Measuring Quality at the Surgeon Level

Patients expect high-quality surgical care and increasingly are looking for ways to assess the quality of the surgeon they are seeing, but quality measurement is often more complicated than one might expect. Measurement of individual surgeon quality in a manner that allows for comparison among surgeons is particularly difficult. While the concept of measuring individual surgeon quality has a long history, technology now allows for new and innovative ways to measure and achieve surgical excellence. However, some recent efforts to make surgeon-level quality data publicly available have highlighted the challenges of this work. Through this chapter, the reader will be introduced to a brief history of surgical quality measurement, learn about the current state of quality measurement, and get a glimpse into what the future holds

The Impact of Undergraduate Research Experience Intensity on Measures of Student Success

Despite the growing interest to provide research engagement opportunities to undergraduate students, few studies have investigated how engagement “intensity” impacts measures of student success. A quasi-experimental, matched-subject design was employed to study differences between varying levels of research experience intensity (i.e., Experienced, Novice, Control groups) on Graduating GPA, Time to Graduate, and type of post-graduation experience. Results indicated that experienced students had significantly higher graduating GPAs than novice or control students, and both research groups had significantly lower time to graduate than the control group. Findings also indicated experienced student researchers are significantly more likely to progress to graduate school than either novice research or control students. Implications for implementing research initiatives are discussed

Paleoethnobotany of the archaeological site of Qhenchapata, ayllu sucso Auccaylle (San Sebastián - Cuzco)

Este artículo aborda la paleoetnobotánica registrada en el sitio arqueológico de Qhenchapata, ubicado en el distrito de San Sebastián, departamento de Cusco, este sitio presenta evidencia de dos ocupaciones, ambas determinadas por incendios: el primero, al finalizar el Horizonte Tardío o Inca y el segundo, en el Periodo Colonial. La evidencia paleoetnobotánica junto a la recabada en el proceso de excavación nos permitió determinar el uso de la arquitectura presente en Quenchapata. In this work we present the recorded paleoethnobotany at the site of Qhenchapata, located in San Sebastián district, Cusco region, where we find two occupations determined for two fires: the first, when finished the Late Horizon or Inca Period; and the second one, in the Colonial Period. The paleoethnobotany evidence plus archaeology evidence recovered during the excavation process determined what was the use of the architecture present in this place

Palliative Endoscopic Salvage of a Functionally Obstructed Gastrojejunostomy - Report of Technique

BACKGROUND: Gastric outlet obstruction secondary to foregut gastrointestinal malignancies can be managed with a variety of medical, endoscopic, and surgical options. Laparoscopic gastrojejunostomy is an option for those patients who are able to tolerate an operation as a long-term palliative option. This operation may be associated with some significant postoperative technical and nontechnical complications, including delayed gastric emptying. This paper describes an incision-less, endoscopic option that we propose can be used to salvage a functionally obstructed gastrojejunostomy. CASE DESCRIPTION: A 57-year old male patient had a history of pancreatic adenocarcinoma causing gastric outlet obstruction and underwent a previously created surgical gastrojejunostomy at an outside hospital. His procedure was complicated by anastomotic leak and essentially persistent obstructive symptoms secondary to delayed gastric emptying. Though his anastomosis was demonstrably patent, these symptoms were thought to be secondary to a functional obstruction at the gastrojejunostomy. After repeated workups and many failed attempts to treat these symptoms, he ultimately underwent endoscopic placement of an uncovered colonic stent into the efferent limb of his gastrojejunostomy. This allowed for preferential drainage of gastric contents down the efferent limb, and improvement of his delayed gastric emptying. CONCLUSIONS: In a select group of patients with advanced foregut malignancy, and with high re-operative risks, salvage endoscopic stenting may be useful in the palliation of symptoms from a functionally obstructed gastrojejunostomy

Economic growth and inequality : the role of fiscal policies

This paper analyses the impact of different instruments of fiscal policy on economic growth as well as on income inequality, using an unbalanced panel of 43 upper-middle and high income countries for the period 1972-2006. We consider and estimate two individual equations explaining growth and inequality in order to assess the incidence of different fiscal policies. Firstly, our approach considers imposing orthogonal assumptions between growth and inequality in both equations, and secondly, it allows growth to be included in the inequality equation, and inequality to be included in the growth equation. The empirical results suggest that an increase in the size of government measured through current expenditures and direct taxes diminishes economic growth while reducing inequality, being public investment the only fiscal policy that may break this trade-off between efficiency and equity, since increases in this item reduces inequality without harming output. Therefore, the results reflect that the trade-off between efficiency and equity that governments often confront when designing their fiscal policies may be avoided

Combining Chemistry and College Writing: A New Model for an Honors Undergraduate Chemistry Course

Faculty in the Departments of Chemistry and English at Florida Atlantic University (FAU) have designed and implemented an innovative, writing intensive, advanced, second-semester chemistry course combined with a laboratory component that satisfies both second semester General Chemistry and College Writing criteria. This unusual configuration differs from typical honors chemistry courses because of its “writing to learn” approach to teaching indepth scientific content, the nature of research, and research methods. The opportunity to develop this course emerged from a collaborative relationship between our institution’s Writing Across the Curriculum (WAC) program and our chemistry department

Assessment of Student Learning of Undergraduate Research: Challenges, Strategies and Solutions

The complexities involved in establishing rigorous assessment practices across diverse content areas with faculty of varying degrees of assessment expertise can be challenging. Florida Atlantic University’s undergraduate research initiative includes a curricular and co-curricular initiative to enhance research in courses and programs across all disciplines. Faculty engage in curricular changes to improve student learning assessed through a common rubric and co-curricular involvement through rubrics developed for our symposium and undergraduate research journal. Participants will explore tools created to facilitate curricular and co-curricular change and reporting options used to more accurately reflect the effect such an initiative has on student learning

Evaluation of accessibility: A preliminary analysis of recipients of Florida Atlantic’s Undergraduate Research Certificate

As the most diverse institution in the Florida State University System, FAU is a Hispanic-serving, R2 university with over 30,000 students with a large transfer student population. While engagement in High Impact Practices (HIPs) such as Undergraduate Research is well documented in the literature, there still remains a need to incentivize and quantify student engagement in undergraduate research, especially to our diverse population. At Florida Atlantic, a 12-credit, university-wide certificate program was developed to recognize undergraduate students for systematic progress of excellence in undergraduate research. The intent was to provide evidence to future employers and graduate schools that the student has achieved proficiency in Research. The certificate was designed with our diverse student population in mind, accounting for ensuring accessibility to both our traditional students and transfer student population. This interactive presentation will describe the criteria for the Undergraduate Research Certificate and how diverse student needs were included in the design. We will share how Florida Atlantic implemented the certificate and collected data on student engagement. We will present preliminary data and analysis of the recipients of the certificate over the past three years and evaluate whether our model accomplished our goal of accessibility. Presenters will engage session attendees in a discussion of strategies employed including establishing institutional partnerships and collaborations, marketing the certificate, data collection, and share lessons learned and next steps

Catalyzing Curricular Change: Implementing and Assessing a Model for Integrating Research into the Curriculum

The curriculum grant program at Florida Atlantic University fosters the integration of undergraduate research and inquiry skills (URI) into the curriculum by supporting assignment, course and programmatic level enhancements. Faculty promote URI skills, represented by specific learning outcomes, by scaffolding student experiences within courses and across programs. Our model has undergone revisions in response to identifying best practices and more effective delivery strategies. Participants will explore methods to promote faculty development, encourage diverse content-area participation, and structure faculty communication to ensure impact and sustainability of efforts. Participants will also be exposed to examples of assessment tools and resultant data

Supporting Faculty during a pandemic: Creating collaborations to support Undergraduate Research

As campuses quickly pivoted to remote teaching and engagement during COVID-19, faculty faced significant challenges in converting their research and mentorship with undergraduates. At Florida Atlantic University, we observed a decline in faculty engagement with undergraduate researchers during summer 2020. In an effort to better support faculty mentors, we established a collaboration between FAU’s Office of Undergraduate Research and Inquiry, the Division of Research, Center for E-Learning, University Libraries, and FAU High School. This team created a resource guide and hosted a panel session to assist faculty whose research and mentorship of undergraduates were impacted by going virtual. In this presentation, we will discuss survey data documenting the decline in undergraduate research engagement and challenges faculty faced, including creating a remote community of inquiry, remote access to university instruments/software, and consideration for alternative, remote projects. We will also share the resource document we created to assist faculty