coriolis force and estimating Coriolis force and torque applied to the Ares-1 vehicle during its ascent, based on an internal ballistics model for a multi-segmented solid rocket booster (SRB).

  13. Knudsen forces on microcantilevers (United States)

    Passian, A.; Wig, A.; Meriaudeau, F.; Ferrell, T. L.; Thundat, T.


    When two surfaces at two different temperatures are separated by a distance comparable to a mean-free path of the molecules of the ambient medium, the surfaces experience Knudsen force. This mechanical force can be important in microelectromechanical systems and in atomic force microscopy. A theoretical discussion of the magnitude of the forces and the conditions where they can be encountered is discussed. A potential application of the Knudsen force in designing a cantilever-based vacuum gauge is discussed.

  14. [Galileo and centrifugal force]. (United States)

    Vilain, Christiane

    This work intends to focus on Galileo's study of what is now called "centrifugal force," within the framework of the Second Day of his Dialogo written in 1632, rather than on the previously published commentaries on the topic. Galileo proposes three geometrical demonstrations in order to prove that gravity will always overcome centrifugalforce, and that the potential rotation of the Earth, whatever its speed, cannot in any case project objects beyond it. Each of these demonstrations must consequently contain an error and it has seemed to us that the first one had not been understood up until now. Our analysis offers an opportunity to return to Galileo's geometrical representation of dynamical questions; actually, we get an insight into the sophistication of Galileo's practices more than into his mistakes. Our second point, concerning the historiography of the problem, shows an evolution from anachronic critics to more contextual considerations, in the course of the second half of the twentieth century.

  15. Development of AR Surgical Navigation Systems for Multiple Surgical Regions. (United States)

    Suzuki, Naoki; Hattori, Asaki; Iimura, Jiro; Otori, Nobuyoshi; Onda, Shinji; Okamoto, Tomoyoshi; Yanaga, Katsuhiko


    The purpose of our research is to develop surgical navigation systems to enhance surgical safety. Our systems make use of augmented reality technology to superimpose, on the surgery screen on a real time basis, patients' organ models reconstructed in 3D from their X-ray CT data taken before surgery. By doing so, the systems display anatomical risk materials, tumors and blood vessels which surgeons cannot see with their naked eyes. This will in turn lead to surgeons intuitively grasping the inner structures of the operational fields. We so far have been developing navigation systems that can conduct surgeries in various fields. The basic structure of the navigation systems are the same. The navigation systems uses different peripheral equipment and different methods to display navigation images which best meet the demands of each type of surgery. In this thesis, we report on our navigation systems for 2 types of surgery - endoscopic sinus surgery and hepatobilialy-pancreatic surgery.

  16. Treatment of aging vocal folds: surgical approaches. (United States)

    Seino, Yutomo; Allen, Jacqui E


    Aging may affect the voice through either physiological or pathological changes. Globally society is aging and the working lifetime is extending. Increasing numbers of elderly will present with voice issues. This review examines current thinking regarding surgical treatment of the aging voice. The mainstay of surgical treatment remains injection laryngoplasty and medialization thyroplasty. In-office injection laryngoplasty is increasingly common. Data suggest that patients with vocal fold atrophy do not achieve as much benefit from augmentation treatments as other causes of glottal incompetence. In addition the timing of injection laryngoplasty may influence the rate of subsequent medialization thyroplasty. Disease-specific treatments can provide some benefit to voice, such as deep brain stimulation in Parkinson's disease. Novel treatments including growth factor therapy are entering clinical practice and will provide new options for the clinician in future. Voice disorders affect approximately 20% of the elderly population. Causes include neurologic, malignant, iatrogenic and benign vocal fold disorders. These should be ruled out before accepting dysphonia is age-related in nature. Treatment should be specific to recognized vocal disorders but may also address physiologic changes in the glottis. Injection laryngoplasty and thyroplasty remain effective options for treating glottal incompetence but novel therapies are showing promising results.

  17. Mechanical performance of gamma irradiated surgical sutures

    Energy Technology Data Exchange (ETDEWEB)

    Pino, Eddy S.; Rela, Paulo P. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)


    Surgical sutures are medical devices made of natural or synthetic polymeric materials that, due to its end-use, have to be sterilized. Historically, the sterilization by heat or using ethylene oxide had presented so numerous drawbacks that today the non-pollutant radiation sterilization has become a well established sterilization process, that brings, environmental, technical, and economical advantages. The amount of irradiation doses required for sterilization of health care products is 25 kGy in most instances to achieve the necessary sterility assurance level. As high energy radiation produces modifications in the molecular structure of organic materials with changes in its mechanical properties, the aim of this work was to evaluate the mechanical behavior of surgical sutures under irradiation. Silk, polyamide and catgut sutures were gamma irradiated up to doses of 50 kGy in an industrial irradiation sterilization plant. Afterwards, these sutures were mechanical tested for tensile strength under knot following the specifications of the NBR13904 draft standard, using the CTRD-INSTRON at IPEN. The mechanical lab results show that sutures made of Silk and Polyamide do not present any change in their mechanical performance up to the dose of 50 kGy. On the other hand, Catgut present mechanical stability up to 30 kGy and afterwards, a slight decrease in its tensile strength was detected. (author)

  18. Mentoring during surgical training: consensus recommendations for mentoring programmes from the Association of Surgeons in Training. (United States)

    Sinclair, P; Fitzgerald, J E F; McDermott, F D; Derbyshire, L; Shalhoub, J


    Mentoring has been present within surgical training for many years, albeit in different forms. There is evidence that formal mentoring can improve patient outcomes and facilitate learning and personal growth in the mentee. The Association of Surgeons in Training (ASiT) is an independent educational charity working to promote excellence in surgical training. This document recommends the introduction of a structured mentoring programme, which is readily accessible to all surgical trainees. A review of the available evidence--including an ASiT-led survey of its membership--highlights the desire of surgical trainees to have a mentor, whilst the majority do not have access to one. There is also limited training for those in mentoring roles. In response, ASiT have implemented a pilot mentoring scheme, with surgical trainees acting both as mentors and mentees. Based on the existing literature, survey data and pilot experience, ASiT formalises in this document consensus recommendations for mentoring in surgical training.

  19. Strategic planning ensures surgical success in cases of proliferative vitreoretinopathy. (United States)

    Lakhanpal, R Ross; Hariprasad, Seenu M


    For this Practical Retina column, Dr. Ross Lakhanpal from Baltimore was asked to comment on the current state of thinking and management options for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery.We are all aware that PVR continues to be an important cause of recurrent RD after successful repair. This feared complication has been reported to occur in up to 8% of patients after undergoing RD repair. Despite the historic progress made in managing various vitreoretinal diseases over the past decade, most retina specialists will agree that an unmet need remains in this landscape. Fortunately, advances in various surgical technologies such as instrumentation, lighting, and visualization have improved the outcomes after PVR management.Dr. Lakhanpal discusses causes of PVR, management goals, surgical techniques, and pearls to avoid complications after managing PVR. His experience working in an urban tertiary surgical retina practice enables him to offer insights that will be highly valued by our community.

  20. The importance of an ethics curriculum in surgical education. (United States)

    Keune, Jason D; Kodner, Ira J


    The nature of surgical work provides fertile ground in which ethical problems can grow. The concept of what it means to be a "good surgeon" includes the ability to reason and deliberate about how the surgeon's unique technical capabilities integrate with larger society. Ethics education at the resident level is important for several reasons. It can ensure that care is delivered in a socially and ethically responsible manner through global and emergent effects on institutions and traditions. It will prepare residents for leadership positions. It can allow residents to confront issues, such as the scientific underdetermination of surgical practice, the application of new technologies to trusting patients that have been developed by for-profit companies, and a surgical environment that is becoming increasingly institutionalized. Resident ethics education provides the opportunity for a model of collective deliberation to be developed that can be used to make sense of ethical problems as they arise.

  1. Cataract Surgical Uptake Among Older Adults in Ghana. (United States)

    Ackuaku-Dogbe, E M; Yawson, A E; Biritwum, R B


    In sub-Saharan Africa, cataract surgical services are highly inadequate and surgical uptake for cataract is low. This paper describes cataract surgical uptake among older adults in Ghana. This work was based on World Health Organization's multi-country Study on global Ageing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and Department of Community Health, University of Ghana Medical School. A nationally representative sample of 5571 older adults (≥50 years) and a small sample of persons 18-49 years were interviewed. Data was obtained on uptake of cataract surgery in older adults and analyzed using descriptive measures and chi square for associations in categorical outcome measures. Overall surgical uptake was 48.9% among older adults and was slightly higher among older men (49.1%) than women (48%). Cataract surgical uptake was relatively higher in the 60-69 years group (55%), urban residents (52.6%) and those living without partners (50%). Educational and income levels of older persons did not affect cataract surgical uptake. Regional differences in cataract surgical uptake existed; was less than 60% in all ten regions (except one), and the two regions with most self-reported cataracts (Ashanti and Greater Accra) had less than 50% uptake. Intensive public education, engagement of community groups and increased access to cataract surgery at health facilities and outreach services need consideration at national/sub-national levels. Further investigations to garner equity in national eye care efforts are recommended.

  2. Mobility Work

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bossen, Claus


    We posit the concept of Mobility Work to describe efforts of moving about people and things as part of accomplishing tasks. Mobility work can be seen as a spatial parallel to the concept of articulation work proposed by the sociologist Anselm Strauss. Articulation work describes efforts...... of coordination necessary in cooperative work, but focuses, we argue, mainly on the temporal aspects of cooperative work. As a supplement, the concept of mobility work focuses on the spatial aspects of cooperative work. Whereas actors seek to diminish the amount of articulation work needed in collaboration...... by constructing Standard Operation Procedures (SOPs), actors minimise mobility work by constructing Standard Operation Configurations (SOCs). We apply the concept of mobility work to the ethnography of hospital work, and argue that mobility arises because of the need to get access to people, places, knowledge and...

  3. Master-slave robot force telepresence technology

    Institute of Scientific and Technical Information of China (English)


    In order to make the manipulators useful, some force-feedback is required to enable the operator to sense the robot's feelings. Without force-feedback, many tasks will not be able to be carried out. For these rea sons, a master-slave system with different kinematics has been developed. The system permits us to vary the ra tio of the position/attitude, to design a master manipulator without considering the kinematics of the slave ma nipulator, and so on. To overcome the difficulties, a master-slave manipulator system with different kinematics is proposed. The master manipulator is force-controlled via a force torque sensor in the handle. As to master slave manipulator system with two way force feedback is concerned, the force goes to the actuator from the oper ator, and come back to the operator from the actuator. The working situation is viewed by the stereo TV supervi sory system. The force and vision telepresence are thus achieved. In order to ensure the maneuverability, direct drive DC motors and PWM servo units are adopted to improve the response speed. It can provide force response in a wide range. A lot of experiments were performed with the master-slave manipulator system force telepres ence to study the force response under restricted environment. By two force sensors, the force-position bilateral force response system effectively decreases the affection of friction and inertia force, and increases the authen ticity of bilateral force response. When the slave manipulator ann is encountered with soft-object(sponge), in the experiments, the operator can clearly have the fine feeling as if he himself is contacted with the object.

  4. Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus. (United States)

    Rouleau, Dominique M; Mutch, Jennifer; Laflamme, Georges-Yves


    Greater tuberosity fractures of the humerus can be successfully treated nonsurgically in most patients. However, as little as 3 to 5 mm of superior greater tuberosity displacement may adversely affect rotator cuff biomechanics and lead to subacromial impingement in patients who are active. In these cases, surgical treatment is recommended. Multiple surgical techniques include open and arthroscopic options tailored to fracture morphology, and strategies for repair include the use of suture anchors, transosseous sutures, tension bands, and plates/screws. Three classification systems are commonly used to describe greater tuberosity fractures: the AO, Neer, and morphologic classifications. Several hypotheses have been discussed for the mechanism of greater tuberosity fractures and the deforming forces of the rotator cuff, and the use of advanced imaging is being explored.

  5. Design and application of compliant mechanisms for surgical tools. (United States)

    Kota, S; Lu, K-J; Kreiner, K; Trease, B; Arenas, J; Geiger, J


    This paper introduces the benefits of exploiting elasticity in the engineering design of surgical tools, in general, and of minimally invasive procedures, in particular. Compliant mechanisms are jointless mechanisms that rely on elastic deformation to transmit forces and motion. The lack of traditional joints in these single-piece flexible structures offers many benefits, including the absence of wear debris, pinch points, crevices, and lubrication. Such systems are particularly amenable to embedded sensing for haptic feedback and embedded actuation with active-material actuators. The paper provides an overview of design synthesis methods developed at the Compliant Systems Design Laboratory and focuses specifically on surgical applications. Compliant systems have potential to integrate. well within the constraints of laparoscopic procedures and telerobotic surgery. A load-path representation is used within a genetic algorithm to solve two gripper example problems. In addition, the paper illustrates the design and construction of an organ (kidney) manipulator for use in minimally invasive procedures.

  6. Management of intrusive luxation with immediate surgical repositioning

    Directory of Open Access Journals (Sweden)

    Mazumdar Dibyendu


    Full Text Available Intrusive luxation is one of the most severe forms of traumatic injuries in which the affected tooth is forced to displace deeper into the alveolus. As a consequence of this type of injury, maximum damage occurs to the pulp and all the supporting structures. This report presents a case of severe intrusive luxation of mature maxillary central and lateral incisor in a 40-year-old male. The intruded tooth was immediately repositioned (surgical extrusion and splinted within hours following injury. Antibiotic therapy was initiated at the time of repositioning and maintained for 5 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 2 months later. Definitive root canal treatment with Gutta percha was accomplished at a later appointment. Clinical and radiographic examination 6, 12 and 24 months after the surgical extrusion revealed satisfactory progressive apical and periodontal healing.

  7. Experimental Investigation of the Velocity Effect on Adhesion Forces with an Atomic Force Microscope

    Institute of Scientific and Technical Information of China (English)

    魏征; 赵亚溥


    Capillary forces are significantly dominant in adhesive forces measured with an atomic force microscope (AFM)in ambient air, which are always thought to be dependent on water film thickness, relative humidity, and the free energy of water film. We study the nature of the pull-off force on a variety of surfaces as a function of tip velocity.It is found that the capillary forces are of relatively strong dependence on tip velocity. The present experiment is expected to provide a better understanding of the work mechanism of AFM in ambient air.


    Directory of Open Access Journals (Sweden)

    Ioana Olariu


    Full Text Available Building an effective sales force starts with selecting good salespeople, but good salespeople are very difficult to find. The reason for this is that most sales jobs are very demanding and require a great deal from the salesperson. There are many different types of sales jobs. Before it can hire salespeople, each company must do a careful job analysis to see what particular types of selling and other skills are necessary for each sales job. One task of the market planner is to establish clear objectives each year for the entire sales force, for each region, each sales office, and each salesperson. Sales jobs are different from in-house jobs in some significant ways. Nevertheless, each company must continually work on building and maintaining an effective sales force using the following steps: recruitment, selection, training, compensation and evaluation of each salesperson.

  9. Post surgical pain treatment - adults (United States)

    ... of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology . 2012;116:248-73. PMID: 22227789 www.ncbi. ... chap 18. Sherwood ER, Williams CG, Prough DS. Anesthesiology principles, pain management, and conscious sedation. In: Townsend ...

  10. Surgical and Nonsurgical Management of Bilateral Periapical ...

    African Journals Online (AJOL)

    Journal of Surgical Technique and Case Report | Jan-Jun 2011 | Vol-3 | Issue-1. 44. Surgical .... incisor and canine. Same was ... The operative field was isolated, and access preparation .... environment in which periapical healing can occur.

  11. Surgical intervention in patients with necrotizing pancreatitis

    NARCIS (Netherlands)

    Besselink, MG; de Bruijn, MT; Rutten, JP; Boermeester, MA; Hofker, HS; Gooszen, HG


    Background: This study evaluated the various surgical strategies for treatment of (suspected) infected necrotizing pancreatitis (INP) and patient referrals for this condition in the Netherlands. Methods: This retrospective study included all 106 consecutive patients who had surgical treatment for IN

  12. Surgical treatment in thoraco-lumbar region fractures.

    Directory of Open Access Journals (Sweden)

    Jorge Alberto Jerez Labrada


    Full Text Available Background: thoraco-lumbar fractures may affect people at any moment of their lives, especially at their most fruitful and useful stage. Its correct diagnosis and treatment may directly influence in the posterior evolution of the patients. Objectives: to evaluate the results of the surgical treatment in thoraco-lumbar region fractures. Methods: a descriptive retrospective correlational study of series cases which included 54 patients attended due to thoraco-lumbar region fractures in the University Hospital “Dr. Gustavo Aldereguía Lima” in Cienfuegos city, Cuba from January 1999 to June 2007. Age, sex, etiology of the fracture, type and level of the fractures, associated diseases, surgical techniques used for, pre and post operatory neurological damage, usage of metilprednisolone, complications and final results were the variables taken into consideration in this study. Results: most of the patients belonged to male sex under the age of 45. The totality of the cases had type IV fracture, and a great part of them had Denis type II fracture having surgical treatment. The causes of the lesions were traffic accidents, working accidents and height falls. The most useful surgical techniques were posterior decompression, instrumentation and fusion. Surgery improved the neurological damage in almost half of sick patients with this condition. Complications were minimum and rupture of the implant was predominant. Conclusion: surgical treatment in thoraco-lumbar region fractures had satisfactory results in our milieu.

  13. Evaluation of robotic minimally invasive surgical skills using motion studies. (United States)

    Jun, Seung-Kook; Sathia Narayanan, Madusudanan; Singhal, Pankaj; Garimella, Sudha; Krovi, Venkat


    Robotic Minimally Invasive Surgery, and the engendered computer-integration, offers unique opportunities for quantitative computer-based surgical-performance evaluation. In this work, we examine extension of traditional manipulative skill assessment, having deep roots in performance evaluation in manufacturing industries, for applicability to robotic surgical skill evaluation. This method relies on: defining task-level segmentation of modular sub-tasks/micro-motions called 'Therbligs' that can be combined to perform a given task; and analyzing intra- and inter-user performance variance by studying surgeons' performance over each 'Therbligs'. Any of the performance metrics of macro-motions-from motion-economy, tool motion measurements to handed-symmetry-can now be extended over the micro-motion temporal segments. Evaluation studies were based on video recordings of surgical tasks in two settings: first, we examined performance of two representative manipulation exercises (peg board and pick-and-place) on a da Vinci surgical SKILLS simulator. This affords a relatively-controlled and standardized test-scenarios for surgeons with varied experience-levels. Second, task-sequences from real surgical videos were analyzed with a list of predefined 'Therbligs' in order to investigate its overall usefulness.

  14. Minimally Invasive Surgery Survey: A Survey of Surgical Team Members' Perceptions for Successful Minimally Invasive Surgery. (United States)

    Yurteri-Kaplan, Ladin A; Andriani, Leslie; Kumar, Anagha; Saunders, Pamela A; Mete, Mihriye M; Sokol, Andrew I


    To develop a valid and reliable survey to measure surgical team members' perceptions regarding their institution's requirements for successful minimally invasive surgery (MIS). Questionnaire development and validation study (Canadian Task Force classification II-2). Three hospital types: rural, urban/academic, and community/academic. Minimally invasive staff (team members). Development and validation of a minimally invasive surgery survey (MISS). Using the Safety Attitudes questionnaire as a guide, we developed questions assessing study participants' attitudes regarding the requirements for successful MIS. The questions were closed-ended and responses based on a 5-point Likert scale. The large pool of questions was then given to 4 focus groups made up of 3 to 6 individuals. Each focus group consisted of individuals from a specific profession (e.g., surgeons, anesthesiologists, nurses, and surgical technicians). Questions were revised based on focus group recommendations, resulting in a final 52-question set. The question set was then distributed to MIS team members. Individuals were included if they had participated in >10 MIS cases and worked in the MIS setting in the past 3 months. Participants in the trial population were asked to repeat the questionnaire 4 weeks later to evaluate internal consistency. Participants' demographics, including age, gender, specialty, profession, and years of experience, were captured in the questionnaire. Factor analysis with varimax rotation was performed to determine domains (questions evaluating similar themes). For internal consistency and reliability, domains were tested using interitem correlations and Cronbach's α. Cronbach's α > .6 was considered internally consistent. Kendall's correlation coefficient τ closer to 1 and with p high test-retest reliability (τ = .3-.7, p < .05). The final questionnaire was made up of 29 questions from the original 52 question set. The MISS is a reliable and valid tool that

  15. Surgical skin-marking techniques. (United States)

    Granick, M S; Heckler, F R; Jones, E W


    Surgical skin-marking inks and dyes are in everyday use for designing and planning incisions in plastic and reconstructive surgery. We have traced the historical development of surgical skin-marking techniques from ancient times to the present. The biochemical characteristics of the commonly used marking agents are discussed. A three-part experiment utilizing a pig model was carried out to test the tissue inflammatory response to the various dyes and inks when used intradermally as tattoos, the persistence of such tattoos, and the ease of skin erasure for each of eight stains. Methylene blue and gentian violet are recommended as the best all-purpose marking agents. The use of proprietary inks is discouraged.

  16. Surgical considerations about amyloid goiter. (United States)

    García Villanueva, Augusto; García Villanueva, María Jesús; García Villanueva, Mercedes; Rojo Blanco, Roberto; Collado Guirao, María Vicenta; Cabañas Montero, Jacobo; Beni Pérez, Rafael; Moreno Montes, Irene


    Amyloidosis is an uncommon syndrome consisting of a number of disorders having in common an extracellular deposit of fibrillary proteins. This results in functional and structural changes in the affected organs, depending on deposit location and severity. Amyloid infiltration of the thyroid gland may occur in 50% and up to 80% of patients with primary and secondary amyloidosis respectively. Amyloid goiter (AG) is a true rarity, usually found associated to secondary amyloidosis. AG may require surgical excision, usually because of compressive symptoms. We report the case of a patient with a big AG occurring in the course of a secondary amyloidosis associated to polyarticular onset juvenile idiopathic arthritis who underwent total thyroidectomy. Current literature is reviewed, an attempt is made to provide action guidelines, and some surgical considerations on this rare condition are given.

  17. Surgical training in the Netherlands. (United States)

    Borel-Rinkes, Inne H M; Gouma, Dirk J; Hamming, Jaap F


    Surgical training in the Netherlands has traditionally been characterized by learning on the job under the classic master-trainee doctrine. Over the past decades, it has become regionally organized with intensive structural training courses, and a peer-based quality control system. Recently, the nationwide programme has been modernized further and now involves a systematic, competency-based education with structural training courses, formalized assessment and room for reflection by residents under the supervision of surgical teaching groups. To this end, a uniform web-based digital portfolio is being introduced to facilitate monitoring of the individual resident's progress. Though requiring inspirational leadership, commitment, and determination, this modernization has sparked enthusiasm among trainees and teachers.

  18. Surgical tools and medical devices

    CERN Document Server

    Jackson, Mark


    This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

  19. [Surgical treatment of paralytic lagophthalmos]. (United States)

    Schrom, T; Bast, F


    Impairment of the peripheral or central part of the facial nerve causes an ipsilateral peripheral facial nerve paresis. It is quite a common syndrome and affects 20-35 persons per 100,000 per year in Western Europe and the United States. A possible complication of facial palsy is paralytic lagophthalmos with aesthetic and functional impairment for the patient. Beside primary nerve reconstructive procedures plastic-reconstructive procedures play a major role in correcting paralytic lagophthalmos. The eyebrow, upper and lower lids, medial and lateral lid angle as well as the lacrimal system need to be seen as functional units and can be corrected with local surgical procedures. Restoration of eye closure is the most important goal in treating the affected eye. Due to the significant aesthetic limitations and resultant psychological stress for the patient cosmetic aspects must be included in the surgical concept.

  20. Implementing lean in a surgical ward

    DEFF Research Database (Denmark)

    Edwards, Kasper; Nielsen, Anders Paarup; Jacobsen, Peter

    Using the well-known principles from lean management in an orthopedic surgical ward at a major Danish hospital reorganized their work-flow and processes. The ward has ten operating rooms and performs the complete range of the orthopedic procedures ranging from patients that need simple standard...... for productivity improvement. Lean management has its origins in industrial production, but it is now being transferred to many other sectors, e.g., health care. Two important prerequisites exist for implementing lean management: Firstly, stable and standardized processes and secondly leveling of production...... be planned in advance and meet the prerequisites for lean management. Two of ten operating rooms have been allocated to this flow. Selected surgeons, nurses and porters have been allocated to the two operating rooms and they remain in the sterile environment for the duration of the workday. The effect...

  1. Independent Navigation System for a Surgical Colonoscope

    Directory of Open Access Journals (Sweden)

    Lilia A. Ochoa-Luna


    Full Text Available This paper provides a novel algorithm to attain the independent navigation of a colonoscopy surgical endoscope. First, it introduces a brief description of this issue through the scientist advance for medical robotics. It then makes a quickly count of the existent methods and at the end it provides the basis in order to propose a new alternative solution with help from vision-guidance. That means that images will be processed and interpreted with the purpose of maintaining the endoscope always at the intestine center. All this considered will help us to reduce colonoscopy surgeries consequences and the most important advantage of this new method proposed is that surgeons will accomplish their work easier and more efficiently.

  2. A New Surgical Technique for Ingrown Toenail


    Seyed Reza Mousavi; Jaledin Khoshnevice


    Background. Ingrowing toenails are a common condition which, when recurrent and painful, are often treated surgically. The aim of this study is to present a new simple surgical technique for ingrown toenails with good results. Method and Patients. The selected 250 patients with affected toes were surgically treated by our technique and observed from 1998 to 2004. Marginal nail elevation combined with surgical excision of the granulation tissue was more successful. For fixing the nail margin o...

  3. 68 INVITED Personalized surgical treatment for sarcoma

    National Research Council Canada - National Science Library

    Hohenberger, P


    ... belongtothemodernsurgicalapproachinthebattleagainstlocalisedand locallyadvancedprostatecancer. 67 INVITED Personalized surgical treatment for early breast cancer E.Rutgers. The Netherlands Cancer Institute, Department...

  4. Aesthetic Surgical Crown Lengthening Procedure



    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most h...

  5. Surgical checklists: the human factor.

    LENUS (Irish Health Repository)

    O Connor, Paul


    BACKGROUND: Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. METHODS: Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. RESULTS: Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. CONCLUSION: In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.

  6. [Surgical anatomy of the nose]. (United States)

    Nguyen, P S; Bardot, J; Duron, J B; Jallut, Y; Aiach, G


    Thorough knowledge of the anatomy of the nose is an essential prerequisite for preoperative analysis and the understanding of surgical techniques. Like a tent supported by its frame, the nose is an osteo-chondral structure covered by a peri-chondroperiosteal envelope, muscle and cutaneous covering tissues. For didactic reasons, we have chosen to treat this chapter in the form of comments from eight key configurations that the surgeon should acquire before performing rhinoplasty.

  7. [Surgical options in ulcerative colitis]. (United States)

    Hultén, L; Ecker, K W


    Surgery is needed in every second patient with pancolitis. Historically four surgical options have been developed: conventional ileostomy, ileorectostomy, continent ileostomy (Kock's pouch) and ileo-anal pouch. However, in emergent or unclear situations subtotal colectomy, ileostomy and preservation of the rectum is the most suitable operation. After recovery and in elective indications proctectomy and proctocolectomy establish the general surgical standard. Today, in most cases ileo-pouch-anal anastomosis is performed instead of creation of an ileostomy. Both lowered frequency of defecation and acceptable continence contribute to a better quality of life. However, functional disturbances are not uncommon and result in most cases from complications of the demanding technique. Definitive cure of the colitis is in interference with the risk of pouchitis in about 30%. The cumulative probability to loose the pouch may rise to 15-20% in the long-term course. Thus, ileorectostomy may be considered as a first step of surgical treatment, since pelvic nerve damage is excluded, function is much better and persistent proctitis can be treated topically. The attractively is that ileo-anal pouch can be performed later on, when decreasing function and increasing risk of malignant change will eventually require proctectomy. A Kock-pouch is seldom considered, especially in patients with ileostomy wishing sure fecal control. But the continent reservoir becomes more and more interesting again since it can be reconstructed from a failed ileo-anal pouch without loss of bowel. Conventional ileostomy should be reserved for patients not suitable for reconstructive methods or those who consider pough operations risk. However, it is the safest procedure with absolute cure of disease. The optimal choice of method considers medical and surgical aspects as well as patients conception and desire.

  8. Towards MRI guided surgical manipulator. (United States)

    Chinzei, K; Miller, K


    The advantages of surgical robots and manipulators are well recognized in the clinical and technical community. Precision, accuracy and the potential for telesurgery are the prime motivations in applying advanced robot technology in surgery. In this paper critical interactions between Magnetic Resonance Imaging equipment and mechatronic devices are discussed and a novel Magnetic Resonance compatible surgical robot is described. Experimental results of the effects from several passive (metallic materials) and active (ultrasound motors) mechanical elements are demonstrated. The design principles for Magnetic Resonance compatible robots are established and the compatibility of the proposed robot is assessed by comparing images taken with and without the robot's presence within Signa SP/I GE Medical Systems scanner. The results showed that, in principle, it is possible to construct precision mechatronic devices intended to operate inside MR scanner. Use of such a device will not cause image shift or significant degradation of signal-to-noise-ratio. An MR compatible surgical assist robot was designed and constructed. The robot is not affected by the presence of strong magnetic fields and is able to manoeuvre during imaging without compromising the quality of images. A novel image-guided robot control scheme was proposed. As a part of the control scheme, biomechanics-based organ deformation model was constructed and validated by in-vivo experiment. It has been recognised that for robust control of an image guided surgical robot the precise knowledge of the mechanical properties of soft organs operated on must be known. As an illustration, results in mathematical modelling and computer simulation of brain deformation are given. The novel MR compatible robot was designed to position and direct an axisymmetric tool, such as a laser pointer or a biopsy catheter. New Robot control system based on the prediction of soft organ deformation was proposed.

  9. Bipolar electrosurgical vessel-sealing device with compressive force monitoring. (United States)

    Chen, Roland K; Chastagner, Matthew W; Geiger, James D; Shih, Albert J


    Bipolar electrosurgical vessel sealing is commonly used in surgery to perform hemostasis. The electrode compressive force is demonstrably an important factor affecting the vessel seal burst pressure, an index of the seal quality. Using a piezoresistive force sensor attached to the handle of a laparoscopic surgical device, applied handle force was measured and used to predict the electrosurgical vessel compressive force and the pressure at the electrode. The sensor enables the monitoring of vessel compressive force during surgery. Four levels of compressive force were applied to seal three types of porcine vessels (carotid artery, femoral artery, and jugular vein). The burst pressure of the vessel seal was tested to evaluate the seal quality. Compressive pressure was found to be a statistically significant factor affecting burst pressure for femoral arteries and jugular veins. Vessels sealed with low compressive pressure (<300 kPa) have a higher failure rate (burst pressure<100 mm Hg) than vessels sealed with high compressive pressure. An adequate compressive force is required to generate the compressive pressure needed to form a seal with high burst pressure. A laparoscopic surgical device with compressive force monitoring capability can help ensure adequate compressive pressure, vessel burst pressure, and quality of seal.

  10. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes. (United States)

    Sinclair, Alan; Morley, John E; Rodriguez-Mañas, Leo; Paolisso, Giuseppe; Bayer, Tony; Zeyfang, Andrej; Bourdel-Marchasson, Isabelle; Vischer, Ulrich; Woo, Jean; Chapman, Ian; Dunning, Trisha; Meneilly, Graydon; Rodriguez-Saldana, Joel; Gutierrez Robledo, Luis Miguel; Cukierman-Yaffe, Tali; Gadsby, Roger; Schernthaner, Guntram; Lorig, Kate


    Diabetes mellitus is a highly prevalent metabolic condition in ageing societies associated with high levels of morbidity, multiple therapies, and functional deterioration that challenges even the best of health care systems to deliver high-quality, individualized care. Most international clinical guidelines have ignored the often-unique issues of frailty, functional limitation, changes in mental health, and increasing dependency that characterize many aged patients with diabetes. A collaborative Expert Group of the IAGG and EDWPOP and an International Task Force have explored the key issues that affect diabetes in older people using a robust method comprising a Delphi process and an evidence-based review of the literature. Eight domains of interest were initially agreed and discussed: hypoglycemia, therapy, care home diabetes, influence of comorbidities, glucose targets, family/carer perspectives, diabetes education, and patient safety. A set of "consensus" statements was produced in each domain of interest. These form a foundation for future policy development in this area and should influence the clinical behavior and approach of all health professionals engaged in delivering diabetes care to older people.

  11. Surgical smoke and ultrafine particles

    Directory of Open Access Journals (Sweden)

    Nowak Dennis


    Full Text Available Abstract Background Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine ( Methods To measure the amount of generated particulates in 'surgical smoke' during different surgical procedures and to quantify the particle number concentration for operation room personnel a condensation particle counter (CPC, model 3007, TSI Inc. was applied. Results Electro-cauterization and argon plasma tissue coagulation induced the production of very high number concentration (> 100000 cm-3 of particles in the diameter range of 10 nm to 1 μm. The peak concentration was confined to the immediate local surrounding of the production side. In the presence of a very efficient air conditioning system the increment and decrement of ultrafine particle occurrence was a matter of seconds, with accumulation of lower particle number concentrations in the operation room for only a few minutes. Conclusion Our investigation showed a short term very high exposure to ultrafine particles for surgeons and close assisting operating personnel – alternating with longer periods of low exposure.

  12. Ethical issues in surgical innovation. (United States)

    Miller, Megan E; Siegler, Mark; Angelos, Peter


    Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new approach will be beneficial to patients, not all innovations are successful or result in improved patient care. The ethical dilemma of surgical innovation lies in the uncertainty of whether a particular innovation will prove to be a "good thing." This uncertainty creates challenges for surgeons, patients, and the healthcare system. By its very nature, innovation introduces a potential risk to patient safety, a risk that may not be fully known, and it simultaneously fosters an optimism bias. These factors increase the complexity of informed consent and shared decision making for the surgeon and the patient. Innovative procedures and their associated technology raise issues of cost and resource distribution in the contemporary, financially conscious, healthcare environment. Surgeons and institutions must identify and address conflicts of interest created by the development and application of an innovation, always preserving the best interest of the patient above the academic or financial rewards of success. Potential strategies to address the challenges inherent in surgical innovation include collecting and reporting objective outcomes data, enhancing the informed consent process, and adhering to the principles of disclosure and professionalism. As surgeons, we must encourage creativity and innovation while maintaining our ethical awareness and responsibility to patients.

  13. Surgical treatment for myelodysplastic clubfoot,

    Directory of Open Access Journals (Sweden)

    Alexandre Zuccon


    Full Text Available Objective:To analyze the results from surgical treatment of 69 cases of clubfoot in 43 patients with myelodysplasia according to clinical and radiographic criteria, at our institution between 1984 and 2004.Methods:This was a retrospective study involving analysis of medical files, radiographs and consultations relating to patients who underwent surgical correction of clubfoot. The surgical technique consisted of radical posteromedial and lateral release with or without associated talectomy.Results:The patients' mean age at the time of the surgery was four years and two months, and the mean length of postoperative follow-up was seven years and two months. Satisfactory results were achieved in 73.9% of the feet and unsatisfactory results in 26.1% (p < 0.0001.Conclusion:Residual deformity in the immediate postoperative period was associated with unsatisfactory results. Opening of the Kite (talocalcaneal angle in feet that only underwent posteromedial and lateral release, along with appropriate positioning of the calcaneus in cases that underwent talectomy, was the radiographic parameter that correlated with satisfactory results.

  14. 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.

  15. Uncommon surgical emergencies in neonatology. (United States)

    Angotti, R; Bulotta, A L; Ferrara, F; Molinaro, F; Cerchia, E; Meucci, D; Messina, M


    Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

  16. Control tower to surgical theater

    Directory of Open Access Journals (Sweden)

    Buccioli Matteo


    Full Text Available The main social priority is to reduce public debt and to streamline national health service (NHS costs. Consequently, health managers need to acquire operating methods within their managerial structures so that all available resources are better planned in terms of effectiveness and efficiency, without compromising patient safety. In order to identify the information categories needed to know the whole surgical process is necessary to divide these in two main categories, supply and demand. Demand Information Group (DIG contains the information that identify patients and its needs in terms of care. Instead Supply Information Group (SIG contains information about hospital resources in order to cover the supply. The surgical process analyzed in terms such as industrial production process has the goal of produce the “health product for the patient” and its central part is performed in the operating room by a surgical team. This does not mean that the precedent and subsequent phases of the operating room have minor importance, in fact to obtain a high quality “health product” and reduce to a minimum the clinical risks related to the patient it is necessary that each phase of the process is carried out in the right way. The implementation of a Control Tower Approach allows for the management of productive process, able to guide hospital managers to identify the best strategies and to improve the risk management of patient safety in response to the guidelines of the World Health Organization.

  17. Surgical Treatment for Hepatocellular Carcinoma

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    Ahmad A Madkhali


    Full Text Available Hepatocellular carcinoma (HCC is an epithelial tumor derived from hepatocytes; it accounts for 80% of all primary liver cancers and ranks globally as the fourth leading cause of cancer-related deaths. HCC treatment is a multidisciplinary and a multimodal task, with surgery in the form of liver resection and liver transplantation (LT representing the only potentially curative modality. However, there are variable opinions and discussions about applying these surgical options and using other supporting treatments. This article is a narrative review that includes articles published from 1984 to 2013 located by searching scientific databases such as PubMed, SCOPUS, and Elsevier, with the main keyword of hepatocellular carcinoma in addition to other keywords such as liver transplantation, liver resection, transarterial chemoembolization, portal vein embolization, bridging therapy, and downstaging. In this review, we focus mainly on the surgical treatment options offered for HCC, in order to illustrate the current relevant data available in the literature to help in applying these surgical options and to use other supporting treatment modalities when appropriate.

  18. Surgical smoke in dermatologic surgery. (United States)

    Oganesyan, Gagik; Eimpunth, Sasima; Kim, Silvia Soohyun; Jiang, Shang I Brian


    Potential dangers associated with smoke generated during electrosurgery have been described. However, the use of smoke management in dermatology is unknown. There is no objective data showing the amount or the composition of the smoke generated in dermatologic surgeries. To assess the use of smoke management in dermatologic surgery and provide data on the amount and chemical composition of surgical smoke. A total of 997 surveys were sent to dermatologic surgeons across the United States to assess the use of smoke management. Amounts and concentrations of particulates and chemical composition were measured during electrosurgery using a particulate meter and the Environmental Protection Agency-standardized gas chromatography-mass spectrometry analysis. Thirty-two percent of the surgeons responded to the survey, and 77% of the respondents indicated no use of smoke management at all. Only approximately 10% of surgeons reported consistent use of smoke management. Active electrosurgery produced significant amounts of particulates. In addition, surgical smoke contained high concentrations of known carcinogens, such as benzene, butadiene, and acetonitrile. Surgical smoke contains toxic compounds and particulates. Most dermatologic surgeons do not use smoke management within their practices. Raising the awareness of the potential risks can help increase the use of smoke management.

  19. Surgical Treatment of Skin Tumors

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    Full Text Available When we mention about surgical treatment of any tumor residing on the skin independent of its benign or malignant nature, the first method we recall is excision. Elliptical excision is the mainstay of the dermatologic surgery. Each excision ends with a defect for which we are responsible to repair functionally and cosmetically. The diameter of the tumor we excised and the safety margin used for excision determine the diameter of the final defect. After achieving tumor free lateral and deep margins with the appropriate surgical method, we decide between the repair options of second intention healing, primary repair, flaps, full or split thickness grafts, considering the diameter and the anatomic localization of the defect, for the best functional and cosmetic result for that specific defect. This review overviews not only the most common dermatologic surgical methods, but also Mohs surgery which is a method rarely used in our country, although it is the treatment of choice for the treatment of high risk basal cell carcinoma (BCC and squamous cell carcinoma (SCC.

  20. Is surgical workforce diversity increasing? (United States)

    Andriole, Dorothy A; Jeffe, Donna B; Schechtman, Kenneth B


    We sought to determine the extent to which recent increases in levels of gender and racial diversity in the overall resident-physician workforce were evident among core-surgical specialty resident workforces. Chi-square tests for trend assessed the importance of changes from 1996 to 2004 in proportions of women and African Americans in the surgery-resident workforce. Surgery-resident trends were compared with overall resident workforce trends using two-tailed t-tests to compare regression slopes that quantified rates of change over time. Chi-square tests assessed differences between proportions of women and African Americans in the current overall board-certified workforce and their proportions in the surgery board-certified workforce. From 1996 to 2004, proportions of women increased in all seven surgical specialties studied. Compared with the overall trend toward increasing proportions of women in the resident workforce, the trend in one surgical specialty was larger (obstetrics/gynecology, p 0.05), and two were smaller (each p 0.05). Proportions of African Americans decreased in three specialties (each p workforce, except obstetrics/gynecology, remained lower than in the overall board-certified workforce (each p workforces have persisted since 1996 and will likely perpetuate ongoing surgery board-certified workforce disparities.