International surgery: definition, principles and Canadian practice

PubMed Central

Lett, Ronald

2003-01-01

This article is dedicated to the Canadian international surgeon, Norman Bethune (1890–1939). International surgery is defined as a humanitarian branch of medicine concerned with the treatment of bodily injuries or disorders by incision or manipulations, emphasizing cooperation and understanding among nations and involving education, research, development and advocacy. In this article I review the colonial past, the dark ages following the Declaration of Alma-Ata, the progress made and the present challenges in international surgery. I present a definition of international surgery that recognizes the current era of surgical humanitarianism, validates a global understanding of surgical issues and promotes cooperation among nations. Included are the principles of international surgery: education, research, infrastructure development and advocacy. International surgical projects are classified according to type (clinical, relief, developmental) and integration strategy (vertical or horizontal). Also reviewed are the Canadian practice of international surgery by nongovernmental, professional and academic organizations and the requirements of international and Canadian funding agencies, the development concepts basic to all projects, including results-based management and the cross-cutting themes of gender equity, environmental protection and human safety. I recommend formalizing international surgery into a discipline as a means of promoting surgical care in low-income countries. If international surgery is to be sustained in Canada, infrastructure and support from Canadian surgeons is particularly important. An understanding of the history, definition and classification of international surgery should promote surgical care in low-income countries. PMID:14577711

[Telemedicine in otorhinolaryngology. Basic principles and possible applications].

PubMed

Plinkert, P K; Plinkert, B; Zenner, H P

2000-09-01

Telemedicine includes all medical activities involved in diagnosis, therapeutics or social medicine undertaken by an electronic transfer medium. This technique requires the transmission of visual and acoustic information over long distances and does not require the specialist to be personally present at the requested consultation. In the last few years, the digital data transmission, e.g., ISDN (ISDN (Integrated Service Digital Network), has become available and has facilitated the use of telecommunication. Recently, the real-time transmission of acoustic and visual signals will be improved by use of asynchronous transfer mode (ATM). Advanced telecommunication applications in minimally invasive ENT surgery are experimental in most cases. We can distinguish three different telesurgical developments: surgical teleconsultation, surgical teleassistance, and surgical telemanipulation. The different applications and transmission media are explained and discussed.

Surgical errors and risks – the head and neck cancer patient

PubMed Central

Harréus, Ulrich

2013-01-01

Head and neck surgery is one of the basic principles of head and neck cancer therapy. Surgical errors and malpractice can have fatal consequences for the treated patients. It can lead to functional impairment and has impact in future chances for disease related survival. There are many risks for head and neck surgeons that can cause errors and malpractice. To avoid surgical mistakes, thorough preoperative management of patients is mandatory. As there are ensuring operability, cautious evaluation of preoperative diagnostics and operative planning. Moreover knowledge of anatomical structures of the head and neck, of the medical studies and data as well as qualification in modern surgical techniques and the surgeons ability for critical self assessment are basic and important prerequisites for head and neck surgeons in order to make out risks and to prevent from mistakes. Additionally it is important to have profound knowledge in nutrition management of cancer patients, wound healing and to realize and to be able to deal with complications, when they occur. Despite all precaution and surgical care, errors and mistakes cannot always be avoided. For that it is important to be able to deal with mistakes and to establish an appropriate and clear communication and management for such events. The manuscript comments on recognition and prevention of risks and mistakes in the preoperative, operative and postoperative phase of head and neck cancer surgery. PMID:24403972

Planning the Surgical Correction of Spinal Deformities: Toward the Identification of the Biomechanical Principles by Means of Numerical Simulation

PubMed Central

Galbusera, Fabio; Bassani, Tito; La Barbera, Luigi; Ottardi, Claudia; Schlager, Benedikt; Brayda-Bruno, Marco; Villa, Tomaso; Wilke, Hans-Joachim

2015-01-01

In decades of technical developments after the first surgical corrections of spinal deformities, the set of devices, techniques, and tools available to the surgeons has widened dramatically. Nevertheless, the rate of complications due to mechanical failure of the fixation or the instrumentation remains rather high. Indeed, basic and clinical research about the principles of deformity correction and the optimal surgical strategies (i.e., the choice of the fusion length, the most appropriate instrumentation, and the degree of tolerable correction) did not progress as much as the implantable devices and the surgical techniques. In this work, a software approach for the biomechanical simulation of the correction of patient-specific spinal deformities aimed to the identification of its biomechanical principles is presented. The method is based on three-dimensional reconstructions of the spinal anatomy obtained from biplanar radiographic images. A user-friendly graphical user interface allows for the planning of the desired deformity correction and to simulate the implantation of pedicle screws. Robust meshing of the instrumented spine is provided by using consolidated computational geometry and meshing libraries. Based on a finite element simulation, the program is able to predict the loads and stresses acting in the instrumentation as well as those in the biological tissues. A simple test case (reduction of a low-grade spondylolisthesis at L3–L4) was simulated as a proof of concept, and showed plausible results. Despite the numerous limitations of this approach which will be addressed in future implementations, the preliminary outcome is promising and encourages a wide effort toward its refinement. PMID:26579518

Spontaneous hepatic rupture in pregnancy.

PubMed

Nelson, E W; Archibald, L; Albo, D

1977-12-01

Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery and are found to have subcapsular hematomas of the right hepatic lobe with free rupture into the peritoneal cavity and resultant exsanguinating hemorrhage. The association of toxemia and disseminated intravascular coagulation with secondary microembolic damage to the liver and other organs has been discussed. Basic surgical principles in the managment of hepatic subcapsular hematomas, and the prolonged postoperative course and frequent complications in these patients have been stressed.

Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods.

PubMed

Papaspyros, Sotiris C; Kar, Ashok; O'Regan, David

2015-06-01

Over the past two centuries the surgical profession has undergone a profound evolution in terms of efficiency and outcomes. Societal concerns in relation to quality assurance, patient safety and cost reduction have highlighted the issue of training expert surgeons. The core elements of a training model build on the basic foundations of gross and fine motor skills. In this paper we provide an analysis of the ergonomic principles involved and propose relevant training techniques. We have endeavored to provide both the trainer and trainee perspectives. This paper is structured into four sections: 1) Pre-operative preparation issues, 2) technical skills and instrument handling, 3) low fidelity simulation models and 4) discussion of current concepts in crew resource management, deliberate practice and assessment. Rehearsal, warm-up and motivation-enhancing techniques aid concentration and focus. Appropriate posture, comprehension of ergonomic principles in relation to surgical instruments and utilisation of the non-dominant hand are essential skills to master. Low fidelity models can be used to achieve significant progress through the early stages of the learning curve. Deliberate practice and innate ability are complementary to each other and may be considered useful adjuncts to surgical skills development. Safe medical care requires that complex patient interventions be performed by highly skilled operators supported by reliable teams. Surgical ergonomics lie at the heart of any training model that aims to produce professionals able to function as leaders of a patient safety oriented culture. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Optimizing the positional relationships between instruments used in laparoscopic simulation using a simple trigonometric method.

PubMed

Lorias Espinoza, Daniel; Ordorica Flores, Ricardo; Minor Martínez, Arturo; Gutiérrez Gnecchi, José Antonio

2014-06-01

Various methods for evaluating laparoscopic skill have been reported, but without detailed information on the configuration used they are difficult to reproduce. Here we present a method based on the trigonometric relationships between the instruments used in a laparoscopic training platform in order to provide a tool to aid in the reproducible assessment of surgical laparoscopic technique. The positions of the instruments were represented using triangles. Basic trigonometry was used to objectively establish the distances among the working ports RL, the placement of the optical port h', and the placement of the surgical target OT. The optimal configuration of a training platform depends on the selected working angles, the intracorporeal/extracorporeal lengths of the instrument, and the depth of the surgical target. We demonstrate that some distances, angles, and positions of the instruments are inappropriate for satisfactory laparoscopy. By applying basic trigonometric principles we can determine the ideal placement of the working ports and the optics in a simple, precise, and objective way. In addition, because the method is based on parameters known to be important in both the performance and quantitative quality of laparoscopy, the results are generalizable to different training platforms and types of laparoscopic surgery.

Endoscopic Endonasal Management of Craniopharyngioma.

PubMed

Zacharia, Brad E; Amine, Muhamad; Anand, Vijay; Schwartz, Theodore H

2016-02-01

Craniopharyngioma is a rare clinical entity that poses a significant management challenge given their location and propensity to recur. As part of a minimally disruptive treatment paradigm, the expanded endonasal approach has the potential to improve rates of resection, improve postoperative visual recovery, and minimize surgical morbidity. This article updates the otolaryngologic community on the basic principles and techniques regarding the incorporation of the endoscopic, endonasal approach in the management paradigm of craniopharyngioma. Copyright © 2016 Elsevier Inc. All rights reserved.

The Gibson and Piggott osteotomy for adult hallux valgus.

PubMed

Rangrez, Arshad Bashir; Dar, Tahir Ahmed; Badoo, Abdul Rashid; Wani, Sharief Ahmed; Dhar, Shabir Ahmed; Mumtaz, Imran; Ahmed, Muzzaffar

2012-01-01

The Gibson and Piggott procedure for hallux valgus is based on sound surgical principles addressing the basic pathologies of this disorder. However, this procedure has not been studied extensively in the literature in comparison to the Mitchell and Chevron osteotomies. We report a prospective study conducted on 50 adult feet with hallux valgus. The Gibson and Piggot osteotomy was done on all the feet. We obtained 76% excellent and 18% good results with this procedure. The results bear out the fact that this procedure is a useful procedure for the management of this disorder.

Prosthetic Consideration in Implant-supported Prosthesis: A Review of Literature

PubMed Central

Gowd, Manga Snigdha; Shankar, Thatapudi; Ranjan, Rajeev; Singh, Arpita

2017-01-01

Modern dentistry has changed tremendously with implant therapy. For the successful implant therapy, making a proper treatment plan considering both surgical and prosthetic part in mind is the key of success. Often practitioners tend to create a treatment plan overlooking the basic principles of prosthetic part. This present review has discussed various prosthetic consideration of implant-supported prosthesis. A step-by-step detailed prosthetic option with their indications has been discussed to help all dental implant practitioners in making of an optimal treatment plan for each case. PMID:28713760

Pharmacovigilance and principle of nonmaleficence in sex reassignment.

PubMed

Zamarytė, Kristina; Stakišaitis, Donatas; Širinskienė, Agnė; Narbekovas, Andrius; Juškevičius, Jonas

2012-01-01

Physicians are obliged to provide treatment that is consistent with their commitment to avoid or minimize harm (nonmaleficence) and their commitment to do good (beneficence). Therefore, if patient's desires were contradictory to the primary aim of medicine, the doctor's calling would require him/her to thoroughly analyze the cause of the disease and provide an adequate as well as ethical treatment rather than obediently follow patient's requests. Yet, chemical and surgical sex reassignment is one of the areas where some physicians surrender to the desire of their patients instead of finding out what their real condition is and trying to manage it in a way the essence of medicine would require. The objective of this article was to provide specific pharmacovigilance search details for the evaluation of the current situation and the scientific background of the treatment of gender dysphoria and to analyze its conformity with one of the two main ethical principles of medicine - nonmaleficence. Literature retrieval was accessed through Medline (1979-2011) using the terms "gender dysphoria," "replacement hormonal therapy," and "pharmacovigilance." The article concludes that hormonal and surgical interventions have not proven to be medically justified and could be harmful, not treating the cause, but resulting in irreversible disability. Thus, these interventions contradict the principle of nonmaleficence and goals of basic therapeutics and pharmacovigilance. They are not based on clinical trials and are lacking a thorough follow-up assessment.

The Sex Difference in Basic Surgical Skills Learning: A Comparative Study.

PubMed

Lou, Zheng; Yan, Fei-Hu; Zhao, Zhi-Qing; Zhang, Wei; Shui, Xian-Qi; Liu, Jia; Zhuo, Dong-Lan; Li, Li; Yu, En-da

2016-01-01

Very little is known of sex-related differences among medical students in the acquisition of basic surgical skills at an undergraduate level. The aim of this study was to investigate the sex differences in basic surgical skills learning and the possible explanations for sex disparities within basic surgical skills education. A didactic description of 10 surgical skills was performed, including knot tying, basic suture I, basic suture II, sterile technique, preoperative preparation, phlebotomy, debridement, laparotomy, cecectomy, and small bowel resection with hand-sewn anastomosis. The students were rated on a 100-point scale for each basic surgical skill. Later during the same semester all the students took the final theoretical examination. A total of 342 (male = 317 and female = 25) medical students participated in a single skills laboratory as part of their third-year medical student clerkship. The mean scores for each of the 10 surgical skills were higher in female group. The difference in sterile technique, preoperative preparation, cecectomy, and small bowel resection with hand-sewn anastomosis reached the significant level. Compared with male medical students, the mean theory examination score was significantly higher in female medical students. Approximately 76% of the (19 of 25) female students expressed their interest in pursuing a surgical career, whereas only 65.5% (207 of 317) male students wanted to be surgical professionals (p = 0.381). Female medical students completed basic surgical skills training more efficiently and passed the theoretical examination with significantly higher scores than male medical students. In the future, studies should be done in other classes in our institution and perhaps other schools to see if these findings are reliable or valid or just a reflection of this 1 sample. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

System design and animal experiment study of a novel minimally invasive surgical robot.

PubMed

Wang, Wei; Li, Jianmin; Wang, Shuxin; Su, He; Jiang, Xueming

2016-03-01

Robot-assisted minimally invasive surgery has shown tremendous advances over the traditional technique. However, currently commercialized systems are large and complicated, which vastly raises the system cost and operation room requirements. A MIS robot named 'MicroHand' was developed over the past few years. The basic principle and the key technologies are analyzed in this paper. Comparison between the proposed robot and the da Vinci system is also presented. Finally, animal experiments were carried out to test the performance of MicroHand. Fifteen animal experiments were carried out from July 2013 to December 2013. All animal experiments were finished successfully. The proposed design method is an effective way to resolve the drawbacks of previous generations of the da Vinci surgical system. The animal experiment results confirmed the feasibility of the design. Copyright © 2015 John Wiley & Sons, Ltd.

Natural language generation of surgical procedures.

PubMed

Wagner, J C; Rogers, J E; Baud, R H; Scherrer, J R

1999-01-01

A number of compositional Medical Concept Representation systems are being developed. Although these provide for a detailed conceptual representation of the underlying information, they have to be translated back to natural language for used by end-users and applications. The GALEN programme has been developing one such representation and we report here on a tool developed to generate natural language phrases from the GALEN conceptual representations. This tool can be adapted to different source modelling schemes and to different destination languages or sublanguages of a domain. It is based on a multilingual approach to natural language generation, realised through a clean separation of the domain model from the linguistic model and their link by well defined structures. Specific knowledge structures and operations have been developed for bridging between the modelling 'style' of the conceptual representation and natural language. Using the example of the scheme developed for modelling surgical operative procedures within the GALEN-IN-USE project, we show how the generator is adapted to such a scheme. The basic characteristics of the surgical procedures scheme are presented together with the basic principles of the generation tool. Using worked examples, we discuss the transformation operations which change the initial source representation into a form which can more directly be translated to a given natural language. In particular, the linguistic knowledge which has to be introduced--such as definitions of concepts and relationships is described. We explain the overall generator strategy and how particular transformation operations are triggered by language-dependent and conceptual parameters. Results are shown for generated French phrases corresponding to surgical procedures from the urology domain.

The efficacy of virtual reality simulation training in laparoscopy: a systematic review of randomized trials.

PubMed

Larsen, Christian Rifbjerg; Oestergaard, Jeanett; Ottesen, Bent S; Soerensen, Jette Led

2012-09-01

Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Controlled trials. All randomized controlled trials investigating the effect of VR training in laparoscopy, with outcome measured as surgical performance. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Operation time was reduced by 17-50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA - IIB) to support the use of VR simulators in laparoscopic training. © 2012 The Authors  Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, G.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

WE-A-304-02: Strategies and Technologies for Cranial Radiosurgery Planning: Gamma Knife

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schlesinger, D.

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Futuremore » directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.« less

Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration.

PubMed

Bonte, Katrien; Huvenne, Wouter; De Loof, Marie; Deron, Philippe; Viaene, Annick; Duprez, Fréderic; Vermeersch, Hubert

2015-12-01

Intractable aspiration is a serious, often life-threatening condition due to its potential impact on pulmonary function. Aspiration requires therapeutic measures, starting with conservative management but often necessitating surgical treatment. The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis. In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients, representing the largest reported cohort thus far. LTS is a reliable surgical technique to treat intractable aspiration, with restoration of oral intake, thereby improving the general condition and quality of life of these unfortunate patients. Furthermore, voice restoration can be achieved in selected patients, by placement of a voice prosthesis.

What's in a Rash? Viral Exanthem Versus CBRNE Exposure: Teleconsultation Support for Two Special Forces Soldiers With Diffuse Rash in an Austere Environment.

PubMed

Lee, Howard D; Butterfield, Samuel; Maddry, Joseph; Powell, Douglas; Vasios, William N; Yun, Heather; Ferraro, David; Pamplin, Jeremy C

2018-01-01

Review clinical thought process and key principles for diagnosing weaponized chemical and biologic injuries. Clinical Context: Special Operation Forces (SOF) team deployed in an undisclosed, austere environment. Organic Expertise: Two SOF Soldiers with civilian EMT-Basic certification. Closest Medical Support: Mobile Forward Surgical Team (2 hours away); medical consults available by e-mail, phone, or video-teleconsultation. Earliest Evacuation: Earliest military evacuation from country 12-24 hours. With teleconsultation, patients departed to Germany as originally scheduled without need for Medical Evacuation. 2018.

Learning surgically oriented anatomy in a student-run extracurricular club: an education through recreation initiative.

PubMed

Ullah, Shahnoor M; Bodrogi, Andrew; Cristea, Octav; Johnson, Marjorie; McAlister, Vivian C

2012-01-01

Didactic and laboratory anatomical education have seen significant reductions in the medical school curriculum due, in part, to the current shift from basic science to more clinically based teaching in North American medical schools. In order to increase medical student exposure to anatomy, with clinical applicability, a student-run initiative called surgically oriented anatomy prosectors (SOAP) club was created within the extracurricular program at the Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada. SOAP invites surgeons and residents from various surgical specialties to demonstrate, on a cadaver, a surgical procedure of their choosing. During the demonstration, the anatomy, as it relates to the surgical procedure, is discussed. The students then break into smaller groups to examine the relevant anatomy on the cadavers, during which time the discussion is broadened. The group continues the conversation in a social environment with refreshments. SOAP is one of the most popular extracurricular clubs with 65% of first and second year medical students registered as members. The high demand for SOAP, along with the positive participant feedback, may be due to its utilization of the principle of education through recreation, which seeks to provide opportunities for learning seamlessly throughout all facets of life. It also demonstrates the desire, amongst certain medical students, to learn applied anatomy, particularly within a surgical context. Copyright © 2012 American Association of Anatomists.

Cardiac 3D Printing and its Future Directions.

PubMed

Vukicevic, Marija; Mosadegh, Bobak; Min, James K; Little, Stephen H

2017-02-01

Three-dimensional (3D) printing is at the crossroads of printer and materials engineering, noninvasive diagnostic imaging, computer-aided design, and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review, we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation, including coregistration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and surgical and catheter-based structural disease, 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cardiac 3D Printing and Its Future Directions

PubMed Central

Vukicevic, Marija; Mosadegh, Bobak; Min, James K.; Little, Stephen H.

2017-01-01

3D printing is at the crossroads of printer and materials engineering; non-invasive diagnostic imaging; computer aided design (CAD); and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation including co-registration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and in surgical and catheter-based structural disease – 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions. PMID:28183437

The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation

PubMed Central

Brindle, Timothy; Johnson, Darren L.

2001-01-01

Objective: To review basic meniscal anatomy, histology, and biomechanical principles as they apply to surgery and rehabilitation. Data Sources: We searched MEDLINE and CINAHL for the years 1960–1999 using the terms meniscus, surgery, rehabilitation, meniscal repair, and arthroscopy. Data Synthesis: Injuries to a healthy meniscus are usually produced by a compressive force coupled with transverse-plane tibiofemoral rotation as the knee moves from flexion to extension during rapid cutting or pivoting. The goal of meniscal surgery is to restore a functional meniscus to prevent the development of degenerative osteoarthritis in the involved knee. The goal of rehabilitation is to restore patient function based on individual needs, considering the type of surgical procedure, which meniscus was repaired, the presence of coexisting knee pathology (particularly ligamentous laxity or articular cartilage degeneration), the type of meniscal tear, the patient's age, preoperative knee status (including time between injury and surgery), decreased range of motion or strength, and the patient's athletic expectations and motivations. Progressive weight bearing and joint stress are necessary to enhance the functionality of the meniscal repair; however, excessive shear forces may be disruptive. Prolonged knee immobilization after surgery can result in the rapid development of muscular atrophy and greater delays in functional recovery. Conclusions/Recommendations: Accelerated joint mobility and weight-bearing components of rehabilitation protocols represent the confidence placed in innovative surgical fixation methods. After wound healing, an aquatic therapy environment may be ideal during all phases of rehabilitation after meniscal surgery (regardless of the exact procedure), providing the advantages of controlled weight bearing and mobility progressions. Well-designed, controlled, longitudinal outcome studies for patients who have undergone meniscectomy, meniscal repair, or meniscal reconstruction are lacking. PMID:16558666

Undergraduate basic surgical skills education: impact on attitudes to a career in surgery and surgical skills acquisition.

PubMed

McAnena, P F; O'Halloran, N; Moloney, B M; Courtney, D; Waldron, R M; Flaherty, G; Kerin, M J

2018-05-01

Basic surgical skills modules in medical education are effective in teaching skills and increasing confidence among students approaching surgery. However, these modules are not delivered universally and their effect on the professional development of graduates has not been established. We aimed to assess the impact of a 10-week basic surgical skills module on attitudes and technical skills of first year medical students compared to interns. Eighteen students participated and were assessed using a 4-part questionnaire. Technical skills were assessed by observing students perform a basic interrupted suture, using the objective structured assessment of technical skills (OSATS) tool. Fourteen interns were recruited. Students were more confident in surgical scrubbing (mean score 4.0 vs. 2.86, p = 0.001), and performing a basic suture (4.05 vs. 1.93, p = 0.000), more enthusiastic about assisting with an operation (4.5 vs. 3.0, p = 0.001) and more likely to consider a career in surgery (4.16 vs. 2.28, p = 0.000). Technical skills were greater in the student group (mean score 30.8 vs. 19.6, p = 0.001). Five interns had taken part in surgical skills modules as undergraduates. Their technical skills were significantly higher compared to interns who had not (n = 9) (28.8 vs. 14.5, p = 0.006), and they were more likely to consider a career in surgery (3.6 vs. 1.5, p = 0.036). The introduction of surgical skills teaching to the undergraduate medical curriculum has a positive impact on students' attitudes towards surgery and accelerates basic technical skills development. Consideration should be given to development of a standardised undergraduate core curriculum in basic surgical skills teaching.

41 CFR 102-85.25 - What is the basic principle governing OAs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... principle governing OAs? 102-85.25 Section 102-85.25 Public Contracts and Property Management Federal... POLICY FOR OCCUPANCY IN GSA SPACE Pricing Policy-General § 102-85.25 What is the basic principle governing OAs? The basic principle governing OAs is to adopt the private sector practice of capturing in a...

Glossary of Terms

MedlinePlus

... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology 2018-2019 Basic and ... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology Print 2018-2019 Basic ...

Training considerations for the intracoelomic implantation of electronic tags in fish with a summary of common surgical errors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cooke, Steven J.; Wagner, Glenn N.; Brown, Richard S.

2011-01-01

Training is a fundamental part of all scientific and technical disciplines. This is particularly true for all types of surgeons. For surgical procedures, a number of skills are necessary to reduce mistakes. Trainees must learn an extensive yet standardized set of problem-solving and technical skills to handle challenges as they arise. There are currently no guidelines or consistent training methods for those intending to implant electronic tags in fish; this is surprising, considering documented cases of negative consequences of fish surgeries and information from studies having empirically tested fish surgical techniques. Learning how to do fish surgery once is insufficientmore » for ensuring the maintenance or improvement of surgical skill. Assessment of surgical skills is rarely incorporated into training, and is needed. Evaluation provides useful feedback that guides future learning, fosters habits of self-reflection and self-remediation, and promotes access to advanced training. Veterinary professionals should be involved in aspects of training to monitor basic surgical principles. We identified attributes related to knowledge, understanding, and skill that surgeons must demonstrate prior to performing fish surgery including a “hands-on” assessment using live fish. Included is a summary of common problems encountered by fish surgeons. We conclude by presenting core competencies that should be required as well as outlining a 3-day curriculum for training surgeons to conduct intracoelomic implantation of electronic tags. This curriculum could be offered through professional fisheries societies as professional development courses.« less

[Principles of Teaching in Surgery - State of the Art].

PubMed

Busemann, A; Patrzyk, M; Busemann, C; Heidecke, C-D

2016-06-01

Ten to 15 years ago the number of applications for a surgical residency position was very much larger than the positions available. Today, this situation has clearly reversed itself as indicated through a noticeable deficit in recruits. The decision to become a surgeon has become more uncommon. This can be blamed upon not only the demotivatingly viewed "work-life imbalance" associated with being a surgeon, but also on the basically non-inspiring training process during medical school. Due to the fact that university educators/instructors are not fundamentally trained teachers, they often fail in their capacity to convey their extensive knowledge to medical students and potentially future surgical residents. The quality of primary as well as postgraduate training is an important central factor in the effort to once again restore the attractive image of surgery within the realm of the medical disciplines. This paper presents an overview of the basic modern training concepts by which every surgeon should be able to effectively convey knowledge and practical skills. Furthermore, this work should inspire a more intensive interest in clinical graduate and postgraduate education. Due to the hand in hand relationship, this manuscript does not differentiate between student teaching and postgraduate training. Georg Thieme Verlag KG Stuttgart · New York.

Basic research and 12 years of clinical experience in computer-assisted navigation technology: a review.

PubMed

Ewers, R; Schicho, K; Undt, G; Wanschitz, F; Truppe, M; Seemann, R; Wagner, A

2005-01-01

Computer-aided surgical navigation technology is commonly used in craniomaxillofacial surgery. It offers substantial improvement regarding esthetic and functional aspects in a range of surgical procedures. Based on augmented reality principles, where the real operative site is merged with computer generated graphic information, computer-aided navigation systems were employed, among other procedures, in dental implantology, arthroscopy of the temporomandibular joint, osteotomies, distraction osteogenesis, image guided biopsies and removals of foreign bodies. The decision to perform a procedure with or without computer-aided intraoperative navigation depends on the expected benefit to the procedure as well as on the technical expenditure necessary to achieve that goal. This paper comprises the experience gained in 12 years of research, development and routine clinical application. One hundred and fifty-eight operations with successful application of surgical navigation technology--divided into five groups--are evaluated regarding the criteria "medical benefit" and "technical expenditure" necessary to perform these procedures. Our results indicate that the medical benefit is likely to outweight the expenditure of technology with few exceptions (calvaria transplant, resection of the temporal bone, reconstruction of the orbital floor). Especially in dental implantology, specialized software reduces time and additional costs necessary to plan and perform procedures with computer-aided surgical navigation.

Basic needs and their predictors for intubated patients in surgical intensive care units.

PubMed

Liu, Jin-Jen; Chou, Fan-Hao; Yeh, Shu-Hui

2009-01-01

This study was conducted to investigate the basic needs and communication difficulties of intubated patients in surgical intensive care units (ICUs) and to identify predictors of the basic needs from the patient characteristics and communication difficulties. In this descriptive correlational study, 80 surgical ICU patients were recruited and interviewed using 3 structured questionnaires: demographic information, scale of basic needs, and scale of communication difficulties. The intubated patients were found to have moderate communication difficulties. The sense of being loved and belonging was the most common need in the intubated patients studied (56.00 standardized scores). A significantly positive correlation was found between communication difficulties and general level of basic needs (r = .53, P < .01), and another positive correlation was found between the length of stay in ICUs and the need for love and belonging (r = .25, P < .05). The basic needs of intubated patients could be significantly predicted by communication difficulties (P = .002), use of physical restraints (P = .010), lack of intubation history (P = .005), and lower educational level (P = .005). These 4 predictors accounted for 47% of the total variance in basic needs. The intubated patients in surgical ICUs had moderate basic needs and communication difficulties. The fact that the basic needs could be predicted by communication difficulties, physical restraints, and educational level suggests that nurses in surgical ICUs need to improve skills of communication and limit the use of physical restraints, especially in patients with a lower educational level.

5 CFR 551.401 - Basic principles.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...

Do Racial and Gender Disparities Exist in Newer Glaucoma Treatments?

MedlinePlus

... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology 2018-2019 Basic and ... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology Print 2018-2019 Basic ...

The biology of distraction osteogenesis for correction of mandibular and craniomaxillofacial defects: A review

PubMed Central

Natu, Subodh Shankar; Ali, Iqbal; Alam, Sarwar; Giri, Kolli Yada; Agarwal, Anshita; Kulkarni, Vrishali Ajit

2014-01-01

Limb lengthening by distraction osteogenesis was first described in 1905. The technique did not gain wide acceptance until Gavril Ilizarov identified the physiologic and mechanical factors governing successful regeneration of bone formation. Distraction osteogenesis is a new variation of more traditional orthognathic surgical procedure for the correction of dentofacial deformities. It is most commonly used for the correction of more severe deformities and syndromes of both the maxilla and the mandible and can also be used in children at ages previously untreatable. The basic technique includes surgical fracture of deformed bone, insertion of device, 5-7 days rest, and gradual separation of bony segments by subsequent activation at the rate of 1 mm per day, followed by an 8-12 weeks consolidation phase. This allows surgeons, the lengthening and reshaping of deformed bone. The aim of this paper is to review the principle, technical considerations, applications and limitations of distraction osteogenesis. The application of osteodistraction offers novel solutions for surgical-orthodontic management of developmental anomalies of the craniofacial skeleton as bone may be molded into different shapes along with the soft tissue component gradually thereby resulting in less relapse. PMID:24688555

Early developments and clinical applications of total parenteral nutrition.

PubMed

Dudrick, Stanley J

2003-01-01

This article recounts the conditions and status of surgical nutrition support in the 1960s and the antecedent basic and clinical investigational work leading to the development of a practical and efficacious method of adequate nourishment entirely by vein in Beagle puppies; describes the subsequent clinical application of the knowledge, techniques, and technology to the first successful long-term total parenteral nutrition (TPN) support of critically ill pediatric and adult patients; and admonishes nutritionists of all backgrounds that some need for parenteral nutrition will likely always exist and that it is incumbent upon everyone to continue endeavors to advance the germinal methodology to perfection. The relevant indications, limitations, hindrances, motivational factors, and studies regarding the development of TPN are reviewed, and the fundamental investigational work culminating in the first successful growth and development of Beagle puppies and a human infant fed entirely by vein are described firsthand. The details of the orderly and logical scientific development of the principles and components of the techniques in animals, infants, and adults are related. Knowledge, techniques, and technologic constituents of the first successful long-term TPN system were developed in the basic biochemical and animal laboratories initially in 6 puppies and subsequently adapted clinically for the efficacious long-term i.v. support of 6 critically ill surgical adult patients and a newborn infant before its widespread clinical application. Long-term TPN was inaugurated successfully as a safe and effective i.v. feeding technique nearly 4 decades ago. However, basic and clinical investigations must continue to be encouraged, supported, and carried out in the quest to perfect the current rudimentary technology, methodology, and outcomes.

The Basic Surgical Skills Course in Sub-Saharan Africa: An Observational Study of Effectiveness.

PubMed

Fergusson, Stuart J; Sedgwick, David M; Ntakiyiruta, Georges; Ntirenganya, Faustin

2018-04-01

The Basic Surgical Skills (BSS) course is a common component of postgraduate surgical training programmes in sub-Saharan Africa, but was originally designed in a UK context, and its efficacy and relevance have not been formally assessed in Africa. An observational study was carried out during a BSS course delivered to early-stage surgical trainees from Rwanda and the Democratic Republic of the Congo. Technical skill in a basic wound closure task was assessed in a formal Objective Structured Assessment of Technical Skills (OSAT) before and after course completion. Participants completed a pre-course questionnaire documenting existing surgical experience and self-perceived confidence levels in surgical skills which were to be taught during the course. Participants repeated confidence ratings and completed course evaluation following course delivery. A cohort of 17 participants had completed a pre-course median of 150 Caesarean sections as primary operator. Performance on the OSAT improved from a mean of 10.5/17 pre-course to 14.2/17 post-course (mean of paired differences 3.7, p < 0.001). Improvements were seen in 15/17 components of wound closure. Pre-course, only 47% of candidates were forming hand-tied knots correctly and 38% were appropriately crossing hands with each throw, improving to 88 and 76%, respectively, following the course (p = 0.01 for both components). Confidence levels improved significantly in all technical skills taught, and the course was assessed as highly relevant by trainees. The Basic Surgical Skills course is effective in improving the basic surgical technique of surgical trainees from sub-Saharan Africa and their confidence in key technical skills.

A pilot study designed to acquaint medical educators with basic pedagogic principles.

PubMed

McLeod, P J; Brawer, J; Steinert, Y; Chalk, C; McLeod, A

2008-02-01

Faculty development activities in medical schools regularly target teaching behaviours but rarely address basic pedagogic principles underlying those behaviours. Although many teachers have an intuitive or tacit knowledge of basic pedagogic principles, overt knowledge of fundamental educational principles is rare. We conducted a short-term pilot study designed to transform teachers' tacit knowledge into explicit knowledge of pedagogic principles. We hypothesized that conscious awareness of these principles will positively influence their teaching effectiveness. The intervention included a workshop, provision of a workbook on pedagogic principles and free access to educational consultants. For the intervention, we chose a purposive sample of experienced teachers at our medical school. Evaluation of the impact of the intervention using questionnaires and semi-structured interviews revealed three notable findings; 1. Participants were surprised to discover the existence of an extensive body of pedagogic science underlying teaching and learning. 2. They were enthusiastic about the intervention and expressed interest in learning more about basic pedagogic principles. 3. The knowledge acquired had an immediate impact on their teaching.

10 Tips to Reduce Your Chance of Losing Vision from the Most Common Cause of Blindness

MedlinePlus

... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology 2018-2019 Basic and ... 2019 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology Print 2018-2019 Basic ...

Congenital heart surgery: surgical performance according to the Aristotle complexity score.

PubMed

Arenz, Claudia; Asfour, Boulos; Hraska, Viktor; Photiadis, Joachim; Haun, Christoph; Schindler, Ehrenfried; Sinzobahamvya, Nicodème

2011-04-01

Aristotle score methodology defines surgical performance as 'complexity score times hospital survival'. We analysed how this performance evolved over time and in correlation with case volume. Aristotle basic and comprehensive complexity scores and corresponding basic and comprehensive surgical performances were determined for primary (main) procedures carried out from 2006 to 2009. Surgical case volume performance described as unit performance was estimated as 'surgical performance times the number of primary procedures'. Basic and comprehensive complexity scores for the whole cohort of procedures (n=1828) were 7.74±2.66 and 9.89±3.91, respectively. With an early survival of 97.5% (1783/1828), mean basic and comprehensive surgical performances reached 7.54±2.54 and 9.64±3.81, respectively. Basic surgical performance varied little over the years: 7.46±2.48 in 2006, 7.43±2.58 in 2007, 7.50±2.76 in 2008 and 7.79±2.54 in 2009. Comprehensive surgical performance decreased from 9.56±3.91 (2006) to 9.22±3.94 (2007), and then to 9.13±3.77 (2008), thereafter increasing up to 10.62±3.67 (2009). No significant change of performance was observed for low comprehensive complexity levels 1-3. Variation concerned level 4 (p=0.048) which involved the majority of procedures (746, or 41% of cases) and level 6 (p<0.0001) which included a few cases (20, or 1%), whereas for level 5, statistical significance was almost attained: p=0.079. With a mean annual number of procedures of 457, mean basic and comprehensive unit performance was estimated at 3447±362 and 4405±577, respectively. Basic unit performance increased year to year from 3036 (2006, 100%) to 3254 (2007, 107.2%), then 3720 (2008, 122.5%), up to 3793 (2009, 124.9%). Comprehensive unit performance also increased: from 3891 (2006, 100%) to 4038 (2007, 103.8%), 4528 (2008, 116.4%) and 5172 (2009, 132.9%). Aristotle scoring of surgical performance allows quality assessment of surgical management of congenital heart disease over time. The newly defined unit performance appears to well reflect the trend of activity and efficiency of a congenital heart surgery department. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

A rational approach to the outpatient management of lacerations in pediatric patients.

PubMed

Kanegaye, J T

1998-08-01

Lacerations are a frequent reason for pediatric health care visits. Many are referred to EDs or to surgical specialists but may be treated by the pediatrician who has the time and interest in maintaining wound care skills. Although skin closure is often viewed as the primary event in wound care, local anesthesia and wound toilet are equally important aspects in which expertise is often undervalued. On occasion, patient anxiety and resistance complicates wound care, and a variety of sedative techniques facilitates completion of procedures that otherwise would require general anesthesia. Adherence to basic principles and the occasional use of innovations in wound care enable the clinician to bring about optimal outcomes.

Novel Hybrid Operating Table for Neuroendovascular Treatment.

PubMed

Jong-Hyun, Park; Jonghyeon, Mun; Dong-Seung, Shin; Bum-Tae, Kim

2017-03-25

The integration of interventional and surgical techniques is requiring the development of a new working environment equipped for the needs of an interdisciplinary neurovascular team. However, conventional surgical and interventional tables have only a limited ability to provide for these needs. We have developed a concept mobile hybrid operating table that provides the ability for such a team to conduct both endovascular and surgical procedures in a single session. We developed methods that provide surgeons with angiography-guided surgery techniques for use in a conventional operating room environment. In order to design a convenient device ideal for practical use, we consulted with mechanical engineers. The mobile hybrid operating table consists of two modules: a floating tabletop and a mobile module. In brief, the basic principle of the mobile hybrid operating table is as follows: firstly, the length of the mobile hybrid operating table is longer than that of a conventional surgical table and yet shorter than a conventional interventional table. It was designed with the goal of exhaustively meeting the intensive requirements of both endovascular and surgical procedures. Its mobile module allows for the floating tabletop to be moved quickly and precisely. It is important that during a procedure, a patient can be moved without being repositioned, particularly with a catheter in situ. Secondly, a slim-profile headrest facilitates the mounting of a radiolucent head cramp system for cranial stabilization and fixation. We have introduced a novel invention, a mobile hybrid operating table for use in an operating suite.

[Principles of management of periprosthetic fractures].

PubMed

Röderer, G; Gebhard, F; Scola, A

2016-03-01

The increasing numbers of primary total hip and knee replacements have subsequently led to growing rates of periprosthetic fractures. In many cases geriatric patients with osteopenia or osteoporotic bone quality are affected. The goal of treatment is the retention or reconstruction of joint function using open reduction and internal fixation or a revision prosthesis. The aim of this article is a description of the basic principles of treatment of periprosthetic fractures of the lower extremities. An exact description of the fracture using current classification systems with imaging diagnostics is mandatory. This also includes an assessment of the stability of the prosthesis. In the case of a stable prosthesis and a good bone stock open reduction and internal fixation should be performed. In these cases locking plates are standard procedure. If fracture reduction is possible minimally invasive procedures can be performed which help to reduce the surgical trauma and accelerate rehabilitation. If the prosthesis is loose it has to be exchanged for a revision implant. If vast bony defects result they can be augmented using wedges. Conservative treatment plays only a subordinate role in selected cases. Periprosthetic fractures show an increasing incidence and occur more frequently in the geriatric patient population. Due to comorbidities and poor bone quality surgical treatment is a challenge. The fracture must be exactly classified using the appropriate classification system in order to clarify if the prosthesis can be retained or if it has to be exchanged.

Anatomical knowledge retention in third-year medical students prior to obstetrics and gynecology and surgery rotations.

PubMed

Jurjus, Rosalyn A; Lee, Juliet; Ahle, Samantha; Brown, Kirsten M; Butera, Gisela; Goldman, Ellen F; Krapf, Jill M

2014-01-01

Surgical anatomy is taught early in medical school training. The literature shows that many physicians, especially surgical specialists, think that anatomical knowledge of medical students is inadequate and nesting of anatomical sciences later in the clinical curriculum may be necessary. Quantitative data concerning this perception of an anatomical knowledge deficit are lacking, as are specifics as to what content should be reinforced. This study identifies baseline areas of strength and weakness in the surgical anatomy knowledge of medical students entering surgical rotations. Third-year medical students completed a 20-25-question test at the beginning of the General Surgery and Obstetrics and Gynecology rotations. Knowledge of inguinal anatomy (45.3%), orientation in abdominal cavity (38.8%), colon (27.7%), and esophageal varices (12.8%) was poor. The numbers in parentheses are the percentage of questions answered correctly per topic. In comparing those scores to matched test items from this cohort as first-year students in the anatomy course, the drop in retention overall was very significant (P = 0.009) from 86.9 to 51.5%. Students also scored lower in questions relating to pelvic organs (46.7%), urogenital development (54.0%), pulmonary development (17.8%), and pregnancy (17.8%). These data showed that indeed, knowledge of surgical anatomy is poor for medical students entering surgical clerkships. These data collected will be utilized to create interactive learning modules, aimed at improving clinically relevant anatomical knowledge retention. These modules, which will be available to students during their inpatient surgical rotations, connect basic anatomy principles to clinical cases, with the ultimate goal of closing the anatomical knowledge gap. © 2014 American Association of Anatomists.

Heart failure in sub-Saharan Africa: A clinical approach.

PubMed

Kraus, S; Ogunbanjo, G; Sliwa, K; Ntusi, N A B

2016-01-01

Despite medical advances, heart failure (HF) remains a global health problem and sub-Saharan Africa (SSA) is no exception, with decompensated HF being the most common primary diagnosis for patients admitted to hospital with heart disease. In SSA the in-hospital mortality rate of decompensated HF is up to 8.3%. HF is a clinical syndrome that is caused by a diverse group of aetiologies, each requiring unique management strategies, highlighting the need for diagnostic certainty and a broad understanding of the complex pathophysiology of this condition. While there are a number of advanced medical, device and surgical interventions being tailored for HF internationally, the fundamental basic principles of HF management, such as patient education, effective management of congestion and initiation of disease-modifying medical therapies, remain a challenge on our continent. This review addresses both the epidemiology of HF in SSA and principles of management that focus specifically on symptom relief, prevention of hospitalisation and improving survival in this population.

[Concealed penis and its surgical correction: a report of 63 cases].

PubMed

Cheng, Fan; Zhang, Xiaobin; Liu, Xiuheng; Zhou, Jiangqiao; Xia, Yue; Ge, Minghuan

2004-02-01

To evaluate the basic principles of surgical correction of concealed penis. From Jan. 1999 to Dec. 2002, 63 cases of concealed penis, aged from 1 year and 6 months to 19 years with a mean age of 7 years and 2 months, were corrected with two different approaches: 37 cases of group A with obesity were corrected by anchoring micrus tissue onto the pubis at the base of the penis, and 26 cases of group B by fixing the subcutateous tissues at both sides of the penile shaft to the deep tunica albuginea at the penile root. Then prepuce plasty was carried out. Six-month postoperative follow-up found adequate exposure of the penis in all of group A, prepuce oedema in 7 cases, abdomen fat liquidization in 3 cases, unsatisfactory recovery of incision hollow in 3 cases and patchy numbness of the glans in 1 case. The 25 cases of group B had satisfactory exposure of the penis, with no obvious prepuce oedema, 1 case with retraction of the penis 7 days after operation. Various surgical procedures could be adopted for concealed penis, and the key to the satisfactory appearance is the restoration of penile tunicae and the fixation at the base of the penis. Further study is needed to determine the natural history of these disorders as well as which conditions and what age will benefit most from surgical intervention.

Comfort as a basic need in hospitalized patients in Iran: a hermeneutic phenomenology study.

PubMed

Yousefi, Hojatollah; Abedi, Heidar Ali; Yarmohammadian, Mohammad Hossein; Elliott, Doug

2009-09-01

This paper is a report of a study conducted to explore the comfort experiences of hospitalized patients during their admission to medical-surgical wards in an Iranian hospital. Comfort has various definitions, ranging from a basic human need, to a process, function or an outcome of nursing. As comfort is a substantive need throughout life in health and illness, providing comfort is a major function and challenge for holistic nursing care. This hermeneutic phenomenological study was conducted between July 2006 and April 2007 in six medical-surgical wards of one of a university hospital in Iran. Data were generated with 22 participants (16 hospitalized patients and six nurses), using in-depth interviews to capture their detailed experiences of comfort. Analysis based on the framework of Diekelmann enabled data interpretation and elaboration of shared themes. One constitutive pattern, 'Comfort: a need of hospitalized patients' and four related themes - A friend in hospital, Relief of suffering within a calm environment, Seeking God, and Presence among family - were identified in the data. These findings offer unique insight for planning and implementing appropriate clinical practices in Iran, especially in caring for Muslim patients. Two major implications are to: (1) consider comfort criteria during nursing assessment and planning of care during a patient's hospitalization and (2) note that Shiite people in particular are more comfortable and feel better when they are able to follow their religious principles.

Low-fidelity bench models for basic surgical skills training during undergraduate medical education.

PubMed

Denadai, Rafael; Saad-Hossne, Rogério; Todelo, Andréia Padilha; Kirylko, Larissa; Souto, Luís Ricardo Martinhão

2014-01-01

It is remarkable the reduction in the number of medical students choosing general surgery as a career. In this context, new possibilities in the field of surgical education should be developed to combat this lack of interest. In this study, a program of surgical training based on learning with models of low-fidelity bench is designed as a complementary alternative to the various methodologies in the teaching of basic surgical skills during medical education, and to develop personal interests in career choice.

Using Adult Learning Principles in Adult Basic and Literacy Education. Practice Application Brief.

ERIC Educational Resources Information Center

Imel, Susan

Adult basic and literacy education (ABLE) is a complex undertaking that serves diverse learners with a variety of needs. Although no definitive list of adult education principles exists in the literature, the following principles have been identified in multiple sources devoted to principles of effective adult education: involve learners in…

[The 80-th anniversary of the use of an operating microscope in otorhinolaryngology. Part II. Technical principle and operation of surgical microscope].

PubMed

Mroczkowski, Edward; Wielgosz, Romuald

2004-01-01

The first step to microsurgery is getting to know about technical principle and operation of the surgical microscopes. Special attention is paid to those modules and items of microscopes, which surgeon use most frequently, such as objectives, binocular tubes, eyepieces.

Surgical insertions of transmitters and telemetry methods in fisheries research

USGS Publications Warehouse

Wargo Rub, A. Michelle; Jepsen, Niels; Liedtke, Theresa L.; Moser, L; Weber III, E. P. Scott

2015-01-01

Use of electronic transmitter and monitoring systems to track movements of aquatic animals has increased continuously since the inception of these systems in the mid-1950s. The purpose of the present report is to provide information about veterinary principles and their incorporation into surgical implantation procedures for fish. We also intend to provide insight into the unique challenges of field-based aquatic surgical studies. Within this context, 4 aspects of the process for surgical implantation of transmitters in fish (ie, handling, aseptic technique, anesthesia, and implantation) will be described. Effects of surgical insertion of transmitters (ie, tagging) and aspects of the surgical implantation process where collaboration and professional exchanges among nonveterinarian researchers and veterinarians may be most fruitful will be discussed. Although this report focuses on surgical implantation, the principles and protocols described here (other than incision and suture placement) are also applicable to studies that involve injection of transmitters into fish.

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

PubMed

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

2011-08-01

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

A geospatial evaluation of timely access to surgical care in seven countries

PubMed Central

Banguti, Paulin; Chackungal, Smita; Chanthasiri, Traychit; Chao, Tiffany E; Dahn, Bernice; Derbew, Milliard; Dhar, Debashish; Esquivel, Micaela M; Evans, Faye; Hendel, Simon; LeBrun, Drake G; Notrica, Michelle; Saavedra-Pozo, Iracema; Shockley, Ross; Uribe-Leitz, Tarsicio; Vannavong, Boualy; McQueen, Kelly A; Spain, David A; Weiser, Thomas G

2017-01-01

Abstract: Objective To assess the consistent availability of basic surgical resources at selected facilities in seven countries. Methods In 2010–2014, we used a situational analysis tool to collect data at district and regional hospitals in Bangladesh (n = 14), the Plurinational State of Bolivia (n = 18), Ethiopia (n = 19), Guatemala (n = 20), the Lao People's Democratic Republic (n = 12), Liberia (n = 12) and Rwanda (n = 25). Hospital sites were selected by pragmatic sampling. Data were geocoded and then analysed using an online data visualization platform. Each hospital’s catchment population was defined as the people who could reach the hospital via a vehicle trip of no more than two hours. A hospital was only considered to show consistent availability of basic surgical resources if clean water, electricity, essential medications including intravenous fluids and at least one anaesthetic, analgesic and antibiotic, a functional pulse oximeter, a functional sterilizer, oxygen and providers accredited to perform surgery and anaesthesia were always available. Findings Only 41 (34.2%) of the 120 study hospitals met the criteria for the provision of consistent basic surgical services. The combined catchments of the study hospitals in each study country varied between 3.3 million people in Liberia and 151.3 million people in Bangladesh. However, the combined catchments of the study hospitals in each study country that met the criteria for the provision of consistent basic surgical services were substantially smaller and varied between 1.3 million in Liberia and 79.2 million in Bangladesh. Conclusion Many study facilities were deficient in the basic infrastructure necessary for providing basic surgical care on a consistent basis. PMID:28603310

Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature.

PubMed

von Bremen, J; Ruf, S

2011-08-01

To systematically review the literature published on orthodontic treatment principles in patients with juvenile idiopathic arthritis (JIA). Several electronic databases (PubMed, Medpilot, Web of Science, and DIMDI) and orthodontic and rheumatologic literature were systematically searched for studies published until May 2010. The articles were rated by two independent reviewers and included after three selection steps (title-abstract-full text). Articles had to be studies performed on ≥ 5 patients with a disease onset before the age of 16. The selection process resulted in the inclusion of three publications on dentofacial orthopedics and six on combined surgical orthodontic therapy. The three studies on dentofacial orthopedics aimed to improve the mandibular retrusion by means of removable functional appliances (activator). Whereas these orthodontic approaches comprised relatively large and homogeneous patient samples (14, 22, and 72 subjects, aged 6-16), the surgical studies were basically case series with a large age span of the patients (5-12 subjects, aged 10-44). In these surgical treatment approaches, orthodontics was limited to pre-surgical leveling and post-surgical finishing, while the skeletal discrepancy was treated surgically by a variety of techniques (costochondral grafts, bilateral sagittal spilt osteotomy, Le Fort I, and genioplasty). The treatment goals of both approaches were improvement of esthetics and function and/or pain reduction, and both approaches showed satisfactory results. Because of the heterogeneity of the subject material and the low level of evidence of the papers, it is difficult to draw any conclusions on the orthodontic/dentofacial orthopedic management of JIA. It appears as if removable functional appliances may be beneficial in adolescent patients with JIA. © 2011 John Wiley & Sons A/S.

Virtual reality in surgical education.

PubMed

Ota, D; Loftin, B; Saito, T; Lea, R; Keller, J

1995-03-01

Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

Modern history of surgical management of lung abscess: from Harold Neuhof to current concepts.

PubMed

Schweigert, Michael; Dubecz, Attila; Stadlhuber, Rudolf J; Stein, Hubert J

2011-12-01

Harold Neuhof was one of the pioneers of thoracic surgery in the early decades of the last century. Inspired by his preceptor Howard Lilienthal he proposed an entirely new concept for surgery on acute lung abscess. The aim of his one-stage procedure was adequate drainage of the abscess cavity. His approach proved to be the first major breakthrough in the treatment of acute lung abscess. Therapy of pulmonary abscess was again radically changed by the advent of antibiotics in the late 1940s. However, the basic principles of Neuhof's concept still influence modern-day management of putrid lung abscess. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Management of intestinal failure in children.

PubMed

Dalzell, A Mark

2015-10-01

The management of children with intestinal failure is a rewarding but resource intensive process. There is however variability in practice and outcome for patients, despite the basic principles of care and measures of success being well defined. The importance of multidisciplinary working is paramount and there is an urgent need to obtain collaboration between paediatric surgical and medical gastroenterological colleagues and an obligation of commissioners to see that there is recognition and implementation of ideal practice as an essential element in improving the outlook for children with intestinal failure in the United Kingdom. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Three-Dimensional Printing: Basic Principles and Applications in Medicine and Radiology.

PubMed

Kim, Guk Bae; Lee, Sangwook; Kim, Haekang; Yang, Dong Hyun; Kim, Young-Hak; Kyung, Yoon Soo; Kim, Choung-Soo; Choi, Se Hoon; Kim, Bum Joon; Ha, Hojin; Kwon, Sun U; Kim, Namkug

2016-01-01

The advent of three-dimensional printing (3DP) technology has enabled the creation of a tangible and complex 3D object that goes beyond a simple 3D-shaded visualization on a flat monitor. Since the early 2000s, 3DP machines have been used only in hard tissue applications. Recently developed multi-materials for 3DP have been used extensively for a variety of medical applications, such as personalized surgical planning and guidance, customized implants, biomedical research, and preclinical education. In this review article, we discuss the 3D reconstruction process, touching on medical imaging, and various 3DP systems applicable to medicine. In addition, the 3DP medical applications using multi-materials are introduced, as well as our recent results.

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: a controlled simulation study.

PubMed

Arefiev, Katharine; Warycha, Melanie; Whiting, Dennis; Alam, Murad

2012-10-01

Surgical fires are a rare, but serious complication of dermatologic procedures involving electrosurgical and laser devices. Given the lack of data regarding basic fire safety principles, many dermatologists remain unaware of this potential risk. We evaluated the flammability of topical preparations and surgical drapes commonly encountered in the immediate operative field during cutaneous and laser surgery. Surgical dressings, drapes, and pork belly skin were examined for fire risk upon exposure to isopropyl alcohol, chlorhexidine gluconate, and aluminum chloride under dry, saturated, and damp conditions. Both electrosurgery and a carbon-dioxide laser were used as ignition sources. At least some char was observed in 86 of 126 simulated conditions (68%). Flames occurred in 2 test conditions: dry underpad drapes and cotton balls exposed to the carbon-dioxide laser. In general, drapes and dressings dampened or saturated with isopropyl alcohol failed to ignite with electrofulguration or electrodessication, although sparks and moderate char developed on pork belly skin and the underpad drape. Materials dampened or saturated with chlorhexidine gluconate, which contains isopropyl alcohol, generated less smoke and char compared with materials exposed to aluminum chloride, which does not contain alcohol. Future studies may assess the flammability of materials in the setting of oxygen supplementation. In common cutaneous surgical environments, electrosurgery or ablative laser may lead to char and rarely to fire. Char may be seen in up to two thirds of simulated conditions, and in a minute proportion of conditions, fire is observed. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Assessment of capacity for surgery, obstetrics and anaesthesia in 17 Ghanaian hospitals using a WHO assessment tool.

PubMed

Choo, Shelly; Perry, Henry; Hesse, Afua A J; Abantanga, Francis; Sory, Elias; Osen, Hayley; Fleischer-Djoleto, Charles; Moresky, Rachel; McCord, Colin W; Cherian, Meena; Abdullah, Fizan

2010-09-01

To survey infrastructure characteristics, personnel, equipment and procedures of surgical, obstetric and anaesthesia care in 17 hospitals in Ghana. The assessment was completed by WHO country offices using the World Health Organization Tool for Situational Analysis to Assess Emergency and Essential Surgical Care, which surveyed infrastructure, human resources, types of surgical interventions and equipment in each facility. Overall, hospitals were well equipped with general patient care and surgical supplies. The majority of hospitals had a basic laboratory (100%), running water (94%) and electricity (82%). More than 75% had the basic supplies needed for general patient care and basic intra-operative care, including sterilization. Almost all hospitals were able to perform major surgical procedures such as caesarean sections (88%), herniorrhaphy (100%) and appendectomy (94%), but formal training of providers was limited: a few hospitals had a fully qualified surgeon (29%) or obstetrician (36%) available. The greatest barrier to improving surgical care at district hospitals in Ghana is the shortage of adequately trained medical personnel for emergency and essential surgical procedures. Important future steps include strengthening their number and qualifications. © 2010 Blackwell Publishing Ltd.

Basic Principles of Animal Science. Reprinted.

ERIC Educational Resources Information Center

Florida State Dept. of Education, Tallahassee.

The reference book is designed to fulfill the need for organized subject matter dealing with basic principles of animal science to be incorporated into the high school agriculture curriculum. The material presented is scientific knowledge basic to livestock production. Five units contain specific information on the following topics: anatomy and…

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

PubMed

Kotsis, Sandra V; Chung, Kevin C

2013-05-01

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

Business knowledge in surgeons.

PubMed

Satiani, Bhagwan

2004-07-01

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

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

PubMed

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

2007-11-01

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

Fact or Infection: Do Surgical Trainees Know Enough About Infection Control?

PubMed Central

Brady, RRW; McDermott, C; Gibb, AP; Paterson-Brown, S

2008-01-01

INTRODUCTION There exists a high level of non-compliance with basic infection control measures by medical staff. One explanation may be a lack of familiarity with contemporary infection control guidelines. As surgical trainees represent a key group of stakeholders responsible for the delivery of recommended infection control practice, we assessed knowledge of infection control guidelines amongst current UK surgical trainees. MATERIALS AND METHODS Without warning, during the annual meeting of the UK Association of Surgeons in Training (ASiT), participating surgical trainees were asked to complete a questionnaire examining their basic knowledge of infection control and methicillin-resistant Staphylococcus aureus (MRSA) based on recently published guidelines. RESULTS A total of 52 trainees (13 higher surgical trainees [HSTs]; 39 basic surgical trainees [BSTs]) returned completed questionnaires in the study. BSTs demonstrated a higher level of knowledge of infection control, outperforming the HSTs in 7 out of 11 questions. Of surgical trainees, 61.5% were misinformed regarding the prevalence of MRSA blood-stream infections and 69% were unaware of policies for transfer of MRSA-positive patients. Analysis revealed areas of concern in regards to an adequate general level of knowledge of infection control in surgical trainees, particularly in some key areas. CONCLUSIONS To ensure patient safety and reduce hospital-acquired infections, it is vital that focused, co-ordinated programmes of education, in this rapidly changing field, are prioritised and formalised into surgical training, selection and assessment. PMID:18990279

Thrombocytopenia

MedlinePlus

... EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 7th ed. Philadelphia, PA: Elsevier; 2018: ... EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 7th ed. Philadelphia, PA: Elsevier; 2018: ...

Simulation in paediatric urology and surgery. Part 1: An overview of educational theory.

PubMed

Nataraja, Ramesh M; Webb, Nathalie; Lopez, Pedro-Jose

2018-03-01

Surgical training has changed radically in the last few decades. The traditional Halstedian model of time-bound apprenticeship has been replaced with competency-based training. Advanced understanding of mastery learning principles has vastly altered educational methodology in surgical training, in terms of instructional design, delivery of educational content, assessment of learning, and programmatic evaluation. As part of this educational revolution, fundamentals of simulation-based education have been adopted into all levels and aspects of surgical training, requiring an understanding of concepts of fidelity and realism and the impact they have on learning. There are many educational principles and theories that can help clinical teachers understand the way that their trainees learn. In the acquisition of surgical expertise, concepts of mastery learning, deliberate practice, and experiential learning are particularly important. Furthermore, surgical teachers need to understand the principles of effective feedback, which is essential to all forms of skills learning. This article, the first of two papers, presents an overview of relevant learning theory for the busy paediatric surgeon and urologist. Seeking to introduce the concepts underpinning current changes in surgical education and training, providing practical tips to optimise teaching endeavours. Copyright © 2018 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

CADDIS Volume 4. Data Analysis: Basic Principles & Issues

EPA Pesticide Factsheets

Use of inferential statistics in causal analysis, introduction to data independence and autocorrelation, methods to identifying and control for confounding variables, references for the Basic Principles section of Data Analysis.

The Data Protection Act 1998: an audit of its effect on surgical trainees' practice.

PubMed

Webb, Jill B

2002-09-01

The Data Protection Act 1998 came into force in March 2000 and has significant implications on our normal practice. A survey of surgical specialist registrars was made to establish knowledge of the Act and adherence to its eight principles. Knowledge was patchy and adherence minimal, Simple guidelines are suggested to help juniors keep within the principles of the Act.

Unilateral Cleft Lip: Principles and Practice of Surgical Management

PubMed Central

Tse, Raymond

2012-01-01

Management of cleft lip and palate requires a unique understanding of the various dimensions of care to optimize outcomes of surgery. The breadth of treatment spans multiple disciplines and the length of treatment spans infancy to adulthood. Although the focus of reconstruction is on form and function, changes occur with growth and development. This review focuses on the surgical management of the primary cleft lip and nasal deformity. In addition to surgical treatment, the anatomy, clinical spectrum, preoperative care, and postoperative care are discussed. Principles of surgery are emphasized and controversies are highlighted. PMID:24179447

Surgical treatment of osteoporotic fractures: An update on the principles of management.

PubMed

Yaacobi, Eyal; Sanchez, Daniela; Maniar, Hemil; Horwitz, Daniel S

2017-12-01

The treatment of osteoporotic fractures continues to challenge orthopedic surgeon. The fragility of the underlying bone in conjunction with the need for specific implants led to the development of explicit surgical techniques in order to minimize implant failure related complications, morbidity and mortality. From the patient's perspective, the existence of frailty, dementia and other medical related co-morbidities induce a complex situation necessitating high vigilance during the perioperative and post-operative period. This update reviews current principles and techniques essential to successful surgical treatment of these injuries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Module Cluster: TTP-001.00 (GSC) Reinforcement Principles for Classroom Use.

ERIC Educational Resources Information Center

Brent, George

The purpose of this module cluster is to enable students to define the basic operant terms, to state the basic operant principles, to read operant measurement charts, and to use operant principles in elementary classrooms with both social and academic behaviors. It is intended for use by teacher education students with the cooperation of an…

Application of See One, Do One, Teach One Concept in Surgical Training

PubMed Central

Kotsis, Sandra V.; Chung, Kevin C.

2016-01-01

Background The traditional method of teaching in Surgery is known as “See One, Do One, Teach One.” However, many have argued that this method is no longer applicable mainly because of concerns for patient safety. The purpose of this paper is to show that the basis of the traditional teaching method is still valid in surgical training if it is combined with various adult learning principles. Methods We reviewed literature regarding the history of the formation of the surgical residency program, adult learning principles, mentoring, and medical simulation. We provide examples for how these learning techniques can be incorporated into a surgical resident training program. Results The surgical residency program created by Dr. William Halsted remained virtually unchanged until recently with reductions in resident work hours and changes to a competency-based training system. Such changes have reduced the teaching time between attending physicians and residents. Learning principles such as “Experience, Observation, Thinking and Action” as well as deliberate practice can be used to train residents. Mentoring is also an important aspect in teaching surgical technique. We review the different types of simulators: standardized patients, virtual reality applications, and high-fidelity mannequin simulators and the advantages and disadvantages of using them. Conclusions The traditional teaching method of “see one, do one, teach one” in surgical residency programs is simple but still applicable. It needs to evolve with current changes in the medical system to adequately train surgical residents and also provide patients with safe, evidence-based care. PMID:23629100

Cushing's syndrome: from physiological principles to diagnosis and clinical care

PubMed Central

Raff, Hershel; Carroll, Ty

2015-01-01

The physiological control of cortisol synthesis in the adrenal cortex involves stimulation of adrenocorticotrophic hormone (ACTH) by hypothalamic corticotrophin-releasing hormone (CRH) and then stimulation of the adrenal by ACTH. The control loop of the hypothalamic–pituitary–adrenal (HPA) axis is closed by negative feedback of cortisol on the hypothalamus and pituitary. Understanding this system is required to master the diagnosis, differential diagnosis and treatment of endogenous hypercortisolism – Cushing's syndrome. Endogenous Cushing's syndrome is caused either by excess ACTH secretion or by autonomous cortisol release from the adrenal cortex. Diagnosis of cortisol excess exploits three physiological principles: failure to achieve the normal nadir in the cortisol diurnal rhythm, loss of sensitivity of ACTH-secreting tumours to cortisol negative feedback, and increased excretion of free cortisol in the urine. Differentiating a pituitary source of excess ACTH (Cushing's disease) from an ectopic source is accomplished by imaging the pituitary and sampling for ACTH in the venous drainage of the pituitary. With surgical removal of ACTH or cortisol-secreting tumours, secondary adrenal insufficiency ensues because of the prior suppression of the HPA axis by glucocorticoid negative feedback. Medical therapy is targeted to the anatomical location of the dysregulated component of the HPA axis. Future research will focus on new diagnostics and treatments of Cushing's syndrome. These are elegant examples of translational research: understanding basic physiology informs the development of new approaches to diagnosis and treatment. Appreciating pathophysiology generates new areas for inquiry of basic physiological and biochemical mechanisms. PMID:25480800

Nondestructive Testing Eddy Current Basic Principles RQA/M1-5330.12 (V-I).

ERIC Educational Resources Information Center

National Aeronautics and Space Administration, Huntsville, AL. George C. Marshall Space Flight Center.

As one in the series of programmed instruction handbooks, prepared by the U.S. space program, home study material is presented in this volume concerning familiarization and orientation on basic eddy current principles. The subject is presented under the following headings: Basic Eddy Current Concepts, Eddy Current Generation and Distribution,…

Three basic principles of success.

PubMed

Levin, Roger

2003-06-01

Basic business principles all but ensure success when they are followed consistently. Putting strategies, objectives and tactics in place is the first step toward being able to document systems, initiate scripting and improve staff training. Without the basic steps, systems, scripting and training the practice for performance would be hit or miss, at best. More importantly, applying business principles ensures that limited practice resources are dedicated to the achievement of the strategy. By following this simple, three-step process, a dental practice can significantly enhance both financial success and dentist and staff satisfaction.

Improving basic surgical skills for final year medical students: the value of a rural weekend.

PubMed

House, A K; House, J

2000-05-01

Hospitals employing medical graduates often express concern at the inexperience of new interns in basic surgical skills. In self assessment questionnaires, our senior medical students reported little clinical procedural experience. A practical skills workshop was staged in order to set learning goals for the final study year. This gave the students an opportunity to learn, revise and practice basic surgical techniques. The Bruce Rock rural community sponsored a surgical camp at the beginning of the academic year. Ninety-five (80%) of the class registered at the workshop, which rotated them through teaching modules, with private study opportunities and the capacity to cater for varied skill levels. Eight teaching stations with multiple access points were provided, and ten mock trauma scenarios were staged to augment the learning process. The teaching weekend was rated by students on an evaluative entrance and exit questionnaire. Sixty-five (73%) students returned questionnaires. They recorded significant improvement (P < 0.05) in their ability to handle the teaching stations. All students had inserted intravenous lines in practice prior to the camp, so the rating change in intravenous line insertion ability was not statistically significant. The weekend retreat offers students a chance to focus on surgical skills, free from the pressures of a clinical setting or the classroom. The emphasis was on the value of practice and primary skills learning. Students endorsed the camp as relevant, practical and an enjoyable learning experience for basic surgical skills.

Evaluation of Medical Students' Attitudes and Performance of Basic Surgery Skills in a Training Program Using Fresh Human skin, Excised During Body Contouring Surgeries.

PubMed

Rothenberger, Jens; Seyed Jafari, Seyed Morteza; Schnabel, Kai P; Tschumi, Christian; Angermeier, Sarina; Shafighi, Maziar

2015-01-01

Learning surgical skills in the operating room may be a challenge for medical students. Therefore, more approaches using simulation to enable students to develop their practical skills are required. We hypothesized that (1) there would be a need for additional surgical training for medical students in the pre-final year, and (2) our basic surgery skills training program using fresh human skin would improve medical students' surgical skills. We conducted a preliminary survey of medical students to clarify the need for further training in basic surgery procedures. A new approach using simulation to teach surgical skills on human skin was set up. The procedural skills of 15 randomly selected students were assessed in the operating room before and after participation in the simulation, using Objective Structured Assessment of Technical Skills. Furthermore, subjective assessment was performed based on students' self-evaluation. The data were analyzed using SPSS, version 21 (SPSS, Inc., Chicago, IL). The study took place at the Inselspital, Bern University Hospital. A total of 186 pre-final-year medical students were enrolled into the preliminary survey; 15 randomly selected medical students participated in the basic surgical skills training course on the fresh human skin operating room. The preliminary survey revealed the need for a surgical skills curriculum. The simulation approach we developed showed significant (p < 0.001) improvement for all 12 surgical skills, with mean cumulative precourse and postcourse values of 31.25 ± 5.013 and 45.38 ± 3.557, respectively. The self-evaluation contained positive feedback as well. Simulation of surgery using human tissue samples could help medical students become more proficient in handling surgical instruments before stepping into a real surgical situation. We suggest further studies evaluating our proposed teaching method and the possibility of integrating this simulation approach into the medical school curriculum. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Principles of Surgical Treatment in the Midface Trauma - Theory and Practice

PubMed Central

VRINCEANU, Daniela; BANICA, Bogdan

2014-01-01

Introduction: Facial trauma is a common injury in the urban setting. Many studies have been published on the epidemiology and treatment of facial fractures, but few of them conducted in emergencies hospital as ours. The purpose of this study was to present theory and practice in surgical treatment of midface trauma. Materials and method: We will present a retrospective study and a cases series report with our personal experience in diagnosis and treatment of middle floor facial trauma. Craniofacial trauma in context of polytrauma involves a screening condition assessment of the patient to prioritize lesions and frequently require a multidisciplinary approach: neurosurgeon, ENT surgeon, maxillo-facial surgeon, ophthalmologist, plastic surgeon and so on. Axial and coronal CT are mandatory and three-dimensional CT reconstruction can be extremely useful. Surgical indication in middle floor facial trauma is given by functional and aesthetic deficits. Results: We will present the surgical principles we use in treatment of fractured nose, in fractures of maxilla, in fractures of the zygomatic arch with or without zygoma body fractures and fractures of the floor of orbit. Discussions: The surgical technique was imposed by coexisting lesions of neuro and viscerocranium, by the complexity of the fracture, by functional or aesthetic deficits and by our surgical experience. Conclusions: The main principles in middle face trauma are an accurate and complete lesions evaluation; mixed surgery team with maxillofacial surgeon and neurosurgeon. PMID:25705306

Multi-imager compatible actuation principles in surgical robotics.

PubMed

Stoianovici, D

2005-01-01

Today's most successful surgical robots are perhaps surgeon-driven systems, such as the daVinci (Intuitive Surgical Inc., USA, www.intuitivesurgical.com). These have already enabled surgery that was unattainable with classic instrumentation; however, at their present level of development, they have limited utility. The drawback of these systems is that they are independent self-contained units, and as such, they do not directly take advantage of patient data. The potential of these new surgical tools lies much further ahead. Integration with medical imaging and information are needed for these devices to achieve their true potential. Surgical robots and especially their subclass of image-guided systems require special design, construction and control compared to industrial types, due to the special requirements of the medical and imaging environments. Imager compatibility raises significant engineering challenges for the development of robotic manipulators with respect to imager access, safety, ergonomics, and above all the non-interference with the functionality of the imager. These apply to all known medical imaging types, but are especially challenging for achieving compatibility with the class of MRI systems. Even though a large majority of robotic components may be redesigned to be constructed of MRI compatible materials, for other components such as the motors used in actuation, prescribing MRI compatible materials alone is not sufficient. The electromagnetic motors most commonly used in robotic actuation, for example, are incompatible by principle. As such, alternate actuation principles using "intervention friendly" energy should be adopted and/or devised for these special surgical and radiological interventions. This paper defines the new concept of Multi-Imager Compatibility of surgical manipulators and describes its requirements. Subsequently, the paper gives several recommendations and proposes new actuation principles for this concept. Several implementations have been constructed and tested, and the results are presented here. This is the first paper addressing these issues. Copyright 2005 Robotic Publications Ltd.

Dynamic sealing principles

NASA Technical Reports Server (NTRS)

Zuk, J.

1976-01-01

The fundamental principles governing dynamic sealing operation are discussed. Different seals are described in terms of these principles. Despite the large variety of detailed construction, there appear to be some basic principles, or combinations of basic principles, by which all seals function, these are presented and discussed. Theoretical and practical considerations in the application of these principles are discussed. Advantages, disadvantages, limitations, and application examples of various conventional and special seals are presented. Fundamental equations governing liquid and gas flows in thin film seals, which enable leakage calculations to be made, are also presented. Concept of flow functions, application of Reynolds lubrication equation, and nonlubrication equation flow, friction and wear; and seal lubrication regimes are explained.

New Simulation Methods to Facilitate Achieving a Mechanistic Understanding of Basic Pharmacology Principles in the Classroom

ERIC Educational Resources Information Center

Grover, Anita; Lam, Tai Ning; Hunt, C. Anthony

2008-01-01

We present a simulation tool to aid the study of basic pharmacology principles. By taking advantage of the properties of agent-based modeling, the tool facilitates taking a mechanistic approach to learning basic concepts, in contrast to the traditional empirical methods. Pharmacodynamics is a particular aspect of pharmacology that can benefit from…

[Surgical treatment in otogenic facial nerve palsy].

PubMed

Feng, Guo-Dong; Gao, Zhi-Qiang; Zhai, Meng-Yao; Lü, Wei; Qi, Fang; Jiang, Hong; Zha, Yang; Shen, Peng

2008-06-01

To study the character of facial nerve palsy due to four different auris diseases including chronic otitis media, Hunt syndrome, tumor and physical or chemical factors, and to discuss the principles of the surgical management of otogenic facial nerve palsy. The clinical characters of 24 patients with otogenic facial nerve palsy because of the four different auris diseases were retrospectively analyzed, all the cases were performed surgical management from October 1991 to March 2007. Facial nerve function was evaluated with House-Brackmann (HB) grading system. The 24 patients including 10 males and 14 females were analysis, of whom 12 cases due to cholesteatoma, 3 cases due to chronic otitis media, 3 cases due to Hunt syndrome, 2 cases resulted from acute otitis media, 2 cases due to physical or chemical factors and 2 cases due to tumor. All cases were treated with operations included facial nerve decompression, lesion resection with facial nerve decompression and lesion resection without facial nerve decompression, 1 patient's facial nerve was resected because of the tumor. According to HB grade system, I degree recovery was attained in 4 cases, while II degree in 10 cases, III degree in 6 cases, IV degree in 2 cases, V degree in 2 cases and VI degree in 1 case. Removing the lesions completely was the basic factor to the surgery of otogenic facial palsy, moreover, it was important to have facial nerve decompression soon after lesion removal.

Using a depth-sensing infrared camera system to access and manipulate medical imaging from within the sterile operating field.

PubMed

Strickland, Matt; Tremaine, Jamie; Brigley, Greg; Law, Calvin

2013-06-01

As surgical procedures become increasingly dependent on equipment and imaging, the need for sterile members of the surgical team to have unimpeded access to the nonsterile technology in their operating room (OR) is of growing importance. To our knowledge, our team is the first to use an inexpensive infrared depthsensing camera (a component of the Microsoft Kinect) and software developed inhouse to give surgeons a touchless, gestural interface with which to navigate their picture archiving and communication systems intraoperatively. The system was designed and developed with feedback from surgeons and OR personnel and with consideration of the principles of aseptic technique and gestural controls in mind. Simulation was used for basic validation before trialing in a pilot series of 6 hepatobiliary-pancreatic surgeries. The interface was used extensively in 2 laparoscopic and 4 open procedures. Surgeons primarily used the system for anatomic correlation, real-time comparison of intraoperative ultrasound with preoperative computed tomography and magnetic resonance imaging scans and for teaching residents and fellows. The system worked well in a wide range of lighting conditions and procedures. It led to a perceived increase in the use of intraoperative image consultation. Further research should be focused on investigating the usefulness of touchless gestural interfaces in different types of surgical procedures and its effects on operative time.

Back-to-basics with a surgical rotation programme.

PubMed

Hall, Catherine L

This article describes the development and implementation of a rotation programme for Band 5 nurses within the surgical directorate at Heart of England NHS Foundation Trust. The article highlights the challenges raised for nurses with health service modernization and develops the rationale for the need for a different way of thinking. At Heart of England NHS Foundation Trust, the authors evaluation has led to the development of the surgical rotation programme for Band 5 nurses. This rotation programme challenged basic clinical practice and traditional modes of staff placement. Indications, so far, are that quality of care for patients has improved and nurses satisfaction has increased as a result of the implementation of the Band 5 surgical rotation programme.

Peer-assisted teaching of basic surgical skills.

PubMed

Preece, Ryan; Dickinson, Emily Clare; Sherif, Mohamed; Ibrahim, Yousef; Ninan, Ann Susan; Aildasani, Laxmi; Ahmed, Sartaj; Smith, Philip

2015-01-01

Basic surgical skills training is rarely emphasised in undergraduate medical curricula. However, the provision of skills tutorials requires significant commitment from time-constrained surgical faculty. We aimed to determine how a peer-assisted suturing workshop could enhance surgical skills competency among medical students and enthuse them towards a career in surgery. Senior student tutors delivered two suturing workshops to second- and third- year medical students. Suturing performance was assessed before and after teaching in a 10-min suturing exercise (variables measured included number of sutures completed, suture tension, and inter-suture distance). Following the workshop, students completed a questionnaire assessing the effect of the workshop on their suturing technique and their intention to pursue a surgical career. Thirty-five students attended. Eighty-one percent believed their medical school course provided insufficient basic surgical skills training. The mean number of sutures completed post-teaching increased significantly (p < 0.001), and the standard deviation of mean inter-suture distance halved from ± 4.7 mm pre-teaching, to ± 2.6 mm post-teaching. All students found the teaching environment to be relaxed, and all felt the workshop helped to improve their suturing technique and confidence; 87% found the peer-taught workshop had increased their desire to undertake a career in surgery. Peer-assisted learning suturing workshops can enhance medical students' competence with surgical skills and inspire them towards a career in surgery. With very little staff faculty contribution, it is a cheap and sustainable way to ensure ongoing undergraduate surgical skills exposure.

Virtual reality training for endoscopic surgery: voluntary or obligatory?

PubMed

van Dongen, K W; van der Wal, W A; Rinkes, I H M Borel; Schijven, M P; Broeders, I A M J

2008-03-01

Virtual reality (VR) simulators have been developed to train basic endoscopic surgical skills outside of the operating room. An important issue is how to create optimal conditions for integration of these types of simulators into the surgical training curriculum. The willingness of surgical residents to train these skills on a voluntary basis was surveyed. Twenty-one surgical residents were given unrestricted access to a VR simulator for a period of four months. After this period, a competitive element was introduced to enhance individual training time spent on the simulator. The overall end-scores for individual residents were announced periodically to the full surgical department, and the winner was awarded a prize. In the first four months of study, only two of the 21 residents (10%) trained on the simulator, for a total time span of 163 minutes. After introducing the competitive element the number of trainees increased to seven residents (33%). The amount of training time spent on the simulator increased to 738 minutes. Free unlimited access to a VR simulator for training basic endoscopic skills, without any form of obligation or assessment, did not motivate surgical residents to use the simulator. Introducing a competitive element for enhancing training time had only a marginal effect. The acquisition of expensive devices to train basic psychomotor skills for endoscopic surgery is probably only effective when it is an integrated and mandatory part of the surgical curriculum.

Medical ethics: four principles plus attention to scope.

PubMed

Gillon, R

1994-07-16

The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and justice--plus concern for their scope of application. It offers a common, basic moral analytical framework and a common, basic moral language. Although they do not provide ordered rules, these principles can help doctors and other health care workers to make decisions when reflecting on moral issues that arise at work.

International consensus statement on surgical education and training in an era of reduced working hours.

PubMed

Collins, John P

2011-01-01

An international consensus statement has been developed as a reference on the key principles to be considered during discussions on surgical education and training and the delivery of surgical care in an era of restricted hours. Copyright © 2011. Published by Elsevier Ltd.

4D microscope-integrated OCT improves accuracy of ophthalmic surgical maneuvers

NASA Astrophysics Data System (ADS)

Carrasco-Zevallos, Oscar; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Todorich, Bozho; Shieh, Christine; Kuo, Anthony; Toth, Cynthia; Izatt, Joseph A.

2016-03-01

Ophthalmic surgeons manipulate micron-scale tissues using stereopsis through an operating microscope and instrument shadowing for depth perception. While ophthalmic microsurgery has benefitted from rapid advances in instrumentation and techniques, the basic principles of the stereo operating microscope have not changed since the 1930's. Optical Coherence Tomography (OCT) has revolutionized ophthalmic imaging and is now the gold standard for preoperative and postoperative evaluation of most retinal and many corneal procedures. We and others have developed initial microscope-integrated OCT (MIOCT) systems for concurrent OCT and operating microscope imaging, but these are limited to 2D real-time imaging and require offline post-processing for 3D rendering and visualization. Our previously presented 4D MIOCT system can record and display the 3D surgical field stereoscopically through the microscope oculars using a dual-channel heads-up display (HUD) at up to 10 micron-scale volumes per second. In this work, we show that 4D MIOCT guidance improves the accuracy of depth-based microsurgical maneuvers (with statistical significance) in mock surgery trials in a wet lab environment. Additionally, 4D MIOCT was successfully performed in 38/45 (84%) posterior and 14/14 (100%) anterior eye human surgeries, and revealed previously unrecognized lesions that were invisible through the operating microscope. These lesions, such as residual and potentially damaging retinal deformation during pathologic membrane peeling, were visualized in real-time by the surgeon. Our integrated system provides an enhanced 4D surgical visualization platform that can improve current ophthalmic surgical practice and may help develop and refine future microsurgical techniques.

Basic principles, methodology, and applications of remote sensing in agriculture

NASA Technical Reports Server (NTRS)

Moreira, M. A. (Principal Investigator); Deassuncao, G. V.

1984-01-01

The basic principles of remote sensing applied to agriculture and the methods used in data analysis are described. Emphasis is placed on the importance of developing a methodology that may help crop forecast, basic concepts of spectral signatures of vegetation, the methodology of the LANDSAT data utilization in agriculture, and the remote sensing program application of INPE (Institute for Space Research) in agriculture.

Basic surgical training in the era of the European Working Time Directive: what are the problems and solutions?

PubMed

Skipworth, R J E; Terrace, J D; Fulton, L A; Anderson, D N

2008-11-01

Imposed reductions in working hours will impact significantly on the ability of surgical trainees to achieve competency. The objective of this study was to obtain the opinions of Scottish surgical trainees concerning the training they receive, in order to inform and guide the development of future, high-standard training programmes. An anonymous questionnaire was sent to basic surgical trainees on the Edinburgh, Aberdeen and Dundee Basic Surgical Rotations commencing after August 2002. Thirty six questionnaire responses were analysed. Very few of the returned comments were complimentary to the existing training structure; indeed, most comments demonstrated significant trainee disappointment. Despite "regular" exposure to operative sessions, training tutorials and named consultant trainers, the most common concern was a perceived lack of high-quality, structured, operative exposure and responsibility. Textbooks and journals remain the most frequently utilised learning tools, with high-tech systems such as teleconferencing, videos, CD-ROMS, and DVDs being poorly exploited. Current surgical training is not meeting the expectation of the majority of its trainees. To solve this problem will require extensive revision of attitudes and current educational format. A greater emphasis on the integration of 21st century learning tools in the training programme may help bridge this gap.

The first cut is the deepest: basic surgical training in ophthalmology.

PubMed

Gibson, A; Boulton, M G; Watson, M P; Moseley, M J; Murray, P I; Fielder, A R

2005-12-01

To examine the basic surgical training received by Senior House Officers (SHOs) in ophthalmology and the influence on training of sociodemographic and organisational factors. Cross-sectional survey of SHOs in recognised UK surgical training posts asking about laboratory training and facilities, surgical experience, demographic details, with the opportunity to add comments. A total of 314/466 (67%) questionnaires were returned. In all, 67% had attended a basic surgical course, 40% had access to wet labs and 39% had spent time in a wet lab in the previous 6 months. The mean number of part phakoemulsification (phako) procedures performed per week was 0.79; the mean number of full phakos performed per week was 0.74. The number of part phakos performed was negatively correlated, and the number of full phakos completed was positively correlated, with length of time as an SHO. Respondents who had larger operating lists performed more full phakos per week (P<0.001). Compared to men, women were less likely to have access to a wet lab (P=0.013), had completed fewer full phakos per week (P=0.003), and were less likely to have completed 50 full phakos (P=0003). SHOs' comments revealed concerns about their limited 'hands on' experience. There are significant shortcomings in the basic surgical training SHOs receive, particularly in relation to wet lab experience and opportunities to perform full intraocular procedures. SHOs themselves perceive their training as inadequate. Women are disadvantaged in both laboratory and patient-based training, but minority ethnic groups and those who qualified overseas are not.

Post surgical pain treatment - adults

MedlinePlus

... 18. Hernandez A, Sherwood ER. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice . 20th ...

Current state and future development of intracranial neuroendoscopic surgery.

PubMed

Cinalli, Giuseppe; Cappabianca, Paolo; de Falco, Raffaele; Spennato, Pietro; Cianciulli, Emilio; Cavallo, Luigi Maria; Esposito, Felice; Ruggiero, Claudio; Maggi, Giuseppe; de Divitiis, Enrico

2005-05-01

Since the introduction of the modern, smaller endoscopes in the 1960s, neuroendoscopy has become an expanding field of neurosurgery. Neuroendoscopy reflects the tendency of modern neurosurgery to aim towards minimalism; that is, access and visualization through the narrowest practical corridor and maximum effective action at the target point with minimal disruption of normal tissue. Transventricular neuroendoscopy allows the treatment of several pathologies inside the ventricular system, such as obstructive hydrocephalus and intra-/paraventricular tumors or cysts, often avoiding the implantation of extracranial shunts or more invasive craniotomic approaches. Endoscopic endonasal transphenoidal surgery allows the treatment of pathologies of the sellar and parasellar region, with the advantage of a wider vision of the surgical field, less traumatism of the nasal structures, greater facility in the treatment of possible recurrences and reduced complications. However, an endoscope may be used to assist microsurgery in virtually any kind of neurosurgical procedures (endoscope-assisted microsurgery), particularly in aneurysm and tumor surgery. Basic principles of optical imaging and the physics of optic fibers are discussed, focusing on the neuroendoscope. The three main chapters of neuroendoscopy (transventricular, endonasal transphenoidal and endoscope-assisted microsurgery) are reviewed, concerning operative instruments, surgical procedures, main indications and results.

Surgical and anesthesiological considerations of awake craniotomy: Cerrahpasa experience.

PubMed

Sanus, Galip Zihni; Yuksel, Odhan; Tunali, Yusuf; Ozkara, Cigdem; Yeni, Naz; Ozlen, Fatma; Tanriverdi, Taner; Ozyurt, Emin; Uzan, Mustafa

2015-01-01

Awake craniotomy (AC) with electrical cortical stimulation has become popular during the last ten years although the basic principles were introduced almost 50 years ago. The aim of this paper is to share with the readers our experience in 25 patients who underwent AC with electrical stimulation. Twenty-five patients who underwent AC between 2010 and 2013 are the subjects of this paper. All patients were diagnosed with intraaxial lesions involving the functional area itself or very close to it by preoperative imaging. During surgery, the functional area was demonstrated by cortical electrical stimulation and resection aimed to preserve it in order to avoid an irreversible functional deficit. Total resection was possible in 80% while in 20% subtotal resection had to be performed because of involvement of the functional area itself. The neurological complication rate was found to be 16% (4 patients) and all were transient. No complication regarding anesthesia was noted. Awake craniotomy in selected patients is very effective, safe and practical for supratentorial lesions close to the eloquent area. Complications related to the surgery itself are uncommon and general anesthesia is avoided. The hospital stay including the intensive care unit is short which makes it very economical surgical procedure.

The British society for gynaecological endoscopy endometriosis centres project.

PubMed

Saridogan, Ertan; Byrne, Dominic

2013-01-01

Management of advanced endometriosis frequently requires a multidisciplinary team approach and international guidelines suggest treatment in centres of expertise. Due to variability of published outcome data, prospective data collection and standardisation of reporting systems have been suggested to improve our understanding of surgical outcomes. The British Society for Gynaecological Endoscopy (BSGE) Endometriosis Centres were established to manage rectovaginal endometriosis, to collect treatment and outcome data, and to provide these data to patients, clinicians and healthcare commissioners. The BSGE Endometriosis Centres Project works on the principle of voluntary participation. Centres that would like to be recognised or accredited as a BSGE Endometriosis Centre need to fulfil a number of basic requirements including working in appropriate multidisciplinary clinical teams, auditing their outcome and having sufficient workload to maintain their surgical skills. The project has already had an impact on where the patients with advanced endometriosis are treated in the United Kingdom. Patients and healthcare professionals are becoming aware of their presence and more patients with the condition are being referred to these centres. It is also expected that the accredited centre status would be required for funding by healthcare commissioners for this type endometriosis. Copyright © 2013 S. Karger AG, Basel.

A CAL Program to Teach the Basic Principles of Genetic Engineering--A Change from the Traditional Approach.

ERIC Educational Resources Information Center

Dewhurst, D. G.; And Others

1989-01-01

An interactive computer-assisted learning program written for the BBC microcomputer to teach the basic principles of genetic engineering is described. Discussed are the hardware requirements software, use of the program, and assessment. (Author/CW)

Typewriting Methodology 1977: Eight Basic Principles for Good Results

ERIC Educational Resources Information Center

Winger, Fred E.

1977-01-01

The eight basic principles of teaching methodology discussed are as follows: Stress position and technique, stress skill building, stress the pretest/practice/posttest method, stress action research, stress true production skills, stress good proofreading skills, stress performance goals, and stress individualized instruction. (TA)

AGARD Flight Test Instrumentation Series. Volume 1, Issue 2. Basic Principles of Flight Test Instrumentation Engineering (Introduction Generale aux Principles de Base de l’Instrumentation des Essais en Vol)

DTIC Science & Technology

1994-03-01

evaluation of its anticipated value. If the program can be accomplished using conventional techniques , this should be seriously considered. Development or...the direct frequency generating principles such as, pulse tachos, turbine flowmeters, and encoders, also Doppler and laser techniques used for...CERAMIC BLOCK Figure 5.3. The basic concepts of the laser ring gyro (LRG). The principle depends upon the guidance of two beams of laser light around an

Shapes, Proportions, and Variations in Breast Aesthetic Ideals: The Definition of Breast Beauty, Analysis, and Surgical Practice.

PubMed

Mallucci, Patrick; Branford, Olivier Alexandre

2015-10-01

There are few objective analyses in the plastic surgical literature to define an aesthetically pleasing template for breast shape and proportion. The authors previously identified key objective parameters that define breast aesthetic ideals in 2 studies: an observational analysis of 100 models with natural breasts, and a population analysis with 1315 respondents. From these data a simple yet reproducible formula for surgical planning in breast augmentation has been developed to consistently achieve beautiful breasts, namely the ICE principle. This article proposes that this principle be used as the basis for design in aesthetic breast surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

Data Representation, Coding, and Communication Standards.

PubMed

Amin, Milon; Dhir, Rajiv

2015-06-01

The immense volume of cases signed out by surgical pathologists on a daily basis gives little time to think about exactly how data are stored. An understanding of the basics of data representation has implications that affect a pathologist's daily practice. This article covers the basics of data representation and its importance in the design of electronic medical record systems. Coding in surgical pathology is also discussed. Finally, a summary of communication standards in surgical pathology is presented, including suggested resources that establish standards for select aspects of pathology reporting. Copyright © 2015 Elsevier Inc. All rights reserved.

Mechanical Ventilation: State of the Art.

PubMed

Pham, Tài; Brochard, Laurent J; Slutsky, Arthur S

2017-09-01

Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs. We also highlight recent data on patient-ventilator dyssynchrony, humidified high-flow oxygen through nasal cannula, extracorporeal life support, and the weaning phase. Finally, we discuss the future of mechanical ventilation, addressing avenues for improvement. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

New Combinational Method for Noninvasive Treatments of Superficial Tissues for Body Aesthetics Applications

NASA Astrophysics Data System (ADS)

Rybyanets, A. N.; Naumenko, A. A.

The paper introduces an innovative combinational treatment method based on ultrasonic standing waves (USW) technology for noninvasive surgical, therapeutic, lypolitic or cosmetic treatment of tissues including subcutaneous adipose tissue, cellulite or skin on arbitrary body part of patient. The method is based on simultaneous or successive applying of constructively interfering physically and biologically sensed influences: USW, ultrasonic shear waves, radio-frequency (RF) heating, and vacuum massage. The paper provides basic physical principles of USW as well as critical comparison of USW and HIFU methods. The results of finite-elements and finite- difference modeling of USW transducer design and nodal pattern structure in tissue are presented. Biological effects of USW-tissue interaction and synergetic aspects of USW and RF combination are explored. Combinational treatment transducer designs and original in-vitro experiments on tissues are described.

Principles of three-dimensional printing and clinical applications within the abdomen and pelvis.

PubMed

Bastawrous, Sarah; Wake, Nicole; Levin, Dmitry; Ripley, Beth

2018-04-04

Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.

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

PubMed

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

2017-01-30

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

Medical ethics: four principles plus attention to scope.

PubMed Central

Gillon, R.

1994-01-01

The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and justice--plus concern for their scope of application. It offers a common, basic moral analytical framework and a common, basic moral language. Although they do not provide ordered rules, these principles can help doctors and other health care workers to make decisions when reflecting on moral issues that arise at work. Images p184-a p187-a PMID:8044100

"They Have to Adapt to Learn": Surgeons' Perspectives on the Role of Procedural Variation in Surgical Education.

PubMed

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2016-01-01

Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons' perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents. This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. Our sample included 99 hours of observation across 45 cases with 14 surgeons. Semistructured, audio-recorded interviews (n = 14) occurred immediately following observational periods. Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents' efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons' teaching raises questions about the lack of attention to this form of complexity in current workplace-based assessment strategies. Failure to recognize the role of such variations may threaten the implementation of competency-based medical education in surgery. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

PubMed Central

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2017-01-01

OBJECTIVE Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons’ perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents. DESIGN AND SETTING This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. PARTICIPANTS Our sample included 99 hours of observation across 45 cases with 14 surgeons. Semistructured, audio-recorded interviews (n = 14) occurred immediately following observational periods. RESULTS Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents’ efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. CONCLUSIONS Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons’ teaching raises questions about the lack of attention to this form of complexity in current workplace-based assessment strategies. Failure to recognize the role of such variations may threaten the implementation of competency-based medical education in surgery. PMID:26705062

TRAINING IN INDUSTRY--THE MANAGEMENT OF LEARNING.

ERIC Educational Resources Information Center

BASS, BERNARD M.; VAUGHAN, JAMES A.

THE PRINCIPLES OF LEARNING BEHAVIOR DERIVED THROUGH LABORATORY STUDY CAN BE EXTENDED TO EXPLAIN MUCH OF THE COMPLEX LEARNING REQUIRED IN INDUSTRIAL TRAINING PROGRAMS. A REVIEW OF THE BASIC PRINCIPLES OF HUMAN LEARNING INTRODUCES FOUR BASIC CONCEPTS--DRIVE, STIMULUS, RESPONSE, AND REINFORCER--AND DISCUSSES CLASSICAL AND INSTRUMENTAL CONDITIONING…

Designing User-Computer Dialogues: Basic Principles and Guidelines.

ERIC Educational Resources Information Center

Harrell, Thomas H.

This discussion of the design of computerized psychological assessment or testing instruments stresses the importance of the well-designed computer-user interface. The principles underlying the three main functional elements of computer-user dialogue--data entry, data display, and sequential control--are discussed, and basic guidelines derived…

Box- or Virtual-Reality Trainer: Which Tool Results in Better Transfer of Laparoscopic Basic Skills?-A Prospective Randomized Trial.

PubMed

Brinkmann, Christian; Fritz, Mathias; Pankratius, Ulrich; Bahde, Ralf; Neumann, Philipp; Schlueter, Steffen; Senninger, Norbert; Rijcken, Emile

Simulation training improves laparoscopic performance. Laparoscopic basic skills can be learned in simulators as box- or virtual-reality (VR) trainers. However, there is no clear recommendation for either box or VR trainers as the most appropriate tool for the transfer of acquired laparoscopic basic skills into a surgical procedure. Both training tools were compared, using validated and well-established curricula in the acquirement of basic skills, in a prospective randomized trial in a 5-day structured laparoscopic training course. Participants completed either a box- or VR-trainer curriculum and then applied the learned skills performing an ex situ laparoscopic cholecystectomy on a pig liver. The performance was recorded on video and evaluated offline by 4 blinded observers using the Global Operative Assessment of Laparoscopic Skills (GOALS) score. Learning curves of the various exercises included in the training course were compared and the improvement in each exercise was analyzed. Surgical Skills Lab of the Department of General and Visceral Surgery, University Hospital Muenster. Surgical novices without prior surgical experience (medical students, n = 36). Posttraining evaluation showed significant improvement compared with baseline in both groups, indicating acquisition of laparoscopic basic skills. Learning curves showed almost the same progression with no significant differences. In simulated laparoscopic cholecystectomy, total GOALS score was significantly higher for the box-trained group than the VR-trained group (box: 15.31 ± 3.61 vs. VR: 12.92 ± 3.06; p = 0.039; Hedge׳s g* = 0.699), indicating higher technical skill levels. Despite both systems having advantages and disadvantages, they can both be used for simulation training for laparoscopic skills. In the setting with 2 structured, validated and almost identical curricula, the box-trained group appears to be superior in the better transfer of basic skills into an experimental but structured surgical procedure. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Basics of LASIK Eye Surgery

MedlinePlus

... Vea esta página en español The Basics of LASIK Eye Surgery Share This Page Facebook Twitter Linked- ... Surgery Surgical Alternatives to LASIK For More Information  LASIK Basics If you wear glasses or contact lenses, ...

Cushing's syndrome: from physiological principles to diagnosis and clinical care.

PubMed

Raff, Hershel; Carroll, Ty

2015-02-01

The physiological control of cortisol synthesis in the adrenal cortex involves stimulation of adrenocorticotrophic hormone (ACTH) by hypothalamic corticotrophin-releasing hormone (CRH) and then stimulation of the adrenal by ACTH. The control loop of the hypothalamic-pituitary-adrenal (HPA) axis is closed by negative feedback of cortisol on the hypothalamus and pituitary. Understanding this system is required to master the diagnosis, differential diagnosis and treatment of endogenous hypercortisolism--Cushing's syndrome. Endogenous Cushing's syndrome is caused either by excess ACTH secretion or by autonomous cortisol release from the adrenal cortex. Diagnosis of cortisol excess exploits three physiological principles: failure to achieve the normal nadir in the cortisol diurnal rhythm, loss of sensitivity of ACTH-secreting tumours to cortisol negative feedback, and increased excretion of free cortisol in the urine. Differentiating a pituitary source of excess ACTH (Cushing's disease) from an ectopic source is accomplished by imaging the pituitary and sampling for ACTH in the venous drainage of the pituitary. With surgical removal of ACTH or cortisol-secreting tumours, secondary adrenal insufficiency ensues because of the prior suppression of the HPA axis by glucocorticoid negative feedback. Medical therapy is targeted to the anatomical location of the dysregulated component of the HPA axis. Future research will focus on new diagnostics and treatments of Cushing's syndrome. These are elegant examples of translational research: understanding basic physiology informs the development of new approaches to diagnosis and treatment. Appreciating pathophysiology generates new areas for inquiry of basic physiological and biochemical mechanisms. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

Training femoral neck screw insertion skills to surgical trainees: computer-assisted surgery versus conventional fluoroscopic technique.

PubMed

Nousiainen, Markku T; Omoto, Daniel M; Zingg, Patrick O; Weil, Yoram A; Mardam-Bey, Sami W; Eward, William C

2013-02-01

: Femoral neck fractures are among the most common orthopaedic injuries impacting the health care system. Surgical management of such fractures with cannulated screws is a commonly performed procedure. The acquisition of surgical skills necessary to perform this procedure typically involves learning on real patients with fluoroscopic guidance. This study attempts to determine if a novel computer-navigated training model improves the learning of this basic surgical skill. A multicenter, prospective, randomized, and controlled study was conducted using surgical trainees with no prior experience in surgically managing femoral neck fractures. After a training session, participants underwent a pretest by performing the surgical task (screw placement) on a simulated hip fracture using fluoroscopic guidance. Immediately after, participants were randomized into either undergoing a training session using conventional fluoroscopy or computer-based navigation. Immediate posttest, retention (4 weeks later), and transfer tests were performed. Performance during the tests was determined by radiographic analysis of hardware placement. Screw placement by trainees was ultimately equal to the level of an expert surgeon with either training technique. Participants who trained with computer navigation took fewer attempts to position hardware and used less fluoroscopy time than those trained with fluoroscopy. When those trained with fluoroscopy used computer navigation at the transfer test, less fluoroscopy time and dosage was used. The concurrent augmented feedback provided by computer navigation did not affect the learning of this basic surgical skill in surgical novices. No compromise in learning occurred if the surgical novice trained with one type of technology and transferred to using the other. The findings of this study suggest that computer navigation may be safely used to train surgical novices in a basic procedure. This model avoids using both live patients and harmful radiation without a compromise in the acquisition of a 3-dimensional technical skill.

Shoulder arthroscopy: the basics.

PubMed

Farmer, Kevin W; Wright, Thomas W

2015-04-01

Shoulder arthroscopy is a commonly performed and accepted procedure for a wide variety of pathologies. Surgeon experience, patient positioning, knowledge of surgical anatomy, proper portal placement, and proper use of instrumentation can improve technical success and minimize complication risks. This article details the surgical anatomy, indications, patient positioning, portal placement, instrumentation, and complications for basic shoulder arthroscopy. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Declaration of Basic Principles for the Treatment of Prisoners.

ERIC Educational Resources Information Center

Cosman, J. W.

1989-01-01

Education does not flourish in prisons because of prevailing notions about the punitive and retributive purposes of prisons. The United Nations is considering a Declaration of Basic Principles for the Treatment of Prisoners that is intended to bring education to the forefront of criminal justice policy. (SK)

The Stock Market and Economic Principles: A Curriculum Project.

ERIC Educational Resources Information Center

Savino, Ronald J.

This paper outlines how to teach macroeconomic principles through mock stock market investing while helping students develop economic awareness, interest, and comprehension on a more sophisticated level. The basic textbook is "The Economy Today" (B. R. Schiller). After two weeks of teaching basic economic concepts and vocabulary, such as…

Behavior Modification: Basic Principles. Third Edition

ERIC Educational Resources Information Center

Lee, David L.; Axelrod, Saul

2005-01-01

This classic book presents the basic principles of behavior emphasizing the use of preventive techniques as well as consequences naturally available in the home, business, or school environment to change important behaviors. This book, and its companion piece, "Measurement of Behavior," represents more than 30 years of research and strategies in…

Basic principles of variable speed drives

NASA Technical Reports Server (NTRS)

Loewenthal, S. H.

1973-01-01

An understanding of the principles which govern variable speed drive operation is discussed for successful drive application. The fundamental factors of torque, speed ratio, and power as they relate to drive selection are discussed. The basic types of variable speed drives, their operating characteristics and their applications are also presented.

Surgical extractions for periodontal disease in a Western Lowland gorilla.

PubMed

Huff, John F

2010-01-01

This case report describes surgical exraction of multiple premolar and molar teeth in a Western Lowland gorilla. Postoperative photographs and radiographs indicated complete healing of the extraction sites. This case report includes a review of gorilla dental anatomy, oral disease in primates, pathogenesis of periodontal disease, predisposing factors to periodontal disease, and principles of surgical tooth extraction.

A History of Thoracic Aortic Surgery.

PubMed

McFadden, Paul Michael; Wiggins, Luke M; Boys, Joshua A

2017-08-01

Ancient historical texts describe the presence of aortic pathology conditions, although the surgical treatment of thoracic aortic disease remained insurmountable until the 19th century. Surgical treatment of thoracic aortic disease then progressed along with advances in surgical technique, conduit production, cardiopulmonary bypass, and endovascular technology. Despite radical advances in aortic surgery, principles established by surgical pioneers of the 19th century hold firm to this day. Copyright © 2017 Elsevier Inc. All rights reserved.

Complex surgery for locally advanced bone and soft tissue sarcomas of the shoulder girdle.

PubMed

Lesenský, Jan; Mavrogenis, Andreas F; Igoumenou, Vasilios G; Matejovsky, Zdenek; Nemec, Karel; Papagelopoulos, Panayiotis J; Fabbri, Nicola

2017-08-01

Surgical management of primary musculoskeletal tumors of the shoulder girdle is cognitively and technically demanding. Over the last decades, advances in the medical treatments, imaging and surgical techniques have fostered limb salvage surgery and reduced the need for amputation. Despite well-accepted general principles, an individualized approach is often necessary to accommodate tumor extension, anatomical challenges and patient characteristics. A combination of techniques is often required to achieve optimal oncologic and durable functional outcome. Goal of this article is to review approach and management of patients with locally advanced sarcomas of the shoulder girdle requiring major tumor surgery, to illustrate principles of surgical strategy, outcome and complications, and to provide useful guidelines for the treating physicians.

[A new low-cost webcam-based laparoscopic training model].

PubMed

Langeron, A; Mercier, G; Lima, S; Chauleur, C; Golfier, F; Seffert, P; Chêne, G

2012-01-01

To validate a new laparoscopy home training model (GYN Trainer®) in order to practise and learn basic laparoscopic surgery. Ten junior surgical residents and six experienced operators were timed and assessed during six laparoscopic exercises performed on the home training model. Acquisition of skill was 35%. All the novices significantly improved performance in surgical skills despite an 8% partial loss of acquisition between two training sessions. Qualitative evaluation of the system was good (3.8/5). This low-cost personal laparoscopic model seems to be a useful tool to assist surgical novices in learning basic laparoscopic skills. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Designing Tracking Software for Image-Guided Surgery Applications: IGSTK Experience

PubMed Central

Enquobahrie, Andinet; Gobbi, David; Turek, Matt; Cheng, Patrick; Yaniv, Ziv; Lindseth, Frank; Cleary, Kevin

2009-01-01

Objective Many image-guided surgery applications require tracking devices as part of their core functionality. The Image-Guided Surgery Toolkit (IGSTK) was designed and developed to interface tracking devices with software applications incorporating medical images. Methods IGSTK was designed as an open source C++ library that provides the basic components needed for fast prototyping and development of image-guided surgery applications. This library follows a component-based architecture with several components designed for specific sets of image-guided surgery functions. At the core of the toolkit is the tracker component that handles communication between a control computer and navigation device to gather pose measurements of surgical instruments present in the surgical scene. The representations of the tracked instruments are superimposed on anatomical images to provide visual feedback to the clinician during surgical procedures. Results The initial version of the IGSTK toolkit has been released in the public domain and several trackers are supported. The toolkit and related information are available at www.igstk.org. Conclusion With the increased popularity of minimally invasive procedures in health care, several tracking devices have been developed for medical applications. Designing and implementing high-quality and safe software to handle these different types of trackers in a common framework is a challenging task. It requires establishing key software design principles that emphasize abstraction, extensibility, reusability, fault-tolerance, and portability. IGSTK is an open source library that satisfies these needs for the image-guided surgery community. PMID:20037671

Introduction to Surgical Technology. Teacher Edition.

ERIC Educational Resources Information Center

Bushey, Vicki; And Others

This instructor's manual contains 14 units of instruction for a course on surgical technology designed to include the entry-level competencies students need to enter any of the more advanced surgical technology courses. Each unit includes some or all of the following basic components of a unit of instruction: objective sheet, suggested activities…

Surgical Techniques. Second Edition. Teacher Edition.

ERIC Educational Resources Information Center

Bushey, Vicki; And Others

This instructor's manual contains 18 units of instruction for a course on surgical technology designed to include the entry-level competencies students need as a surgical technologist. Each unit includes some or all of the following basic components of a unit of instruction: objective sheet, suggested activities for the teacher, assignment sheets…

Kuhn's Paradigm and Example-Based Teaching of Newtonian Mechanics.

ERIC Educational Resources Information Center

Whitaker, M. A. B.

1980-01-01

Makes a recommendation for more direct teaching of the basic principles of mechanics. Contends that students currently learn mechanics in terms of standard examples. This causes difficulty when the student is confronted with a problem that can be solved from basic principles, but which does not fit a standard category. (GS)

5 CFR 551.401 - Basic principles.

Code of Federal Regulations, 2011 CFR

2011-01-01

... direction of the agency is “hours of work.” Such time includes: (1) Time during which an employee is required to be on duty; (2) Time during which an employee is suffered or permitted to work; and (3) Waiting... FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...

New Principles and Basic Approaches for the Curricula of Engineering Degree Courses.

ERIC Educational Resources Information Center

Gargione, Luiz Antonio

This paper presents new principles and basic approaches for the curricula of engineering degree courses. The accentuated evolution of engineering, the fast technological transformations and, still, the impact provoked by government regulations in the field of education in Brazil have called attention to these issues. Following these changes, it…

Chapter 4. Basic considerations for range and wildland revegetation and restoration

Treesearch

Richard Stevens

2004-01-01

Plummer and others (1968) proposed 10 principles to follow when planning and implementing rangeland revegetation programs. These principles - or basic considerations for rangeland managers - are applicable to most sites in the Western United States (Jordan 1981; Merkel and Herbal 1973), and many projects in the Intermountain area have been conducted successfully by...

Uniqueness of Zinc as a Bioelement: Principles and Applications in Bioinorganic Chemistry--III.

ERIC Educational Resources Information Center

Ochiai, Ei-Ichiro

1988-01-01

Attempts to delineate certain basic principles and applications of bioinorganic chemistry to oxidation-reduction reactions. Examines why zinc(II) is so uniquely suited to enzymated reactions of the acid-base type. Suggests the answer may be in the natural abundance and the basic physicochemical properties of zinc(II). (MVL)

Effect of an intervention based on basic Buddhist principles on the spiritual well-being of patients with terminal cancer.

PubMed

Chimluang, Janya; Thanasilp, Sureeporn; Akkayagorn, Lanchasak; Upasen, Ratchaneekorn; Pudtong, Noppamat; Tantitrakul, Wilailuck

2017-12-01

To evaluate the effect of an intervention based on basic Buddhist principles on the spiritual well-being of patients with terminal cancer. This quasi-experimental research study had pre- and post-test control groups. The experimental group received conventional care and an intervention based on basic Buddhist principles for three consecutive days, including seven activities based on precept activities, concentration activities and wisdom activities. The control group received conventional care alone. Forty-eight patients participated in this study: 23 in the experimental group and 25 in the control group. Their mean age was 53 (standard deviation 10) years. The spiritual well-being of participants in the experimental group was significantly higher than that of participants in the control group at the second post-test (P < 0.05). An intervention based on basic Buddhist principles improved the spiritual well-being of patients with terminal cancer. This result supports the beneficial effects of implementing this type of intervention for patients with terminal cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King's College London School of Medicine.

PubMed

Hamaoui, Karim; Sadideen, Hazim; Saadeddin, Munir; Onida, Sarah; Hoey, Andrew W; Rees, John

2013-01-01

Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King's College London School of Medicine, and the programme was evaluated. A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula.

Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King’s College London School of Medicine

PubMed Central

2013-01-01

Purpose: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King’s College London School of Medicine, and the programme was evaluated. Methods: A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. Results: Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. Conclusion: A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula. PMID:24498471

Virtual reality simulators and training in laparoscopic surgery.

PubMed

Yiannakopoulou, Eugenia; Nikiteas, Nikolaos; Perrea, Despina; Tsigris, Christos

2015-01-01

Virtual reality simulators provide basic skills training without supervision in a controlled environment, free of pressure of operating on patients. Skills obtained through virtual reality simulation training can be transferred on the operating room. However, relative evidence is limited with data available only for basic surgical skills and for laparoscopic cholecystectomy. No data exist on the effect of virtual reality simulation on performance on advanced surgical procedures. Evidence suggests that performance on virtual reality simulators reliably distinguishes experienced from novice surgeons Limited available data suggest that independent approach on virtual reality simulation training is not different from proctored approach. The effect of virtual reality simulators training on acquisition of basic surgical skills does not seem to be different from the effect the physical simulators. Limited data exist on the effect of virtual reality simulation training on the acquisition of visual spatial perception and stress coping skills. Undoubtedly, virtual reality simulation training provides an alternative means of improving performance in laparoscopic surgery. However, future research efforts should focus on the effect of virtual reality simulation on performance in the context of advanced surgical procedure, on standardization of training, on the possibility of synergistic effect of virtual reality simulation training combined with mental training, on personalized training. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Surgical management of Crohn's disease.

PubMed

Lu, Kim C; Hunt, Steven R

2013-02-01

Although medical management can control symptoms in a recurring incurable disease, such as Crohn's disease, surgical management is reserved for disease complications or those problems refractory to medical management. In this article, we cover general principles for the surgical management of Crohn's disease, ranging from skin tags, abscesses, fistulae, and stenoses to small bowel and extraintestinal disease. Copyright © 2013 Elsevier Inc. All rights reserved.

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

PubMed Central

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

2017-01-01

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

Basic principles of a flexible astronomical data processing system in UNIX environment.

NASA Astrophysics Data System (ADS)

Verkhodanov, O. V.; Erukhimov, B. L.; Monosov, M. L.; Chernenkov, V. N.; Shergin, V. S.

Methods of construction of a flexible system for astronomical data processing (FADPS) are described. An example of construction of such a FADPS for continuum radiometer data of the RATAN-600 is presented. The Job Control Language of this system is the Job Control Language of OS UNIX. It is shown that using basic commands of the data processing system (DPS) a user, knowing basic principles of Job in OS UNIX, can create his own mini-DPS. Examples of such mini-DPSs are presented.

What does the American Board of Surgery In-Training/Surgical Basic Science Examination tell us about graduate surgical education?

PubMed

DaRosa, D A; Shuck, J M; Biester, T W; Folse, R

1993-01-01

This research sought to identify the strengths and weakness in residents' basic science knowledge and, second, to determine whether they progressively improve in their abilities to recall basic science information and clinical management facts, to analyze cause-effect relationships, and to solve clinical problems. Basic science knowledge was assessed by means of the results of the January 1990 American Board of Surgery's In-Training/Surgical Basic Science Exam (IT/SBSE). Postgraduate year (PGY) 1 residents' scores were compared with those of PGY5 residents. Content related to a question was considered "known" if 67% or more of the residents in each of the two groups answered it correctly. Findings showed 44% of the content tested by the basic science questions were unknown by new and graduating residents. The second research question required the 250 IT/SBSE questions to be classified into one of three levels of thinking abilities: recall, analysis, and inferential thinking. Profile analysis (split-plot analysis of variance) for each pair of resident levels indicated significant (P < 0.001) differences in performance on questions requiring factual recall, analysis, and inference between all levels except for PGY3s and PGY4s. The results of this research enable program directors to evaluate strengths and weaknesses in residency training curricula and the cognitive development of residents.

Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles.

PubMed

Lee, Soo-Hoon; Khanuja, Harpal S; Blanding, Renee J; Sedgwick, Jeanne; Pressimone, Kathleen; Ficke, James R; Jones, Lynne C

2017-10-30

Teamwork training improves short-term teamwork behaviors. However, improvements are often not sustained. The purpose of this study was to explore the extent to which teamwork reinforcement activities for orthopedic surgery teams lead to sustained teamwork behaviors. Seven months after 104 staff from an orthopedic surgical unit were trained in Team Strategies and Tools to Enhance Performance and Patient Safety principles, 4 reinforcement activities were implemented regarding leadership and communication: lectures with videos on leadership skills for nursing staff; an online self-paced learning program on communication skills for nursing staff; a 1-page summary on leadership skills e-mailed to surgical staff; and a 1-hour perioperative grand rounds on Team Strategies and Tools to Enhance Performance and Patient Safety principles for anesthesia staff and new staff. Twenty-four orthopedic surgical teams were evaluated on teamwork behaviors during surgery by 2 observers before and after the reinforcement period using the Observational Teamwork Assessment for Surgery tool. After reinforcement, leadership (P = 0.022) and communication (P = 0.044) behaviors improved compared with prereinforcement levels. Specifically, nursing staff improved in leadership (P = 0.016) and communication (P = 0.028) behaviors, surgical staff improved in leadership behaviors (P = 0.009), but anesthesia staff did not improve in any teamwork behaviors. Sustained improvement in teamwork behaviors requires reinforcement. Level III, prospective pre-post cohort study.

Surgical techniques on periodontal plastic surgery and soft tissue regeneration: consensus report of Group 3 of the 10th European Workshop on Periodontology.

PubMed

Sanz, Mariano; Simion, Massimo

2014-04-01

The scope was to review the three main clinical indications in periodontal plastic surgical procedures. To review the fundamental principles in periodontal plastic surgery, the main surgical designs in flap surgery applied to the treatment of recessions, peri-implant soft tissue deficiencies and soft tissue ridge augmentation, as well as the surgical principles of using autologous connective tissue grafts and soft tissue substitutes. In the pre-operative phase, the key elements are the control of prognostic factors affecting the patient, namely oral hygiene, tobacco smoking cessation and systemic disease control. In the operative phase, the principles of flap design, mobilization, advancement, adaptation and stabilization. In the post-operative phase infection control, including effective oral hygiene measures, antiseptic treatment and other medications. In single recession defects, the most widely used flap technique is the coronally advanced flap and in specific clinical situations the laterally positioned flap. In multiple recession defects, the number of defects and their location and depth guide the surgical design, being one design with and the other without vertical releasing incisions. When flaps are used in combination with grafts the tunnel flap is also used extensively. The key elements are the donor site selection and harvesting technique, its tissue integration and volume stability. Given the current evidence, various clinical recommendations on the use of flaps and grafts are provided. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Autopsies for anatomical teaching and training in clinical forensic medicine].

PubMed

Hammer, U; Blaas, V; Büttner, A; Philipp, M

2015-12-01

Clinical forensic medicine does not only entail examination of patients after physical violence but also the option of clinical autopsies, e.g. after non-notifiable complications of medical interventions, after fatalities closely following medical interventions or fatalities as a result of injuries when the public prosecutor decides not to order a medicolegal autopsy. Based on this routine the Institute of Forensic Medicine at the University of Rostock offers a training course in topographical anatomy to physicians for further training in interventional and surgical disciplines. At the beginning of autopsies the participants can explore the approaches of interventional puncture techniques as well as surgical techniques and the basic topographical anatomy in small groups of 2-4 persons under the supervision of forensic examiners. The format is essentially oriented to the early further training period but fulfils the requirements for the exploration of complex operative techniques. The course was adapted for physicians and offered separately to students. The explorations are performed manually or by support with autopsy instruments. The courses offer an ideal room for individual, discipline-specific topics and result in a great benefit for all participants. A statistical assessment can only be achieved with a larger number of participants. Making autopsy rooms available for teaching and further training represents an additional feature to the profile of clinical forensic medicine. Lessons in topographical anatomy provide a great benefit for patient safety. It seems to be important to offer the opportunity to address individual interests in a closed meeting to consolidate skills and abilities in a non-judgemental environment. The post-mortem examiners have to ensure that the autopsy is carried out lege artis. Basic ethical principles and all regulations from an accredited scope have to be adhered to.

The Basic Principles and Methods of the System Approach to Compression of Telemetry Data

NASA Astrophysics Data System (ADS)

Levenets, A. V.

2018-01-01

The task of data compressing of measurement data is still urgent for information-measurement systems. In paper the basic principles necessary for designing of highly effective systems of compression of telemetric information are offered. A basis of the offered principles is representation of a telemetric frame as whole information space where we can find of existing correlation. The methods of data transformation and compressing algorithms realizing the offered principles are described. The compression ratio for offered compression algorithm is about 1.8 times higher, than for a classic algorithm. Thus, results of a research of methods and algorithms showing their good perspectives.

Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI).

PubMed

Alvarez-Nebreda, Maria Loreto; Bentov, Nathalie; Urman, Richard D; Setia, Sabeena; Huang, Joe Chin-Sun; Pfeifer, Kurt; Bennett, Katherine; Ong, Thuan D; Richman, Deborah; Gollapudi, Divya; Alec Rooke, G; Javedan, Houman

2018-06-01

Frailty is an age-related, multi-dimensional state of decreased physiologic reserve that results in diminished resiliency and increased vulnerability to stressors. It has proven to be an excellent predictor of unfavorable health outcomes in the older surgical population. There is agreement in recommending that a frailty evaluation should be part of the preoperative assessment in the elderly. However, the consensus is still building with regards to how it should affect perioperative care. The Society for Perioperative Assessment and Quality Improvement (SPAQI) convened experts in the fields of gerontology, anesthesiology and preoperative assessment to outline practical steps for clinicians to assess and address frailty in elderly patients who require elective intermediate or high risk surgery. These recommendations summarize evidence-based principles of measuring and screening for frailty, as well as basic interventions that can help improve patient outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

Simultaneous double-rod rotation technique in posterior instrumentation surgery for correction of adolescent idiopathic scoliosis.

PubMed

Ito, Manabu; Abumi, Kuniyoshi; Kotani, Yoshihisa; Takahata, Masahiko; Sudo, Hideki; Hojo, Yoshihiro; Minami, Akio

2010-03-01

The authors present a new posterior correction technique consisting of simultaneous double-rod rotation using 2 contoured rods and polyaxial pedicle screws with or without Nesplon tapes. The purpose of this study is to introduce the basic principles and surgical procedures of this new posterior surgery for correction of adolescent idiopathic scoliosis. Through gradual rotation of the concave-side rod by 2 rod holders, the convex-side rod simultaneously rotates with the the concave-side rod. This procedure does not involve any force pushing down the spinal column around the apex. Since this procedure consists of upward pushing and lateral translation of the spinal column with simultaneous double-rod rotation maneuvers, it is simple and can obtain thoracic kyphosis as well as favorable scoliosis correction. This technique is applicable not only to a thoracic single curve but also to double major curves in cases of adolescent idiopathic scoliosis.

Heart Transplant in Children: What a Primary Care Provider Needs to Know.

PubMed

Sehgal, Swati; Shea, Emily; Kelm, Lauren; Kamat, Deepak

2018-04-01

Heart transplantation is offered to children with heart failure that is not amenable to medical or surgical therapy. Indications for heart transplant include unrepairable congenital heart disease, failed palliation of congenital heart disease, and cardiomyopathies. There has been tremendous progress in this field since the first heart transplant was performed in 1967. Each year, approximately 500 pediatric heart transplants take place worldwide. Pediatric heart transplant survivors are living longer with their initial transplant. Many pediatric practitioners are faced with caring for these patients before as well as after the heart transplant and, therefore, they should be knowledgeable about basic principles related to heart transplant. There are certain complications that are unique to this population, and medication side-effects, evaluation and management of a febrile illness, opportunistic infections, vaccination, pregnancy, and exercise recommendations are areas that require special consideration. [Pediatr Ann. 2018;47(4):e172-e178.]. Copyright 2018, SLACK Incorporated.

Implant-retained craniofacial prostheses for facial defects

PubMed Central

Federspil, Philipp A.

2012-01-01

Craniofacial prostheses, also known as epistheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant-retained prostheses came with the development of the modern silicones and bone anchorage. Following the discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium in the 1960s. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral implant systems were developed. Grouped implant systems have also been developed which may be placed more reliably in areas with low bone presentation, as in the nasal and orbital region, or the ideally pneumatised mastoid process. Today, even large facial prostheses may be securely retained. The classical atraumatic surgical technique has remained an unchanged prerequisite for successful implantation of any system. This review outlines the basic principles of osseointegration as well as the main features of extraoral implantology. PMID:22073096

Cutaneous resurfacing with CO2 and erbium: YAG lasers: preoperative, intraoperative, and postoperative considerations.

PubMed

Alster, T S

1999-02-01

The development and integration of pulsed and scanned CO2 and erbium:YAG laser systems into mainstream surgical practice over the past years has revolutionized cutaneous resurfacing. These lasers are capable of delivering to skin high peak fluences to effect controlled tissue vaporization, while leaving an acceptably narrow zone of residual thermal damage. The inherent technological differences that exist between the two distant laser systems in terms of ablation depths, degree of thermal coagulation, and postoperative side-effects and complications guide patient selection and management. This article reviews the basic principles of CO2 and erbium:YAG laser resurfacing, including preoperative, intraoperative, and postoperative patient considerations. Side-effects and complications encountered after laser resurfacing are discussed with specific guidelines provided on their appropriate management. Anticipated future developments and cutting-edge research endeavors in cutaneous laser resurfacing are also briefly outlined.

Using the Child's Environment To Teach at Home and School. ERIC/CSMEE Digest.

ERIC Educational Resources Information Center

Heimlich, Joe E.

This digest details how global concepts of environmental education, the basic principles of ecology, and the importance of environmental responsibility can be made concrete for children at home and at school. Topics discussed are: basic principles of ecology, "What is the home?"--teaching environment through the home, and living and the…

Using "Basic Principles" to Understand Complex Science: Nicotine Smoke Chemistry and Literature Analogies

ERIC Educational Resources Information Center

Seeman, Jeffrey I.

2005-01-01

The chemical and physical properties of nicotine and its carboxylic acid salts found in tobacco provided as an interesting example to understand basic principles of complex science. The result showed that the experimental data used were inconsistent to the conclusion made, and the transfer of nicotine smoke from tobacco to smoke cannot be…

Analysis of the Structure of Surgical Activity for a Suturing and Knot-Tying Task

PubMed Central

Vedula, S. Swaroop; Malpani, Anand O.; Tao, Lingling; Chen, George; Gao, Yixin; Poddar, Piyush; Ahmidi, Narges; Paxton, Christopher; Vidal, Rene; Khudanpur, Sanjeev; Hager, Gregory D.; Chen, Chi Chiung Grace

2016-01-01

Background Surgical tasks are performed in a sequence of steps, and technical skill evaluation includes assessing task flow efficiency. Our objective was to describe differences in task flow for expert and novice surgeons for a basic surgical task. Methods We used a hierarchical semantic vocabulary to decompose and annotate maneuvers and gestures for 135 instances of a surgeon’s knot performed by 18 surgeons. We compared counts of maneuvers and gestures, and analyzed task flow by skill level. Results Experts used fewer gestures to perform the task (26.29; 95% CI = 25.21 to 27.38 for experts vs. 31.30; 95% CI = 29.05 to 33.55 for novices) and made fewer errors in gestures than novices (1.00; 95% CI = 0.61 to 1.39 vs. 2.84; 95% CI = 2.3 to 3.37). Transitions among maneuvers, and among gestures within each maneuver for expert trials were more predictable than novice trials. Conclusions Activity segments and state flow transitions within a basic surgical task differ by surgical skill level, and can be used to provide targeted feedback to surgical trainees. PMID:26950551

Principles of project management

NASA Technical Reports Server (NTRS)

1982-01-01

The basic principles of project management as practiced by NASA management personnel are presented. These principles are given as ground rules and guidelines to be used in the performance of research, development, construction or operational assignments.

What deserves our respect? Reexamination of respect for autonomy in the context of the management of chronic conditions.

PubMed

Enzo, Aya; Okita, Taketoshi; Asai, Atsushi

2018-05-29

The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle-respect for autonomy-is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient's decisions, behaviors, emotions, or life-style regardless of his or her "autonomous" capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities.

Does simulation-based training facilitate the integration of human anatomy with surgery? A report of a novel Surgical Anatomy Course.

PubMed

Torres, K; Denisow-Pietrzyk, M; Pietrzyk, Ł; Maciejewski, R; Torres, A

2018-01-01

Knowledge of gross anatomy, as a basic core subject, is fundamental for medical students and essential to medical practitioners, particularly for those intending a surgical career. However, both medical students and clinical teachers have found a significant gap in teaching basic sciences and the transition into clinical skills. The authors present a Surgical Anatomy Course developed to teach the anatomical basis of surgical procedures with particular emphasis on laparo-scopic skills while incorporating medical simulation. An evaluation of the students' satisfaction of the Surgical Anatomy Course was completed using a mix of multiple choice and open-ended questions, and a six-point Likert Scale. Questions were asked about the students' perceived improvement in surgical and laparoscopic skills. Manual skills were assessed using a laparoscopic simulator. Both evaluation of the course structure and the general impression of the course were positive. Most students believed the course should be an integral part of a modern curriculum. The course supported the traditional surgical classes and improved anatomical knowledge and strengthened students' confidentiality and facilitated understanding and taking surgical rotations. A medical course combining the practical learning of anatomy and surgical-based approaches will bring out the best from the students. Medical students positively evaluated the Surgical Anatomy Course as useful and benefi-cial regarding understanding anatomical structure and relationship necessary for further surgical education. (Folia Morphol 2018; 77, 2: 279-285).

Disasters and mass casualties: I. General principles of response and management.

PubMed

Born, Christopher T; Briggs, Susan M; Ciraulo, David L; Frykberg, Eric R; Hammond, Jeffrey S; Hirshberg, Asher; Lhowe, David W; O'Neill, Patricia A

2007-07-01

Disaster planning and response to a mass casualty incident pose unique demands on the medical community. Because they would be required to confront many casualties with bodily injury and surgical problems, surgeons in particular must become better educated in disaster management. Compared with routine practice, triage principles in disasters require an entirely different approach to evaluation and care and often run counter to training and ethical values. An effective response to disaster and mass casualty events should focus on an "all hazards" approach, defined as the ability to adapt and apply fundamental disaster management principles universally to any mass casualty incident, whether caused by people or nature. Organizational tools such as the Incident Command System and the Hospital Incident Command System help to effect a rapid and coordinated response to specific situations. The United States federal government, through the National Response Plan, has the responsibility to respond quickly and efficiently to catastrophic incidents and to ensure critical life-saving assistance. International medical surgical response teams are capable of providing medical, surgical, and intensive care services in austere environments anywhere in the world.

Principles of ear nose and throat surgery for pregnant women.

PubMed

Baruah, Paramita; Jasraj, Kailey; Ahmad, Ijaz

2017-04-02

Management of the pregnant surgical patient is challenging. The surgical procedure is usually postponed until the postpartum period, although this may not be possible in emergency situations. This article highlights the optimal management of the pregnant woman requiring ear nose and throat surgery.

Do soft skills predict surgical performance?: a single-center randomized controlled trial evaluating predictors of skill acquisition in virtual reality laparoscopy.

PubMed

Maschuw, K; Schlosser, K; Kupietz, E; Slater, E P; Weyers, P; Hassan, I

2011-03-01

Virtual reality (VR) training in minimal invasive surgery (MIS) is feasible in surgical residency and beneficial for the performance of MIS by surgical trainees. Research on stress-coping of surgical trainees indicates the additional impact of soft skills on VR performance in the surgical curriculum. The aim of this study was to evaluate the impact of structured VR training and soft skills on VR performance of trainees. The study was designed as a single-center randomized controlled trial. Fifty first-year surgical residents with limited experience in MIS ("camera navigation" in laparoscopic cholecystectomy only) were randomized for either 3 months of VR training or no training. Basic VR performance and defined soft skills (self-efficacy, stress-coping, and motivation) were assessed prior to randomization using basic modules of the VR simulator LapSim(®) and standardized psychological questionnaires. Three months after randomization VR performance was reassessed. Outcome measurement was based on the results derived from the most complex of the basic VR modules ("diathermy cutting") as the primary end point. A correlation analysis of the VR end-point performance and the psychological scores was done in both groups. Structured VR training enhanced VR performance of surgical trainees. An additional correlation to high motivational states (P < 0.05) was found. Low levels of self-efficacy and negative stress-coping were related to poor VR performance in the untrained control group (P < 0.05). This correlation was absent in the trained intervention group (P > 0.05). Low self-efficacy and negative stress-coping strategies seem to predict poor VR performance. However, structured training along with high motivational states is likely to balance out this impairment.

Acupressure for Educators: An Illustrated Workbook for the Practice of Simple Acupressure Techniques. Experiencing Energy. Third Edition.

ERIC Educational Resources Information Center

St. John, Jeanne

The guidelines are intended to familiarize educators with the basics of acupressure and to suggest ways in which the principles may help relieve anxiety and stress in school students. Eight energy exercises are introduced, followed by a review of the basic principles of energy and guidelines for giving and receiving acupressure. Illustrations of…

Communicative Skills: A Selected Bibliography. Revised.

DTIC Science & Technology

1991-06-01

Bibliography CONTENTS Communicating Person-to-Person ....................... 1 Public Speaking ...................................... 3 Basic Principles...34Microphones: What You Don’t Know Can Hurt You." ARMED FORCES COMPTROLLER, Vol. 35, Spring 1990, pp. 35- 36. (Periodical) Machan , Dyan. "Do You...August 1985, pp. 35-41. (Periodical) BASIC PRINCIPLES AND GUIDELINES FOR CLEAR WRITING "’Badly’ She, Wrote." TRAINING & DEVELOPMENT JOURNAL, Vol. 43

Basic Principles of Lyophilization, Part 1.

PubMed

Akers, Michael J

2015-01-01

The achievement of a high-quality lyophilized (freeze-dried) dosage form involves the combination of optimal formulation design and optimal freeze-dry cycle design. This 2-part article describes how this can be done. Part 1 discusses the basic principles and procedures of lyophilization up to a discussion on the different stages of lyophilization. The stages of lyophilization are discussed in part 2.

Cost Reporting at a Navy Branch Clinic

DTIC Science & Technology

1993-03-01

John Wiley & Sons, 1991. 15 Horngren , Charles, Cost Accounting -=A Managerial Emphasis, 5th Edition, Prentice Hall, Inc., Englewood Cliffs, N.J., 1982...traditionally reported under a partial cost reporting system. By applying basic principles of managerial accounting , a full cost reporting system is...traditionally reported under a partial cost reporting system. By applying basic principles of managerial accounting , a proposed full cost reporting

On the Principles of English Teaching Reform in Higher Vocational Colleges Based on "The Basic Requirements of English Curriculum Teaching in Higher Vocational Colleges"

ERIC Educational Resources Information Center

Liu, Huijun; Ning, Yida

2017-01-01

English teaching reform is critical for the cultivation of skilled talents and the development of national economy. The paper attempts to analyze the guidance principles of English teaching reform in the higher vocational colleges underlying "The Basic Requirements of English Curriculum Teaching in Higher Vocational Colleges",…

Using the Chemistry of Fireworks to Engage Students in Learning Basic Chemical Principles: A Lesson in Eco-Friendly Pyrotechnics

ERIC Educational Resources Information Center

Steinhauser, Georg; Klapotke, Thomas M.

2010-01-01

Fascination with fireworks and pyrotechnics can be used for educational purposes. Several aspects of pyrochemistry such as redox reactions, flame colors, or the theory of combustion can be incorporated in the curriculum to illustrate some basic chemical principles, guaranteeing a lesson that will be engaging and memorable. Beyond classic…

A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery.

PubMed

Zevin, Boris; Levy, Jeffrey S; Satava, Richard M; Grantcharov, Teodor P

2012-10-01

Simulation-based training can improve technical and nontechnical skills in surgery. To date, there is no consensus on the principles for design, validation, and implementation of a simulation-based surgical training curriculum. The aim of this study was to define such principles and formulate them into an interoperable framework using international expert consensus based on the Delphi method. Literature was reviewed, 4 international experts were queried, and consensus conference of national and international members of surgical societies was held to identify the items for the Delphi survey. Forty-five international experts in surgical education were invited to complete the online survey by ranking each item on a Likert scale from 1 to 5. Consensus was predefined as Cronbach's α ≥0.80. Items that 80% of experts ranked as ≥4 were included in the final framework. Twenty-four international experts with training in general surgery (n = 11), orthopaedic surgery (n = 2), obstetrics and gynecology (n = 3), urology (n = 1), plastic surgery (n = 1), pediatric surgery (n = 1), otolaryngology (n = 1), vascular surgery (n = 1), military (n = 1), and doctorate-level educators (n = 2) completed the iterative online Delphi survey. Consensus among participants was achieved after one round of the survey (Cronbach's α = 0.91). The final framework included predevelopment analysis; cognitive, psychomotor, and team-based training; curriculum validation evaluation and improvement; and maintenance of training. The Delphi methodology allowed for determination of international expert consensus on the principles for design, validation, and implementation of a simulation-based surgical training curriculum. These principles were formulated into a framework that can be used internationally across surgical specialties as a step-by-step guide for the development and validation of future simulation-based training curricula. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Inhalers and nebulizers: basic principles and preliminary measurements

NASA Astrophysics Data System (ADS)

Misik, Ondrej; Lizal, Frantisek; Asl, Vahid Farhikhteh; Belka, Miloslav; Jedelsky, Jan; Elcner, Jakub; Jicha, Miroslav

2018-06-01

Inhalers are hand-held devices which are used for administration of therapeutic aerosols via inhalation. Nebulizers are larger devices serving for home and hospital care using inhaled medication. This contribution describes the basic principles of dispersion of aerosol particles used in various types of inhalers and nebulizers, and lists the basic physical mechanisms contributing to the deposition of inhaled particles in the human airways. The second part of this article presents experimental setup, methodology and preliminary results of particle size distributions produced by several selected inhalers and nebulizers.

The surgical correction of mandibular prognathism using rigid internal fixation--a report of a new technique together with its long-term stability.

PubMed Central

Reitzik, M.

1988-01-01

A historical review of the literature for the surgical correction of mandibular prognathism is presented, together with a list of ideal conditions for the successful treatment of this condition. This is a report of a new surgical technique which satisfies the majority of these principles and demonstrates stability at the osteotomy site. PMID:3207331

Fuzzy logic

NASA Technical Reports Server (NTRS)

Zadeh, Lofti A.

1988-01-01

The author presents a condensed exposition of some basic ideas underlying fuzzy logic and describes some representative applications. The discussion covers basic principles; meaning representation and inference; basic rules of inference; and the linguistic variable and its application to fuzzy control.

Robotic radical cystectomy and intracorporeal urinary diversion: The USC technique.

PubMed

Abreu, Andre Luis de Castro; Chopra, Sameer; Azhar, Raed A; Berger, Andre K; Miranda, Gus; Cai, Jie; Gill, Inderbir S; Aron, Monish; Desai, Mihir M

2014-07-01

Radical cystectomy is the gold-standard treatment for muscle-invasive and refractory nonmuscle-invasive bladder cancer. We describe our technique for robotic radical cystectomy (RRC) and intracorporeal urinary diversion (ICUD), that replicates open surgical principles, and present our preliminary results. Specific descriptions for preoperative planning, surgical technique, and postoperative care are provided. Demographics, perioperative and 30-day complications data were collected prospectively and retrospectively analyzed. Learning curve trends were analyzed individually for ileal conduits (IC) and neobladders (NB). SAS(®) Software Version 9.3 was used for statistical analyses with statistical significance set at P < 0.05. Between July 2010 and September 2013, RRC and lymph node dissection with ICUD were performed in 103 consecutive patients (orthotopic NB=46, IC 57). All procedures were completed robotically replicating the open surgical principles. The learning curve trends showed a significant reduction in hospital stay for both IC (11 vs. 6-day, P < 0.01) and orthotopic NB (13 vs. 7.5-day, P < 0.01) when comparing the first third of the cohort with the rest of the group. Overall median (range) operative time and estimated blood loss was 7 h (4.8-13) and 200 mL (50-1200), respectively. Within 30-day postoperatively, complications occurred in 61 (59%) patients, with the majority being low grade (n = 43), and no patient died. Median (range) nodes yield was 36 (0-106) and 4 (3.9%) specimens had positive surgical margins. Robotic radical cystectomy with totally ICUD is safe and feasible. It can be performed using the established open surgical principles with encouraging perioperative outcomes.

Basic hydraulic principles of open-channel flow

USGS Publications Warehouse

Jobson, Harvey E.; Froehlich, David C.

1988-01-01

The three basic principles of open-channel-flow analysis--the conservation of mass, energy, and momentum--are derived, explained, and applied to solve problems of open-channel flow. These principles are introduced at a level that can be comprehended by a person with an understanding of the principles of physics and mechanics equivalent to that presented in the first college level course of the subject. The reader is assumed to have a working knowledge of algebra and plane geometry as well as some knowledge of calculus. Once the principles have been derived, a number of example applications are presented that illustrate the computation of flow through culverts and bridges, and over structures, such as dams and weirs. Because resistance to flow is a major obstacle to the successful application of the energy principle to open-channel flow, procedures are outlined for the rational selection of flow resistance coefficients. The principle of specific energy is shown to be useful in the prediction of water-surface profiles both in the qualitative and quantitative sense. (USGS)

Risk communication basics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Corrado, P.G.

In low-trust, high-concern situations, 50% of your credibility comes from perceived empathy and caring, demonstrated in the first 30 s you come in contact with someone. There is no second chance for a first impression. These and other principles contained in this paper provide you with a basic level of understanding of risk communication. The principles identified are time-tested caveats and will assist you in effectively communicating technical information.

Basic principles of management for cervical spine trauma.

PubMed

O'Dowd, J K

2010-03-01

This article reviews the basic principles of management of cervical trauma. The technique and critical importance of careful assessment is described. Instability is defined, and the incidence of a second injury is highlighted. The concept of spinal clearance is discussed. Early reduction and stabilisation techniques are described, and the indications, and approach for surgery reviewed. The importance of the role of post-injury rehabilitation is identified.

General medicine and surgery for dental practitioners: part 2. Medical emergencies in dental practice: the drug box, equipment and basic principles of management.

PubMed

Greenwood, M; Meechan, J G

2014-06-13

Dental practitioners need knowledge of the diagnosis and management of medical emergencies. This paper deals with the general aspects of emergency treatment including basic management principles which are applicable to all emergencies. The next paper in this series, part 3, deals with more specific aspects of medical emergency management.

JPRS Report, China, Handbook of Military Knowledge for Commanders

DTIC Science & Technology

1988-03-07

Chemical and Biological Weapons Chapter I Nuclear Weapons (178) A. Summary Statement on Nuclear Weapons (178) 1. Basic Principles of Nuclear...199) 1. Basic Principles of Protection Against Nuclear, Chemical and Biological Weapons* (199) 2. Maior Actions For Protection Against Nuclear...people’s bodies through the digestive tract. Skin contact. Biological warfare agents may enter the body directly through the skin , mucous membranes or

Conduction of Electrical Current to and Through the Human Body: A Review

PubMed Central

Fish, Raymond M.; Geddes, Leslie A.

2009-01-01

Objective: The objective of this article is to explain ways in which electric current is conducted to and through the human body and how this influences the nature of injuries. Methods: This multidisciplinary topic is explained by first reviewing electrical and pathophysiological principles. There are discussions of how electric current is conducted through the body via air, water, earth, and man-made conductive materials. There are also discussions of skin resistance (impedance), internal body resistance, current path through the body, the let-go phenomenon, skin breakdown, electrical stimulation of skeletal muscles and nerves, cardiac dysrhythmias and arrest, and electric shock drowning. After the review of basic principles, a number of clinically relevant examples of accident mechanisms and their medical effects are discussed. Topics related to high-voltage burns include ground faults, ground potential gradient, step and touch potentials, arcs, and lightning. Results: The practicing physician will have a better understanding of electrical mechanisms of injury and their expected clinical effects. Conclusions: There are a variety of types of electrical contact, each with important characteristics. Understanding how electric current reaches and travels through the body can help the clinician understand how and why specific accidents occur and what medical and surgical problems may be expected. PMID:19907637

[How does our specialty present itself on the Internet?].

PubMed

Rechenberg, U; Josten, C; Grüner, S; Klima, S

2013-08-01

The huge amount of information on the internet about orthopaedic and trauma surgical issues is very often unclear and hard to control in reliability, autonomy and expertise. The aim of this work is to evaluate German-speaking internet sites with orthopaedic and trauma surgical contents. Over a period of two months (from May to June) in 2012 different websites about 20 common orthopaedic and trauma surgical diseases were analysed on the internet by Google search engine. The first ten search results were evaluated for the HON code principles (Health On the Net Foundation). Furthermore there was an evaluation about qualification of the first 50 websites. The best 1,000 placed websites on Google were analysed for the authoritative value: academic, commercial, media, non-medical, physicians, non-profit and miscellaneous. Only 194 from 200 websites could be evaluated by the HON code principles. Overall 188 websites complied the principle of transparency, followed by privacy with 150 sites and authoritative with 134 sites. Only 90 websites give information about financial disclosure. Medical articles of the website Wikipedia appear most frequently. In the second part of this work it is shown that non-profit sites and sites by physicians are the most frequent. The fewest results are given by academic and commercial sites with 93 and 85 online hits. In summary, it is shown that most of the websites about medical information have inadequate quality. This statement is in accord with some U. S. American publications. It is clear that Wikipedia has a top-ranking on the internet when it is about medical information. Wikipedia almost achieves all of the HON code principles. It is possible to give better medical online information about orthopaedic and trauma surgical issues published by professionals. Georg Thieme Verlag KG Stuttgart · New York.

Gamma-Ray Telescope and Uncertainty Principle

ERIC Educational Resources Information Center

Shivalingaswamy, T.; Kagali, B. A.

2012-01-01

Heisenberg's Uncertainty Principle is one of the important basic principles of quantum mechanics. In most of the books on quantum mechanics, this uncertainty principle is generally illustrated with the help of a gamma ray microscope, wherein neither the image formation criterion nor the lens properties are taken into account. Thus a better…

A mechanism producing power law etc. distributions

NASA Astrophysics Data System (ADS)

Li, Heling; Shen, Hongjun; Yang, Bin

2017-07-01

Power law distribution is playing an increasingly important role in the complex system study. Based on the insolvability of complex systems, the idea of incomplete statistics is utilized and expanded, three different exponential factors are introduced in equations about the normalization condition, statistical average and Shannon entropy, with probability distribution function deduced about exponential function, power function and the product form between power function and exponential function derived from Shannon entropy and maximal entropy principle. So it is shown that maximum entropy principle can totally replace equal probability hypothesis. Owing to the fact that power and probability distribution in the product form between power function and exponential function, which cannot be derived via equal probability hypothesis, can be derived by the aid of maximal entropy principle, it also can be concluded that maximal entropy principle is a basic principle which embodies concepts more extensively and reveals basic principles on motion laws of objects more fundamentally. At the same time, this principle also reveals the intrinsic link between Nature and different objects in human society and principles complied by all.

Establishing ethics in an organization by using principles.

PubMed

Hawks, Val D; Benzley, Steven E; Terry, Ronald E

2004-04-01

Laws, codes, and rules are essential for any community, public or private, to operate in an orderly and productive fashion. Without laws and codes, anarchy and chaos abound and the purpose and role of the organization is lost. However, danger is significant, and damage serious and far-reaching when individuals or organizations become so focused on rules, laws, and specifications that basic principles are ignored. This paper discusses the purpose of laws, rules, and codes, to help understand basic principles. With such an understanding an increase in the level of ethical and moral behavior can be obtained without imposing detailed rules.

[A basic health care center. Care oriented at the community].

PubMed

Marquilles Bonet, C; Quesada Santaulaira, L; Florensa Roca, C; Piñol Jové, M A; Cruz Esteve, I; Rodríguez Rosich, A

1997-01-01

Principle problems of a basic health care area (Lérida) are identified. This area, which has a patient case load of 22,244 people, was studied during the winter of 1993-94 by using information from various sources. Results indicate that the population of this community are basically young, urban, have a high cultural and social level, and are mostly employed. The principle causes of mortality are the same as in the rest of Cataluña. Diseases that cause the most working days lost to illness are: respiratory, mental and bone-joint problems. The most frequent diseases seen in the clinic are: hypertension, respiratory infections, endocrine and mental. An overall look at the state of health of these patients show that the principle problems are: tobacco use, high blood pressure, arthritis, lumbago, depression, stroke, diabetes and breast cancer.

Development of laparoscopic skills in Medical students naive to surgical training

PubMed Central

Cavalini, Worens Luiz Pereira; Claus, Christiano Marlo Paggi; Dimbarre, Daniellson; Cury, Antonio Moris; Bonin, Eduardo Aimoré; Loureiro, Marcelo de Paula; Salvalaggio, Paolo

2014-01-01

Objective To assess the acquisition of basic laparoscopic skills of Medical students trained on a surgical simulator. Methods First- and second-year Medical students participated on a laparoscopic training program on simulators. None of the students had previous classes of surgical technique, exposure to surgical practice nor training prior to the enrollment in to the study. Students´ time were collected before and after the 150-minute training. Skill acquisition was measured comparing time and scores of students and senior instructors of laparoscopic surgery Results Sixty-eight students participated of the study, with a mean age of 20.4 years, with a predominance of first-year students (62%). All students improved performance in score and time, after training (p<0,001). Score improvement in the exercises ranged from 294.1 to 823%. Univariate and multivariate analyses identified that second-year Medical students have achieved higher performance after training. Conclusions Medical students who had never been exposed to surgical techniques can acquire basic laparoscopic skills after training in simulators. Second-year undergraduates had better performance than first-year students. PMID:25628198

IN VITRO FLOW ANALYSIS OF NOVEL DOUBLE-CUTTING, OPEN-PORT, ULTRAHIGH-SPEED VITRECTOMY SYSTEMS.

PubMed

Zehetner, Claus; Moelgg, Marion; Bechrakis, Emmanouil; Linhart, Caroline; Bechrakis, Nikolaos E

2017-10-09

To analyze the performance and flow characteristics of novel double-cutting, open-port, 23-, 25-, and 27-gauge ultrahigh-speed vitrectomy systems. In vitro fluidic measurements were performed to assess the volumetric aspiration profiles of several vitrectomy systems in basic salt solution and egg white. Double-cutting open-port vitrectomy probes delivered stable aspiration flow rates that were less prone to flow variation affected by the cutting speed. Increase in cutting frequency to the maximum level resulted in flow reduction of less than 10% (0.0%-9.5%). Commercially available 23-, 25-, and 27-G double-cutting probes exhibited higher egg-white and basic salt solution flow rates at all evaluated cut rates, with aspirational efficiencies being 1.1 to 2.9 times the flow rates of standard single-blade vitrectomy probes of the same caliber at the maximum preset vacuum. The highest relative differences were observed at faster cut rates. The newly introduced double-cutting open-port vitrectomy probes delivered stable aspiration flow rates that were less prone to flow variation affected by the cutting speed. The fluidic principle of constant flow even at the highest cut rates and low vacuum levels might impact surgical strategies, especially when performing manipulations close to the retina.

An ion-pair principle for enantioseparations of basic analytes by nonaqueous capillary electrophoresis using the di-n-butyl L-tartrate-boric acid complex as chiral selector.

PubMed

Wang, Li-Juan; Liu, Xiu-Feng; Lu, Qie-Nan; Yang, Geng-Liang; Chen, Xing-Guo

2013-04-05

A chiral recognition mechanism of ion-pair principle has been proposed in this study. It rationalized the enantioseparations of some basic analytes using the complex of di-n-butyl l-tartrate and boric acid as the chiral selector in methanolic background electrolytes (BGEs) by nonaqueous capillary electrophoresis (NACE). An approach of mass spectrometer (MS) directly confirmed that triethylamine promoted the formation of negatively charged di-n-butyl l-tartrate-boric acid complex chiral counter ion with a complex ratio of 2:1. And the negatively charged counter ion was the real chiral selector in the ion-pair principle enantioseparations. It was assumed that triethylamine should play its role by adjusting the apparent acidity (pH*) of the running buffer to a higher value. Consequently, the effects of various basic electrolytes including inorganic and organic ones on the enantioseparations in NACE were investigated. The results showed that most of the basic electrolytes tested were favorable for the enantioseparations of basic analytes using di-n-butyl l-tartrate-boric acid complex as the chiral ion-pair selector. Copyright © 2013 Elsevier B.V. All rights reserved.

The NASA planning process, appendix D. [as useful planning approach for solving urban problems

NASA Technical Reports Server (NTRS)

Annett, H. A.

1973-01-01

The planning process is outlined which NASA used in making some fundamental post-Apollo decisions concerning the reuseable space shuttle and the orbiting laboratory. It is suggested that the basic elements and principles of the process, when combined, form a useful planning approach for solving urban problems. These elements and principles are defined along with the basic strengths of the planning model.

Previniendo el Uso de Drogas entre Ninos y Adolescentes: Una Guia Basada en Investigaciones (Preventing Drug Use among Children and Adolescents: A Research-Based Guide).

ERIC Educational Resources Information Center

Sloboda, Zili; David, Susan L.

This question and answer guide provides an overview of the research on the origins and pathways of drug abuse, the basic principles derived from effective drug abuse prevention research, and the application of research results to the prevention of drug use among young people. The basic principles derived from drug abuse prevention research are…

Basic principles of management for cervical spine trauma

PubMed Central

2009-01-01

This article reviews the basic principles of management of cervical trauma. The technique and critical importance of careful assessment is described. Instability is defined, and the incidence of a second injury is highlighted. The concept of spinal clearance is discussed. Early reduction and stabilisation techniques are described, and the indications, and approach for surgery reviewed. The importance of the role of post-injury rehabilitation is identified. PMID:19701655

On Ruch's Principle of Decreasing Mixing Distance in classical statistical physics

NASA Astrophysics Data System (ADS)

Busch, Paul; Quadt, Ralf

1990-10-01

Ruch's Principle of Decreasing Mixing Distance is reviewed as a statistical physical principle and its basic suport and geometric interpretation, the Ruch-Schranner-Seligman theorem, is generalized to be applicable to a large representative class of classical statistical systems.

Surgical simulation: Current practices and future perspectives for technical skills training.

PubMed

Bjerrum, Flemming; Thomsen, Ann Sofia Skou; Nayahangan, Leizl Joy; Konge, Lars

2018-06-17

Simulation-based training (SBT) has become a standard component of modern surgical education, yet successful implementation of evidence-based training programs remains challenging. In this narrative review, we use Kern's framework for curriculum development to describe where we are now and what lies ahead for SBT within surgery with a focus on technical skills in operative procedures. Despite principles for optimal SBT (proficiency-based, distributed, and deliberate practice) having been identified, massed training with fixed time intervals or a fixed number of repetitions is still being extensively used, and simulators are generally underutilized. SBT should be part of surgical training curricula, including theoretical, technical, and non-technical skills, and be based on relevant needs assessments. Furthermore, training should follow evidence-based theoretical principles for optimal training, and the effect of training needs to be evaluated using relevant outcomes. There is a larger, still unrealized potential of surgical SBT, which may be realized in the near future as simulator technologies evolve, more evidence-based training programs are implemented, and cost-effectiveness and impact on patient safety is clearly demonstrated.

The Structuring Principle: Political Socialization and Belief Systems

ERIC Educational Resources Information Center

Searing, Donald D.; And Others

1973-01-01

Assesses the significance of data on childhood political learning to political theory by testing the structuring principle,'' considered one of the central assumptions of political socialization research. This principle asserts that basic orientations acquired during childhood structure the later learning of specific issue beliefs.'' The…

Streamlining the Acquisition Process: Should Program Directors be Granted Contracting Authority

DTIC Science & Technology

1989-09-01

relationship between program directors and contracting officers contradicts basic management principles. One of Fayol’s principles of management is that...Franklin, Stephen G. Principles of Management , Eighth Edition. Homewood, II: Richard D. Irwin, Inc., 1982. Thybony, William W. Government Contracting based

Incorporating simulation into gynecologic surgical training.

PubMed

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

2017-11-01

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

Surgical robotics in otolaryngology: expanding the technology envelope.

PubMed

Gourin, Christine G; Terris, David J

2004-06-01

Surgical robotics arose as an extension of virtual reality and robotic technology developed by the United States Department of Defense. Current surgical robotic systems have been used to perform a variety of minimally invasive surgical procedures. The Food and Drug Administration recently granted approval for the clinical use of two surgical robotic systems. Laboratory and clinical experience suggests that the use of surgical robotics is associated with some distinct advantages and disadvantages when compared with conventional open procedures. Robotic surgery has recently been described in the head and neck, and as a result the otolaryngologist should have a basic understanding of the potential applications of surgical robotics in head and neck surgery. Surgical robotic technology is evolving but appears to have a distinct place in the surgical armamentarium.

32 CFR Appendix A to Part 272 - Principles for the Conduct and Support of Basic Research

Code of Federal Regulations, 2010 CFR

2010-07-01

... Research A Appendix A to Part 272 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMINISTRATION AND SUPPORT OF BASIC RESEARCH BY THE... Research 1. Basic research is an investment. The DoD Components are to view and manage basic research...

What proportion of basic surgical trainees continue in a surgical career? A survey of the factors which are important in influencing career decisions.

PubMed

Richards, J M J; Drummond, R; Murray, J; Fraser, S; MacDonald, A; Parks, R W

2009-10-01

Since the launch of Modernising Medical Careers, trainees are selected for a run-through training programme in a single surgical specialty. The surgical training bodies are currently considering the recommendations of the Tooke report as they review the policy for selection into surgical training in the UK. There is little information available on the factors involved in career choices amongst surgical trainees and this study aimed to address this issue. Trainees appointed to the Basic Surgical Training Programmes in the west and south-east of Scotland (1996-2006) were contacted by email and invited to participate in an online survey. Of 467 trainees identified, valid email addresses were available for 299 of which 191 (64%) responded to the survey. One hundred and forty-nine (78%) trainees were still working in surgery but 38 (20%) had moved to a non-surgical specialty and 4 (2%) had left the medical profession. Of those who had obtained a NTN at the time of the survey (n = 138), 62 (45%) had a NTN in the specialty they chose at the start of the BST but 34 (25%) had changed to a different surgical specialty and 42 (30%) had left surgery altogether. For those still working in surgery, enjoyment of the specialty was the most important factor affecting career choice. Achieving an acceptable work/life balance was the most significant factor influencing trainees who left surgery. The majority of trainees recruited to surgery at an early stage change specialty or leave surgery altogether. Both social and professional factors are important in career choices. The findings of this study support a period of core surgical training to provide flexibility prior to further training in a surgical specialty.

Mathematical foundations of biomechanics.

PubMed

Niederer, Peter F

2010-01-01

The aim of biomechanics is the analysis of the structure and function of humans, animals, and plants by means of the methods of mechanics. Its foundations are in particular embedded in mathematics, physics, and informatics. Due to the inherent multidisciplinary character deriving from its aim, biomechanics has numerous connections and overlapping areas with biology, biochemistry, physiology, and pathophysiology, along with clinical medicine, so its range is enormously wide. This treatise is mainly meant to serve as an introduction and overview for readers and students who intend to acquire a basic understanding of the mathematical principles and mechanics that constitute the foundation of biomechanics; accordingly, its contents are limited to basic theoretical principles of general validity and long-range significance. Selected examples are included that are representative for the problems treated in biomechanics. Although ultimate mathematical generality is not in the foreground, an attempt is made to derive the theory from basic principles. A concise and systematic formulation is thereby intended with the aim that the reader is provided with a working knowledge. It is assumed that he or she is familiar with the principles of calculus, vector analysis, and linear algebra.

Basic science and surgical treatment options for articular cartilage injuries of the knee.

PubMed

Tetteh, Elizabeth S; Bajaj, Sarvottam; Ghodadra, Neil S

2012-03-01

The complex structure of articular cartilage allows for diverse knee function throughout range of motion and weight bearing. However, disruption to the structural integrity of the articular surface can cause significant morbidity. Due to an inherently poor regenerative capacity, articular cartilage defects present a treatment challenge for physicians and therapists. For many patients, a trial of nonsurgical treatment options is paramount prior to surgical intervention. In instances of failed conservative treatment, patients can undergo an array of palliative, restorative, or reparative surgical procedures to treat these lesions. Palliative methods include debridement and lavage, while restorative techniques include marrow stimulation. For larger lesions involving subchondral bone, reparative procedures such as osteochondral grafting or autologous chondrocyte implantation are considered. Clinical success not only depends on the surgical techniques but also requires strict adherence to rehabilitation guidelines. The purpose of this article is to review the basic science of articular cartilage and to provide an overview of the procedures currently performed at our institution for patients presenting with symptomatic cartilage lesions.

Thresholds of Principle and Preference: Exploring Procedural Variation in Postgraduate Surgical Education.

PubMed

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2015-11-01

Expert physicians develop their own ways of doing things. The influence of such practice variation in clinical learning is insufficiently understood. Our grounded theory study explored how residents make sense of, and behave in relation to, the procedural variations of faculty surgeons. We sampled senior postgraduate surgical residents to construct a theoretical framework for how residents make sense of procedural variations. Using a constructivist grounded theory approach, we used marginal participant observation in the operating room across 56 surgical cases (146 hours), field interviews (38), and formal interviews (6) to develop a theoretical framework for residents' ways of dealing with procedural variations. Data analysis used constant comparison to iteratively refine the framework and data collection until theoretical saturation was reached. The core category of the constructed theory was called thresholds of principle and preference and it captured how faculty members position some procedural variations as negotiable and others not. The term thresholding was coined to describe residents' daily experiences of spotting, mapping, and negotiating their faculty members' thresholds and defending their own emerging thresholds. Thresholds of principle and preference play a key role in workplace-based medical education. Postgraduate medical learners are occupied on a day-to-day level with thresholding and attempting to make sense of the procedural variations of faculty. Workplace-based teaching and assessment should include an understanding of the integral role of thresholding in shaping learners' development. Future research should explore the nature and impact of thresholding in workplace-based learning beyond the surgical context.

Evolving Educational Techniques in Surgical Training.

PubMed

Evans, Charity H; Schenarts, Kimberly D

2016-02-01

Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

Computed tomography, magnetic resonance, and ultrasound imaging: basic principles, glossary of terms, and patient safety.

PubMed

Cogbill, Thomas H; Ziegelbein, Kurt J

2011-02-01

The basic principles underlying computed tomography, magnetic resonance, and ultrasound are reviewed to promote better understanding of the properties and appropriate applications of these 3 common imaging modalities. A glossary of frequently used terms for each technique is appended for convenience. Risks to patient safety including contrast-induced nephropathy, radiation-induced malignancy, and nephrogenic systemic fibrosis are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

Understanding the Magic of the Bicycle; Basic scientific explanations to the two-wheeler's mysterious and fascinating behavior

NASA Astrophysics Data System (ADS)

Connolly, Joseph W.

The bicycle is a common, yet unique mechanical contraption in our world. In spite of this, the bike's physical and mechanical principles are understood by a select few. You do not have to be a genius to join this small group of people who understand the physics of cycling. This is your guide to fundamental principles (such as Newton's laws) and the book provides intuitive, basic explanations for the bicycle's behaviour. Each concept is introduced and illustrated with simple, everyday examples. Although cycling is viewed by most as a fun activity, and almost everyone acquires the basic skills at a young age, few understand the laws of nature that give magic to the ride. This is a closer look at some of these fun, exhilarating, and magical aspects of cycling. In the reading, you will also understand other physical principles such as motion, force, energy, power, heat, and temperature.

Medical Ultrasound Imaging.

ERIC Educational Resources Information Center

Hughes, Stephen

2001-01-01

Explains the basic principles of ultrasound using everyday physics. Topics include the generation of ultrasound, basic interactions with material, and the measurement of blood flow using the Doppler effect. (Author/MM)

A Lemon Cell Battery for High-Power Applications

ERIC Educational Resources Information Center

Muske, Kenneth R.; Nigh, Christopher W.; Weinstein, Randy D.

2007-01-01

The use of lemon cell battery to run an electric DC motor is demonstrated for chemistry students. This demonstration aids the students in understanding principles behind the design and construction of the lemon cell battery and principles governing the electric DC motor and other basic principles.

Adopting Basic Principles of the United Nations Academic Impact Initiative (UNAI): Can Cultural Differences Be Predicted from Value Orientations and Globalization?

PubMed Central

Nechtelberger, Andrea; Renner, Walter; Nechtelberger, Martin; Supeková, Soňa Chovanová; Hadjimarkou, Maria; Offurum, Chino; Ramalingam, Panchalan; Senft, Birgit; Redfern, Kylie

2017-01-01

The United Nations Academic Impact (UNAI) Initiative has set forth 10 Basic Principles for higher education. In the present study, a 10 item self-report questionnaire measuring personal endorsement of these principles has been tested by self-report questionnaires with university and post-graduate students from Austria, China, Cyprus, India, Nigeria, and Slovakia (total N = 976, N = 627 female, mean age 24.7 years, s = 5.7). Starting from the assumptions of Moral Foundations Theory (MFT), we expected that personal attitudes toward the UNAI Basic Principles would be predicted by endorsement of various moral foundations as suggested by MFT and by the individual's degree of globalization. Whereas for the Austrian, Cypriot, and Nigerian sub- samples this assumption was largely confirmed, for the Chinese, Indian, and Slovak sub- samples only small amounts of the variance could be explained by regression models. All six sub-samples differed substantially with regard to their overall questionnaire responses: by five discriminant functions 83.6% of participants were classified correctly. We conclude that implementation of UNAI principles should adhere closely to the cultural requirements of the respective society and, where necessary should be accompanied by thorough informational campaigns about UN educational goals. PMID:29180977

Adopting Basic Principles of the United Nations Academic Impact Initiative (UNAI): Can Cultural Differences Be Predicted from Value Orientations and Globalization?

PubMed

Nechtelberger, Andrea; Renner, Walter; Nechtelberger, Martin; Supeková, Soňa Chovanová; Hadjimarkou, Maria; Offurum, Chino; Ramalingam, Panchalan; Senft, Birgit; Redfern, Kylie

2017-01-01

The United Nations Academic Impact (UNAI) Initiative has set forth 10 Basic Principles for higher education. In the present study, a 10 item self-report questionnaire measuring personal endorsement of these principles has been tested by self-report questionnaires with university and post-graduate students from Austria, China, Cyprus, India, Nigeria, and Slovakia (total N = 976, N = 627 female, mean age 24.7 years, s = 5.7). Starting from the assumptions of Moral Foundations Theory (MFT), we expected that personal attitudes toward the UNAI Basic Principles would be predicted by endorsement of various moral foundations as suggested by MFT and by the individual's degree of globalization. Whereas for the Austrian, Cypriot, and Nigerian sub- samples this assumption was largely confirmed, for the Chinese, Indian, and Slovak sub- samples only small amounts of the variance could be explained by regression models. All six sub-samples differed substantially with regard to their overall questionnaire responses: by five discriminant functions 83.6% of participants were classified correctly. We conclude that implementation of UNAI principles should adhere closely to the cultural requirements of the respective society and, where necessary should be accompanied by thorough informational campaigns about UN educational goals.

[3-dimensional computer animation--a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study--picture versus text].

PubMed

Hermann, M

2002-05-01

The rigorous implementation of clear preoperative information is mandatory for the patient's understanding, acceptance and written informed consent to all diagnostic and surgical procedures. In the present study, I evaluated whether new media are suitable for conveying basic information to patients; I analysed the merits of computerized animation to illustrate a difficult treatment process, i.e., the progressive steps of a thyroid operation, in comparison to the use of conventional flyers. 3D animation software was employed to illustrate the basic anatomy of the thyroid and the larnyx; the principle of thyroidectomy was explained by visualizing the surgical procedure step by step. Finally, the possible complications that may result from the intraoperative manipulations were also visually explained. Eighty patients entered a prospective randomisation: on the day before surgery, group 1 watched the computer animation, whereas group 2 was given the identical information in a written text (= standard flyer). The evaluation included a questionnaire with scores of 1-5, rating the patients' understanding, subjective and objective knowledge, emotional factors like anxiety and trust, and the willingness to undergo an operation. Understanding of and subjective knowledge about the surgical procedure and possible complications, the degree of trust in professional treatment, the reduction in anxiety and readiness for the operation were significantly better after watching the computer animation than after reading the text. However, active knowledge did not improve significantly. The interest in the preoperative information was high in both groups. The benefit of computer animation was enhanced in a second inquiry; patients who had only read the text had a significant improvement in parameters after an additional exposure to the video animation. Preoperative surgical information can be optimized by presenting the operative procedure via computer animation. Nowadays, several types of new media such as the world wide web, CD, DVD, and digital TV are readily available and--as shown here--suitable for effective visual explanation. Most patients are familiar with acquiring new information by one of these means. An appropriately designed 3D repre-sentation is met with a high level of acceptance, as the present study clearly shows. Modern patient-based information systems are necessary. They can no longer be the sole responsibility of the medical profession, but must be on the agenda of hospital managements and of medical care systems as well.

A Curriculum Guide for Electricity/Electronics.

ERIC Educational Resources Information Center

Rouse, Bill, Comp.

This curriculum guide is designed to upgrade the secondary electrical trades program in Mississippi by broadening its scope to incorporate basic electronic principles. Covered in the individual chapters of the guide are the following courses: basic electricity (occupational information, basic physics, circuit fundamentals, resistance and Ohm's…

Basic Electronics I.

ERIC Educational Resources Information Center

Robertson, L. Paul

Designed for use in basic electronics programs, this curriculum guide is comprised of twenty-nine units of instruction in five major content areas: Orientation, Basic Principles of Electricity/Electronics, Fundamentals of Direct Current, Fundamentals of Alternating Current, and Applying for a Job. Each instructional unit includes some or all of…

[Studies on the immunologic behavior of standardized virus-induced rat tumor after cryosurgical and surgical treatment].

PubMed

Jaeschock, R R

1976-01-01

The authors report on the behavior of a virus-induced tumor in the rat after cryosurgical and surgical treatment and re-implantation of different tumor suspensions. No specific "immune-cryothermic response" could be demonstrated. The principle of the lysis of the re-implantate lies in devitalizing the primary tumor.

The Aristotelian Principle and Education.

ERIC Educational Resources Information Center

Pekarsky, Daniel

1980-01-01

For the Aristotelian principle to become operative, certain principles must be met. Individuals should be free from anxiety about satisfying basic needs. They cannot enjoy complexity in their lives beyond a certain point. To have satisfying lives, individuals should engage in both passive and active enjoyments, leading from a lower to a higher…

CEP's Eleven Principles of Effective Character Education

ERIC Educational Resources Information Center

Lickona, Tom; Schaps, Eric; Lewis, Catherine

2007-01-01

There is no single script for effective character education, but there are some important basic principles. This document presents eleven principles that schools and other groups can use to plan a character education effort and to evaluate available character education programs: (1) Promotes core ethical values and supportive performance values as…

Using Design Principles to Teach Technical Communication.

ERIC Educational Resources Information Center

Markel, Mike

1995-01-01

Compares the writing of two students--a competent writer and a weak one--in a technical communication course before and after discussion of design principles. Finds that a basic understanding of design principles helped them improve document macrostructure but had little effect on document microstructure. Suggests that integrating document design…

Organizing to Manage Base-Level Service Contracts in the 1990s.

DTIC Science & Technology

1986-04-01

management of service contracts is the present day organizational structure. The structure is flawed and violates basic principles of management . Until the...are classic principles of management . To state the principle I will quote Ernest Dale: "Authority should be commensurate with responsibility. That is

Impact of an Interactive Vascular Surgery Web-Based Educational Curriculum on Surgical Trainee Knowledge and Interest.

PubMed

Zayed, Mohamed A; Lilo, Emily A; Lee, Jason T

The surgical council on resident education developed an online competency-based self-study curriculum for general surgery residency trainees. Vascular surgery trainees are yet to have a similarly validated and readily accessible self-study curriculum. We sought to determine the effect of an interactive online vascular surgery curriculum on trainee knowledge and interest in vascular surgery. Over 15 months, 53 trainees (36 medical students and 16 surgical residents) performing a vascular surgery rotation were enrolled in a prospective, randomized, 2-cohort study. Before starting a 4-week rotation, trainee baseline demographics were collected, and a pretest was administered to evaluate baseline vascular surgery knowledge. During the same study period, 31 trainees (GROUP 1) were randomized to an interactive online curriculum with weekly reading assignments, and 21 trainees (GROUP 2) did not have access to the online curriculum. At the conclusion, all trainees received a posttest and survey to evaluate any change in vascular surgery knowledge and interest. Although 26.8% of trainees predicted that online computer modules would be a beneficial learning tool, most of trainees indicated textbook reading and case discussions are preferred. Analysis of GROUPS 1 and 2 revealed no significant differences in the average trainee age, training level, sex, or number of surgical cases observed during the rotation. Improvement in vascular surgery knowledge in GROUP 1 was significantly higher compared to GROUP 2 (average increase in posttest scores of 16.1% vs 6.6%, p = 0.009). New interest in vascular surgery was increased by 22.2% in GROUP 1, but was decreased by 40% in GROUP 2 (p < 0.001). Basic vascular surgery principles can be efficiently introduced through an interactive online curriculum. This type of self-study can improve trainee knowledge, and foster interest in vascular surgery. As in other specialties, a standardized and validated online vascular surgery curriculum should be developed for emerging trainees. Published by Elsevier Inc.

Principles and application of shock-tubes and shock tunnels

NASA Technical Reports Server (NTRS)

Ried, R. C.; Clauss, H. G., Jr.

1963-01-01

The principles, theoretical flow equations, calculation techniques, limitations and practical performance characteristics of basic and high performance shock tubes and shock tunnels are presented. Selected operating curves are included.

Female genital mutilation reversal: a general approach.

PubMed

Anand, Mallika; Stanhope, Todd J; Occhino, John A

2014-07-01

Female genital mutilation (FGM) is a violation of human rights; yet, more than 100 million females are estimated to have undergone the procedure worldwide. There is an increased need for physician education in treating FGM. Female pelvic surgeons have a unique opportunity to treat this population of patients. Here, we depict the classification of FGM and a general approach to FGM reversal. We specifically address the procedure of type III FGM reversal, or defibulation. In this video, we first highlight the importance of the problem of FGM. Next, we present the classification of FGM using an original, simple, schematic diagram highlighting they key anatomic structures involved in the four types of FGM. We then present a simple case of reversal of type III FGM, a procedure also known as defibulation. After depicting the surgical procedure, we discuss clinical results and summarize key principles of the defibulation procedure. Our patient was a 25-year-old woman who had undergone type III FGM as a child in Somalia. She desired restoration of vaginal function. We performed a reversal, and her postoperative course was uncomplicated. By 6 weeks postoperatively, she was able to engage in sexual intercourse without dyspareunia. FGM is a problem at the doorsteps of female pelvic medicine and reconstructive surgery. Our video demonstrates a basic surgical approach that can be applied to simple cases of type III FGM presenting to the female pelvic surgeon.

Single-Incision Transumbilical Surgery (SITUS) versus Single-Port Laparoscopic Surgery and conventional laparoscopic surgery: a prospective randomized comparative study of performance with novices in a dry laboratory.

PubMed

Schoenthaler, Martin; Avcil, Tuba; Sevcenco, Sabina; Nagele, Udo; Hermann, Thomas E W; Kuehhas, Franklin E; Shariat, Shahrokh F; Frankenschmidt, Alexander; Wetterauer, Ulrich; Miernik, Arkadiusz

2015-01-01

To evaluate the Single-Incision Transumbilical Surgery (SITUS) technique as compared to an established laparoendoscopic single-site surgery (LESS) technique (Single-Port Laparoscopic Surgery, SPLS) and conventional laparoscopy (CLS) in a surgical simulator model. Sixty-three medical students without previous laparoscopic experience were randomly assigned to one of the three groups (SITUS, SPLS and CLS). Subjects were asked to perform five standardized tasks of increasing difficulty adopted from the Fundamentals of Laparoscopic Surgery curriculum. Statistical evaluation included task completion times and accuracy. Overall performances of all tasks (except precision cutting) were significantly faster and of higher accuracy in the CLS and SITUS groups than in the SPLS group (p = 0.004 to p < 0.001). CLS and SITUS groups alone showed no significant difference in performance times and accuracy measurements for all tasks (p = 0.048 to p = 0.989). SITUS proved to be a simple, but highly effective technique to overcome restrictions of SPLS. In a surgical simulator model, novices were able to achieve task performances comparable to CLS and did significantly better than using a port-assisted LESS technique such as SPLS. The demonstrated advantages of SITUS may be attributed to a preservation of the basic principles of conventional laparoscopy, such as the use of straight instruments and an adequate degree of triangulation.

The impact of robotic surgery in urology.

PubMed

Giedelman, C A; Abdul-Muhsin, H; Schatloff, O; Palmer, K; Lee, L; Sanchez-Salas, R; Cathelineau, X; Dávila, H; Cavelier, L; Rueda, M; Patel, V

2013-01-01

More than a decade ago, robotic surgery was introduced into urology. Since then, the urological community started to look at surgery from a different angle. The present, the future hopes, and the way we looked at our past experience have all changed. Between 2000 and 2011, the published literature was reviewed using the National Library of Medicine database and the following key words: robotic surgery, robot-assisted, and radical prostatectomy. Special emphasis was given to the impact of the robotic surgery in urology. We analyzed the most representative series (finished learning curve) in each one of the robotic approaches regarding perioperative morbidity and oncological outcomes. This article looks into the impact of robotics in urology, starting from its background applications before urology, the way it was introduced into urology, its first steps, current status, and future expectations. By narrating this journey, we tried to highlight important modifications that helped robotic surgery make its way to its position today. We looked as well into the dramatic changes that robotic surgery introduced to the field of surgical training and its consequence on its learning curve. Basic surgical principles still apply in Robotics: experience counts, and prolonged practice provides knowledge and skills. In this way, the potential advantages delivered by technology will be better exploited, and this will be reflected in better outcomes for patients. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

Use of split-thickness plantar skin grafts in the management of leg and foot skin defects.

PubMed

Liu, Hung-Hui; Chang, Chun-Kai; Huang, Chih-Han; Wu, Jen-Ru; Chen, Chun-Yu; Huang, Dun-Wei; Chu, Tzi-Shiang; Hsu, Kuo-Feng; Wang, Chi-Yu; Chiang, I-Han; Ou, Kuang-Ling; Wang, Chih-Hsin; Dai, Niann-Tzyy; Chen, Shyi-Gen; Tzeng, Yuan-Sheng

2018-05-24

The basic principle of donor site selection is to take skin from areas that will heal with minimal scarring while balancing the needs of the recipient site. For skin loss from the lower legs and feet, the most common harvest site for split-thickness skin grafts is the anterior or posterior thigh; grafts from the plantar areas have been mostly used to cover the volar aspect of digits and palms. Between September 2015 and September 2017, 42 patients with areas of skin loss on the legs or feet were treated with plantar skin grafts because of their cosmetic benefits and the convenience of the surgical procedure and postoperative wound care. Our technique of harvesting a single layer of split-thickness skin graft (0.014 in. thick) from a non-weight-bearing area of the foot of the injured leg is simple and provided good functional and cosmetic outcomes at both the donor and recipient sites. All patients were very satisfied with the recovery progress and final results. Therefore, in the management of skin defects in the lower legs or feet that comprise less than 1.5% of the total body surface area, our surgical method is a reliable alternative to anterior or posterior thigh skin grafting. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Quality improvement 101 for surgeons: Navigating the alphabet soup.

PubMed

Santore, Matthew T; Islam, Saleem

2015-12-01

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

Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills.

PubMed

Havemann, Maria Cecilie; Dalsgaard, Torur; Sørensen, Jette Led; Røssaak, Kristin; Brisling, Steffen; Mosgaard, Berit Jul; Høgdall, Claus; Bjerrum, Flemming

2018-05-14

Increasing focus on patient safety makes it important to ensure surgical competency among surgeons before operating on patients. The objective was to gather validity evidence for a virtual-reality simulator test for robotic surgical skills and evaluate its potential as a training tool. Surgeons with varying experience in robotic surgery were recruited: novices (zero procedures), intermediates (1-50), experienced (> 50). Five experienced surgeons rated five exercises on the da Vinci Skills Simulator. Participants were tested using the five exercises. Participants were invited back 3 times and completed a total of 10 attempts per exercise. The outcome was the average simulator performance score for the 5 exercises. 32 participants from 5 surgical specialties were included. 38 participants completed all 4 sessions. A moderate correlation between the average total score and robotic experience was identified for the first attempt (Spearman r = 0.58; p = 0.0004). A difference in average total score was observed between novices and intermediates [median score 61% (IQR 52-66) vs. 83% (IQR 75-91), adjusted p < 0.0001], as well as novices and experienced [median score 61% (IQR 52-66) vs. 80 (IQR 69-85), adjusted p = 0.002]. All three groups improved their performance between the 1st and 10th attempts (p < 0.00). This study describes validity evidence for a virtual-reality simulator for basic robotic surgical skills, which can be used for assessment of basic competency and as a training tool. However, more validity evidence is needed before it can be used for certification or high-stakes assessment.

[Pneumonia in wounded].

PubMed

Ovchinnikov, Iu V; Kharitonov, M A; Sadykov, R R; Shelukhin, V A; Gaĭduk, S V; Bogomolov, A B; Ivanov, V V; Dobrovol'skaia, L M

2015-02-01

Pneumonia is one of the common complications of wounds of any localization. Therapists are involved into the treatment of lung lesions in wounded in the ICU, in the surgical and if the patient arrives "on follow-up care,"--in the medical ward. The article analyzes the main statistical indicators reflecting the prevalence and clinical and pathogenetic characteristics of lung pathology in wounded during the Great Patriotic War, during the fighting Soviet troops in the Republic of Afghanistan, the 1st and 2nd Chechen campaign. Pneumonia as a manifestation of traumatic disease can occur in two ways. Primary pneumonia is in close connection with the pathogenetic traumatic injury. Secondary lung lesions complicate the injury at a later date and are due to the introduction of a nosocomial infection process flora. We describe the clinical picture of pneumonia in the affected, the basic pathogenesis, principles of therapy. Successful treatment of lung pathology in wounded depends on the performance of a complex of activities involving a wide range of doctors of various specialties.

Soft-tissue grafting for peri-implantitis-a treatment option in case of unsuitable skeletal basic morphology of the alveolar bone and lack of keratinized mucosa: a retrospective clinical cohort study.

PubMed

Stiller, Michael; Mengel, Rainer; Becher, Sebastian; Brinkmann, Bernhard; Peleska, Barbara; Kluk, Esther

2015-12-01

This retrospective study evaluated soft-tissue grafting as a surgical treatment option for peri-implantitis in case of unsuitable basic skeletal morphology of the alveolar bone and lack of keratinized mucosa. Twenty-eight patients (21 females, 7 males, at a mean age 59.4 years) were included with a total of 54 implants. All implants showed peri-implantitis and attached keratinized buccal mucosa of ≤2 mm. A surgical procedure of soft-tissue grafting (STG) was made by inserting an inlay and inlay-onlay transplant. Clinical investigations were made prior to the STG (baseline) and after 9-180 months (Ø 43 months) including the following parameters: soft-tissue biotype, skeletal basic morphology of the alveolar bone, width of the peri-implant keratinized mucosa (KM), mobility of the KM, pocket probing depth (PPD), and bleeding on probing (BOP). Nearly all patients showed a thin soft-tissue biotype. The analysis of the skeletal basic morphology of the alveolar bone revealed a narrow apical base in 18 patients, middle base in 7 patients, and broad base in 3 patients. Width of the KM increased significantly (p < 0.01) from 0.4 ± 0,5 mm to 4.3 ± 1.5 mm after STG and PPD was significantly (p < 0,01) reduced from 6.3 ± 2,3 mm to 4.1 ± 1.9 mm. A significant reduction (p < 0.01) in BOP was recorded. All patients reported a clinical improvement of the inflammatory symptoms at follow-up. The results of this study showed that the STG can be applied successfully as a surgical treatment of peri-implantitis. It remains unclear whether soft-tissue biotype or the skeletal basic morphology of the alveolar bone affects the outcome of this surgical treatment.

Compact teleoperated laparoendoscopic single-site robotic surgical system: Kinematics, control, and operation.

PubMed

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

2017-12-01

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.

Eosinophil count - absolute

MedlinePlus

... BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; ... HE, Weitz JI, Anastasi J, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; ...

Basic Understanding of Earth Tunneling by Melting : Volume 1. Basic Physical Principles.

DOT National Transportation Integrated Search

1974-07-01

A novel technique, which employs the melting of rocks and soils as a means of excavating or tunneling while simultaneously generating a glass tunnel lining and/or primary support, was studied. The object of the study was to produce a good basic under...

Pacific Partnership 2007: The First Dedicated United States Ship Humanitarian and Civic Assistance Mission

DTIC Science & Technology

2010-10-25

surgical patients. Other eye surgeries corrected ptyergium and strabismus. Pediatric surgical cases were mainly hernia repair and cleft palate / cleft ... lip repair. Basic medical care, MEDCAP, was provided ashore at each location of the mission. PP07 MEDCAP mission data, consolidated from daily

Medical-Surgical II. Teacher Edition.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This publication is designed to provide students with the knowledge they need to pursue a career in medical-surgical nursing. Fifteen units are provided. Each instructional unit includes some or all of the basic components of a unit of instruction: performance objectives, suggested activities for the teacher, information sheets, job sheets,…

Medical-Surgical I. Teacher Edition.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This publication is designed to provide students with the knowledge they need to pursue a career in medical-surgical nursing. Eight units are provided. Each instructional unit includes some or all of the basic components of a unit of instruction: performance objectives, suggested activities for the teacher, information sheets, job sheets, written…

[Management of occult malformations at the lateral skull base].

PubMed

Bryson, E; Draf, W; Hofmann, E; Bockmühl, U

2005-12-01

Occult malformations of the lateral skull base are rare anomalies, but can cause severe complications such as recurrent meningitis. Therefore, they need to be precisely delineated and sufficient surgical closure is mandatory. Between 1986 and 2004 twenty patients (10 children and 10 adults) with occult malformations at the lateral skull base were treated surgically at the ENT-Department of the Hospital Fulda gAG. Of these 3 Mondini-malformations, 11 defects of the tegmen tympani or the mastoidal roof, 2 dural lesions to the posterior fossa and 4 malformations within the pyramidal apex have been found. Four patients have had multiple anomalies. Routing symptom was in all cases at least one previous meningitis. Radiological diagnostics included high-resolution computed tomography (CT) and magnetic resonance imaging (MRI) as well as CT- or MR-cisternography. Depending on type and localisation of the defect the following surgical algorithm was carried out: The trans-mastoidal approach was used in all cases of Mondini-malformation (including obliteration of the ear), in case of lesions to the posterior fossa as well as partly in anomalies at the tegmen tympani and mastoidal roof, respectively. Defects of the pyramidal apex should be explored via the trans-mastoidal way if the lesion is located caudally to the inner auditory canal (IAC), whereas the trans-temporal approach should be used if the lesion is situated ventral to the IAC and dorso-medially to the internal carotid artery (ICA). The trans-temporal approach was also performed in large defects of the tegmen tympani and mastoidal roof as well as in recurrences. In all cases of recurrent meningitis caused by agents of the upper airway tract the basic principle should be to search for occult skull base malformations radiologically as well as by sodium fluorescein endoscopy as long as the anomaly is detected.

Complete tissue coverage achieved by scaffold-based tissue engineering in the fetal sheep model of Myelomeningocele.

PubMed

Watanabe, Miho; Li, Haiying; Kim, Aimee G; Weilerstein, Aaron; Radu, Anteneta; Davey, Marcus; Loukogeorgakis, Stavros; Sánchez, Melissa D; Sumita, Kazutaka; Morimoto, Naoki; Yamamoto, Masaya; Tabata, Yasuhiko; Flake, Alan W

2016-01-01

Myelomeningocele (MMC) is the most severe form of spina bifida, one of the most common congenital anomalies. Although open fetal surgical repair of the MMC defect has been shown to result in improved outcomes, a less invasive approach applicable earlier in gestation than the current open surgical approach between 19 and 26 weeks of gestation is desirable for further improvement of neurological symptoms, as well as reduction of maternal and fetal risks. We previously reported the therapeutic potential of a scaffold-based tissue engineering approach in a fetal rat MMC model. The objective of this study was to confirm the long-term efficacy of this approach in the surgically created fetal sheep MMC model. Gelatin-based or gelatin/collagen hybrid sponges were prepared with and without basic fibroblast growth factor (bFGF) incorporation. The defect was covered by a sponge and secured by a supporting sheet with adhesive at 100 days of gestation or the gelatin/collagen hybrid with bFGF was secured with adhesive without the sheet. Although sheets were found detached at term (140 days' gestation), both gelatin-based and gelatin/collagen hybrid sponges had integrated within the newly formed granulation tissue, resulting in complete coverage of the MMC defect. The release of bFGF from sponges resulted in enhanced formation of granulation tissue and epithelialization. There was also evidence of improved preservation of the spinal cord with less associated damage on histological analysis and reversal of hindbrain herniation. These experiments provide important proof-of-principle evidence of the efficacy of scaffold-based tissue engineered coverage for the prenatal treatment of MMC. Copyright © 2015 Elsevier Ltd. All rights reserved.

The maximum entropy production principle: two basic questions.

PubMed

Martyushev, Leonid M

2010-05-12

The overwhelming majority of maximum entropy production applications to ecological and environmental systems are based on thermodynamics and statistical physics. Here, we discuss briefly maximum entropy production principle and raises two questions: (i) can this principle be used as the basis for non-equilibrium thermodynamics and statistical mechanics and (ii) is it possible to 'prove' the principle? We adduce one more proof which is most concise today.

A Chemistry Lesson at Three Mile Island.

ERIC Educational Resources Information Center

Mammano, Nicholas J.

1980-01-01

Details the procedures used in utilizing the hydrogen bubble incident at Three Mile Island to relate these basic chemical principles to nuclear chemistry: gas laws, Le Chatelier's principle and equilibrium, and stoichiometry. (CS)

Supply-demand balance in outward-directed networks and Kleiber's law

PubMed Central

Painter, Page R

2005-01-01

Background Recent theories have attempted to derive the value of the exponent α in the allometric formula for scaling of basal metabolic rate from the properties of distribution network models for arteries and capillaries. It has recently been stated that a basic theorem relating the sum of nutrient currents to the specific nutrient uptake rate, together with a relationship claimed to be required in order to match nutrient supply to nutrient demand in 3-dimensional outward-directed networks, leads to Kleiber's law (b = 3/4). Methods The validity of the supply-demand matching principle and the assumptions required to prove the basic theorem are assessed. The supply-demand principle is evaluated by examining the supply term and the demand term in outward-directed lattice models of nutrient and water distribution systems and by applying the principle to fractal-like models of mammalian arterial systems. Results Application of the supply-demand principle to bifurcating fractal-like networks that are outward-directed does not predict 3/4-power scaling, and evaluation of water distribution system models shows that the matching principle does not match supply to demand in such systems. Furthermore, proof of the basic theorem is shown to require that the covariance of nutrient uptake and current path length is 0, an assumption unlikely to be true in mammalian arterial systems. Conclusion The supply-demand matching principle does not lead to a satisfactory explanation for the approximately 3/4-power scaling of mammalian basal metabolic rate. PMID:16283939

Supply-demand balance in outward-directed networks and Kleiber's law.

PubMed

Painter, Page R

2005-11-10

Recent theories have attempted to derive the value of the exponent alpha in the allometric formula for scaling of basal metabolic rate from the properties of distribution network models for arteries and capillaries. It has recently been stated that a basic theorem relating the sum of nutrient currents to the specific nutrient uptake rate, together with a relationship claimed to be required in order to match nutrient supply to nutrient demand in 3-dimensional outward-directed networks, leads to Kleiber's law (b = 3/4). The validity of the supply-demand matching principle and the assumptions required to prove the basic theorem are assessed. The supply-demand principle is evaluated by examining the supply term and the demand term in outward-directed lattice models of nutrient and water distribution systems and by applying the principle to fractal-like models of mammalian arterial systems. Application of the supply-demand principle to bifurcating fractal-like networks that are outward-directed does not predict 3/4-power scaling, and evaluation of water distribution system models shows that the matching principle does not match supply to demand in such systems. Furthermore, proof of the basic theorem is shown to require that the covariance of nutrient uptake and current path length is 0, an assumption unlikely to be true in mammalian arterial systems. The supply-demand matching principle does not lead to a satisfactory explanation for the approximately 3/4-power scaling of mammalian basal metabolic rate.

[Computerization and robotics in medical practice].

PubMed

Dervaderics, J

1997-10-26

The article gives the outlines of all principles used in computing included the non-electrical and analog computers and the artifical intelligence followed by citing examples as well. The principles and medical utilization of virtual reality are also mentioned. There are discussed: surgical planning, image guided surgery, robotic surgery, telepresence and telesurgery, and telemedicine implemented partially via Internet.

Principles of Tendon Reconstruction Following Complex Trauma of the Upper Limb

PubMed Central

Chattopadhyay, Arhana; McGoldrick, Rory; Umansky, Elise; Chang, James

2015-01-01

Reconstruction of tendons following complex trauma to the upper limb presents unique clinical and research challenges. In this article, the authors review the principles guiding preoperative assessment, surgical reconstruction, and postoperative rehabilitation and management of the upper extremity. Tissue engineering approaches to address tissue shortages for tendon reconstruction are also discussed. PMID:25685101

Rethinking the Formula: Suggestions for Improving Basic Course Texts.

ERIC Educational Resources Information Center

Robie, Harry

There are three arguments against the usefulness of present basic course textbooks in speech communication. First, there are certain inherent forces that will always drive textbook publishers toward the production of textbooks unsuitable for the basic course: "mentioning" (mentioning every principle ever heard of by potential users of…

Training Course for Power Operating Personnel. Lesson No. 6: Alternating-Current Generator Excitation.

ERIC Educational Resources Information Center

Department of the Interior, Denver, CO. Engineering and Research Center.

Subjects covered in this text are controlling the hydroelectric generator, generator excitation, basic principles of direct current generation, direction of current flow, basic alternating current generator, alternating and direct current voltage outputs, converting alternating current to direct current, review of the basic generator and…

Label Review Training: Module 1: Label Basics, Page 21

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Learn about types of labels.

Military Curriculum Materials for Vocational and Technical Education. Engine Principles, 8-3. Edition 5.

ERIC Educational Resources Information Center

Ohio State Univ., Columbus. National Center for Research in Vocational Education.

This individualized, self-paced course for independent study in engine principles has been adapted from military curriculum materials for vocational education use. The course provides the student with basic information on engine principles including different kinds of combustion engines, lubrication systems, and cooling systems. It is organized…

Introduction to Therapeutic and Counseling Principles: A Manual for Human Service Workers.

ERIC Educational Resources Information Center

Alaska State Dept. of Health and Social Services, Juneau. Div. of Mental Health and Developmental Disabilities.

This manual introduces some of the essential principles of counseling. It is geared toward the training and education of those who have not had significant prior counseling experiences and is not comprehensive. These topics are discussed, focusing on basic, introductory material: (1) general principles of human behavior and motivation including…

Legality Principle of Crimes and Punishments in Iranian Legal System

ERIC Educational Resources Information Center

Habibzadeh, Mohammad Ja'far

2006-01-01

The Principle of legality of crimes and punishments (nullum crimen, nulla poena sine lege) refers to the fact that an act is not considered a crime and deserves no punishment, unless the Legislator determines and announces the criminal title and its penalty before. The legality principle protects individual security by ensuring basic individual…

77 FR 27509 - Self-Regulatory Organizations; Municipal Securities Rulemaking Board; Order Approving Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-10

... Principle; (2) Role of the Underwriter/Conflicts of Interest; (3) Representations to Issuers; (4) Required... municipal securities.'' See Interpretive Notice at endnote 1. A. Basic Fair Dealing Principle The... made in a fair and balanced manner based on principles of fair dealing and good faith. \\11\\ The...

Ensuring the safety of surgical teams when managing casualties of a radiological dirty bomb.

PubMed

Williams, Geraint; O'Malley, Michael; Nocera, Antony

2010-09-01

The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team. 2010 Elsevier Ltd. All rights reserved.

The development of neural stimulators: a review of preclinical safety and efficacy studies.

PubMed

Shepherd, Robert K; Villalobos, Joel; Burns, Owen; Nayagam, David

2018-05-14

Given the rapid expansion of the field of neural stimulation and the rigorous regulatory approval requirements required before these devices can be applied clinically, it is important that there is clarity around conducting preclinical safety and efficacy studies required for the development of this technology. The present review examines basic design principles associated with the development of a safe neural stimulator and describes the suite of preclinical safety studies that need to be considered when taking a device to clinical trial. Neural stimulators are active implantable devices that provide therapeutic intervention, sensory feedback or improved motor control via electrical stimulation of neural or neuro-muscular tissue in response to trauma or disease. Because of their complexity, regulatory bodies classify these devices in the highest risk category (Class III), and they are therefore required to go through a rigorous regulatory approval process before progressing to market. The successful development of these devices is achieved through close collaboration across disciplines including engineers, scientists and a surgical/clinical team, and the adherence to clear design principles. Preclinical studies form one of several key components in the development pathway from concept to product release of neural stimulators. Importantly, these studies provide iterative feedback in order to optimise the final design of the device. Key components of any preclinical evaluation include: in vitro studies that are focussed on device reliability and include accelerated testing under highly controlled environments; in vivo studies using animal models of the disease or injury in order to assess safety and, given an appropriate animal model, the efficacy of the technology under both passive and electrically active conditions; and human cadaver and ex vivo studies designed to ensure the device's form factor conforms to human anatomy, to optimise the surgical approach and to develop any specialist surgical tooling required. The pipeline from concept to commercialisation of these devices is long and expensive; careful attention to both device design and its preclinical evaluation will have significant impact on the duration and cost associated with taking a device through to commercialisation. Carefully controlled in vitro and in vivo studies together with ex vivo and human cadaver trials are key components of a thorough preclinical evaluation of any new neural stimulator. © 2018 IOP Publishing Ltd.

Essentials of finance for occupational physicians.

PubMed

Miller, K; Fallon, L F

2001-01-01

Comprehending the principles of finance is paramount to understanding the way an organization chooses to generate and use its financial resources. Financial principles may be employed in the same way a physician reviews fundamental systems to gauge a person s health. Just as basic anatomical and physiological components are used to assess the health of an individual, basic financial elements exist to ascertain the health of an organization. This chapter explains risk assessment, accounts receivable management, inventory, depreciation, capital formation, ratio analysis, and more.

A Data Definition Language for GLAD (Graphic Language for Databases).

DTIC Science & Technology

1986-06-20

basic premises. These principles state that a DBMS interface must be descriptive, powerful, easy-to use and easy to learn . This thesis proposes a data...basic premises. These principles state that a DBMS interface must be descriptive, powerful, easy to use and easy to learn . This thesis proposes a data...criteria will be the most successful. 9 If a system is hard to learn , of those capable of mastering the system few may be willing to expend the time and

Application of Six Sigma towards improving surgical outcomes.

PubMed

Shukla, P J; Barreto, S G; Nadkarni, M S

2008-01-01

Six Sigma is a 'process excellence' tool targeting continuous improvement achieved by providing a methodology for improving key steps of a process. It is ripe for application into health care since almost all health care processes require a near-zero tolerance for mistakes. The aim of this study is to apply the Six Sigma methodology into a clinical surgical process and to assess the improvement (if any) in the outcomes and patient care. The guiding principles of Six Sigma, namely DMAIC (Define, Measure, Analyze, Improve, Control), were used to analyze the impact of double stapling technique (DST) towards improving sphincter preservation rates for rectal cancer. The analysis using the Six Sigma methodology revealed a Sigma score of 2.10 in relation to successful sphincter preservation. This score demonstrates an improvement over the previous technique (73% over previous 54%). This study represents one of the first clinical applications of Six Sigma in the surgical field. By understanding, accepting, and applying the principles of Six Sigma, we have an opportunity to transfer a very successful management philosophy to facilitate the identification of key steps that can improve outcomes and ultimately patient safety and the quality of surgical care provided.

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

PubMed

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

2013-05-01

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

Updates in Head and Neck Reconstruction.

PubMed

Largo, Rene D; Garvey, Patrick B

2018-02-01

After reading this article, the participant should be able to: 1. Have a basic understanding of virtual planning, rapid prototype modeling, three-dimensional printing, and computer-assisted design and manufacture. 2. Understand the principles of combining virtual planning and vascular mapping. 3. Understand principles of flap choice and design in preoperative planning of free osteocutaneous flaps in mandible and midface reconstruction. 4. Discuss advantages and disadvantages of computer-assisted design and manufacture in reconstruction of advanced oncologic mandible and midface defects. Virtual planning and rapid prototype modeling are increasingly used in head and neck reconstruction with the aim of achieving superior surgical outcomes in functionally and aesthetically critical areas of the head and neck compared with conventional reconstruction. The reconstructive surgeon must be able to understand this rapidly-advancing technology, along with its advantages and disadvantages. There is no limit to the degree to which patient-specific data may be integrated into the virtual planning process. For example, vascular mapping can be incorporated into virtual planning of mandible or midface reconstruction. Representative mandible and midface cases are presented to illustrate the process of virtual planning. Although virtual planning has become helpful in head and neck reconstruction, its routine use may be limited by logistic challenges, increased acquisition costs, and limited flexibility for intraoperative modifications. Nevertheless, the authors believe that the superior functional and aesthetic results realized with virtual planning outweigh the limitations.

Principles of plastic surgery portrayed by the professional life of Dr John Peter Mettauer.

PubMed

Avashia, Yash J; Thaller, Seth R

2011-11-01

Regarded as "America's first plastic surgeon," Dr John Peter Mettauer's professional life displays 3 fundamental keystones of plastic surgery: education, innovation, and practice. To fully appreciate the history of our plastic surgery, one must look beyond a purely factual recount of noteworthy actions performed decades ago. Fundamental principles that governed achievements of our predecessors remain applicable even today. Dr Mettauer thrived as a medical student under the influence of distinguished professors in medicine at the University of Pennsylvania. Later, he continued to propagate their basic tenets when he established his medical institute in 1837. Throughout his life, Dr Mettauer combined ingenuity with scientific inquiry to devise numerous unprecedented surgical techniques and instruments. He was a prolific writer and exquisitely documented his work in medical journals for the benefit of both contemporary and future surgeons. One of Dr Mettauer's momentous achievements in plastic surgery that displays his remarkable capabilities was his contributions to management of both simple and complicated cases of cleft palate. He was the first to describe relaxing lateral incisions for treating complete cleft palates and, incidentally, was the first to successfully treat this in America. He invariably replicated similar success in establishing techniques for treating a wide range of anatomic deformities. Cumulatively, Dr Mettauer's lifelong commitment and diligence have truly laid a foundation for the eventual progress and success in the field of plastic surgery.

Thresholds of Principle and Preference: Exploring Procedural Variation in Postgraduate Surgical Education

PubMed Central

Apramian, Tavis; Cristancho, Sayra; Watling, Chris; Ott, Michael; Lingard, Lorelei

2017-01-01

Background Expert physicians develop their own ways of doing things. The influence of such practice variation in clinical learning is insufficiently understood. Our grounded theory study explored how residents make sense of, and behave in relation to, the procedural variations of faculty surgeons. Method We sampled senior postgraduate surgical residents to construct a theoretical framework for how residents make sense of procedural variations. Using a constructivist grounded theory approach, we used marginal participant observation in the operating room across 56 surgical cases (146 hours), field interviews (38), and formal interviews (6) to develop a theoretical framework for residents’ ways of dealing with procedural variations. Data analysis used constant comparison to iteratively refine the framework and data collection until theoretical saturation was reached. Results The core category of the constructed theory was called thresholds of principle and preference and it captured how faculty members position some procedural variations as negotiable and others not. The term thresholding was coined to describe residents’ daily experiences of spotting, mapping, and negotiating their faculty members’ thresholds and defending their own emerging thresholds. Conclusions Thresholds of principle and preference play a key role in workplace-based medical education. Postgraduate medical learners are occupied on a day-to-day level with thresholding and attempting to make sense of the procedural variations of faculty. Workplace-based teaching and assessment should include an understanding of the integral role of thresholding in shaping learners’ development. Future research should explore the nature and impact of thresholding in workplace-based learning beyond the surgical context. PMID:26505105

Basic physics of ultrasound imaging.

PubMed

Aldrich, John E

2007-05-01

The appearance of ultrasound images depends critically on the physical interactions of sound with the tissues in the body. The basic principles of ultrasound imaging and the physical reasons for many common artifacts are described.

Label Review Training: Module 1: Label Basics, Page 20

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. This section focuses on supplemental labeling.

Label Review Training: Module 1: Label Basics, Page 22

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Learn about what labels require review.

Label Review Training: Module 1: Label Basics, Page 18

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. This section discusses the types of labels.

Label Review Training: Module 1: Label Basics, Page 26

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Learn about mandatory and advisory label statements.

Label Review Training: Module 1: Label Basics, Page 19

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. This section covers supplemental distributor labeling.

Label Review Training: Module 1: Label Basics, Page 15

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Learn about the consequences of improper labeling.

Label Review Training: Module 1: Label Basics, Page 14

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Learn about positive effects from proper labeling.

Basic Concepts and Principles of Marketing.

ERIC Educational Resources Information Center

Beder, Hal

1986-01-01

Presents an overview of marketing concepts and principles. These include (1) organizational objectives, (2) exchange, (3) value, (4) market segmentation, (5) market position, (6) consumer analysis, (7) product, (8) promotion, (9) place, and (10) price. (CH)

ENVIRONMENTAL HYDRAULICS

EPA Science Inventory

The thermal, chemical, and biological quality of water in rivers, lakes, reservoirs, and near coastal areas is inseparable from a consideration of hydraulic engineering principles: therefore, the term environmental hydraulics. In this chapter we discuss the basic principles of w...

Video and accelerometer-based motion analysis for automated surgical skills assessment.

PubMed

Zia, Aneeq; Sharma, Yachna; Bettadapura, Vinay; Sarin, Eric L; Essa, Irfan

2018-03-01

Basic surgical skills of suturing and knot tying are an essential part of medical training. Having an automated system for surgical skills assessment could help save experts time and improve training efficiency. There have been some recent attempts at automated surgical skills assessment using either video analysis or acceleration data. In this paper, we present a novel approach for automated assessment of OSATS-like surgical skills and provide an analysis of different features on multi-modal data (video and accelerometer data). We conduct a large study for basic surgical skill assessment on a dataset that contained video and accelerometer data for suturing and knot-tying tasks. We introduce "entropy-based" features-approximate entropy and cross-approximate entropy, which quantify the amount of predictability and regularity of fluctuations in time series data. The proposed features are compared to existing methods of Sequential Motion Texture, Discrete Cosine Transform and Discrete Fourier Transform, for surgical skills assessment. We report average performance of different features across all applicable OSATS-like criteria for suturing and knot-tying tasks. Our analysis shows that the proposed entropy-based features outperform previous state-of-the-art methods using video data, achieving average classification accuracies of 95.1 and 92.2% for suturing and knot tying, respectively. For accelerometer data, our method performs better for suturing achieving 86.8% average accuracy. We also show that fusion of video and acceleration features can improve overall performance for skill assessment. Automated surgical skills assessment can be achieved with high accuracy using the proposed entropy features. Such a system can significantly improve the efficiency of surgical training in medical schools and teaching hospitals.

Functional and Therapeutic Indications of Liposuction: Personal Experience and Review of the Literature.

PubMed

Atiyeh, Bishara; Costagliola, Michel; Illouz, Yves-Gerard; Dibo, Saad; Zgheib, Elias; Rampillon, Florence

2015-08-01

Liposuction is the most common cosmetic surgical procedure worldwide. It has evolved from being designed primarily for body contouring to becoming essential adjunct to various other aesthetic procedures, greatly enhancing their outcome. Despite its hard clear differentiation between an aesthetic and therapeutic indication for some pathologic conditions, liposuction has been increasingly applied to a gamut of disorders as a therapeutic tool or to improve function. In fact, liposuction has ceased to define a specific procedure and became synonymous to a surgical technique or tool same as the surgical knife, laser, electrocautery, suture material, or even wound-dressing products. At present, there seems to be an enormous potential for the application of the basic liposuction technique in ablative and reconstructive surgery outside the realm of purely aesthetic procedures. The present review contemplates the various nonaesthetic applications of liposuction, displaying the enormous potentials of what should be considered a basic surgical technique rather than a specific aesthetic procedure. Implications of this new definition of liposuction should induce third-party public payers and insurance companies to reconsider their remuneration and reimbursement policies.

[Excision and immediate suture technic in the treatment of pilonidal fistula. Our experience].

PubMed

Calcina, G; Setti, P; Benati, L; Savioli, A; Galli, G

1995-09-01

The authors report their personal experience of the "excision and primary suture" operating technique in the surgical treatment of pilonidal sinus. A rapid recovery by postoperative day 10 was achieved in 58 out of 60 cases treated (96.7%). Dehiscence of the surgical wound was observed in 2 cases (3.3%) following ischemic lesion caused by decubitus of the cutaneous margins and healing occurred by second intenti. No cases of short- or long-term recidivation were observed. The advantages of this method are the early return to working activities, minor patient discomfort and the reduced risk that the surgical would might become infected. Three basic stages for the successful outcome of this type of surgery have been identified as follows: 1) Although and accurate tricotomy of the sacro-coccigeal region. Antibiotic therapy is started about 2 hours before surgery. 2) The precise execution of the surgical technique. 3) The continuation of antibiotic therapy until postoperative day 7. Compressive medication is removed on postoperative day 4. If these three basic stages are respected, no cases of recidivation will occur.

Technical innovations that may facilitate real-time telementoring of damage control surgery in austere environments: a proof of concept comparative evaluation of the importance of surgical experience, telepresence, gravity and mentoring in the conduct of damage control laparotomies.

PubMed

Kirkpatrick, Andrew W; LaPorta, Anthony; Brien, Susan; Leslie, Tim; Glassberg, Elon; McKee, Jessica; Ball, Chad G; Wright Beatty, Heather E; Keillor, Jocelyn; Roberts, Derek J; Tien, Homer

2015-06-01

Bleeding to death is the most preventable cause of posttraumatic death worldwide. Despite the fact that many of these deaths are anatomically salvageable with relatively basic surgical interventions, they remain lethal in actuality in prehospital environments when no facilities and skills exist to contemplate undertaking basic damage control surgery (DCS). With better attention to prehospital control of extremity hemorrhage, intracavitary bleeding (especially intraperitoneal) remains beyond the scope of prehospital providers. However, recent revolutions in the informatics and techniques of telementoring (TMT), DCS and highly realistic accelerated training of motivated first responders suggests that basic lifesaving DCS may have applicability to save bleeding patients in austere environments previously considered unsalvageable. Especially with informatic advances, any provider with Internet connectivity can potentially be supported by highly proficient specialists with content expertise in the index problem. This unprecedented TMT support may allow highly motivated but inexperienced personnel to provide advanced surgical interventions in extreme environments in many austere locations both on and above the planet.

Basic science faculty in surgical departments: advantages, disadvantages and opportunities.

PubMed

Chinoy, Mala R; Moskowitz, Jay; Wilmore, Douglas W; Souba, Wiley W

2005-01-01

The number of Ph.D. faculty in clinical departments now exceeds the number of Ph.D. faculty in basic science departments. Given the escalating pressures on academic surgeons to produce in the clinical arena, the recruitment and retention of high-quality Ph.D.s will become critical to the success of an academic surgical department. This success will be as dependent on the surgical faculty understanding the importance of the partnership as the success of the Ph.D. investigator. Tighter alignment among the various clinical and research programs and between surgeons and basic scientists will facilitate the generation of new knowledge that can be translated into useful products and services (thus improving care). To capitalize on what Ph.D.s bring to the table, surgery departments may need to establish a more formal research infrastructure that encourages the ongoing exchange of ideas and resources. Physically removing barriers between the research groups, encouraging the open exchange of techniques and observations and sharing core laboratories is characteristic of successful research teams. These strategies can meaningfully contribute to developing successful training program grants, program projects and bringing greater research recognition to the department of surgery.

Application of basic principles of physics to head and neck MR angiography: troubleshooting for artifacts.

PubMed

Pandey, Shilpa; Hakky, Michael; Kwak, Ellie; Jara, Hernan; Geyer, Carl A; Erbay, Sami H

2013-05-01

Neurovascular imaging studies are routinely used for the assessment of headaches and changes in mental status, stroke workup, and evaluation of the arteriovenous structures of the head and neck. These imaging studies are being performed with greater frequency as the aging population continues to increase. Magnetic resonance (MR) angiographic imaging techniques are helpful in this setting. However, mastering these techniques requires an in-depth understanding of the basic principles of physics, complex flow patterns, and the correlation of MR angiographic findings with conventional MR imaging findings. More than one imaging technique may be used to solve difficult cases, with each technique contributing unique information. Unfortunately, incorporating findings obtained with multiple imaging modalities may add to the diagnostic challenge. To ensure diagnostic accuracy, it is essential that the radiologist carefully evaluate the details provided by these modalities in light of basic physics principles, the fundamentals of various imaging techniques, and common neurovascular imaging pitfalls. ©RSNA, 2013.

[Injury of subclavian artery in severe trauma of the shoulder girdle and chest].

PubMed

Samokhvalov, I M; Reva, V A; Pronchenko, A A; Petrov, A N

2013-01-01

The authors consider one of possible variants of surgical treatment of shoulder girdle trauma, which is accompanied by an injury of the main artery. It is based on the application of the principle of staged surgical treatment (damage control orthopedic). The well-timed sufficient diagnostics and treatment of bone-arterial trauma, coordinated work of several surgical teams, the appropriate postoperative management of patients with the using of postponed high-technology intervention allowed obtaining an optimal functional result for extremely severe multitrauma of the chest and limb.

Overview of Frontal Sinus Pathology and Management.

PubMed

Vázquez, Alejandro; Baredes, Soly; Setzen, Michael; Eloy, Jean Anderson

2016-08-01

The frontal sinus is the most complex of all paranasal sinuses. Given its proximity to the cranial vault and orbit, frontal sinus pathology can progress to involve these structures and lead to significant morbidity, or even mortality. Surgical management of the frontal sinus is technically challenging. Various open and endoscopic surgical techniques are available to the otolaryngologist. This article presents an overview of the major disease entities that affect the frontal sinus, with a special emphasis on treatment principles and surgical management. Copyright © 2016 Elsevier Inc. All rights reserved.

[Deployment surgery from the viewpoint of the German Red Cross].

PubMed

Grabarek, V

1997-01-01

The German military coinages "deployment medicine" and "deployment surgery" are unusual within the Red Cross Germany (DRK). For its (surgical) deployments, the DRK complies exclusively with the principles of the International Red Cross and Red Crescent Movement. The mobile surgical unit of the DRK's rapid module system is an intentionally "low-tech" medical/surgical unit that also does without any dispensable medical conveniences. For its purposes and objectives it is optimally equipped, and enables the DRK to provide prompt and flexible regionally adjusted relief that is compatible with the Red Cross worldwide.

Small fragment wounds: biophysics, pathophysiology and principles of management.

PubMed

Hill, P F; Edwards, D P; Bowyer, G W

2001-02-01

Military surgical doctrine has traditionally taught that all ballistic wounds should be formally managed by surgical intervention. There is now, however, both experimental and clinical evidence supporting the nonoperative treatment of selected small fragment wounds. Low energy-transfer wounds affecting the soft tissues, without neuro-vascular compromise and with stable fracture patterns, may be suitable for early antibiotic treatment. The management of ballistic wounds to the gastrointestinal tract requires surgical intervention but, advances in the treatment of these wounds, especially those involving the colon, may allow more effective treatment with a reduced morbidity.

The rationale for the introduction of implant dentistry into the dental curriculum.

PubMed

Lang, N P; De Bruyn, H

2009-02-01

This paper provides arguments for the introduction of implant dentistry into the undergraduate curriculum. The survival of teeth is very high when disease is diagnosed and treated properly and maintenance is taken care of. Nevertheless, tooth replacements by fixed and removable prostheses are highly prevalent. It is expected that dentists will face a dramatically increased need to care for elderly patients and partially edentulous patients. Hence, the demand for implant reconstructions will be substantial and more appropriately trained and competent health professionals will be needed. Increasing demands of the patient regarding aesthetics and function will influence the demands for implant therapy. The improvement of oral function and subjective chewing comfort, the preservation of tooth structures or existing reconstructions and the replacement of missing, strategically important teeth are major indications for implant placement. From both a biological and an economical point of view, the single tooth replacement with an implant is the first choice in situations with no or minimally restored neighbouring teeth compared with conventional bridgework. Stability of full dentures represent a major problem especially for the mandible. It is well documented that placement of two implants supporting an overdenture substantially improve chewing capacity, increase quality of life and is a simple and cost-effective treatment thus rendering such treatment a 'standard of care' procedure. There is no doubt that dental students should learn to incorporate the indication of oral implants in their overall treatment planning. Therefore, they will have to understand the basic aspects of healing and tissue integration, basic biomechanical and material science principles as well as surgical and prosthetic techniques. They will have to be able to monitor continuously the peri-implant tissues, render appropriate supportive therapy and cope with biological and technical complications. While it is evident that the surgical procedure per se may require additional competence, the remainder of the aspects mentioned should be taught in the dental curriculum. This should include the attribution of responsibility for maintenance of implants and handling of biological and technical complications. Moreover, it is desirable to include the surgical technique for implant placement for 'straightforward' cases into the dental curriculum. The levels and limitations to which the various aspects of implant dentistry and related skills are to be taught are determined by the academic community. Obviously, ethical and legal aspects of implant dentistry should not be forgotten.

Label Review Training: Module 1: Label Basics, Page 24

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. This page is about which labels require review.

Label Review Training: Module 1: Label Basics, Page 17

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. See an overview of the importance of labels.

Label Review Training: Module 1: Label Basics, Page 25

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review: clarity, accuracy, consistency with EPA policy, and enforceability.

Label Review Training: Module 1: Label Basics, Page 29

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. This page is a quiz on Module 1.

Label Review Training: Module 1: Label Basics, Page 27

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. See examples of mandatory and advisory label statements.

Label Review Training: Module 1: Label Basics, Page 23

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Lists types of labels that do not require review.

BACTEROLOGICAL EXAMINATION OF WATER

EPA Science Inventory

This presentation will focus on basic elements of water bacteriology. The presentation will be part of a seminar entitled, "Microbiology 101." This seminar is designed to provide general information regarding various microorganisms, e.g., bacteria, virus, protozoa. Basic principl...

Integrating Computer Spreadsheet Modeling into a Microeconomics Curriculum: Principles to Managerial.

ERIC Educational Resources Information Center

Clark, Joy L.; Hegji, Charles E.

1997-01-01

Notes that using spreadsheets to teach microeconomics principles enables learning by doing in the exploration of basic concepts. Introduction of increasingly complex topics leads to exploration of theory and managerial decision making. (SK)

The Cyclical Relationship Approach in Teaching Basic Accounting Principles.

ERIC Educational Resources Information Center

Golen, Steven

1981-01-01

Shows how teachers can provide a more meaningful presentation of various accounting principles by illustrating them through a cyclical relationship approach. Thus, the students see the entire accounting relationship as a result of doing business. (CT)

AUTOMOTIVE DIESEL MAINTENANCE 2. UNIT III, AUTOMATIC TRANSMISSIONS--HYDRAULICS (PART I).

ERIC Educational Resources Information Center

Human Engineering Inst., Cleveland, OH.

THIS MODULE OF A 25-MODULE COURSE IS DESIGNED TO INTRODUCE BASIC HYDRAULIC PRINCIPLES AND PROVIDE AN UNDERSTANDING OF HYDRAULIC TRANSMISSIONS USED IN DIESEL POWERED VEHICLES. TOPICS ARE WHY USE HYDRAULICS, REVIEWING BASIC PHYSICS LAWS IN RELATION TO HYDRAULICS, UNDERSTANDING THE HYDRAULIC SYSTEM, AND DEVELOPING A BASIC HYDRAULIC SYSTEM. THE MODULE…

32 CFR Appendix A to Part 272 - Principles for the Conduct and Support of Basic Research

Code of Federal Regulations, 2011 CFR

2011-07-01

... those agencies' investments as appropriate. 5. Merit review is used to select basic research projects... Research A Appendix A to Part 272 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMINISTRATION AND SUPPORT OF BASIC RESEARCH BY THE...

Research-Based Reading Instruction in an Adult Basic Education Program

ERIC Educational Resources Information Center

Perin, Dolores; Greenberg, Daphne

2007-01-01

There is a growing emphasis in adult basic education on research-based reading instruction. Using Kruidenier's (2002) framework of principles and trends, we describe research-based techniques found during a visit to an adult basic education program. We also describe how the program moved to research-based instruction, and the factors that seem…

High frequency x-ray generator basics.

PubMed

Sobol, Wlad T

2002-02-01

The purpose of this paper is to present basic functional principles of high frequency x-ray generators. The emphasis is put on physical concepts that determine the engineering solutions to the problem of efficient generation and control of high voltage power required to drive the x-ray tube. The physics of magnetically coupled circuits is discussed first, as a background for the discussion of engineering issues related to high-frequency power transformer design. Attention is paid to physical processes that influence such factors as size, efficiency, and reliability of a high voltage power transformer. The basic electrical circuit of a high frequency generator is analyzed next, with focus on functional principles. This section investigates the role and function of basic components, such as power supply, inverter, and voltage doubler. Essential electronic circuits of generator control are then examined, including regulation of voltage, current and timing of electrical power delivery to the x-ray tube. Finally, issues related to efficient feedback control, including basic design of the AEC circuitry are reviewed.

Focused Ultrasound Surgery in Oncology: Overview and Principles

PubMed Central

McDannold, Nathan J.; Hynynen, Kullervo; Jolesz, Ferenc A.

2011-01-01

Focused ultrasound surgery (FUS) is a noninvasive image-guided therapy and an alternative to surgical interventions. It presents an opportunity to revolutionize cancer therapy and to affect or change drug delivery of therapeutic agents in new focally targeted ways. In this article the background, principles, technical devices, and clinical cancer applications of image-guided FUS are reviewed. © RSNA, 2011 PMID:21436096

Combating Obesity in the Beginning: Incorporating Wellness and Exercise Principles in Teacher Education Programs

ERIC Educational Resources Information Center

Cavallini, M. Felicia; Wendt, Janice C.; Rice, Desmond

2007-01-01

Schools have the potential to foster healthy behaviors among youths through sound health and physical education programs. Teacher candidates who are being certified through teacher preparation programs should take a course on basic wellness and exercise principles, in order to prepare themselves to teach those principles to all school faculty…

The Impact of Authentic Leadership on Ethical Behavior

DTIC Science & Technology

2016-05-25

56 APPENDIX C - INFORMED CONSENT AND SURVEY INSTRUMENT ...................57 APPENDIX D - DOD PRINCIPLES OF...BEHAVIOR 1 UNCLASSIFIED Chapter 1 Introduction The U.S. Army has been a principled organization since its inception...George H. W. Bush signed Executive Order 12674 on April 12, 1989. This set out 14 basic principles of ethical conduct that Department of Defense

An Analysis of Statements of the Multiplication Principle in Combinatorics, Discrete, and Finite Mathematics Textbooks

ERIC Educational Resources Information Center

Lockwood, Elise; Reed, Zackery; Caughman, John S.

2017-01-01

The multiplication principle serves as a cornerstone in enumerative combinatorics. The principle underpins many basic counting formulas and provides students with a critical element of combinatorial justification. Given its importance, the way in which it is presented in textbooks is surprisingly varied. In this paper, we analyze a number of…

Unerupted lower third molar extractions and their risks for mandibular fracture.

PubMed

Corrêa, Ana Paula Simões; Faverani, Leonardo Perez; Ramalho-Ferreira, Gabriel; Ferreira, Sabrina; Ávila Souza, Francisley; de Oliveira Puttini, Igor; Rangel Garcia-Júnior, Idelmo

2014-05-01

As every surgical procedure extraction of third molars can result in several complications, among them the mandibular angle fracture. Predisposing factors for fracture should be analyzed during and after the surgery. This paper aims to discuss the predisposing factors to the occurrence of mandibular angle fractures during and after the procedure for third molars extraction, as well as surgical principles to avoid this complication.

Surgical Outreach for Children by International Humanitarian Organizations: A Review.

PubMed

Kynes, J Matthew; Zeigler, Laura; McQueen, Kelly

2017-06-28

Low- and middle-income countries carry a disproportionate share of the global burden of pediatric surgical disease and have limited local healthcare infrastructure and human resources to address this burden. Humanitarian efforts that have improved or provided access to necessary basic or emergency surgery for children in these settings have included humanitarian assistance and disaster relief, short-term surgical missions, and long-term projects such as building pediatric specialty hospitals and provider networks. Each of these efforts may also include educational initiatives designed to increase local capacity. This article will provide an overview of pediatric humanitarian surgical outreach including reference to available evidence-based analyses of these platforms and make recommendations for surgical outreach initiatives for children.

Positron Emission Tomography: Principles, Technology, and Recent Developments

NASA Astrophysics Data System (ADS)

Ziegler, Sibylle I.

2005-04-01

Positron emission tomography (PET) is a nuclear medical imaging technique for quantitative measurement of physiologic parameters in vivo (an overview of principles and applications can be found in [P.E. Valk, et al., eds. Positron Emission Tomography. Basic Science and Clinical Practice. 2003, Springer: Heidelberg]), based on the detection of small amounts of posi-tron-emitter-labelled biologic molecules. Various radiotracers are available for neuro-logical, cardiological, and oncological applications in the clinic and in research proto-cols. This overview describes the basic principles, technology, and recent develop-ments in PET, followed by a section on the development of a tomograph with ava-lanche photodiodes dedicated for small animal imaging as an example of efforts in the domain of high resolution tomographs.

Retrocausal Effects As A Consequence of Orthodox Quantum Mechanics Refined To Accommodate The Principle Of Sufficient Reason

NASA Astrophysics Data System (ADS)

Stapp, Henry P.

2011-11-01

The principle of sufficient reason asserts that anything that happens does so for a reason: no definite state of affairs can come into being unless there is a sufficient reason why that particular thing should happen. This principle is usually attributed to Leibniz, although the first recorded Western philosopher to use it was Anaximander of Miletus. The demand that nature be rational, in the sense that it be compatible with the principle of sufficient reason, conflicts with a basic feature of contemporary orthodox physical theory, namely the notion that nature's response to the probing action of an observer is determined by pure chance, and hence on the basis of absolutely no reason at all. This appeal to pure chance can be deemed to have no rational fundamental place in reason-based Western science. It is argued here, on the basis of the other basic principles of quantum physics, that in a world that conforms to the principle of sufficient reason, the usual quantum statistical rules will naturally emerge at the pragmatic level, in cases where the reason behind nature's choice of response is unknown, but that the usual statistics can become biased in an empirically manifest way when the reason for the choice is empirically identifiable. It is shown here that if the statistical laws of quantum mechanics were to be biased in this way then the basically forward-in-time unfolding of empirical reality described by orthodox quantum mechanics would generate the appearances of backward-time-effects of the kind that have been reported in the scientific literature.

Extended score interval in the assessment of basic surgical skills.

PubMed

Acosta, Stefan; Sevonius, Dan; Beckman, Anders

2015-01-01

The Basic Surgical Skills course uses an assessment score interval of 0-3. An extended score interval, 1-6, was proposed by the Swedish steering committee of the course. The aim of this study was to analyze the trainee scores in the current 0-3 scored version compared to a proposed 1-6 scored version. Sixteen participants, seven females and nine males, were evaluated in the current and proposed assessment forms by instructors, observers, and learners themselves during the first and second day. In each assessment form, 17 tasks were assessed. The inter-rater reliability between the current and the proposed score sheets were evaluated with intraclass correlation (ICC) with 95% confidence intervals (CI). The distribution of scores for 'knot tying' at the last time point and 'bowel anastomosis side to side' given by the instructors in the current assessment form showed that the highest score was given in 31 and 62%, respectively. No ceiling effects were found in the proposed assessment form. The overall ICC between the current and proposed score sheets after assessment by the instructors increased from 0.38 (95% CI 0.77-0.78) on Day 1 to 0.83 (95% CI 0.51-0.94) on Day 2. A clear ceiling effect of scores was demonstrated in the current assessment form, questioning its validity. The proposed score sheet provides more accurate scores and seems to be a better feedback instrument for learning technical surgical skills in the Basic Surgical Skills course.

Extended score interval in the assessment of basic surgical skills.

PubMed

Acosta, Stefan; Sevonius, Dan; Beckman, Anders

2015-01-01

Introduction The Basic Surgical Skills course uses an assessment score interval of 0-3. An extended score interval, 1-6, was proposed by the Swedish steering committee of the course. The aim of this study was to analyze the trainee scores in the current 0-3 scored version compared to a proposed 1-6 scored version. Methods Sixteen participants, seven females and nine males, were evaluated in the current and proposed assessment forms by instructors, observers, and learners themselves during the first and second day. In each assessment form, 17 tasks were assessed. The inter-rater reliability between the current and the proposed score sheets were evaluated with intraclass correlation (ICC) with 95% confidence intervals (CI). Results The distribution of scores for 'knot tying' at the last time point and 'bowel anastomosis side to side' given by the instructors in the current assessment form showed that the highest score was given in 31 and 62%, respectively. No ceiling effects were found in the proposed assessment form. The overall ICC between the current and proposed score sheets after assessment by the instructors increased from 0.38 (95% CI 0.77-0.78) on Day 1 to 0.83 (95% CI 0.51-0.94) on Day 2. Discussion A clear ceiling effect of scores was demonstrated in the current assessment form, questioning its validity. The proposed score sheet provides more accurate scores and seems to be a better feedback instrument for learning technical surgical skills in the Basic Surgical Skills course.

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea

PubMed Central

Martin, Janet; Tau, Goa; Cherian, Meena Nathan; Vergel de Dios, Jennifer; Mills, David; Fitzpatrick, Jane; Adu-Krow, William; Cheng, Davy

2015-01-01

Objective To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG. Design Cross-sectional survey. Setting Hospitals and health facilities in PNG. Participants 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. Outcome measures The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment. Results While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services. Conclusions Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. PMID:26674504

A Model to Measure Bombardier/Navigator Performance during Radar Navigation in Device 2F114, A-6E Weapon System Trainer.

DTIC Science & Technology

1981-03-01

systems, sub- systems, equipment, weapons, tactics, missions, etc. Concepts and Principles - Fundamental truths, ideas, opinions and thoughts formed from...verification, etc. Grasping the meaning of concepts and principles , i.e., understanding the basic principles of infrared and radar detection. Understanding...concepts, principles , procedures, etc.). Analysis A demonstration of a learned process of breaking down material (i.e., data, other information) into

Data Banks; Bibliography.

ERIC Educational Resources Information Center

van der Aa, H. J., Comp.; And Others

This 249 item, mostly annotated bibliography cites literature on the general themes of basic principles, hardware, software and application studies of data bases. The broad categories are principles, development possibilities, organizational design, bibliographies, economic aspects, data structure-design, file organization, programing, aviation,…

Label Review Training: Module 1: Label Basics, Page 16

EPA Pesticide Factsheets

This module of the pesticide label review training provides basic information about pesticides, their labeling and regulation, and the core principles of pesticide label review. Learn about the importance of labels and the role in enforcement.

Reviews, Software.

ERIC Educational Resources Information Center

Science Teacher, 1988

1988-01-01

Reviews two software programs for Apple series computers. Includes "Orbital Mech," a basic planetary orbital simulation for the Macintosh, and "START: Stimulus and Response Tools for Experiments in Memory, Learning, Cognition, and Perception," a program that demonstrates basic psychological principles and experiments. (CW)

Arthropod surveillance programs: Basic components, strategies, and analysis

USDA-ARS?s Scientific Manuscript database

Effective entomological surveillance planning stresses a careful consideration of methodology, trapping technologies, and analysis techniques. Herein, the basic principles and technological components of arthropod surveillance plans are described, as promoted in the symposium “Advancements in arthro...

Design principles of a microtubule polymerase

PubMed Central

Geyer, Elisabeth A; Miller, Matthew P; Brautigam, Chad A; Biggins, Sue

2018-01-01

Stu2/XMAP215 microtubule polymerases use multiple tubulin-binding TOG domains and a lattice-binding basic region to processively promote faster elongation. How the domain composition and organization of these proteins dictate polymerase activity, end localization, and processivity is unknown. We show that polymerase activity does not require different kinds of TOGs, nor are there strict requirements for how the TOGs are linked. We identify an unexpected antagonism between the tubulin-binding TOGs and the lattice-binding basic region: lattice binding by the basic region is weak when at least two TOGs engage tubulins, strong when TOGs are empty. End-localization of Stu2 requires unpolymerized tubulin, at least two TOGs, and polymerase competence. We propose a ‘ratcheting’ model for processivity: transfer of tubulin from TOGs to the lattice activates the basic region, retaining the polymerase at the end for subsequent rounds of tubulin binding and incorporation. These results clarify design principles of the polymerase. PMID:29897335

Innovation in pediatric surgical education.

PubMed

Clifton, Matthew S; Wulkan, Mark L

2015-06-01

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. Copyright © 2015 Elsevier Inc. All rights reserved.

[Teaching surgery at the UNAM and some educational concepts.

PubMed

Graue-Wiechers, Enrique

2011-01-01

Nowadays surgery cannot be conceived as independent from medicine; consequently, surgical education cannot be far from the main principles of medical education. This review underlines the characteristics of medical training in the field of surgery. General physicians should be trained to perform surgical procedures under particular situations. A new lesson plan was implemented at the Facultad de Medicina in Mexico City (UNAM), comprised of eight fundamental surgical skills. A well-structured surgical program implies clear and exact definitions of the skills to be acquired during training as well as an appropriate follow-up, knowledge reinforcement, continuing educational skills, application of medical tests for patient care and evaluation of the learning process.

Postliver transplantation vascular and biliary surgical anatomy.

PubMed

Saad, Wael E A; Orloff, Mark C; Davies, Mark G; Waldman, David L; Bozorgzadeh, Adel

2007-09-01

Imaging and management of postliver transplantation complications require an understanding of the surgical anatomy of liver transplantation. There are several methods of liver transplantation. Furthermore, liver transplantation is a complex surgery with numerous variables in its 4 anastomoses: (1) arterial anastomosis, (2) venous inflow (portal venous) anastomosis, (3) venous outflow (hepatic vein, inferior vena cava, or both) anastomosis, and (4) biliary/biliary-enteric anastomosis. The aim of this chapter is to introduce the principles of liver transplant surgical anatomy based on anastomotic anatomy. With radiologists as the target readers, the chapter focuses on the inflow and outflow connections and does not detail intricate surgical techniques or intraoperative maneuvers, operative stages, or vascular shunting.

Exposures of the elbow.

PubMed

Axelrod, Terry S

2014-11-01

This article describes the basic bony, ligamentous, and neurologic anatomy of the structures about the elbow. The surgical exposures of the elbow joint are described, providing details of the various posterior, lateral, and medial approaches to the articular segments. Clinical applications describing the potential benefits of each surgical exposure are provided as examples. Copyright © 2014 Elsevier Inc. All rights reserved.

Emergency, anaesthetic and essential surgical capacity in the Gambia

PubMed Central

Shivute, Nestor; Bickler, Stephen; Cole-Ceesay, Ramou; Jargo, Bakary; Abdullah, Fizan; Cherian, Meena

2011-01-01

Abstract Objective To assess the resources for essential and emergency surgical care in the Gambia. Methods The World Health Organization’s Tool for Situation Analysis to Assess Emergency and Essential Surgical Care was distributed to health-care managers in facilities throughout the country. The survey was completed by 65 health facilities – one tertiary referral hospital, 7 district/general hospitals, 46 health centres and 11 private health facilities – and included 110 questions divided into four sections: (i) infrastructure, type of facility, population served and material resources; (ii) human resources; (iii) management of emergency and other surgical interventions; (iv) emergency equipment and supplies for resuscitation. Questionnaire data were complemented by interviews with health facility staff, Ministry of Health officials and representatives of nongovernmental organizations. Findings Important deficits were identified in infrastructure, human resources, availability of essential supplies and ability to perform trauma, obstetric and general surgical procedures. Of the 18 facilities expected to perform surgical procedures, 50.0% had interruptions in water supply and 55.6% in electricity. Only 38.9% of facilities had a surgeon and only 16.7% had a physician anaesthetist. All facilities had limited ability to perform basic trauma and general surgical procedures. Of public facilities, 54.5% could not perform laparotomy and 58.3% could not repair a hernia. Only 25.0% of them could manage an open fracture and 41.7% could perform an emergency procedure for an obstructed airway. Conclusion The present survey of health-care facilities in the Gambia suggests that major gaps exist in the physical and human resources needed to carry out basic life-saving surgical interventions. PMID:21836755

An introduction to the basic principles of health economics for those involved in the development and delivery of headache care.

PubMed

Kernick, D

2005-09-01

Against a background of increasing demands on limited resources, health economics is gaining an increasing impact on decision making and a basic understanding of the subject is important for all those involved in headache research and service delivery at whatever level. This paper is not intended as a review of the literature in the area of headache economics but discusses some general principles of health economics from the perspective of headache, with a focus on cost of illness studies and economic evaluation.

Using principles from emergency management to improve emergency response plans for research animals.

PubMed

Vogelweid, Catherine M

2013-10-01

Animal research regulatory agencies have issued updated requirements for emergency response planning by regulated research institutions. A thorough emergency response plan is an essential component of an institution's animal care and use program, but developing an effective plan can be a daunting task. The author provides basic information drawn from the field of emergency management about best practices for developing emergency response plans. Planners should use the basic principles of emergency management to develop a common-sense approach to managing emergencies in their facilities.

Research on Basic Design Education: An International Survey

ERIC Educational Resources Information Center

Boucharenc, C. G.

2006-01-01

This paper reports on the results of a survey and qualitative analysis on the teaching of "Basic Design" in schools of design and architecture located in 22 countries. In the context of this research work, Basic Design means the teaching and learning of design fundamentals that may also be commonly referred to as the Principles of Two- and…

Epidemiology and Clinical Research Design, Part 2: Principles.

PubMed

Manja, Veena; Lakshminrusimha, Satyan

This is the third article covering core knowledge in scholarly activities for neonatal physicians. In this article, we discuss various principles of epidemiology and clinical research design. A basic knowledge of these principles is necessary for conducting clinical research and for proper interpretation of studies. This article reviews bias and confounding, causation, incidence and prevalence, decision analysis, cost-effectiveness, sensitivity analysis, and measurement.

Peatland and water in the northern Lake States.

Treesearch

Don H. Boelter; Elon S. Verry

1977-01-01

The North Central Forest Experiment Station expanded its watershed research program in 1960 to include basic peatland studies. This paper reviews and summarizes basic principles developed from these studies of peatland hydrology, organic soil characteristics, and streamflow chemistry.

Virtual reality based surgery simulation for endoscopic gynaecology.

PubMed

Székely, G; Bajka, M; Brechbühler, C; Dual, J; Enzler, R; Haller, U; Hug, J; Hutter, R; Ironmonger, N; Kauer, M; Meier, V; Niederer, P; Rhomberg, A; Schmid, P; Schweitzer, G; Thaler, M; Vuskovic, V; Tröster, G

1999-01-01

Virtual reality (VR) based surgical simulator systems offer very elegant possibilities to both enrich and enhance traditional education in endoscopic surgery. However, while a wide range of VR simulator systems have been proposed and realized in the past few years, most of these systems are far from able to provide a reasonably realistic surgical environment. We explore the basic approaches to the current limits of realism and ultimately seek to extend these based on our description and analysis of the most important components of a VR-based endoscopic simulator. The feasibility of the proposed techniques is demonstrated on a first modular prototype system implementing the basic algorithms for VR-training in gynaecologic laparoscopy.

Simulation-Based Cutaneous Surgical-Skill Training on a Chicken-Skin Bench Model in a Medical Undergraduate Program

PubMed Central

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

2013-01-01

Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described. PMID:23723471

Benchmarking, benchmarks, or best practices? Applying quality improvement principles to decrease surgical turnaround time.

PubMed

Mitchell, L

1996-01-01

The processes of benchmarking, benchmark data comparative analysis, and study of best practices are distinctly different. The study of best practices is explained with an example based on the Arthur Andersen & Co. 1992 "Study of Best Practices in Ambulatory Surgery". The results of a national best practices study in ambulatory surgery were used to provide our quality improvement team with the goal of improving the turnaround time between surgical cases. The team used a seven-step quality improvement problem-solving process to improve the surgical turnaround time. The national benchmark for turnaround times between surgical cases in 1992 was 13.5 minutes. The initial turnaround time at St. Joseph's Medical Center was 19.9 minutes. After the team implemented solutions, the time was reduced to an average of 16.3 minutes, an 18% improvement. Cost-benefit analysis showed a potential enhanced revenue of approximately $300,000, or a potential savings of $10,119. Applying quality improvement principles to benchmarking, benchmarks, or best practices can improve process performance. Understanding which form of benchmarking the institution wishes to embark on will help focus a team and use appropriate resources. Communicating with professional organizations that have experience in benchmarking will save time and money and help achieve the desired results.

Laboratory reptile surgery: principles and techniques.

PubMed

Alworth, Leanne C; Hernandez, Sonia M; Divers, Stephen J

2011-01-01

Reptiles used for research and instruction may require surgical procedures, including biopsy, coelomic device implantation, ovariectomy, orchidectomy, and esophogostomy tube placement, to accomplish research goals. Providing veterinary care for unanticipated clinical problems may require surgical techniques such as amputation, bone or shell fracture repair, and coeliotomy. Although many principles of surgery are common between mammals and reptiles, important differences in anatomy and physiology exist. Veterinarians who provide care for these species should be aware of these differences. Most reptiles undergoing surgery are small and require specific instrumentation and positioning. In addition, because of the wide variety of unique physiologic and anatomic characteristics among snakes, chelonians, and lizards, different techniques may be necessary for different reptiles. This overview describes many common reptile surgery techniques and their application for research purposes or to provide medical care to research subjects.

The Pareto Analysis for Establishing Content Criteria in Surgical Training.

PubMed

Kramp, Kelvin H; van Det, Marc J; Veeger, Nic J G M; Pierie, Jean-Pierre E N

2016-01-01

Current surgical training is still highly dependent on expensive operating room (OR) experience. Although there have been many attempts to transfer more training to the skills laboratory, little research is focused on which technical behaviors can lead to the highest profit when they are trained outside the OR. The Pareto principle states that in any population that contributes to a common effect, a few account for the bulk of the effect. This principle has been widely used in business management to increase company profits. This study uses the Pareto principle for establishing content criteria for more efficient surgical training. A retrospective study was conducted to assess verbal guidance provided by 9 supervising surgeons to 12 trainees performing 64 laparoscopic cholecystectomies in the OR. The verbal corrections were documented, tallied, and clustered according to the aimed change in novice behavior. The corrections were rank ordered, and a cumulative distribution curve was used to calculate which corrections accounted for 80% of the total number of verbal corrections. In total, 253 different verbal corrections were uttered 1587 times and were categorized into 40 different clusters of aimed changes in novice behaviors. The 35 highest-ranking verbal corrections (14%) and the 11 highest-ranking clusters (28%) accounted for 80% of the total number of given verbal corrections. Following the Pareto principle, we were able to identify the aspects of trainee behavior that account for most corrections given by supervisors during a laparoscopic cholecystectomy on humans. This strategy can be used for the development of new training programs to prepare the trainee in advance for the challenges encountered in the clinical setting in an OR. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Principles of direct surgical procedures on the pancreas in surgical treatment of chronic pancreatitis].

PubMed

Kopchak, V M; Khomiak, I V; Cheverdiuk, D A; Kopchak, K V; Duvalko, A V; Serdiuk, V P

2012-01-01

An analysis of treatment of 584 patients with complicated forms of chronic pancreatitis operated during 2000-2100 years was carried out. Quality of life of postoperative patients was estimated according to a technique of calculations of modules EORTC QLQ-C30 and EORTC QLQ-PAN26. The indicators of quality of life have improved by 19.7% in performance of saving duodenal outflow of operations of pancreatic juice. Change of the surgical strategy has led to decreased number of postoperative complications by 4.6% and to satisfactory long-term results in 92.6% of the patients.

Pinhole Surgical Technique for treatment of marginal tissue recession: A case series.

PubMed

Reddy, Saravanan Sampoornam Pape

2017-01-01

The field of periodontal plastic surgery is always a subject of fascination for periodontists, and the importance of pink esthetics is gaining its pace. Preservation of what is existing is more important than its replacement. The same principle also applies to soft-tissue esthetic procedures thereby the concept of minimal surgical invasion came into existence. This article presents a series of five cases with 18 recession sites which were treated with a minimally invasive Pinhole Surgical Technique which resulted in overall root coverage of 96.7% after 6-month follow-up with minimal complications.

Business Management for Independent Schools. Third Edition.

ERIC Educational Resources Information Center

National Association of Independent Schools, Boston, MA.

This business management manual discusses school accounting and reporting principles; in particular, financial management, computerization, and records retention techniques. First is described the basic accounting principles, plant funds, endowment funds, operational funds, chart of accounts, and financial states of the school's annual financial…

Guidelines for the Evaluation of Bilingual Education Programs.

ERIC Educational Resources Information Center

Cardoza, Desdemona

Principles of program evaluation research are outlined so that bilingual education program coordinators can conduct methodologically acceptable program evaluations. The three basic principles of evaluation research are: identification of the program participants, definition of the program intervention, and assessment of program effectiveness.…

Using Case Studies in the Teaching of Physical Principles

ERIC Educational Resources Information Center

Lowe, Ian

1975-01-01

Proposes the use of problems of the everyday world to motivate students to master basic physical principles. Cites the example of conversion of solar energy by a photovoltaic cell as a source of topics in electricity and solid state physics. (CP)

An Analysis of Bid Evaluation Procedures of Contemporary Models for Procurement in Pakistan

DTIC Science & Technology

2016-12-01

21  E.  COMPONENTS FOR BID EVALUATION .........................................21  1.  Market Intelligence...PROCUREMENT SYSTEM ...............................................23  1.  Basic Principles ...43  1.  Principles of Procurement and Prequalification .......................43  2.  Contract Types

Basic Scientific Principles of Diving

ERIC Educational Resources Information Center

MacLean, Don

1976-01-01

Described are some of the physical and physiological scientific principles related to diving. The article is written as supplementary information for a teacher and includes suggested activities, a keyed test, and a bibliography. This article complements one on Sea Lab II in the same issue. (MA)

Clinical management of renal cell carcinoma with venous tumor thrombus.

PubMed

Agochukwu, Nnenaya; Shuch, Brian

2014-06-01

Venous invasion is common in advanced renal cell carcinoma (RCC) due to the unique biology of this cancer. The presence of a tumor thrombus often makes clinical management challenging. In this review, we detail specific preoperative, perioperative, and surgical strategies involving the care of the complex kidney cancer patient with venous tumor involvement. We performed a comprehensive review of selected peer-reviewed publications regarding RCC tumor thrombus biology, medical and surgical management techniques, and immediate and long-term outcomes. The perioperative management may require special imaging techniques, preoperative testing, very recent imaging, and consultation with other surgical services. There are various approaches to these patients as the clinical presentation, stage of disease, primary tumor size, level of thrombus, degree of venous occlusion, presence of bland thrombus, and primary tumor laterality influence management. Select patients with metastatic disease can do well with cytoreductive nephrectomy and thrombectomy. Those with localized disease have a high risk of recurrence; however, some patients can exhibit durable survival with surgery alone. The evolving surgical and medical treatments are discussed. Even when these surgeries are performed in high volume centers, significant perioperative complications are common and greater complications are seen with higher thrombus extent. If surgery is attempted, it is important for urologic oncologists to follow strict attention to specific surgical principles. These general principles include complete vascular control, avoidance of thrombus embolization, close hemodynamic monitoring, and institutional resources for caval resection/replacement and venous bypass if necessary.

[Management of penile cancer patients: new aspects of a rare tumour entity].

PubMed

Roiner, M; Maurer, O; Lebentrau, S; Gilfrich, C; Schäfer, C; Haberl, C; Brookman-May, S D; Burger, M; May, M; Hakenberg, O W

2018-06-01

Over the past few decades, some principles in the treatment of penile cancer have changed fundamentally. While 15 years ago a negative surgical margin of at least 2 cm was considered mandatory, organ-sparing surgery permitting minimal negative surgical margins has a high priority nowadays. The current treatment principle requires as much organ preservation as possible and as much radicality as necessary. The implementation of organ-sparing and reconstructive surgical techniques has improved the quality of life of surviving patients. However, oncological and functional outcomes are still unsatisfactory. Alongside with adequate local treatment of the primary tumour, a consistent management of inguinal lymph nodes is of fundamental prognostic significance. In particular, clinically inconspicuous inguinal lymph nodes staged T1b and upwards need a surgical approach. Sentinel node biopsy, minimally-invasive surgical techniques and modified inguinal lymphadenectomy have reduced morbidity compared to conventional inguinal lymph node dissection. Multimodal treatment with surgery and chemotherapy is required in all patients with lymph node-positive disease; neoadjuvant chemotherapy has been established for patients with locally advanced lymph node disease, and adjuvant treatment after radical inguinal lymphadenectomy for lymph node-positive disease. An increasing understanding of the underlying tumour biology, in particular the role of the human papilloma virus (HPV) and epidermal growth factor receptor (EGFR) status, has led to a new pathological classification and may further enhance treatment options. This review summarises current aspects in the therapeutic management of penile cancer. © Georg Thieme Verlag KG Stuttgart · New York.

20 CFR 901.12 - Eligibility for enrollment.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Basic actuarial knowledge. The applicant shall demonstrate knowledge of basic actuarial mathematics and... mathematics and methodology including compound interest, principles of life contingencies, commutation... concentration was actuarial mathematics, or (ii) Which included at least as many semester hours or quarter hours...

20 CFR 901.12 - Eligibility for enrollment.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Basic actuarial knowledge. The applicant shall demonstrate knowledge of basic actuarial mathematics and... mathematics and methodology including compound interest, principles of life contingencies, commutation... concentration was actuarial mathematics, or (ii) Which included at least as many semester hours or quarter hours...

20 CFR 901.12 - Eligibility for enrollment.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Basic actuarial knowledge. The applicant shall demonstrate knowledge of basic actuarial mathematics and... mathematics and methodology including compound interest, principles of life contingencies, commutation... concentration was actuarial mathematics, or (ii) Which included at least as many semester hours or quarter hours...

Firewalking: A Lesson in Physics.

ERIC Educational Resources Information Center

Taylor, John R.

1989-01-01

Emphasizes firewalking as a good illustration of basic concepts in thermodynamics. Describes the basic principles of firewalking and other factors including the cooling of the surface embers, moisture of the feet, thick skin on the feet, tolerance for pain, and other uncontrolled factors. (YP)

Principles of management.

PubMed

Ambrose, Kate

2005-04-01

This is an online peer reviewed journal, whose board contains recognised experts in the wound management field and which i s edited by Stephen Thomas, author and director of the Surgical Materials Testing Laboratory.

Experimental system for the control of surgically induced infections

NASA Technical Reports Server (NTRS)

1972-01-01

The experimental system is described, and the procedures for surgery usage and maintenance are outlined. Basically the system consists of the following: (1) a portable clean room comprised of a horizontal laminar flow filter system and a transparent walled enclosure, (2) a helmet-shoulder pad assembly, (3) a communications system, (4) a helmet ventilation system, and (5) surgical gowns.

A Review of Indocyanine Green Fluorescent Imaging in Surgery

PubMed Central

Alander, Jarmo T.; Kaartinen, Ilkka; Laakso, Aki; Pätilä, Tommi; Spillmann, Thomas; Tuchin, Valery V.; Venermo, Maarit; Välisuo, Petri

2012-01-01

The purpose of this paper is to give an overview of the recent surgical intraoperational applications of indocyanine green fluorescence imaging methods, the basics of the technology, and instrumentation used. Well over 200 papers describing this technique in clinical setting are reviewed. In addition to the surgical applications, other recent medical applications of ICG are briefly examined. PMID:22577366

Retrocausal Effects as a Consequence of Quantum Mechanics Refined to Accommodate the Principle of Sufficient Reason

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stapp, Henry P.

2011-05-10

The principle of sufficient reason asserts that anything that happens does so for a reason: no definite state of affairs can come into being unless there is a sufficient reason why that particular thing should happen. This principle is usually attributed to Leibniz, although the first recorded Western philosopher to use it was Anaximander of Miletus. The demand that nature be rational, in the sense that it be compatible with the principle of sufficient reason, conflicts with a basic feature of contemporary orthodox physical theory, namely the notion that nature's response to the probing action of an observer is determinedmore » by pure chance, and hence on the basis of absolutely no reason at all. This appeal to pure chance can be deemed to have no rational fundamental place in reason-based Western science. It is argued here, on the basis of the other basic principles of quantum physics, that in a world that conforms to the principle of sufficient reason, the usual quantum statistical rules will naturally emerge at the pragmatic level, in cases where the reason behind nature's choice of response is unknown, but that the usual statistics can become biased in an empirically manifest way when the reason for the choice is empirically identifiable. It is shown here that if the statistical laws of quantum mechanics were to be biased in this way then the basically forward-in-time unfolding of empirical reality described by orthodox quantum mechanics would generate the appearances of backward-time-effects of the kind that have been reported in the scientific literature.« less

Implementing Communication Studies into General Education: The Basic Course as General Education (Or, How We Made It Work for Us).

ERIC Educational Resources Information Center

Buckrop, Jacquelyn J.

At Ball State University in Indiana, the basic course (COMM 210) focuses communication concepts and skills with the goals of helping students understand basic communication principles, providing them with the opportunity to improve their communication skills, and enhancing their awareness of communication's role in culture. Special emphasis is…

Epidemiology and Clinical Research Design, Part 2: Principles

PubMed Central

Manja, Veena; Lakshminrusimha, Satyan

2015-01-01

This is the third article covering core knowledge in scholarly activities for neonatal physicians. In this article, we discuss various principles of epidemiology and clinical research design. A basic knowledge of these principles is necessary for conducting clinical research and for proper interpretation of studies. This article reviews bias and confounding, causation, incidence and prevalence, decision analysis, cost-effectiveness, sensitivity analysis, and measurement. PMID:26236171

Role of Logic and Mentality as the Basics of Wittgenstein's Picture Theory of Language and Extracting Educational Principles and Methods According to This Theory

ERIC Educational Resources Information Center

Heshi, Kamal Nosrati; Nasrabadi, Hassanali Bakhtiyar

2016-01-01

The present paper attempts to recognize principles and methods of education based on Wittgenstein's picture theory of language. This qualitative research utilized inferential analytical approach to review the related literature and extracted a set of principles and methods from his theory on picture language. Findings revealed that Wittgenstein…

Manufacturing Methods and Technology Project Summary Reports

DTIC Science & Technology

1981-06-01

a tough urethane film. The basic principle is to pump two components to a spinning disc, mixing the components just prior to depositing in a well...and check out an electronic target scoring device using developed scientific principles without drastically modifying existing commercial...equipment. The scoring device selected and installed was an Accubar Model ATS-16D using the underlying physics principle of acoustic shock wave propagation

Aerodynamics: The Wright Way

NASA Technical Reports Server (NTRS)

Cole, Jennifer Hansen

2010-01-01

This slide presentation reviews some of the basic principles of aerodynamics. Included in the presentation are: a few demonstrations of the principles, an explanation of the concepts of lift, drag, thrust and weight, a description of Bernoulli's principle, the concept of the airfoil (i.e., the shape of the wing) and how that effects lift, and the method of controlling an aircraft by manipulating the four forces using control surfaces.

Liability exposure for surgical robotics instructors.

PubMed

Lee, Yu L; Kilic, Gokhan; Phelps, John Y

2012-01-01

Surgical robotics instructors provide an essential service in improving the competency of novice gynecologic surgeons learning robotic surgery and advancing surgical skills on behalf of patients. However, despite best intentions, robotics instructors and the gynecologists who use their services expose themselves to liability. The fear of litigation in the event of a surgical complication may reduce the availability and utility of robotics instructors. A better understanding of the principles of duty of care and the physician-patient relationship, and their potential applicability in a court of law likely will help to dismantle some concerns and uncertainties about liability. This commentary is not meant to discourage current and future surgical instructors but to raise awareness of liability issues among robotics instructors and their students and to recommend certain preventive measures to curb potential liability risks. Published by Elsevier Inc.

What You Always Wanted to Know About Monitoring Naval Ship Construction but You Did Not Dare Ask.

DTIC Science & Technology

1990-06-01

CONCEPTUAL DESIGN For the conceptual design of the management efforts, we quote the Principles of Management , as they were presented by Fayol (Ret. l:p...functional groups. The five basic principles of management theory are: Planning, Organizing, Staffing, Directing, and Controlling. These principles... Principles of Management , McGraw-Hill, 1978. 16. ibid. 70 17. ibid. 18. ibid. 19. ibid. 20. Wolfe, P.M., Cochran E.B., and Thompson, W.J., A BERTS- Based

Implementing Liberia's poverty reduction strategy: An assessment of emergency and essential surgical care.

PubMed

Sherman, Lawrence; Clement, Peter T; Cherian, Meena N; Ndayimirije, Nestor; Noel, Luc; Dahn, Bernice; Gwenigale, Walter T; Kushner, Adam L

2011-01-01

To document infrastructure, personnel, procedures performed, and supplies and equipment available at all county hospitals in Liberia using the World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care. Survey of county hospitals using the World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care. Sixteen county hospitals in Liberia. Infrastructure, personnel, procedures performed, and supplies and equipment available. Uniformly, gross deficiencies in infrastructure, personnel, and supplies and equipment were identified. The World Health Organization Tool for Situational Analysis of Emergency and Essential Surgical Care was useful in identifying baseline emergency and surgical conditions for evidenced-based planning. To achieve the Poverty Reduction Strategy and delivery of the Basic Package of Health and Social Welfare Services, additional resources and manpower are needed to improve surgical and anesthetic care.

Subject preferences of first- and second-year medical students for their future specialization at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal - a questionnaire-based study.

PubMed

Jha, Rajesh K; Paudel, Keshab R; Shah, Dev K; Sah, Ajit K; Basnet, Sangharshila; Sah, Phoolgen; Adhikari, Sandeep

2015-01-01

The selection of a discipline for future specialization may be an important factor for the medical students' future career, and it is influenced by multiple factors. The interest of students in the early stages can be improved in subjects related to public health or of academic importance, as per need. A questionnaire-based study was conducted among 265 first- and second-year medical students of Chitwan Medical College, Nepal to find out their subject of preference for postgraduation and the factors affecting their selection along with their interesting basic science subject. Only the responses from 232 completely filled questionnaires were analyzed. The preference of the students for clinical surgical (50.9%), clinical medical (45.3%), and basic medical (3.9%) sciences for postgraduation were in descending order. The most preferred specialty among male students was clinical surgical sciences (56.3%), and among female students, it was clinical medical sciences (53.6%). Although all the students responded to their preferred specialty, only 178 students specified the subject of their interest. General surgery (23.4%), pediatrics (23.4%), and anatomy (2.4%) were the most favored subjects for postgraduation among clinical surgical, clinical medical, and basic medical sciences specialties, respectively. More common reasons for selection of specific subject for future career were found to be: personal interests, good income, intellectual challenge, and others. Many students preferred clinical surgical sciences for their future specialization. Among the reasons for the selection of the specialty for postgraduation, no significant reason could be elicited from the present study.

Survey of the capacity for essential surgery and anaesthesia services in Papua New Guinea.

PubMed

Martin, Janet; Tau, Goa; Cherian, Meena Nathan; Vergel de Dios, Jennifer; Mills, David; Fitzpatrick, Jane; Adu-Krow, William; Cheng, Davy

2015-12-16

To assess capacity to provide essential surgical services including emergency, obstetric and anaesthesia care in Papua New Guinea (PNG) in order to support planning for relevant post-2015 sustainable development goals for PNG. Cross-sectional survey. Hospitals and health facilities in PNG. 21 facilities including 3 national/provincial hospitals, 11 district/rural hospitals, and 7 health centres. The WHO Situational Analysis Tool to Assess Emergency and Essential Surgical Care (WHO-SAT) was used to measure each participating facility's capacity to deliver essential surgery and anaesthesia services, including 108 items related to relevant infrastructure, human resources, interventions and equipment. While major surgical procedures were provided at each hospital, fewer than 30% had uninterrupted access to oxygen, and 57% had uninterrupted access to resuscitation bag and mask. Most hospitals reported capacity to provide general anaesthesia, though few hospitals reported having at least one certified surgeon, obstetrician and anaesthesiologist. Access to anaesthetic machines, pulse oximetry and blood bank was severely limited. Many non-hospital health centres providing basic surgical procedures, but almost none had uninterrupted access to electricity, running water, oxygen and basic supplies for resuscitation, airway management and obstetric services. Capacity for essential surgery and anaesthesia services is severely limited in PNG due to shortfalls in physical infrastructure, human resources, and basic equipment and supplies. Achieving post-2015 sustainable development goals, including universal healthcare, will require significant investment in surgery and anaesthesia capacity in PNG. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Beyond the Virtues-Principles Debate.

ERIC Educational Resources Information Center

Keat, Marilyn S.

1992-01-01

Indicates basic ontological assumptions in the virtues-principles debate in moral philosophy, noting Aristotle's and Kant's fundamental ideas about morality and considering a hermeneutic synthesis of theories. The article discusses what acceptance of the synthesis might mean in the theory and practice of moral pedagogy, offering examples of…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Curceanu, C.; Bragadireanu, M.; Sirghi, D.

The Pauli Exclusion Principle (PEP) is one of the basic principles of modern physics and, even if there are no compelling reasons to doubt its validity, it is still debated today because an intuitive, elementary explanation is still missing, and because of its unique stand among the basic symmetries of physics. We present an experimental test of the validity of the Pauli Exclusion Principle for electrons based on a straightforward idea put forward a few years ago by Ramberg and Snow (E. Ramberg and G. A. Snow 1990 Phys. Lett. B 238 438). We performed a very accurate search ofmore » X-rays from the Pauli-forbidden atomic transitions of electrons in the already filled 1S shells of copper atoms. Although the experiment has a very simple structure, it poses deep conceptual and interpretational problems. Here we describe the experimental method and recent experimental results interpreted as an upper limit for the probability to violate the Pauli Exclusion Principle. We also present future plans to upgrade the experimental apparatus.« less

[Pay attention to the standardized application of new techniques in surgical treatment of thyroid disease].

PubMed

Tian, W; Xi, H Q; Wang, B

2017-08-01

The continuous development and application of new technology in thyroid surgery has promoted the rapid improvement of thyroid surgery. New technology in the field of thyroid surgery has developed rapidly. The application of neural monitoring technology has enabled the thyroid surgery to enter an accurate era. Imtraoperative neuromonitoring and continuous intraoperative neuromonitoring have made the recurrent laryngeal nerve protection more secure. Nano-carbon parathyroid gland negative imaging technology could identify parathyroid gland more precise. However, when the nano-carbon was used, the injection time, position and dosage should be grasped so as to achieve the best effect of negative imaging. Endoscopic and robotic thyroid surgery could meet the demand of cosmetic. "Treatment first, beauty second" is still the principle to be strictly followed. Do not blindly expand indications and pursue endoscopic surgery. Energy surgical instruments' update made the operation more efficient, while the instruments have some disadvantages. Thyroid surgeon must correctly understand the working principle of new energy devices and use them rationally. Through grasping the working principle and application skills of new technology in clinical work, definiting its advantages and disadvantages, adhereing to the "reasonable choice, standard application" principle, learning the pioneers' experience, the application of new thyroid diagnosis and treatment technology could be more reasonable and safe.

The leadership principles of Dr. Martin Luther King, Jr. and their relevance to surgery.

PubMed

Brunicardi, F Charles; Cotton, Ronald T; Cole, George W; Martinez, George

2007-01-01

In order to face the challenges in healthcare this century, it is essential that surgeons understand modern leadership principles. One of the greatest leaders in history was Dr. Martin Luther King, Jr., who provides a shining example of level-5 leadership for us to study. The study of leadership principles of great leaders can provide us with practical methods of conflict resolution as well as inspiration to keep us engaged and focused. As leaders of the medical community, we face numerous challenges, including discovering and implementing new treatments for disease, providing care for the indigent, overcoming educational challenges such as incorporating the ACGME Core Competencies into our surgical training and promoting diversity in education. Achieving these goals is often hindered by the environment in which we labor-nearly 50 million are uninsured, the rising cost of medical care is currently at 16% of the GNP, and reimbursement rates are falling-which makes the practice of surgery a significant challenge. Effective leadership will be paramount in achieving these goals. In this editorial, which summarizes a presentation given to the Surgical Section of the annual National Medical Association meeting, five important leadership principles that are important for surgeons have been selected and related to the outstanding leadership of Dr. Martin Luther King, Jr.

Training opportunities and the role of virtual reality simulation in acquisition of basic laparoscopic skills.

PubMed

Aggarwal, Rajesh; Balasundaram, Indran; Darzi, Ara

2008-03-01

Within the past decade, there has been increasing interest in simulation-based devices for training and assessment of technical skills, especially for minimally invasive techniques such as laparoscopy. The aim of this study was to investigate the perceptions of senior and junior surgeons to virtual reality simulation within the context of current training opportunities for basic laparoscopic procedures. A postal questionnaire was sent to 245 consultants and their corresponding specialist registrar (SpR), detailing laparoscopic surgical practice and their knowledge and use of virtual reality (VR) surgical simulators. One hundred ninety-one (78%) consultants and 103(42%) SpRs returned questionnaires; 16%(10/61) of junior SpRs (year 1-4) had performed more than 50 laparoscopic cholecystectomies to date compared with 76% (32/42) of senior SpRs (year 5-6) (P < 0.001); 90% (55/61) of junior SpRs and 67% (28/42) of senior SpRs were keen to augment their training with VR (P = 0.007); 81% (238/294) of all surgeons agreed that VR has a useful role in the laparoscopic surgical training curriculum. There is a lack of experience in index laparoscopic cases of junior SpRs, and laparoscopic VR simulation is recognized as a useful mode of practice to acquire technical skills. This should encourage surgical program directors to drive the integration of simulation-based training into the surgical curriculum.

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

PubMed

O'Sullivan, K E; Byrne, J S; Walsh, T N

2013-12-01

Application to the Irish basic surgical training (BST) program in Ireland has decreased progressively over the past 5 years. We hypothesised that this decline was secondary to dissatisfaction with training correlated with reduced operative experience and lack of mentorship among BSTs. An anonymous 15 question electronic survey was circulated to all BSTs appraising their impression of the operative experience available to them, their mentorship and their opinions of critical aspects of training. Fifty trainees responded to the survey. At the commencement of training 98 % (n = 43) intended to stay in surgery, decreasing to 79 % (n = 34) during the BST. Trainees who felt they had a mentor were three times more likely to be content in surgical training (OR 3.11; 95 % CI 0.94-10.25, P = 0.06). Trainees satisfied with their allocated rotation were more likely to be content in surgical training (OR 4.5; 95 % CI 1.03-19.6, P = 0.045). Individual trainee comments revealed dissatisfaction with operative exposure. Mentorship and satisfaction with allocated training rotation had a positive impact on trainee satisfaction and correlated with contentedness in surgical training. Operative experience is the main element that trainees report as lacking. This highlights the need for reform of the training system to improve current levels of mentorship and increase operative exposure to enhance its attractiveness to the best quality medical graduates.

The AAPM/RSNA physics tutorial for residents. Basic physics of MR imaging: an introduction.

PubMed

Hendrick, R E

1994-07-01

This article provides an introduction to the basic physical principles of magnetic resonance (MR) imaging. Essential basic concepts such as nuclear magnetism, tissue magnetization, precession, excitation, and tissue relaxation properties are presented. Hydrogen spin density and tissue relaxation times T1, T2, and T2* are explained. The basic elements of a planar MR pulse sequence are described: section selection during tissue excitation, phase encoding, and frequency encoding during signal measurement.

Guest editorial: From neuroscience to neuro-rehabilitation: transferring basic neuroscientific principles from laboratory to bedside.

PubMed

Koenig, Alexander; Luft, Andreas; Cajigas, Iahn

2013-01-21

Several new approaches for treatment of Central Nervous System (CNS) disorders are currently under investigation, including the use of rehabilitation training strategies, which are often combined with electrical and/or pharmacological modulation of spinal locomotor circuitries. While these approaches show great promise in the laboratory setting, there still exists a large gap in knowledge on how to transfer these treatments to daily clinical use. This thematic series presents a cross section of cutting edge approaches with the goal of transferring basic neuroscience principles from the laboratory to the proverbial "bedside".

Polarized electron sources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prepost, R.

1994-12-01

The fundamentals of polarized electron sources are described with particular application to the Stanford Linear Accelerator Center. The SLAC polarized electron source is based on the principle of polarized photoemission from Gallium Arsenide. Recent developments using epitaxially grown, strained Gallium Arsenide cathodes have made it possible to obtain electron polarization significantly in excess of the conventional 50% polarization limit. The basic principles for Gallium and Arsenide polarized photoemitters are reviewed, and the extension of the basic technique to strained cathode structures is described. Results from laboratory measurements of strained photocathodes as well as operational results from the SLAC polarized sourcemore » are presented.« less

Basic principles of Hasse diagram technique in chemistry.

PubMed

Brüggemann, Rainer; Voigt, Kristina

2008-11-01

Principles of partial order applied to ranking are explained. The Hasse diagram technique (HDT) is the application of partial order theory based on a data matrix. In this paper, HDT is introduced in a stepwise procedure, and some elementary theorems are exemplified. The focus is to show how the multivariate character of a data matrix is realized by HDT and in which cases one should apply other mathematical or statistical methods. Many simple examples illustrate the basic theoretical ideas. Finally, it is shown that HDT is a useful alternative for the evaluation of antifouling agents, which was originally performed by amoeba diagrams.

Ready for the OR? – Clinical anatomy and basic surgical skills for students in their preclinical education

PubMed Central

Böckers, Anja; Lippold, Dominique; Fassnacht, Ulrich; Schelzig, Hubert; Böckers, Tobias M.

2011-01-01

Medical students’ first experience in the operating theatre often takes place during their electives and is therefore separated from the university’s medical curriculum. In the winter term 2009/10, the Institute of Anatomy and Cell Biology at the University of Ulm implemented an elective called “Ready for the OR” for 2nd year medical students participating in the dissection course. We attempted to improve learning motivation and examination results by transferring anatomical knowledge into a surgical setting and teaching basic surgical skills in preparation of the students’ first participation in the OR. Out of 69 online applicants, 50 students were randomly assigned to the Intervention Group (FOP) or the Control Group. In 5 teaching session students learned skills like scrubbing, stitching or the identification of frequently used surgical instruments. Furthermore, students visited five surgical interventions which were demonstrated by surgical colleagues on donated bodies that have been embalmed using the Thiel technique. The teaching sessions took place in the institute’s newly built “Theatrum Anatomicum” for an ideal simulation of a surgical setting. The learning outcomes were verified by OSPE. In a pilot study, an intervention group and a control group were compared concerning their examination results in the dissection course and their learning motivation through standardized SELLMO-test for students. Participants gained OSPE results between 60.5 and 92% of the maximum score. “Ready for the OR” was successfully implemented and judged an excellent add-on to anatomy teaching by the participants. However, we could not prove a significant difference in learning motivation or examination results. Future studies should focus on the learning orientation, the course’s long-term learning effects and the participants’ behavior in a real surgery setting. PMID:21866247

Presurgical cleft lip and palate orthopedics: an overview

PubMed Central

Alzain, Ibtesam; Batwa, Waeil; Cash, Alex; Murshid, Zuhair A

2017-01-01

Patients with cleft lip and/or palate go through a lifelong journey of multidisciplinary care, starting from before birth and extending until adulthood. Presurgical orthopedic (PSO) treatment is one of the earliest stages of this care plan. In this paper we provide a review of the PSO treatment. This review should help general and specialist dentists to better understand the cleft patient care path and to be able to answer patient queries more efficiently. The objectives of this paper were to review the basic principles of PSO treatment, the various types of techniques used in this therapy, and the protocol followed, and to critically evaluate the advantages and disadvantages of some of these techniques. In conclusion, we believe that PSO treatment, specifically nasoalveolar molding, does help to approximate the segments of the cleft maxilla and does reduce the intersegment space in readiness for the surgical closure of cleft sites. However, what we remain unable to prove equivocally at this point is whether the reduction in the dimensions of the cleft presurgically and the manipulation of the nasal complex benefit our patients in the long term. PMID:28615974

Acupuncture and Its Role in Modern Medicine

PubMed Central

Lewin, Andrew J.

1974-01-01

Although both the philosophic and physiologic basis of acupuncture seems fanciful to Western medical thinking, the results obtained in the treatment of certain disease states cannot be lightly dismissed. Its use in the induction of surgical analgesia may have immediate application for Western Medicine. Its mechanism of action is a complete enigma, but information accumulated from research in hypnosis, visceral learning and, most important, the physiology of pain perception may contain clues to the pathophysiologic principles involved. The fact that many disorders for which acupuncture therapy is useful are thought to have a large psychosomatic component only serves to reinforce the Eastern concept of inseparability of mind and body. A great deal of attention is being given to this concept in the current medical literature. In order to define the role of acupuncture in modern medical practice, a more scientific approach in both clinical and basic research is necessary. If acupuncture can be proved safe and efficacious in the treatment of certain diseases, lack of knowledge regarding its mechanism of action should not delay its incorporation into our medical armamentarium. PMID:4590887

Principles and practice of external digital photography in ophthalmology

PubMed Central

Mukherjee, Bipasha; Nair, Akshay Gopinathan

2012-01-01

It is mandatory to incorporate clinical photography in an ophthalmic practice. Patient photographs are routinely used in teaching, presentations, documenting surgical outcomes and marketing. Standardized clinical photographs are part of an armamentarium for any ophthalmologist interested in enhancing his or her practice. Unfortunately, many clinicians still avoid taking patient photographs for want of basic knowledge or inclination. The ubiquitous presence of the digital camera and digital technology has made it extremely easy and affordable to take high-quality images. It is not compulsory to employ a professional photographer or invest in expensive equipment any longer for this purpose. Any ophthalmologist should be able to take clinical photographs in his/her office settings with minimal technical skill. The purpose of this article is to provide an ophthalmic surgeon with guidelines to achieve standardized photographic views for specific procedures, to achieve consistency, to help in pre-operative planning and to produce accurate pre-operative and post-operative comparisons, which will aid in self-improvement, patient education, medicolegal documentation and publications. This review also discusses editing, storage, patient consent, medicolegal issues and importance of maintenance of patient confidentiality. PMID:22446907

Contemporary strategies to improve the outcome in locally advanced pancreatic cancer.

PubMed

Schneider, Rick; Späth, Christoph; Nitsche, Ulrich; Erkan, Mert; Kleeff, Jörg

2017-10-01

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an overall 5-year survival rate of less than 7%. After many years of basic and clinical research efforts, pancreatic cancer patients presenting with locally advanced, unresectable tumors remain a therapeutic challenge. Despite the lack of high quality randomized controlled trials, perioperative/neoadjuvant treatment strategies seem to be beneficial in these patients. At present the FOLFIRINOX regimen, which was established in the palliative setting, is increasingly recognized as the backbone of neoadjuvant therapy for locally advanced PDAC. Surgical resection follows the same principles and guidelines as upfront surgery specifically regarding the extent of resection including lymphadenectomy, vascular resections and multivisceral resections. Because of the limited diagnostic accuracy of restaging after neoadjuvant treatment, an adjusted intraoperative strategy is necessary to minimize the risk of debulking procedures and maximize the chance of a potential curative resection. Locally advanced PDAC requires a multidisciplinary and individualized treatment approach, and further research efforts for novel and innovative therapies. This article provides an updated overview on strategies to improve the outcome in locally advanced PDAC.

[Structured residency training program for otolaryngology: a trendsetting principle].

PubMed

Meyer, J E; Wollenberg, B; Schmidt, C

2008-09-01

A concept for an ORL residency training program is necessary because of personnel bottlenecks, quality assurance and benchmarkings. We have created a 2.5 years' program, which is based on 6 pillars: 1. Acquisition of the necessary specialist knowledge by the resident in self-study. 2. Weekly attendance of training lectures according to a study timetable, a monthly specialist seminar to discuss case examples. 3. Weekly presentation by the resident on an article from the current literature, alternating with a presentation on cases and a morbidity and mortality conference. 4. Annual 60 min learning target test. 5. Definition of a surgical training calendar oriented to the new national ORL training regulations. 6. Internal operation course with preparative exercises in anatomy and visit to an operations course at a renowned otolaryngology clinic each year. After 2.5 years of the training time a revision course is introduced. In this way a basic training will be guaranteed for all residents, which can be assessed by the annual test. Finally, the construction of a further training curriculum should lead to an improved transparent training, a higher standard of quality and improved staff satisfaction.

Persistent air leaks: a review with an emphasis on bronchoscopic management

PubMed Central

Lazarus, Donald R.

2017-01-01

Persistent air leak (PAL) is a cause of significant morbidity in patients who have undergone lung surgery and those with significant parenchymal lung disease suffering from a pneumothorax. Its management can be complex and challenging. Although conservative treatment with chest drain and observation is usually effective, other invasive techniques are needed when conservative treatment fails. Surgical management and medical pleurodesis have long been the usual treatments for PAL. More recently numerous bronchoscopic procedures have been introduced to treat PAL in those patients who are poor candidates for surgery or who decline surgery. These techniques include bronchoscopic use of sealants, sclerosants, and various types of implanted devices. Recently, removable one-way valves have been developed that are able to be placed bronchoscopically in the affected airways, ameliorating air-leaks in patients who are not candidates for surgery. Future comparative trials are needed to refine our understanding of the indications, effectiveness, and complications of bronchoscopic techniques for treating PAL. The following article will review the basic principles of management of PAL particularly focusing on bronchoscopic techniques. PMID:29268535

A six-degree-of-freedom passive arm with dynamic constraints (PADyC) for cardiac surgery application: preliminary experiments.

PubMed

Schneider, O; Troccaz, J

2001-01-01

The purpose of Computer-Assisted Surgery (CAS) is to help physicians and surgeons plan and execute optimal strategies from multimodal image data. The execution of such planned strategies may be assisted by guidance systems. Some of these systems, called synergistic systems, are based on the cooperation of a robotic device with a human operator. We have developed such a synergistic device: PADyC (Passive Arm with Dynamic Constraints). The basic principle of PADyC is to have a manually actuated arm that dynamically constrains the authorized motions of the surgical tool held by the human operator during a planned task. Dynamic constraints are computed from the task definition, and are implemented by a patented mechanical system. In this paper, we first introduce synergistic systems and then focus on modeling and algorithmic issues related to the dynamic constraints. Finally, we describe a 6-degree-of-freedom prototype robot designed for a clinical application (cardiac surgery) and report on preliminary experiments to date. The experimental results are then discussed, and future work is proposed. Copyright 2002 Wiley-Liss, Inc.

The transition from microscopic to endoscopic transsphenoidal surgery: the experience at Brigham and Women's Hospital.

PubMed

Laws, Edward R; Barkhoudarian, Garni

2014-12-01

As interest and enthusiasm for the use of the endoscope in transsphenoidal anterior skull base and pituitary surgery increases, neurosurgeons are increasingly adopting endoscopic technology and associated novel concepts. Often this involves a transition from the standard operating microscope as the main means of visualization to the operating endoscope (2D or 3D) during surgery. The authors' experience with this transition is described, including the rationale, advantages and disadvantages of the two surgical techniques. The successful use of endoscopic surgery for a large variety of pathological problems involving the anterior skull base and the pituitary region is presented. Perceived advantages for the patient and the surgeon are described, as is the occasional need for transition back to the microscopic approach. The endoscopic approach and its allied technology are here to stay. They are useful and occasionally preferable methods for treating a variety of suitable lesions involving the anterior skull base. The importance of incorporating the basic principles of skull base surgery is emphasized. Copyright © 2014 Elsevier Inc. All rights reserved.

Principles and practice of external digital photography in ophthalmology.

PubMed

Mukherjee, Bipasha; Nair, Akshay Gopinathan

2012-01-01

It is mandatory to incorporate clinical photography in an ophthalmic practice. Patient photographs are routinely used in teaching, presentations, documenting surgical outcomes and marketing. Standardized clinical photographs are part of an armamentarium for any ophthalmologist interested in enhancing his or her practice. Unfortunately, many clinicians still avoid taking patient photographs for want of basic knowledge or inclination. The ubiquitous presence of the digital camera and digital technology has made it extremely easy and affordable to take high-quality images. It is not compulsory to employ a professional photographer or invest in expensive equipment any longer for this purpose. Any ophthalmologist should be able to take clinical photographs in his/her office settings with minimal technical skill. The purpose of this article is to provide an ophthalmic surgeon with guidelines to achieve standardized photographic views for specific procedures, to achieve consistency, to help in pre-operative planning and to produce accurate pre-operative and post-operative comparisons, which will aid in self-improvement, patient education, medicolegal documentation and publications. This review also discusses editing, storage, patient consent, medicolegal issues and importance of maintenance of patient confidentiality.

Mass Uncertainty and Application For Space Systems

NASA Technical Reports Server (NTRS)

Beech, Geoffrey

2013-01-01

Expected development maturity under contract (spec) should correlate with Project/Program Approved MGA Depletion Schedule in Mass Properties Control Plan. If specification NTE, MGA is inclusive of Actual MGA (A5 & A6). If specification is not an NTE Actual MGA (e.g. nominal), then MGA values are reduced by A5 values and A5 is representative of remaining uncertainty. Basic Mass = Engineering Estimate based on design and construction principles with NO embedded margin MGA Mass = Basic Mass * assessed % from approved MGA schedule. Predicted Mass = Basic + MGA. Aggregate MGA % = (Aggregate Predicted - Aggregate Basic) /Aggregate Basic.

An assessment of adherence to basic ecological principles by payments for ecosystem service projects.

PubMed

Prager, C M; Varga, A; Olmsted, P; Ingram, J C; Cattau, M; Freund, C; Wynn-Grant, R; Naeem, S

2016-08-01

Programs and projects employing payments for ecosystem service (PES) interventions achieve their objectives by linking buyers and sellers of ecosystem services. Although PES projects are popular conservation and development interventions, little is known about their adherence to basic ecological principles. We conducted a quantitative assessment of the degree to which a global set of PES projects adhered to four ecological principles that are basic scientific considerations for any project focused on ecosystem management: collection of baseline data, identification of threats to an ecosystem service, monitoring, and attention to ecosystem dynamics or the formation of an adaptive management plan. We evaluated 118 PES projects in three markets-biodiversity, carbon, and water-compiled using websites of major conservation organizations; ecology, economic, and climate-change databases; and three scholarly databases (ISI Web of Knowledge, Web of Science, and Google Scholar). To assess adherence to ecological principles, we constructed two scientific indices (one additive [ASI] and one multiplicative [MSI]) based on our four ecological criteria and analyzed index scores by relevant project characteristics (e.g., sector, buyer, seller). Carbon-sector projects had higher ASI values (P < 0.05) than water-sector projects and marginally higher ASI scores (P < 0.1) than biodiversity-sector projects, demonstrating their greater adherence to ecological principles. Projects financed by public-private partnerships had significantly higher ASI values than projects financed by governments (P < 0.05) and marginally higher ASI values than those funded by private entities (P < 0.1). We did not detect differences in adherence to ecological principles based on the inclusion of cobenefits, the spatial extent of a project, or the size of a project's budget. These findings suggest, at this critical phase in the rapid growth of PES projects, that fundamental ecological principles should be considered more carefully in PES project design and implementation in an effort to ensure PES project viability and sustainability. © 2015 Society for Conservation Biology.

Chemical Frustration. A Design Principle for the Discovery of New Complex Alloy and Intermetallic Phases, Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fredrickson, Daniel C

2015-06-23

Final technical report for "Chemical Frustration: A Design Principle for the Discovery of New Complex Alloy and Intermetallic Phases" funded by the Office of Science through the Materials Chemistry Program of the Office of Basic Energy Sciences.

Anticipatory Enrollment Management: Another Level of Enrollment Management

ERIC Educational Resources Information Center

Dennis, Marguerite J.

2012-01-01

Building on the principles of Enrollment Management (EM) and Strategic Enrollment Management (SEM), Anticipatory Enrollment Management (AEM) offers another level of managing enrollment: anticipating future enrollment. AEM is grounded in the basic principles of Customer Relationship Management (CRM) and includes strategic out-reach to parents and…

Influence: A Key to Successful Leadership

ERIC Educational Resources Information Center

Hoy, Wayne K.; Smith, Page A.

2007-01-01

Purpose: The purpose of this article is to examine and condense the literature on influence and persuasion. Design/methodology/approach: The article identifies basic principles of influence in the theoretical and research literature, which are supported by empirical study. Findings: Ten principles of influence were identified, empirical support…

Construction of a Urologic Robotic Surgery Training Curriculum: How Many Simulator Sessions Are Required for Residents to Achieve Proficiency?

PubMed

Wiener, Scott; Haddock, Peter; Shichman, Steven; Dorin, Ryan

2015-11-01

To define the time needed by urology residents to attain proficiency in computer-aided robotic surgery to aid in the refinement of a robotic surgery simulation curriculum. We undertook a retrospective review of robotic skills training data acquired during January 2012 to December 2014 from junior (postgraduate year [PGY] 2-3) and senior (PGY4-5) urology residents using the da Vinci Skills Simulator. We determined the number of training sessions attended and the level of proficiency achieved by junior and senior residents in attempting 11 basic or 6 advanced tasks, respectively. Junior residents successfully completed 9.9 ± 1.8 tasks, with 62.5% completing all 11 basic tasks. The maximal cumulative success rate of junior residents completing basic tasks was 89.8%, which was achieved within 7.0 ± 1.5 hours of training. Of senior residents, 75% successfully completed all six advanced tasks. Senior residents attended 6.3 ± 3.5 hours of training during which 5.1 ± 1.6 tasks were completed. The maximal cumulative success rate of senior residents completing advanced tasks was 85.4%. When designing and implementing an effective robotic surgical training curriculum, an allocation of 10 hours of training may be optimal to allow junior and senior residents to achieve an acceptable level of surgical proficiency in basic and advanced robotic surgical skills, respectively. These data help guide the design and scheduling of a residents training curriculum within the time constraints of a resident's workload.

Thermodynamic and Kinetic Properties of the Electrochemical Cell.

ERIC Educational Resources Information Center

Smith, Donald E.

1983-01-01

Describes basic characteristics of the electrochemical cell. Also describes basic principles of electrochemical procedures and use of these concepts to explain use of the term "primarily" in discussions of methods primarily responsive to equilibrium cell potential, bulk ohmic resistance, and the Faradaic impedance. (JN)

Report on the CDE Examination

ERIC Educational Resources Information Center

Haga, Enoch J.

1971-01-01

The Certificate in Data Education (Basic) examination is designed to certify that successful candidates are academically proficient in those principles and concepts of automation, computing, and data processing (including social and user implications) which are usually taught in basic introductory courses at the college or university level. (CK)

Receiver design and performance characteristics

NASA Technical Reports Server (NTRS)

Simon, M. K.; Yuen, J. H.

1982-01-01

The basic design, principles of operation, and characteristics of deep space communications receivers are examined. In particular, the basic fundamentals of phase-locked loop and Costas loop receivers used for synchronization, tracking, and demodulation of phase-coherent signals in residual carrier and suppressed carrier systems are addressed.

Laboratory Reptile Surgery: Principles and Techniques

PubMed Central

Alworth, Leanne C; Hernandez, Sonia M; Divers, Stephen J

2011-01-01

Reptiles used for research and instruction may require surgical procedures, including biopsy, coelomic device implantation, ovariectomy, orchidectomy, and esophogostomy tube placement, to accomplish research goals. Providing veterinary care for unanticipated clinical problems may require surgical techniques such as amputation, bone or shell fracture repair, and coeliotomy. Although many principles of surgery are common between mammals and reptiles, important differences in anatomy and physiology exist. Veterinarians who provide care for these species should be aware of these differences. Most reptiles undergoing surgery are small and require specific instrumentation and positioning. In addition, because of the wide variety of unique physiologic and anatomic characteristics among snakes, chelonians, and lizards, different techniques may be necessary for different reptiles. This overview describes many common reptile surgery techniques and their application for research purposes or to provide medical care to research subjects. PMID:21333158

Neuronavigation. Principles. Surgical technique.

PubMed Central

Ivanov, Marcel; Vlad Ciurea, Alexandru

2009-01-01

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. PMID:20108488

Innovative surgery and the precautionary principle.

PubMed

Meyerson, Denise

2013-12-01

Surgical innovation involves practices, such as new devices, technologies, procedures, or applications, which are novel and untested. Although innovative practices are believed to offer an improvement on the standard surgical approach, they may prove to be inefficacious or even dangerous. This article considers how surgeons considering innovation should reason in the conditions of uncertainty that characterize innovative surgery. What attitude to the unknown risks of innovative surgery should they take? The answer to this question involves value judgments about the acceptability of risk taking when satisfactory scientific information is not available. This question has been confronted in legal contexts, where risk aversion in the form of the precautionary principle has become increasingly influential as a regulatory response to innovative technologies that pose uncertain future hazards. This article considers whether it is appropriate to apply a precautionary approach when making decisions about innovative surgery.

Training basic laparoscopic skills using a custom-made video game.

PubMed

Goris, Jetse; Jalink, Maarten B; Ten Cate Hoedemaker, Henk O

2014-09-01

Video games are accepted and used for a wide variety of applications. In the medical world, research on the positive effects of playing games on basic laparoscopic skills is rapidly increasing. Although these benefits have been proven several times, no institution actually uses video games for surgical training. This Short Communication describes some of the theoretical backgrounds, development and underlying educational foundations of a specifically designed video game and custom-made hardware that takes advantage of the positive effects of games on basic laparoscopic skills.

Back to Basics: Preventing Surgical Fires.

PubMed

Spruce, Lisa

2016-09-01

When fires occur in the OR, they are devastating and potentially fatal to both patients and health care workers. Fires can be prevented by understanding the fire triangle and methods of reducing fire risk, conducting fire risk assessments, and knowing how to respond if a fire occurs. This Back to Basics article addresses the basics of fire prevention and the steps that can be taken to prevent fires from occurring. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Complications of transplantation. Part 1: renal transplants.

PubMed

Khaja, Minhaj S; Matsumoto, Alan H; Saad, Wael E

2014-10-01

Vascular complications after solid-organ transplantation are not uncommon and may lead to graft dysfunction and ultimately graft loss. A thorough understanding of the surgical anatomy, etiologies, and types of vascular complications, their presentation, and the options for management are important for managing these complex patients. This article reviews the basic surgical anatomy, vascular complications, and endovascular management options of vascular complications in patients with renal transplants.

Principle and experimental investigation of current-driven negative-inductance superconducting quantum interference device

NASA Astrophysics Data System (ADS)

Li, Hao; Liu, Jianshe; Zhang, Yingshan; Cai, Han; Li, Gang; Liu, Qichun; Han, Siyuan; Chen, Wei

2017-03-01

A negative-inductance superconducting quantum interference device (nSQUID) is an adiabatic superconducting logic device with high energy efficiency, and therefore a promising building block for large-scale low-power superconducting computing. However, the principle of the nSQUID is not that straightforward and an nSQUID driven by voltage is vulnerable to common mode noise. We investigate a single nSQUID driven by current instead of voltage, and clarify the principle of the adiabatic transition of the current-driven nSQUID between different states. The basic logic operations of the current-driven nSQUID with proper parameters are simulated by WRspice. The corresponding circuit is fabricated with a 100 A cm-2 Nb-based lift-off process, and the experimental results at low temperature confirm the basic logic operations as a gated buffer.

Basic principles and ecological consequences of changing water regimes: riparian plant communities.

PubMed

Nilsson, Christer; Svedmark, Magnus

2002-10-01

Recent research has emphasized the importance of riparian ecosystems as centers of biodiversity and links between terrestrial and aquatic systems. Riparian ecosystems also belong among the environments that are most disturbed by humans and are in need of restoration to maintain biodiversity and ecological integrity. To facilitate the completion of this task, researchers have an important function to communicate their knowledge to policy-makers and managers. This article presents some fundamental qualities of riparian systems, articulated as three basic principles. The basic principles proposed are: (1) The flow regime determines the successional evolution of riparian plant communities and ecological processes. (2) The riparian corridor serves as a pathway for redistribution of organic and inorganic material that influences plant communities along rivers. (3) The riparian system is a transition zone between land and water ecosystems and is disproportionately plant species-rich when compared to surrounding ecosystems. Translating these principles into management directives requires more information about how much water a river needs and when and how, i.e., flow variables described by magnitude, frequency, timing, duration, and rate of change. It also requires information about how various groups of organisms are affected by habitat fragmentation, especially in terms of their dispersal. Finally, it requires information about how effects of hydrologic alterations vary between different types of riparian systems and with the location within the watershed.

Internationalization of general surgical journals: origin and content of articles published in North America and Great Britain from 1983 to 1998.

PubMed

Tompkins, R K; Ko, C Y; Donovan, A J

2001-12-01

The origin and characteristics of articles published in the 6 highest rated (Institute for Scientific Information classification) English-language general surgical journals have changed significantly during the past 15 years. All articles published in 1983, 1988, 1993, and 1998 in 5 US surgical journals and 1 British surgical journal were reviewed and characterized. Absolute numbers and proportions of national and international articles published in each journal. Articles reviewed included 4868 in US journals and 1380 in the British journal. The total number of US journal articles decreased by 15.1%. The total number of British journal articles increased by 58.9%. The percentage of national articles decreased from 87.5% to 68.8% in US journals (P<.001) and constituted the minority of freely submitted articles in 1998 in 3 of 5 US journals. The percentage of national articles also decreased from 74.8% to 47.1% in the British journal (P<.001). Articles by European and Asian authors showed the most striking increases in all journals. The percentage of basic research articles declined in US journals from 23.3% to 17.9% (P =.001) owing to a 14.9% decline in national basic research articles. The percentage of clinical randomized studies increased from 2.2% to 4.1% (P<.008), but the increase was attributable to international articles. Government funding alone decreased from 13.6% to 11.2%, and government plus another source of funding decreased from 19.2% to 16.7% for national articles in US journals. Internationalization of the highly rated British and the 5 highest rated US general surgical journals has occurred. The decrease in the number of national articles in the US journals has been accompanied by significant decreases in government funding and basic research articles and a static output of clinical randomized studies from North America.

Performance of basic manipulation and intracorporeal suturing tasks in a robotic surgical system: single- versus dual-monitor views.

PubMed

Shah, Rachit D; Cao, Alex; Golenberg, Lavie; Ellis, R Darin; Auner, Gregory W; Pandya, Abhilash K; Klein, Michael D

2009-04-01

Technical advances in the application of laparoscopic and robotic surgical systems have improved platform usability. The authors hypothesized that using two monitors instead of one would lead to faster performance with fewer errors. All tasks were performed using a surgical robot in a training box. One of the monitors was a standard camera with two preset zoom levels (zoomed in and zoomed out, single-monitor condition). The second monitor provided a static panoramic view of the whole surgical field. The standard camera was static at the zoomed-in level for the dual-monitor condition of the study. The study had two groups of participants: 4 surgeons proficient in both robotic and advanced laparoscopic skills and 10 lay persons (nonsurgeons) who were given adequate time to train and familiarize themselves with the equipment. Running a 50-cm rope was the basic task. Advanced tasks included running a suture through predetermined points and intracorporeal knot tying with 3-0 silk. Trial completion times and errors, categorized into three groups (orientation, precision, and task), were recorded. The trial completion times for all the tasks, basic and advanced, in the two groups were not significantly different. Fewer orientation errors occurred in the nonsurgeon group during knot tying (p=0.03) and in both groups during suturing (p=0.0002) in the dual-monitor arm of the study. Differences in precision and task error were not significant. Using two camera views helps both surgeons and lay persons perform complex tasks with fewer errors. These results may be due to better awareness of the surgical field with regard to the location of the instruments, leading to better field orientation. This display setup has potential for use in complex minimally invasive surgeries such as esophagectomy and gastric bypass. This technique also would be applicable to open microsurgery.

Current state of virtual reality simulation in robotic surgery training: a review.

PubMed

Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C

2016-06-01

Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

Making the Leap: the Translation of Innovative Surgical Devices From the Laboratory to the Operating Room.

PubMed

Marcus, Hani J; Payne, Christopher J; Hughes-Hallett, Archie; Gras, Gauthier; Leibrandt, Konrad; Nandi, Dipankar; Yang, Guang-Zhong

2016-06-01

To determine the rate and extent of translation of innovative surgical devices from the laboratory to first-in-human studies, and to evaluate the factors influencing such translation. Innovative surgical devices have preceded many of the major advances in surgical practice. However, the process by which devices arising from academia find their way to translation remains poorly understood. All biomedical engineering journals, and the 5 basic science journals with the highest impact factor, were searched between January 1993 and January 2000 using the Boolean search term "surgery OR surgeon OR surgical". Articles were included if they described the development of a new device and a surgical application was described. A recursive search of all citations to the article was performed using the Web of Science (Thompson-Reuters, New York, NY) to identify any associated first-in-human studies published by January 2015. Kaplan-Meier curves were constructed for the time to first-in-human studies. Factors influencing translation were evaluated using log-rank and Cox proportional hazards models. A total of 8297 articles were screened, and 205 publications describing unique devices were identified. The probability of a first-in-human at 10 years was 9.8%. Clinical involvement was a significant predictor of a first-in-human study (P = 0.02); devices developed with early clinical collaboration were over 6 times more likely to be translated than those without [RR 6.5 (95% confidence interval 0.9-48)]. These findings support initiatives to increase clinical translation through improved interactions between basic, translational, and clinical researchers.

Design, management, and critical evaluation of a surgical basic/clinical science curriculum: the role of an educational chief resident.

PubMed

Gregg, Shea C; Eisenberg, Dan; Duffy, Andrew J; Longo, Walter E

2008-01-01

To demonstrate that a surgery "educational" chief resident can develop a resident-centered, evidence-based, surgical basic/clinical science curriculum that will improve American Board of Surgery In-Training Examination (ABSITE) scores. Retrospective cohort study. Two curriculums were developed by 2 surgical "educational" chief residents (in their final year of training), for the academic years 2005-2006 and 2006-2007. The primary roles of these individuals were to design and maintain a surgical curriculum under the ongoing supervision of the program director. In 2005/2006, a baseline weekly lecture series was developed by assigning topics from multiple textbooks to members of the surgical faculty based on their respective surgical specialties. In 2006/2007, a similar approach was used; however, the lecture series was accompanied by additional activities that have been described in the literature as useful in improving ABSITE performance. These activities included recommended reading assignments, ABSITE-styled questions based on the weekly lecture topic, problem-based learning conferences, and an ABSITE remediation course. To assess the 2 approaches, conference attendance and mean ABSITE total test percent correct scores for categorical and preliminary surgical residents in their 1st through 4th postgraduate years (PGY) of training in 2005/2006 and 2nd through 5th years in 2006/2007 were followed. Subgroup analysis of conference attendance and mean ABSITE percent correct scores was performed on those participating versus those not participating in the ABSITE remediation course. A Likert survey was performed to assess our surgical curriculum in 2007. Twenty-five residents participated in both the 2005/2006 and the 2006/2007 surgical curriculums. Twelve residents were assigned to mandatory remediation, whereas 13 were not required to participate in remediation in 2006/2007. Conference attendance did not significantly change between 2005/2006 and 2006/2007 among remediating residents (75% vs 69%, p = 0.23) but did significantly increase among nonremediating residents (76% vs 83%, p = 0.05). Overall, mean ABSITE percent correct scores significantly increased between the 2006 and the 2007 tests (64.8% vs 71.0%, p = 0.002). In subgroup analysis, those who underwent ABSITE remediation significantly increased their ABSITE score by an average of 10.2 percentage points (p = 0.0002), whereas those not participating in the course did not significantly change their score (2.5 percentage points, p = 0.36). A Likert survey assessing this year's curriculum showed that all components of this year's curriculum were "Somewhat useful" to "Very useful" in both improving surgical knowledge base and preparing for the ABSITE. An educational chief resident designed surgical curriculum, including weekly reading assignments, weekly ABSITE-styled questions, monthly chief resident problem-based conferences, and an ABSITE remediation course, may augment a basic/clinical science lecture series and may improve ABSITE performance.

An Elementary Introduction to Solar Dynamo Theory

NASA Astrophysics Data System (ADS)

Choudhuri, Arnab Rai

2007-07-01

The cyclically varying magnetic field of the Sun is believed to be produced by the hydromagnetic dynamo process. We first summarize the relevant observational data pertaining to sunspots and solar cycle. Then we review the basic principles of MHD needed to develop the dynamo theory. This is followed by a discussion how bipolar sunspots form due to magnetic buoyancy of flux tubes formed at the base of the solar convection zone. Following this, we come to the heart of dynamo theory. After summarizing the basic ideas of a turbulent dynamo and the basic principles of its mean field formulation, we present the famous dynamo wave solution, which was supposed to provide a model for the solar cycle. Finally we point out how a flux transport dynamo can circumvent some of the difficulties associated with the older dynamo models.

Ion-Exchange Chromatography: Basic Principles and Application.

PubMed

Cummins, Philip M; Rochfort, Keith D; O'Connor, Brendan F

2017-01-01

Ion-Exchange Chromatography (IEC) allows for the separation of ionizable molecules on the basis of differences in charge properties. Its large sample-handling capacity, broad applicability (particularly to proteins and enzymes), moderate cost, powerful resolving ability, and ease of scale-up and automation have led to it becoming one of the most versatile and widely used of all liquid chromatography (LC) techniques. In this chapter, we review the basic principles of IEC, as well as the broader criteria for selecting IEC conditions. By way of further illustration, we outline basic laboratory protocols to partially purify a soluble serine peptidase from bovine whole brain tissue, covering crude tissue extract preparation through to partial purification of the target enzyme using anion-exchange chromatography. Protocols for assaying total protein and enzyme activity in both pre- and post-IEC fractions are also described.

Solutions for Failing High Schools: Converging Visions and Promising Models.

ERIC Educational Resources Information Center

Legters, Nettie; Balfanz, Robert; McPartland, James

Promising solutions to the failings of traditional comprehensive high schools were reviewed to identify basic principles and strategies for improving high schools nationwide. Selected research studies, policy documents, and promising high school programs were reviewed. The review revealed the following principles for helping high schools better…

Applied oceanography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bishop, J.M.

This book combines oceanography principles and applications such as marine pollution, resources, and transportation. It is divided into two main parts treating the basic principles of physical oceanography, and presenting a unique systems framework showing how physical oceanography, marine ecology, economics, and government policy may be combined to define the newly developing field of applied oceanography.

Fundamentals of Diesel Engines.

ERIC Educational Resources Information Center

Marine Corps Inst., Washington, DC.

This student guide, one of a series of correspondence training courses designed to improve the job performance of members of the Marine Corps, deals with the fundamentals of diesel engine mechanics. Addressed in the three individual units of the course are the following topics: basic principles of diesel mechanics; principles, mechanics, and…

Institutional Ethics and Values. The Fundamentals. Board Basics.

ERIC Educational Resources Information Center

Corts, Thomas E.

1998-01-01

This booklet offers trustees of institutions of higher education a guide to the ethical principles upon which the institution should base its decisions. An introductory section offers actual examples of unethical decisions by single officials for which the institution was responsible. The following sections each explain a principle and offer…

Reference Collection Development Policy.

ERIC Educational Resources Information Center

Nebraska Univ., Kearney.

The purpose of this policy is to outline those principles that guide the development of the Reference Collection at the Calvin T. Ryan Library, University of Nebraska at Kearney. It clarifies, records, and makes public the basic principles that the members of the Reference Department believe should be applied in adding items to or withdrawing…

Principles of Pesticide Use, Handling, and Application: Instructional Modules for Vocational Agriculture Education. Student Manual.

ERIC Educational Resources Information Center

Ellis Associates, Inc., College Park, MD.

This training package is designed to present the basic principles of pesticide use, handling, and application. Included in this package is information on federal laws and regulations, personal safety, environmental implications, storage and disposal considerations, proper application procedures, and fundamentals of pest management. Successful…

Principles of Pesticide Use, Handling, and Application: Instructional Modules for Vocational Agriculture Education. Teacher Manual.

ERIC Educational Resources Information Center

Ellis Associates, Inc., College Park, MD.

The training package is designed to present the basic principles of pesticide use, handling, and application. Included in this package is information on Federal laws and regulations, personal safety, environmental implications, storage and disposal considerations, proper application procedures, and fundamentals of pest management. Successful…

Basic Comfort Heating Principles.

ERIC Educational Resources Information Center

Dempster, Chalmer T.

The material in this beginning book for vocational students presents fundamental principles needed to understand the heating aspect of the sheet metal trade and supplies practical experience to the student so that he may become familiar with the process of determining heat loss for average structures. Six areas covered are: (1) Background…

The Efficacy of Multimedia Modules for Teaching Basic Literacy-Related Concepts

ERIC Educational Resources Information Center

Sayeski, Kristin L.; Kennedy, Michael J.; de Irala, Sandra; Clinton, Elias; Hamel, Melissa; Thomas, Kristen

2015-01-01

Researchers have found that teacher preparation programs are not universally preparing teacher candidates in concepts associated with the alphabetic principle. Yet, the majority of students with reading disabilities or who struggle with beginning reading have difficulty with phonology and concepts associated with the alphabetic principle. The…

The Global Positioning System and Education in the 21st Century.

ERIC Educational Resources Information Center

Wikle, Thomas A.

2000-01-01

Students should have an understanding of basic Global Positioning System (GPS) principles as well as an awareness of how the technology will impact society in the future. Provides a brief overview of the evolution, principles, and applications of GPS together with suggested activities. (Contains 25 references.) (Author/WRM)

Using marketing principles to promote nursing products and services.

PubMed

Siegel, M

1996-01-01

In this article, the author identifies basic marketing principles that can guide the introduction of new or existing products and services. To illustrate the elements of marketing, an example is used to describe how a new closed-circuit patient education channel was introduced at a midwestern teaching hospital.

Water System Adaptation to Hydrological Changes: Module 10, Basic Principles of Incorporating Adaptation Science into Hydrologic Planning and Design

EPA Science Inventory

This course will introduce students to the fundamental principles of water system adaptation to hydrological changes, with emphasis on data analysis and interpretation, technical planning, and computational modeling. Starting with real-world scenarios and adaptation needs, the co...

Teaching Literacy: From Theory to Practice.

ERIC Educational Resources Information Center

Kerr, Hugo

This book examines the basic principles of the cognitive psychology of literacy and explains how insights gained from that theory can inform and improve reading, spelling, and writing instruction aimed at adults. The following are among the topics discussed in the book's eight chapters: the principles of cognitive psychology (the nervous system,…

Sign Language and the Brain: A Review

ERIC Educational Resources Information Center

Campbell, Ruth; MacSweeney, Mairead; Waters, Dafydd

2008-01-01

How are signed languages processed by the brain? This review briefly outlines some basic principles of brain structure and function and the methodological principles and techniques that have been used to investigate this question. We then summarize a number of different studies exploring brain activity associated with sign language processing…

[Sponsoring of medical conferences, workshops and symposia by pharmaceutical companies. Physicians must be wary of this!].

PubMed

Warntjen, M

2009-12-01

The longstanding conventional forms of cooperation between medical organizations and physicians on the one hand and the pharmaceutical industry and manufacturers of medical products on the other hand nowadays hold the risk of coming into conflict with the public prosecutor. Typical circumstances which are taken up by the investigating authorities are financial supports of medical conferences, workshops and symposia. To understand the problem under criminal law it is important to become acquainted with the protective aim of the statutory offences of the acceptance of benefits according to section sign 331 of the Penal Code (Strafgesetzbuch, StGB) and of corruption according to section sign 332 of the Penal Code. The "trust of the general public in the objectivity of governmental decisions" must be protected and the "evil appearance of the corruptibility of official acts" must be counteracted. A basic differentiation is made between physicians with and without office-bearing functions. By paying attention to the recommendations and basic principles of cooperation between the medical profession and the healthcare industry presented in this article (transparency principle, equivalence principle, documentation principle and separation principle) the emergence of any suspicious factors can be effectively avoided.

Virtual Immunology: Software for Teaching Basic Immunology

ERIC Educational Resources Information Center

Berçot, Filipe Faria; Fidalgo-Neto, Antônio Augusto; Lopes, Renato Matos; Faggioni, Thais; Alves, Luiz Anastácio

2013-01-01

As immunology continues to evolve, many educational methods have found difficulty in conveying the degree of complexity inherent in its basic principles. Today, the teaching-learning process in such areas has been improved with tools such as educational software. This article introduces "Virtual Immunology," a software program available…

Reading Disability: A Human Approach to Learning. Third Edition, Revised & Expanded.

ERIC Educational Resources Information Center

Roswell, Florence G.; Natchez, Gladys

This book organizes the subject of reading disability under the following headings: basic considerations, diagnosis, and treatment. Chapters under the basic-considerations heading explore the causes and neurological and psychological bases of reading disability and psychotherapeutic principles in remedial reading instruction. Two chapters…

Core Competencies for Basic Drafting.

ERIC Educational Resources Information Center

Werner, Claire; Calderon, Ray

These competencies for drafting are designed to cover basic principles and practices for beginning drafters. Each competency appears in a one-page format. It is presented as a goal statement followed by one or more "indicator" statements, which are performance objectives describing an ability that, upon attainment, will establish…

Standardized Curriculum for Diesel Engine Mechanics.

ERIC Educational Resources Information Center

Mississippi State Dept. of Education, Jackson. Office of Vocational, Technical and Adult Education.

Standardized curricula are provided for two courses for the secondary vocational education program in Mississippi: diesel engine mechanics I and II. The eight units in diesel engine mechanics I are as follows: orientation; shop safety; basic shop tools; fasteners; measurement; engine operating principles; engine components; and basic auxiliary…

Motivation in Education.

ERIC Educational Resources Information Center

Ray, Nancy L.

This paper presents basic principles and theories of motivation, attempts to provide a better understanding of the concept, and explores the role motivation plays in learning. Basic theories of motivation are reviewed including: Freud's belief in motivation by the id, unconscious forces, and sexual stages; Jung and Adler's belief that people are…

Environmental Awareness: Just a Pane of Glass Away.

ERIC Educational Resources Information Center

Kopchynski, Kevin

1982-01-01

Highlights several basic ecological principles and suggests corresponding classroom activities for grades five to eight that revolve around a freshwater aquarium. Basic ecological concepts, adaptations, characteristics of aquatic habitats, and pollution problems are outlined in separate tables. A short list of resource materials is included.…

Teaching the Rules of Debit and Credit

ERIC Educational Resources Information Center

Potts, Andrew J.

1974-01-01

A fundamental method of explaining the basic accounting principles and concepts (debit, credit, basic accounting equation) which includes visual aids, reference to local businesses, and drill, does much toward increasing the student's skill and enhancing his understanding of the subject matter. (Sample transparencies are included.) (Author/AJ)

Digital Simulation and Modelling.

ERIC Educational Resources Information Center

Hawthorne, G. B., Jr.

A basically tutorial point of view is taken in this general discussion. The author examines the basic concepts and principles of simulation and modelling and the application of digital computers to these tasks. Examples of existing simulations, a discussion of the applicability and feasibility of simulation studies, a review of simulation…

Safe surgery: validation of pre and postoperative checklists 1

PubMed Central

Alpendre, Francine Taporosky; Cruz, Elaine Drehmer de Almeida; Dyniewicz, Ana Maria; Mantovani, Maria de Fátima; Silva, Ana Elisa Bauer de Camargo e; dos Santos, Gabriela de Souza

2017-01-01

ABSTRACT Objective: to develop, evaluate and validate a surgical safety checklist for patients in the pre and postoperative periods in surgical hospitalization units. Method: methodological research carried out in a large public teaching hospital in the South of Brazil, with application of the principles of the Safe Surgery Saves Lives Programme of the World Health Organization. The checklist was applied to 16 nurses of 8 surgical units and submitted for validation by a group of eight experts using the Delphi method online. Results: the instrument was validated and it was achieved a mean score ≥1, level of agreement ≥75% and Cronbach’s alpha >0.90. The final version included 97 safety indicators organized into six categories: identification, preoperative, immediate postoperative, immediate postoperative, other surgical complications, and hospital discharge. Conclusion: the Surgical Safety Checklist in the Pre and Postoperative periods is another strategy to promote patient safety, as it allows the monitoring of predictive signs and symptoms of surgical complications and the early detection of adverse events. PMID:28699994

A surgical support system for Space Station Freedom

NASA Technical Reports Server (NTRS)

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

1992-01-01

Surgical techniques in microgravity are being developed for the Health Maintenance Facility (HMF) on Space Station Freedom (SSF). This will be a presentation of the proposed surgical capabilities and ongoing hardware and procedural investigations. Methods: Procedures and prototype hardware, which include a medical restraint system, a surgical overhead isolation canopy, a suction device, and a regional laminar flow device were evaluated. This was accomplished by realistic sterile surgical simulations involving both mannequins and animals during KC-135 parabolic flight and in a high fidelity ground based HMF mockup. Results: Animal surgery in the environment of microgravity allowed the observation of unique arterial and venous bleeding characteristics for the first time. The ability to control bleeding and to prevent cabin atmosphere contamination was also demonstrated. Conclusions: The procedures and prototype hardware tested provided valuable information and should be investigated and developed further. The use of standard surgical techniques are possible in microgravity if the principles of personnel and supply restraint and operative field containment are adhered to.

Biology of Adenoid Cystic Carcinoma of the Tracheobronchial Tree and Principles of Management.

PubMed

Maziak, Donna E

2018-05-01

Adenoid cystic carcinoma of the trachea is a rare tumor. The mainstay of treatment remains surgical resection, even in the presence of positive margins or metastatic disease. Perineural involvement commonly causes positive margins and should not deter from resection. Knowledge of releasing maneuvers is essential for surgical success. Long-term follow-up is required with patients presenting late and surviving with recurrent disease for years. Copyright © 2018 Elsevier Inc. All rights reserved.

Cosmic secrets

NASA Astrophysics Data System (ADS)

Schommers, W.

1. The absolute truth. 1.1. Final truth. 1.2. Two important questions. 1.3. Why does the cosmos exist? 1.4. Are the laws of nature independent of the observer's own nature? 1.5. Self0indulgence was dominant. 1.6. Newton's mechanics and its overestimation. 1.7. Scientific realism. 1.8. An important principle: as little outside world as possible. 1.9. Inside world and outside world. 1.10. Principal questions. 1.11. How does science progress? 1.12. Final remarks -- 2. The projection principle. 2.1. The elements of space and time. 2.2. Relationship between matter and space-time. 2.3. Two relevant features. 2.4. Two kinds of "objects". 2.5. Perception processes. 2.6. Inside world and outside world. 2.7. The influence of evolution. 2.8. Information in the picture versus information in basic reality (outside reality). 2.9. Other biological systems. 2.10. How many (geometrical) objects can be in space-time? 2.11. Two types of space-time? 2.12. Summary -- 3. Fictitious realities. 3.1. Conventional quantum theory: critical remarks. 3.2. The projection principle in connection with fictitious realities. 3.3. Distribution of information. 3.4. Basic transformation effects. 3.5. Pictures within projection theory. 3.6. Auxiliary construction. 3.7. Basic laws. 3.8. Extension of conventional quantum theory. 3.9. Only processes are relevant! 3.10. Interactions. 3.11. Distance-independent interactions. 3.12. Arbitrary jumps within (r, t)-space. 3.13.Mach's principle: preliminary remarks. 3.14. Can a lone, elementary object exist in the cosmos? 3.15. The meaning of the potential functions. 3.16. Time. 3.17. Time travel in physics. 3.18. Summary -- 4. Basic reality and levels of reality. 4.1. Hard objects. 4.2. General physical laws. 4.3. States of mind. 4.4. Outside world and basic reality. 4.5. Objective processes. 4.6. Observations. 4.7. No interactions within (r, t)-space. 4.8. The general cannot be deduced from the particular. 4.9. Remarks on the notion "world equation". 4.10. On the anthropic principle. 4.11. Summary -- 5. Cosmological constant and physical reality. 5.1. Introductory remarks. 5.2. The cosmological constant. 5.3. Critical remarks on basic quantum theory. 5.4. Projection theory and the emptying. 5.5. Artificial vacuum effects!? 5.6. On the observation of physically real process. 5.7. Curved spaces. 5.8. Flatness and horizon problem. 5.8. Summary -- 6. Final remarks.

Surgical Assisting

MedlinePlus

... CPR/BLS certification Acceptable health and immunization records Computer literacy Students also must be able to show proof of successful completion of basic science (college level) instruction, including: Microbiology Pathophysiology Pharmacology Anatomy ...

Femtosecond Lasers and Corneal Surgical Procedures.

PubMed

Marino, Gustavo K; Santhiago, Marcony R; Wilson, Steven E

2017-01-01

Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. In conclusion, femtosecond laser is a heavily utilized tool in refractive and nonrefractive corneal surgical procedures, and further technological advances are likely to expand its applications. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

[Pictures balance for optimal surgical management of pelvic endometriosis. Imaging and surgery of endometriosis].

PubMed

Leroy, A; Garabedian, C; Fourquet, T; Azaïs, H; Merlot, B; Collinet, P; Rubod, C

2016-03-01

Endometriosis is a frequent benign pathology that is found in 10-15% of women and in 20% of infertile women. It has an impact on fertility, but also in everyday life. If medical treatment fails, surgical treatment can be offered to the patient. To provide adequate treatment and give clearer information to patients, it seems essential to achieve an optimal preoperative imaging assessment. Thus, the aim of this work is to define the information expected by the surgeon and the indications of each imaging test for each compartment of the pelvis, allowing an ideal surgical management of pelvic endometriosis. We will not discuss imaging techniques' principles and we will not develop the indications and surgical techniques. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Anesthesia - what to ask your doctor - adult

MedlinePlus

... 23364567 . Hernandez A, Sherwood ER. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice . 20th ...

Be FAIR to students: four principles that lead to more effective learning.

PubMed

Harden, Ronald M; Laidlaw, Jennifer M

2013-01-01

A teacher is a professional not a technician. An understanding of some basic principles about learning can inform the teacher or trainer in their day-to-day practice as a teacher or a trainer. The FAIR principles are: provide feedback to the student, engage the student in active learning, individualise the learning to the personal needs of the student and make the learning relevant. Application of the principles can lead to more effective learning - the poor teacher can become a good teacher and the good teacher an excellent teacher.

[Bioethics of principles].

PubMed

Pérez-Soba Díez del Corral, Juan José

2008-01-01

Bioethics emerges about the tecnological problems of acting in human life. Emerges also the problem of the moral limits determination, because they seem exterior of this practice. The Bioethics of Principles, take his rationality of the teleological thinking, and the autonomism. These divergence manifest the epistemological fragility and the great difficulty of hmoralñ thinking. This is evident in the determination of autonomy's principle, it has not the ethical content of Kant's propose. We need a new ethic rationality with a new refelxion of new Principles whose emerges of the basic ethic experiences.

Principles of Burn Pain Management.

PubMed

James, Dominika Lipowska; Jowza, Maryam

2017-10-01

This article describes pathophysiology of burn injury-related pain and the basic principles of burn pain management. The focus is on concepts of perioperative and periprocedural pain management with extensive discussion of opioid-based analgesia, including patient-controlled analgesia, challenges of effective opioid therapy in opioid-tolerant patients, and opioid-induced hyperalgesia. The principles of multimodal pain management are discussed, including the importance of psychological counseling, perioperative interventional pain procedures, and alternative pain management options. A brief synopsis of the principles of outpatient pain management is provided. Copyright © 2017 Elsevier Inc. All rights reserved.

Concepcion de la Educacion Basica en Algunos Paises. Series Divulgaciones No. 1 (The Notion of Basic Education in Several Countries. Information Series No. 1).

ERIC Educational Resources Information Center

Enriquez, Galo, Ed.

This booklet defines and considers basic education and reports on the concept as it is implemented and developed in Argentina, Colombia, Chile, Spain, and Peru. Basic education, as defined here, generally refers to the education of children between the ages of 7 and 16 years. Initial remarks define the issue and discuss general principles. The…

Development of a surgical educational research program-fundamental principles and challenges.

PubMed

Ahmed, Kamran; Ibrahim, Amel; Anderson, Oliver; Patel, Vanash M; Zacharakis, Emmanouil; Darzi, Ara; Paraskeva, Paraskevas; Athanasiou, Thanos

2011-05-15

Surgical educational research is the scientific investigation of any aspect of surgical learning, teaching, training, and assessment. The research into development and validation of educational tools is vital to optimize patient care. This can be accomplished by establishing high quality educational research programs within academic surgical departments. This article aims to identify the components involved in educational research and describes the challenges as well as solutions to establishing a high quality surgical educational research program. A variety of sources including journal articles, books, and online literature were reviewed in order to determine the pathways involved in conducting educational research and establishing a research program. It is vital to ensure that educational research is acceptable, innovative, robust in design, funded correctly, and disseminated successfully. Challenges faced by the current surgical research programs include structural organization, academic support, credibility, time, funding, relevance, and growth. The solutions to these challenges have been discussed. To ensure research in surgical education is of high quality and yields credible results, strong leadership in the organization of an educational research program is necessary. Copyright © 2011 Elsevier Inc. All rights reserved.

A Low-Cost, Passive Navigation Training System for Image-Guided Spinal Intervention.

PubMed

Lorias-Espinoza, Daniel; Carranza, Vicente González; de León, Fernando Chico-Ponce; Escamirosa, Fernando Pérez; Martinez, Arturo Minor

2016-11-01

Navigation technology is used for training in various medical specialties, not least image-guided spinal interventions. Navigation practice is an important educational component that allows residents to understand how surgical instruments interact with complex anatomy and to learn basic surgical skills such as the tridimensional mental interpretation of bidimensional data. Inexpensive surgical simulators for spinal surgery, however, are lacking. We therefore designed a low-cost spinal surgery simulator (Spine MovDigSys 01) to allow 3-dimensional navigation via 2-dimensional images without altering or limiting the surgeon's natural movement. A training system was developed with an anatomical lumbar model and 2 webcams to passively digitize surgical instruments under MATLAB software control. A proof-of-concept recognition task (vertebral body cannulation) and a pilot test of the system with 12 neuro- and orthopedic surgeons were performed to obtain feedback on the system. Position, orientation, and kinematic variables were determined and the lateral, posteroanterior, and anteroposterior views obtained. The system was tested with a proof-of-concept experimental task. Operator metrics including time of execution (t), intracorporeal length (d), insertion angle (α), average speed (v¯), and acceleration (a) were obtained accurately. These metrics were converted into assessment metrics such as smoothness of operation and linearity of insertion. Results from initial testing are shown and the system advantages and disadvantages described. This low-cost spinal surgery training system digitized the position and orientation of the instruments and allowed image-guided navigation, the generation of metrics, and graphic recording of the instrumental route. Spine MovDigSys 01 is useful for development of basic, noninnate skills and allows the novice apprentice to quickly and economically move beyond the basics. Copyright © 2016 Elsevier Inc. All rights reserved.

Subject preferences of first- and second-year medical students for their future specialization at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal – a questionnaire-based study

PubMed Central

Jha, Rajesh K; Paudel, Keshab R; Shah, Dev K; Sah, Ajit K; Basnet, Sangharshila; Sah, Phoolgen; Adhikari, Sandeep

2015-01-01

Introduction The selection of a discipline for future specialization may be an important factor for the medical students’ future career, and it is influenced by multiple factors. The interest of students in the early stages can be improved in subjects related to public health or of academic importance, as per need. Methods A questionnaire-based study was conducted among 265 first- and second-year medical students of Chitwan Medical College, Nepal to find out their subject of preference for postgraduation and the factors affecting their selection along with their interesting basic science subject. Only the responses from 232 completely filled questionnaires were analyzed. Results The preference of the students for clinical surgical (50.9%), clinical medical (45.3%), and basic medical (3.9%) sciences for postgraduation were in descending order. The most preferred specialty among male students was clinical surgical sciences (56.3%), and among female students, it was clinical medical sciences (53.6%). Although all the students responded to their preferred specialty, only 178 students specified the subject of their interest. General surgery (23.4%), pediatrics (23.4%), and anatomy (2.4%) were the most favored subjects for postgraduation among clinical surgical, clinical medical, and basic medical sciences specialties, respectively. More common reasons for selection of specific subject for future career were found to be: personal interests, good income, intellectual challenge, and others. Conclusion Many students preferred clinical surgical sciences for their future specialization. Among the reasons for the selection of the specialty for postgraduation, no significant reason could be elicited from the present study. PMID:26635491

Small Engine Repair. Two-Stroke and Four-Stroke Cycle.

ERIC Educational Resources Information Center

Hires, Bill; And Others

This curriculum guide is intended to assist persons teaching a course in repairing two- and four-stroke cycle small engines. Addressed in the individual units of instruction are the following topics: safety, tools, fasteners, and measurement techniques; basic small engine theory (engine identification and inspection, basic engine principles and…

Alfred-Adler's Basic Concepts and Implications.

ERIC Educational Resources Information Center

Lundin, Robert W.

This book presents the basic principles of Adler's psychology. The first chapter looks at Adlerian psychology as it exists today, and examines earlier influences. The second chapter examines feelings of inferiority and compensation for these feelings. The third chapter considers the nature of goals and how they are formulated. The fourth chapter…

Send Student Interest Skyward! Soaring Teaches Aeronautics Basics

ERIC Educational Resources Information Center

Scarcella, Joe; Wallace, Art

2011-01-01

Gliders and sailplanes provide a great launching platform for teaching about technology and scientific principles. Soaring is technological innovation in action, using earth's natural resources for energy and endurance during flight. This article focuses on the basics of soaring, which educators can use to increase excitement and interest in the…

Send Student Interest Skyward!: Soaring Teaches Aeronautics Basics

ERIC Educational Resources Information Center

Scarcella, Joe; Wallace, Art

2011-01-01

Gliders and sailplanes provide a great launching platform for teaching about technology and scientific principles. Soaring is technological innovation in action, using earth's natural resources for energy and endurance during flight. This article focuses on the basics of soaring, which educators can use to increase excitement and interest in the…

Wholistic Health Care for a Campus Student Health Service.

ERIC Educational Resources Information Center

Van Ness, John H.

1981-01-01

Discusses the importance of environmental and emotional considerations in medical care. Outlines the basic principles of holistic health care and provides a rationale for a campus-based center. Describes an existing holistic student health service and proposes a basic program for a campus holistic health clinic. (RC)

24 CFR 55.1 - Purpose and basic responsibility.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Urban Development FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS General § 55.1 Purpose and basic... alternative.” (2) The purpose of Executive Order 11990, Protection of Wetlands, is “to avoid to the extent... Management, and Executive Order 11990, Protection of Wetlands, and employs the principles of the Unified...

Basic Curriculum Guide--Science. Grades K-6.

ERIC Educational Resources Information Center

Starr, John W., 3rd., Ed.

GRADES OR AGES: K-6. SUBJECT MATTER: Science. ORGANIZATION AND PHYSICAL APPEARANCE: The guide is in two parts--the background, philosophy, and instructional principles of science teaching, including a resource unit model, and the development by grade level of the various basic scientific concepts. The guide also includes information of…

Getting to Grips with Online Delivery.

ERIC Educational Resources Information Center

Booker, Di

This booklet, which is intended for general readers wishing to understand important trends in vocational education and training (VET) in Australia, provides an overview of the basic issues in online delivery of VET. The following topics are discussed in the booklet's first six sections: (1) basic principles of online delivery; (2) benefits and…

Potential Tools for Phenotyping for Physical Characteristics of Plants, Pods, and Seed

USDA-ARS?s Scientific Manuscript database

Advances in phenotyping are a key factor for success in modern breeding as well as for basic plant research. Phenotyping provides a critical means to understand morphological, biochemical, physiological principles in the control of basic plant functions as well as for selecting superior genotypes in...

Basic Laboratory Skills for Water and Wastewater Analysis. Report No. 125.

ERIC Educational Resources Information Center

Clark, Douglas W.

Designed for individuals wanting to acquire an introductory knowledge of basic skills necessary to function in a water or wastewater laboratory, this handbook emphasizes current use of routine equipment and proper procedures. Explanations and illustrations focus on underlying techniques and principles rather than processes for conducting specific…

Astrophysics on the Lab Bench

ERIC Educational Resources Information Center

Hughes, Stephen W.

2010-01-01

In this article some basic laboratory bench experiments are described that are useful for teaching high school students some of the basic principles of stellar astrophysics. For example, in one experiment, students slam a plastic water-filled bottle down onto a bench, ejecting water towards the ceiling, illustrating the physics associated with a…

Mainstreaming: Our Current Knowledge Base.

ERIC Educational Resources Information Center

Bates, Percy, Ed.

The nine author contributed chapters are intended to provide a basic introduction to the rationale and processes of mainstreaming handicapped children. The first paper, "The Whys and Hows of Mainstreaming" by T. Tice, provides a philosophical examination of the basic principles of P.L. 94-142, the Education for All Handicapped Children Act, and…

What Makes Cooperative Learning Work.

ERIC Educational Resources Information Center

Johnson, David W.; Johnson, Roger T.

This paper gives an introduction to cooperative learning (CL), providing a definition of what it is and is not (pseudo-learning groups, traditional classroom learning groups), discussing basic principles, describing two basic types of CL (formal and informal), and listing the benefits of CL suggested by previous research. In order to understand…

DIAGNOSIS AND APPRAISAL OF COMMUNICATION DISORDERS. PRENTICE-HALL FOUNDATIONS OF SPEECH PATHOLOGY SERIES.

ERIC Educational Resources Information Center

DARLEY, FREDERIC L.

THIS TEXT GIVES THE STUDENT AN OUTLINE OF THE BASIC PRINCIPLES OF SCIENTIFIC METHODOLOGY WHICH UNDERLIE EVALUATIVE WORK IN SPEECH DISORDERS. RATIONALE AND ASSESSMENT TECHNIQUES ARE GIVEN FOR EXAMINATION OF THE BASIC COMMUNICATION PROCESSES OF SYMBOLIZATION, RESPIRATION, PHONATION, ARTICULATION-RESONANCE, PROSODY, ASSOCIATED SENSORY AND PERCEPTUAL…

Basic Facts and Figures about the Educational System in Japan.

ERIC Educational Resources Information Center

National Inst. for Educational Research, Tokyo (Japan).

Tables, charts, and graphs convey supporting data that accompany text on various aspects of the Japanese educational system presented in this booklet. There are seven chapters: (1) Fundamental principles of education; (2) Organization of the educational system; (3) Basic statistics of education; (4) Curricula, textbooks, and instructional aids;…

On the Development of Schools' External Public Relations in China.

ERIC Educational Resources Information Center

Tianping, Yang

2003-01-01

Public relations is a basic function of a modern school's management, while external public relationship is a basic principle and component of it. To develop a school's public relationship, efforts should focus on its key publics, strengthening its coordination and communication with governments, education departments, and local communities.…

Using a Self-Administered Visual Basic Software Tool To Teach Psychological Concepts.

ERIC Educational Resources Information Center

Strang, Harold R.; Sullivan, Amie K.; Schoeny, Zahrl G.

2002-01-01

Introduces LearningLinks, a Visual Basic software tool that allows teachers to create individualized learning modules that use constructivist and behavioral learning principles. Describes field testing of undergraduates at the University of Virginia that tested a module designed to improve understanding of the psychological concepts of…

Developing More Effective Curriculum Via "Basic Stuff."

ERIC Educational Resources Information Center

Heitmann, Helen M.

Discussed is the design and development of a physical education curriculum, incorporating principles discussed in the "Basic Stuff" physical education series. Four tasks are suggested for planning the curriculum: (1) develop a unit for activity instruction, where the concepts inherent in the sport or activity skills may be identified; (2) develop…

Dental Assistant Specialty, AFS 981X0.

DTIC Science & Technology

1982-12-01

GRP588, N=37) E. Prosthodontic Assistants (GRP453, N=35) F. Preventive Dentistry-Operative Assistants (GRP486, N=15) G. Orthodontic Assistants (GRP477, N...basic functions. Their assistance to the dentist involved preparing materials and instruments to be used in treating the patient, performing patient pre ...Mix surgical packs or periodontal dressings Don or doff surgical caps, gowns, gloves, shoes, or covers Disassemble or assemble prophylaxis hand pieces

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

PubMed

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

2017-01-01

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

Achieving a predictable 24-hour return to normal activities after breast augmentation: part II. Patient preparation, refined surgical techniques, and instrumentation.

PubMed

Tebbetts, John B

2006-12-01

The goal of this study was to develop practices that would allow patients undergoing subpectoral augmentation to predictably return to full normal activities within 24 hours after the operation, free of postoperative adjuncts. Part I of this study used motion and time study principles to reduce operative times, medication dosages, perioperative morbidity, and recovery times in augmentation mammaplasty. Part II of the study focuses on details of patient education, preoperative planning, instrumentation, and surgical technique modifications that were identified, modified, and implemented to achieve the results reported in part I. Two groups of 16 patients each (groups 1 and 2) were studied retrospectively for comparison to a third group of 627 patients (group 3) studied prospectively. Patients in group 1 had axillary partial retropectoral breast augmentations in 1982-1983, using dissociative anesthesia, blunt instrument implant pocket dissection, and Dow Corning, double-lumen implants containing 20 mg of methylprednisolone and 20 cc of saline in the outer lumen of the implants. Patients in group 2 (1990) had inframammary, retromammary augmentations by using a combination of blunt and electrocautery dissection, Surgitek Replicon polyurethane-covered, silicone gel-filled implants, and general endotracheal anesthesia. Patients in group 3 (1998 to 2001, n = 627) had inframammary partial retropectoral, inframammary retromammary, and axillary partial retropectoral augmentations under general endotracheal anesthesia. Refined practices and surgical techniques from studies of groups 1 and 2 were applied in group 3. Videotapes from operative procedures of groups 1 and 2 were analyzed with macromotion and micromotion study principles, and tables of events were formulated for each move during the operation for all personnel in the operating room. Extensive details of surgical technique were examined and reexamined in 13 different stages by using principles of motion and time studies described in part I of this study to maximize efficiency without any change in quality. Unnecessary or unproductive motions and techniques were progressively eliminated, and essential, productive techniques were streamlined to eliminate wasted time and motion. Instrumentation and surgical techniques were evaluated in detail and modified to minimize bleeding and tissue trauma. Detailed data were presented in part I of this study that document shorter operative times, recovery times, time to discharge home, and time to return to normal activities. This part focuses on the patient education, preoperative planning, instrumentation, and surgical technique changes that were implemented on the basis of the findings in part I of the study. More extensive patient information integrated with staged informed consent resulted in a more in formed and confident patient. Applying motion and time study principles to analysis and refinement of instrumentation and surgical techniques resulted in a substantial reduction in perioperative morbidity and a simpler, shorter 24-hour return to full normal activity for 96 percent of the patients undergoing breast augmentation in group 3 compared with groups 1 and 2. More than 96 percent of patients in group 3 were able to return to normal activities, lift their arms above their heads, lift normal-weight objects, and drive their car within 24 hours after their partial retropectoral breast augmentation. Patient education, preoperative planning, instrumentation, and surgical technique modifications based on motion and time study video analyses reduced surgical trauma and bleeding, reduced perioperative morbidity, and allowed 96 percent of 627 breast augmentation patients in group 3 a predictable return to full, normal activity in 24 hours or less. Specific surgical factors that contributed to these results included (1) prospective hemostasis techniques with a zero tolerance for even the smallest amount of bleeding, (2) strict "no-touch" techniques for periosteum and perichondrium, (3) eliminating all blunt dissection, (4) performing all dissection under direct vision, (5) modified and simplified instrumentation, and (6) optimal use of muscle relaxants during subpectoral dissection.

Achieving a predictable 24-hour return to normal activities after breast augmentation: Part II. Patient preparation, refined surgical techniques, and instrumentation.

PubMed

Tebbetts, John B

2002-01-01

The goal of this study was to develop practices that would allow patients undergoing subpectoral augmentation to predictably return to full normal activities within 24 hours after the operation, free of postoperative adjuncts. Part I of this study used motion and time study principles to reduce operative times, medication dosages, perioperative morbidity, and recovery times in augmentation mammaplasty. Part II of the study focuses on details of patient education, preoperative planning, instrumentation, and surgical technique modifications that were identified, modified, and implemented to achieve the results reported in part I. Two groups of 16 patients each (groups 1 and 2) were studied retrospectively for comparison to a third group of 627 patients (group 3) studied prospectively. Patients in group 1 had axillary partial retropectoral breast augmentations in 1982-1983, using dissociative anesthesia, blunt instrument implant pocket dissection, and Dow Corning, double-lumen implants containing 20 mg of methylprednisolone and 20 cc of saline in the outer lumen of the implants. Patients in group 2 (1990) had inframammary, retromammary augmentations by using a combination of blunt and electrocautery dissection, Surgitek Replicon polyurethane-covered, silicone gel-filled implants, and general endotracheal anesthesia. Patients in group 3 (1998 to 2001, n = 627) had inframammary partial retropectoral, inframammary retromammary, and axillary partial retropectoral augmentations under general endotracheal anesthesia. Refined practices and surgical techniques from studies of groups 1 and 2 were applied in group 3. Videotapes from operative procedures of groups 1 and 2 were analyzed with macromotion and micromotion study principles, and tables of events were formulated for each move during the operation for all personnel in the operating room. Extensive details of surgical technique were examined and reexamined in 13 different stages by using principles of motion and time studies described in part I of this study to maximize efficiency without any change in quality. Unnecessary or unproductive motions and techniques were progressively eliminated, and essential, productive techniques were streamlined to eliminate wasted time and motion. Instrumentation and surgical techniques were evaluated in detail and modified to minimize bleeding and tissue trauma. Detailed data were presented in part I of this study that document shorter operative times, recovery times, time to discharge home, and time to return to normal activities. This part focuses on the patient education, preoperative planning, instrumentation, and surgical technique changes that were implemented on the basis of the findings in part I of the study. More extensive patient information integrated with staged informed consent resulted in a more informed and confident patient. Applying motion and time study principles to analysis and refinement of instrumentation and surgical techniques resulted in a substantial reduction in perioperative morbidity and a simpler, shorter 24-hour return to full normal activity for 96 percent of the patients undergoing breast augmentation in group 3 compared with groups 1 and 2. More than 96 percent of patients in group 3 were able to return to normal activities, lift their arms above their heads, lift normal-weight objects, and drive their car within 24 hours after their partial retropectoral breast augmentation. Patient education, preoperative planning, instrumentation, and surgical technique modifications based on motion and time study video analyses reduced surgical trauma and bleeding, reduced perioperative morbidity, and allowed 96 percent of 627 breast augmentation patients in group 3 a predictable return to full, normal activity in 24 hours or less. Specific surgical factors that contributed to these results included (1) prospective hemostasis techniques with a zero tolerance for even the smallest amount of bleeding, (2) strict "no-touch" techniques for periosteum and perichondrium, (3) eliminating all blunt dissection, (4) performing all dissection under direct vision, (5) modified and simplified instrumentation, and (6) optimal use of muscle relaxants during subpectoral dissection.

Refraction effects of atmosphere on geodetic measurements to celestial bodies

NASA Technical Reports Server (NTRS)

Joshi, C. S.

1973-01-01

The problem is considered of obtaining accurate values of refraction corrections for geodetic measurements of celestial bodies. The basic principles of optics governing the phenomenon of refraction are defined, and differential equations are derived for the refraction corrections. The corrections fall into two main categories: (1) refraction effects due to change in the direction of propagation, and (2) refraction effects mainly due to change in the velocity of propagation. The various assumptions made by earlier investigators are reviewed along with the basic principles of improved models designed by investigators of the twentieth century. The accuracy problem for various quantities is discussed, and the conclusions and recommendations are summarized.

Effectiveness of an infection control programmed unit of instruction in nursing education.

PubMed

Goldrick, B A

1987-02-01

To determine whether programmed instruction is an acceptable, cost-effective alternative to classroom lectures for teaching the basic principles of infection control to nursing students, a 46-frame programmed unit of instruction (PUI), with a pretest and posttest, was developed, piloted, and tested for reliability and validity. The instruments were developed on the basis of current knowledge of the epidemiology of infectious diseases and the 1983 revised Centers for Disease Control guideline for category-specific isolation precautions. A study was undertaken to test the hypothesis: Student nurses who take a PUI in the basic principles of infection control will score higher on posttests than those who do not take the PUI. A sample of 40 subjects was selected from the senior class in a baccalaureate nursing program at a public university. The subjects were randomly assigned to four groups of 10. A Solomon four-group design was used for data analysis, and a two-way analysis of variance was performed on the posttest means. Results indicated that the treatment (PUI) effect was significant (p less than 0.001). Therefore, it was concluded that the PUI in the basic principles of infection control is an effective instrument for nursing education.

Numerical Limitations of 1D Hydraulic Models Using MIKE11 or HEC-RAS software - Case study of Baraolt River, Romania

NASA Astrophysics Data System (ADS)

Andrei, Armas; Robert, Beilicci; Erika, Beilicci

2017-10-01

MIKE 11 is an advanced hydroinformatic tool, a professional engineering software package for simulation of one-dimensional flows in estuaries, rivers, irrigation systems, channels and other water bodies. MIKE 11 is a 1-dimensional river model. It was developed by DHI Water · Environment · Health, Denmark. The basic computational procedure of HEC-RAS for steady flow is based on the solution of the one-dimensional energy equation. Energy losses are evaluated by friction and contraction / expansion. The momentum equation may be used in situations where the water surface profile is rapidly varied. These situations include hydraulic jumps, hydraulics of bridges, and evaluating profiles at river confluences. For unsteady flow, HEC-RAS solves the full, dynamic, 1-D Saint Venant Equation using an implicit, finite difference method. The unsteady flow equation solver was adapted from Dr. Robert L. Barkau’s UNET package. Fluid motion is controlled by the basic principles of conservation of mass, energy and momentum, which form the basis of fluid mechanics and hydraulic engineering. Complex flow situations must be solved using empirical approximations and numerical models, which are based on derivations of the basic principles (backwater equation, Navier-Stokes equation etc.). All numerical models are required to make some form of approximation to solve these principles, and consequently all have their limitations. The study of hydraulics and fluid mechanics is founded on the three basic principles of conservation of mass, energy and momentum. Real-life situations are frequently too complex to solve without the aid of numerical models. There is a tendency among some engineers to discard the basic principles taught at university and blindly assume that the results produced by the model are correct. Regardless of the complexity of models and despite the claims of their developers, all numerical models are required to make approximations. These may be related to geometric limitations, numerical simplification, or the use of empirical correlations. Some are obvious: one-dimensional models must average properties over the two remaining directions. It is the less obvious and poorly advertised approximations that pose the greatest threat to the novice user. Some of these, such as the inability of one-dimensional unsteady models to simulate supercritical flow can cause significant inaccuracy in the model predictions.

The principles of teratology: are they still true?

PubMed

Friedman, Jan M

2010-10-01

James Wilson originally proposed a set of "Principles of Teratology" in 1959, the year before he helped to found the Teratology Society. By 1977, when these Principles were presented in a more definitive form in Wilson and Fraser's Handbook of Teratology, they had become a standard formulation of the basic tenets of the field. Wilson's Principles have continued to guide scientific research in teratology, and they are widely used in teaching. Recent advances in our knowledge of the molecular and cellular bases of embryogenesis serve only to provide a deeper understanding of the fundamental developmental mechanisms that underlie Wilson's Principles of Teratology. © 2010 Wiley-Liss, Inc.

Personality traits and virtual reality performance.

PubMed

Rosenthal, Rachel; Schäfer, Juliane; Hoffmann, Henry; Vitz, Martina; Oertli, Daniel; Hahnloser, Dieter

2013-01-01

Surgeons' personalities have been described as different from those of the general population, but this was based on small descriptive studies limited by the choice of evaluation instrument. Furthermore, although the importance of the human factor in team performance has been recognized, the effect of personality traits on technical performance is unknown. This study aimed to compare surgical residents' personality traits with those of the general population and to evaluate whether an association exists between their personality traits and technical performance using a virtual reality (VR) laparoscopy simulator. In this study, 95 participants (54 residents with basic, 29 with intermediate laparoscopic experience, and 12 students) underwent personality assessment using the NEO-Five Factor Inventory and performed five VR tasks of the Lap Mentor™ basic tasks module. The residents' personality traits were compared with those of the general population, and the association between VR performance and personality traits was investigated. Surgical residents showed personality traits different from those of the general population, demonstrating lower neuroticism, higher extraversion and conscientiousness, and male residents showed greater openness. In the multivariable analysis, adjusted for gender and surgical experience, none of the personality traits was found to be an independent predictor of technical performance. Surgical residents present distinct personality traits that differ from those of the general population. These traits were not found to be associated with technical performance in a virtual environment. The traits may, however, play an important role in team performance, which in turn is highly relevant for optimal surgical performance.

Zebrafish housing systems: a review of basic operating principles and considerations for design and functionality.

PubMed

Lawrence, Christian; Mason, Timothy

2012-01-01

The strategies for housing zebrafish used in biomedical research have evolved considerably over the past three decades. To keep pace with the rapid expansion and development of the zebrafish model system, the field has generally moved from keeping fish at the level of aquarium hobbyist to that of industrialized, recirculating aquaculture. Numerous commercial system vendors now offer increasingly sophisticated housing systems based on design principles that maximize the number of animals that can be housed in a given space footprint, and they are thus able to support large and diverse research programs. This review is designed to provide managers, lab animal veterinarians, investigators, and other parties responsible for care and use of these animals with a comprehensive overview of the basic operating and design principles of zebrafish housing systems. This information can be used to help plan the construction of new facilities and/or the upgrade and maintenance of existing operations.

Principles of treatment for soft tissue sarcoma.

PubMed

Dernell, W S; Withrow, S J; Kuntz, C A; Powers, B E

1998-02-01

Soft tissue sarcomas (STS) are mesenchymal tumors arising from connective tissue elements and are grouped together based on a common biologic behavior. The most common histologic types include malignant peripheral nerve sheath tumors (schwannoma and neurofibrosarcoma) "hemangiopericytoma," fibrosarcoma, and malignant fibrous histiocytoma. These tumors are relatively slow growing yet locally invasive with a high rate of recurrence following conservative management. Appropriate preoperative planning and aggressive surgical resection often result in long-term remission or cure. Identification and evaluation of resection margins are paramount in appropriate case management. The addition of radiotherapy after surgical resection can aid in remission for incompletely resected masses. Systemic chemotherapy for STS should be considered for high-grade tumors with a moderate metastatic potential. Potential prognostic factors include grade, resection margins, size, location, histologic type, and previous treatment, with grade and margins being the most important. Tumor types classified as STS that differ slightly in their presentation or treatment, including synovial cell sarcoma, rhabdomyosarcoma, liposarcoma, and vaccine-associated STS in cats, are discussed. Soft tissue sarcomas can be a frustrating disease to treat, but adherence to solid surgical oncology principles can greatly increase the odds of good disease control.

Hearing Science in Mid-Eighteenth-Century Britain and France

PubMed Central

Gouk, Penelope; Sykes, Ingrid

2011-01-01

Benjamin Martin, the English natural philosopher, and Claude-Nicolas Le Cat, the French surgeon, both published important work on auditory physiology and function in the mid-eighteenth century. Despite their different backgrounds, there was consensus between the two scholars on key principles of hearing research, most notably the importance of the inner ear in relation to auditory perception. Martin's work (1755 [1763?]) drew directly on the surgical work of Le Cat (1741) to demonstrate the importance of the auditory mechanism in listening processes. Le Cat's interest in the ear, however, came in turn from his interest in surgical anatomy. Martin used Le Cat's elegant designs as a tool for the vivid communication of auditory function to a popular, fee-paying audience. The meeting of two very different minds through intellectual agreement and material transfer demonstrates the way in which principles of hearing science were established in the Enlightenment period. PMID:20634220

Journalism and Academic Surgery: The Denver Post and The American Surgeon.

PubMed

Nakayama, Don K

2015-07-01

Publication in professional journals is where advancements in surgery are reported and verified. Thus academic surgery holds common ground with journalism, where the principles of service, communication, and integrity are the basis of their public trust and standing in society. Writing for the Denver Post the author learned lessons that are relevant to academic surgery. Facts have to be solid. There are important issues to be discussed. Articles have to be interesting and not tiresome to read. And if it's something new--the essence of news--get it out there first. The American Surgeon embodies the same principles. The journal is a place where members of the Southeastern Surgical Congress discuss important matters, like surgical education, and share stories of interest, like a Japanese surgeon trying to treat victims of nuclear war. It is accessible yet disciplined, dedicated to advancing our field and fostering fellowship and communication among its members.

Hearing science in mid-eighteenth-century Britain and France.

PubMed

Gouk, Penelope; Sykes, Ingrid

2011-10-01

Benjamin Martin, the English natural philosopher, and Claude-Nicolas Le Cat, the French surgeon, both published important work on auditory physiology and function in the mid-eighteenth century. Despite their different backgrounds, there was consensus between the two scholars on key principles of hearing research, most notably the importance of the inner ear in relation to auditory perception. Martin's work (1755 [1763?]) drew directly on the surgical work of Le Cat (1741) to demonstrate the importance of the auditory mechanism in listening processes. Le Cat's interest in the ear, however, came in turn from his interest in surgical anatomy. Martin used Le Cat's elegant designs as a tool for the vivid communication of auditory function to a popular, fee-paying audience. The meeting of two very different minds through intellectual agreement and material transfer demonstrates the way in which principles of hearing science were established in the Enlightenment period.

[Pre- and post-surgical orthodontic treatment for skeletal open bite].

PubMed

Zhou, Y; Hu, W; Sun, Y

2001-05-01

To Study the principles and rules of pre- and post-surgical orthodontic treatment for skeletal open bite patients. Thirty-two surgically treated open bite cases were analyzed, of which 9 were males, and 23 were females, aged from 16 to 38. Open bite was from 1 to 8.5 mm, average was 4 mm. 31 patients were Class III malocclusion, while 1 patient was Class II malocclusion. 1. Totally 21 patients were treated with orthodontics before and after orthognathic surgery, while 8 patients had pre-surgical orthodontics only, and other 3 had post-surgical orthodontics only. The duration for pre-surgical orthodontics was from 4 to 33 months, average was 12 months. The duration for post-surgical orthodontics was from 3 to 17 months, average was 8.5 months. 2. Presurgical orthodontic treatment included: Alignment of arches, decompensation of incisors, avoiding extrusion of incisors, and slight expansion of arches for coordination of arches. 3. Post-surgical orthodontic treatment included: Closure of residual spaces in the arches, realignment of arches, vertical elastics and Class II or III intermaxillary elastics. Skeletal open bites require combined orthodontic-orthognathic surgery for optimal and esthetical pleasing results.

[The General Principles of Suicide Prevention Policy from the perspective of clinical psychiatry].

PubMed

Cho, Yoshinori; Inagaki, Masatoshi

2014-01-01

In view of the fact that the suicide rate in Japan has remained high since 1998, the Basic Act on Suicide Prevention was implemented in 2006 with the objective of comprehensively promoting suicide prevention measures on a national scale. Based on this Basic Act, in 2007, the Japanese government formulated the General Principles of Suicide Prevention Policy as a guideline for recommended suicide prevention measures. These General Principles were revised in 2012 in accordance with the initial plan of holding a review after five years. The Basic Act places an emphasis on the various social factors that underlie suicides and takes the perspective that suicide prevention measures are also social measures. The slogan of the revised General Principles is "Toward Realization of a Society in which Nobody is Driven to Commit Suicide". The General Principles list various measures that are able to be used universally. These contents would be sufficient if the objective of the General Principles were "realization of a society that is easy to live in"; however, the absence of information on the effectiveness and order of priority for each measure may limit the specific effectiveness of the measures in relation to the actual prevention of suicide. In addition, considering that nearly 90% of suicide victims are in a state at the time of committing suicide in which a psychiatric disorder would be diagnosed, it would appear from a psychiatric standpoint that measures related to mental health, including expansion of psychiatric services, should be the top priority in suicide prevention measures. However, this is not the case in the General Principles, in either its original or revised form. Revisions to the General Principles related to clinical psychiatry provide more detailed descriptions of measures for individuals who unsuccessfully attempt suicide and identify newly targeted mental disorders other than depression; however, the overall proportion of contents relating to psychiatric care remains small. In particular, it must be noted that almost no measures are provided for individuals with chronic psychiatric disorders. We believe that the role of academic societies involved in suicide prevention, including our own, is to organize the contents of the General Principles based on evidence, to advance research in areas lacking in evidence, and to promote support for implementation of activities in areas with clear evidence.

The leadership principles of Dr. Martin Luther King, Jr. and their relevance to surgery.

PubMed Central

Brunicardi, F. Charles; Cotton, Ronald T.; Cole, George W.; Martinez, George

2007-01-01

In order to face the challenges in healthcare this century, it is essential that surgeons understand modern leadership principles. One of the greatest leaders in history was Dr. Martin Luther King, Jr., who provides a shining example of level-5 leadership for us to study. The study of leadership principles of great leaders can provide us with practical methods of conflict resolution as well as inspiration to keep us engaged and focused. As leaders of the medical community, we face numerous challenges, including discovering and implementing new treatments for disease, providing care for the indigent, overcoming educational challenges such as incorporating the ACGME Core Competencies into our surgical training and promoting diversity in education. Achieving these goals is often hindered by the environment in which we labor-nearly 50 million are uninsured, the rising cost of medical care is currently at 16% of the GNP, and reimbursement rates are falling-which makes the practice of surgery a significant challenge. Effective leadership will be paramount in achieving these goals. In this editorial, which summarizes a presentation given to the Surgical Section of the annual National Medical Association meeting, five important leadership principles that are important for surgeons have been selected and related to the outstanding leadership of Dr. Martin Luther King, Jr. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:17304963

Principles and Planning in Nasal and Facial Reconstruction: Making a Normal Face.

PubMed

Menick, Frederick J

2016-06-01

After reading this article, the participant should be able to: 1. Understand the rationale and value of principles of facial reconstruction in the complex patient. 2. Understand the importance of diagnosis and planning. 3. Appreciate the value of surgical staging. 4. Modify tissues to the requirements of the defect. 5. Know how to treat ischemic cover and lining complications. 6. Learn methods of late revision. It is easy to be overwhelmed by a complex defect. What to do? How? When? In what order? Success is determined by careful planning, guided by principles. The aesthetic and anatomical deficiencies must be identified. Then, what is absent, both visually and anatomically, and what is missing must be determined. What are the priorities? What is the best timing for each stage? What are the available options and what will be the likely result? Should I choose another option? How can the surgeon maintain vascularity, transfer tissue, and improve tissue quality and contour? What are potential backup salvage maneuvers? Sound surgical principles based on the contributions of Gillies and Millard provide strategic instructions that help the surgeon "make sense" of a complex problem. They provide coordinated rules that clarify the diagnosis, planning, timing, and stages of repair. These should be combined with a regional unit approach to facial repair that provides tactical rules to establish the skin quality, border outline, and three-dimensional shape of the normal face.

Surgical orthodontics.

PubMed

Strohl, Alexis M; Vitkus, Lauren

2017-08-01

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

VOCATIONAL TALENT EXERCISES, PART B.

ERIC Educational Resources Information Center

George Washington Univ., Washington, DC. School of Education.

THIS WORKBOOK WAS DEVELOPED IN A CURRICULUM PROJECT DESCRIBED IN VT 004 454, TO HELP YOUNG PEOPLE LEARN BASIC PRINCIPLES AND CONCEPTS OF MECHANICS AND TECHNOLOGY BY PROVIDING EXERCISES SIMILAR TO THOSE IN APTITUDE TESTS, EXPLANATIONS OF THE UNDERLYING PRINCIPLES, AND THE CORRECT ANSWERS. IT IS THE SECOND OF FOUR BOOKS WHICH PRESENT 30 EXERCISES…

Principles of Cancer Screening.

PubMed

Pinsky, Paul F

2015-10-01

Cancer screening has long been an important component of the struggle to reduce the burden of morbidity and mortality from cancer. Notwithstanding this history, many aspects of cancer screening remain poorly understood. This article presents a summary of basic principles of cancer screening that are relevant for researchers, clinicians, and public health officials alike. Published by Elsevier Inc.

Principles of Guided Missiles and Nuclear Weapons.

ERIC Educational Resources Information Center

Naval Personnel Program Support Activity, Washington, DC.

Fundamentals of missile and nuclear weapons systems are presented in this book which is primarily prepared as the second text of a three-volume series for students of the Navy Reserve Officers' Training Corps and the Officer Candidate School. Following an introduction to guided missiles and nuclear physics, basic principles and theories are…

Principled Practical Knowledge: Not a Bridge but a Ladder

ERIC Educational Resources Information Center

Bereiter, Carl

2014-01-01

The much-lamented gap between theory and practice in education cannot be filled by practical knowledge alone or by explanatory knowledge alone. Principled practical knowledge (PPK) is a type of knowledge that has characteristics of both practical know-how and scientific theory. Like basic scientific theory, PPK meets standards of explanatory…

Shared Knowledge among Graphic Designers, Instructional Designers and Subject Matter Experts in Designing Multimedia-Based Instructional Media

ERIC Educational Resources Information Center

Razak, Rafiza Abdul

2013-01-01

The research identified and explored the shared knowledge among the instructional multimedia design and development experts comprising of subject matter expert, graphic designer and instructional designer. The knowledge shared by the team was categorized into three groups of multimedia design principles encompasses of basic principles, authoring…

Visual Design Principles Applied To World Wide Web Construction.

ERIC Educational Resources Information Center

Luck, Donald D.; Hunter, J. Mark

This paper describes basic types of World Wide Web pages and presents design criteria for page layout based on principles of visual literacy. Discussion focuses on pages that present information in the following styles: billboard; directory/index; textual; and graphics. Problems and solutions in Web page construction are explored according to…

21 CFR 320.25 - Guidelines for the conduct of an in vivo bioavailability study.

Code of Federal Regulations, 2010 CFR

2010-04-01

... conduct of an in vivo bioavailability study. (a) Guiding principles. (1) The basic principle in an in vivo... not been approved for marketing can be used to measure the following pharmacokinetic data: (i) The bioavailability of the formulation proposed for marketing; and (ii) The essential pharmacokinetic characteristics...

General Semantics in the Labor Room.

ERIC Educational Resources Information Center

Keller, Jo

This paper provides a review of some basic general semantic principles and then applies them to the area of prenatal classes and labor room practices. It first presents an overview of the principle that language is not a neutral factor in human perceptions but an active, reactive force. Next, it looks at the relationship between language and…

Designing future landscapes from principles of form and function

Treesearch

Larry D. Harris; Patrick Kangas

1979-01-01

Future landscapes will consist of a gradient of types ranging from wilderness areas to totally "humanized" environments. The man-dominated landscapes will be required to fulfill multiple functions only one of which is aesthetic enjoyment. It is suggested that basic principles of form and function may contribute to design criteria. Applications to the...

75 FR 30014 - Office of Energy Efficiency and Renewable Energy; Energy Efficiency and Conservation Block Grant...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... submittals for consistency with the requirements of Office of Management and Budget's (OMB) Cost Principles... classes (Basic Financial Assistance and Cost Principles--see the Acquisition Career Management Program... not provided from the National Environmental Policy Act (NEPA) or the Office of Management and Budget...

Chemistry, A Syllabus for Secondary Schools.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

Presented is a modern view of chemistry suitable for pupils with a wide range of skills and abilities. The outline of topics provides the unifying principles of chemistry together with related facts. The principles included in the outline are basic to man's understanding of his environment. The topical outline is divided into nine major units:…

A Device to Demonstrate the Principles of Photometry and Three Experiments for Its Use.

ERIC Educational Resources Information Center

Delumyea, R. Del

1987-01-01

Describes how to construct a simple photometer. Outlines experiments in which this device can be used to demonstrate basic electronic principles, the use of Beer's Law to determine the concentration of an analyte in solution, and the effect of molar absorptivity on the sensitivity of photometric procedures. (TW)

Concepts and Principles for State-Level Higher Education Budgeting. ASHE 1984 Annual Meeting Paper.

ERIC Educational Resources Information Center

Jones, Dennis P.

Basic concepts concerning state-level resource allocation to higher education are discussed. Attention is directed to principles of budgeting regardless of context, the pluralistic nature of higher education, characteristics of higher education production functions, and the typical form of the budget. In addition to the distribution of resources,…

Personality Plus. (Your Guide to Better Health and Personal Development).

ERIC Educational Resources Information Center

de la Concha, Hector

This manual is designed to acquaint individuals with basic principles of personal health, grooming, and personality development. Addressed in the individual chapters of the guide are the following topics: self-evaluation and completion of a personal inventory; proper diet and principles of maintaining a sound body; relaxation techniques; key words…

Training Frontline Staff. Supported Education: A Promising Practice. Evidence-Based Practices KIT (Knowledge Informing Transformation)

ERIC Educational Resources Information Center

Unger, Karen V.

2011-01-01

This four-part workbook will help program leaders teach education specialists the principles, processes, and skills necessary to deliver effective Supported Education services. The workbook includes the following: (1) Basic elements and practice principles of Supported Education; (2) Knowledge and skills to help consumers make informed choices…

The Basic Principles and Methods of the Music Curriculum for the General Education School.

ERIC Educational Resources Information Center

Kabalevskii, Dmitrii

1988-01-01

Delineates the foundations of Dmitri Kabalevskii's music curriculum for general education in the Soviet Union. Stresses teaching music as part of life itself. Bases teaching principles and methods on the song, dance, and march, termed "The Three Whales." Offers extensive lesson plans focusing on first grade music activities. (CH)

Career Education and the Marshmallow Principle.

ERIC Educational Resources Information Center

Hoyt, Kenneth B.

The "Marshmallow Principle" introduced in this paper is stated as follows: "External pressure exerted on an organization to change its basic structure will, for as long as that pressure is applied, cause the organization's structure to bend and assume a new shape. Once the pressure is removed, the organization will reassume its original shape.…

From Barrier Free to Safe Environments: The New Zealand Experience. Monograph #44.

ERIC Educational Resources Information Center

Wrightson, William; Pope, Campbell

Intrinsically safe design is presented as a logical extension of the principles of barrier free design, and as a higher level design strategy for effecting widespread implementation of the basic accessibility requirements for people with disabilities. Two fundamental planning procedures are proposed: including principles of safe and accessible…