Google-induced confidence in decision skills changes experiences : a self-fulfilling prophecy

The Internet is the ultimate memory entity, storing unimaginable amounts of information and capable of retrieving target pieces in less than a second. Thanks to tools like Google, resorting to this entity when trying to remember or learn facts has become as natural for people as eating when feeling hungry. Recent evidence suggests that embracing the Internet as a memory resource deregulates metacognition because people conflate knowledge accessed online with their own. The current research shows that this conflation entails a “feeling of already knowing” that, in consumer contexts, leads to overconfidence in decision skills. Most importantly, and contrasting with the common view of overconfidence as a trap, this research proposes that, albeit illusory, Google-induced choice confidence (the belief that the chosen option is superior to the dismissed ones) gives rise to affective expectations that spill over into subjective experiences. In essence, the Internet entails a self-fulfilling prophecy where it misguides people into believing that they made an objectively optimal decision but also leads them to have subjectively better experiences as the outcome of that decision

Postpneumonectomy syndrome: Surgical management and long-term results

ObjectivePostpneumonectomy syndrome is a rare syndrome of dynamic airway obstruction caused by extreme rotation and shift of the mediastinum after pneumonectomy, resulting in symptomatic central airway compression. We have treated this syndrome by mediastinal repositioning and placement of saline-filled prostheses into the pneumonectomy space. There is a paucity of outcome data for patients treated surgically, with only a single series of 11 patients previously reported. We analyzed our recent experience with treatment of this syndrome and report on the short and long-term outcomes and quality of life assessment of the largest series ever reported of patients treated by mediastinal repositioning.MethodsRecords were reviewed of all patients who underwent mediastinal repositioning for postpneumonectomy syndrome between January of 1992 and June of 2006. Long-term health-related quality of life was assessed by administration of the Saint George's Respiratory Questionnaire.ResultsThere were 18 patients (15 women and 3 men) with a median age of 44 years (range 14–67 years). Thirteen patients had undergone right pneumonectomy, and 5 patients had undergone left pneumonectomy. None of the patients in whom postpneumonectomy syndrome developed after left pneumonectomy had a right-sided aortic arch. Five patients had undergone pneumonectomy in childhood (age < 13 years). The median interval between pneumonectomy and mediastinal repositioning was 7.5 years (range 1.1–54.8 years). The median follow-up was 32 months (range 4–143 months). The operative mortality was 5.6% (1/18). Complications occurred in 5 patients (27.8%): pneumonia in 3 patients and acute respiratory distress syndrome in 2 patients. The median hospitalization was 6 days (range 3–155 days). Some 77% (10/13) of patients reported significant improvement in their breathing and overall state of health after surgery; 15.4% of patients (2/13) were somewhat better, and 7.7% of patients (1/13) had no improvement. No patients' condition was worse after surgery. All patients who reported improvement in their symptoms after surgery remained symptomatically improved at the time of the quality of life assessment. Some 92.3% (12/13) were not at all or only slightly limited in their social activities because of breathing problems, and 84.6% (11/13) were not at all or only slightly limited in their ability to work as a result of their physical health.ConclusionRepositioning of the mediastinum with placement of prostheses for postpneumonectomy syndrome can be performed with low mortality and morbidity. Surgical repositioning provides immediate and lasting symptomatic relief to patients in whom postpneumonectomy syndrome develops

Musculoskeletal disorder and quality of life in seamstresses in the city of Indaial, Santa Catarina, Brazil

Health problems arising from employment relationships have become a worldwide phenomenon. The objective of this study was to evaluate the musculoskeletal symptoms and the quality of life in seamstresses in the city of Indaial (SC), Brazil. This is a descriptive cross-sectional study, with quantitative approach. The sample consisted of 118 seamstresses, located in 48 companies, who responded to three questionnaires: sociodemographic, musculoskeletal symptoms and quality of life. About 71.1% of the evaluated seamstresses presented musculoskeletal symptoms in the last seven days and 88.1% in the last 12 months. The body region most reported was shoulders (18.6%) and the causes of work leave were dorsal and lumbar pain (19.1% and 19.1%, respectively). The most affected quality of life domain was the General health condition (57.03±16.08), followed by Vitality (58.89±17.65), Pain (60.53±22.28), Mental health (66.81±19.19), Emotional aspects (67.72±38.29), Physical aspects (73.94±32.91), Social aspects (75.63±23.10) and Functional capacity (77.16±19.19). It is noticed that the higher the quality of life score, the lower the number of anatomical regions with pain. The combination of preventive measures at work with periods of micropauses, correct postures and workplace exercises can influence in reducing pain, preventing diseases and improving the quality of life.Los problemas de salud decorrentes de la relación de trabajo se han resultado en un fenómeno mundial. El objectivo de este estudio fue evaluar los sintomas osteomusculares y la calidad de vida en profesionales del ramo de la costura en el municipio de Indaial (SC), Brasil. Se trata de un estudio de naturaleza transversal con enfoque quantitativo. La amuestra fue constituida por 118 costureras de 48 empresas, que contestaron a tres cuestionarios: uno sociodemografico, otro de síntomas osteomusculares y, por fín, uno de calidad de vida. De las costureras evaluadas, 71,1% presentaron síntomas osteomusculares en los últimos siete días y 88,1% en los últimos doce meses. La región corporal más afectada de acuerdo con la mayoría de los relatos fue la de los hombros (18,6%) y las causas de alejamiento fueron los dolores dorsales y lumbares (cada uno correspondiendo a 19,1% de los casos). El dominio de calidad de vida más comprometido fue el estado general de salud (57,03±16,08), seguido por los de vitalidad (58,89±17,65), dolor (60,53±22,28), salud mental (66,81±19,19), aspectos emocionales (67,72±38,29), aspectos físicos (73,94±32,91), aspectos sociales (75,63±23,10) y capacidad funcional (77,16±19,19). Se percibe que cuanto mayor sea el escore de calidad de vida, menor será el número de regiones anatómicas con dolor. La asociación de medidas preventivas al trabarse, como períodos de micropausas, atención para posturas correctas y gimnasia laboral, pueden influenciar la reducción de dolor y prevención de enfermidades, como también aprimorar la calidad de vida.Os problemas de saúde decorrentes da relação de trabalho têm se tornado um fenômeno mundial. O objetivo deste estudo foi avaliar os sintomas osteomusculares e a qualidade de vida em profissionais do ramo da costura no município de Indaial (SC). Trata-se de um estudo de natureza transversal com abordagem quantitativa. A amostra foi constituída por 118 costureiras de 48 empresas que responderam a três questionários: um sociodemográfico, outro de sintomas osteomusculares e um de qualidade de vida. Das costureiras avaliadas, 71,1% apresentaram sintomas osteomusculares nos últimos sete dias e 88,1% nos últimos doze meses. A região corporal mais afetada de acordo com a maioria dos relatos foi a dos ombros (18,6%) e as causas de afastamento foram as dores dorsais e lombares (cada uma correspondendo a 19,1% dos casos). O domínio de qualidade de vida mais comprometido foi o estado geral de saúde (57,03±16,08), seguido pelos de vitalidade (58,89±17,65), dor (60,53±22,28), saúde mental (66,81±19,19), aspectos emocionais (67,72±38,29), aspectos físicos (73,94±32,91), aspectos sociais (75,63±23,10) e capacidade funcional (77,16±19,19). Percebe-se que quanto maior o escore de qualidade de vida, menor o número de regiões anatômicas com dor. A associação de medidas preventivas ao trabalhar, como períodos de micropausas, atenção para posturas corretas e ginástica laboral, podem influenciar a redução de dor e prevenção de doenças, como também aprimorar a qualidade de vida

PERCEPÇÃO DE VALOR COMO VARIÁVEL MEDIADORA ENTRE PARTICIPAÇÃO E SATISFAÇÃO DE CLIENTES DE SERVIÇOS BANCÁRIOS: UMA ANÁLISE POR MEIO DE EQUAÇÕES ESTRUTURAIS / Perception of Value as a Mediator for Customer Participation and Customer Satisfaction in Bank Ser

Apesar de representar uma variável de relevância consolidada para a disciplina e para a prática da Administração, em especial na área de marketing, a satisfação do cliente ainda envolve fenômenos que são obscuros para pesquisadores e gestores. Entre estes, cabe destaque para a relação entre a participação do cliente e a satisfação em serviços bancários. Genericamente, teoria e achados empíricos apontam para uma relação direta positiva entre os dois constructos. O interesse, neste estudo, foi avaliar se a percepção de valor poderia atuar como mediadora dessa relação. Foram, então, utilizadas técnicas de modelagem de equações estruturais para realizar o teste de mediação. Os resultados indicaram um modelo em que o efeito direto da participação sobre a satisfação é negativo e o efeito indireto é positivo. Ao final do artigo são apresentadas as implicações teóricas e gerenciais. Palavras-chave: Participação do cliente. Satisfação do cliente. Percepção de valor. Serviços bancários. Modelagem de equações estruturais

Assessment of preoperative accelerated radiotherapy and chemotherapy in stage IIIa (N2) non-small-cell lung cancer

AbstractForty patients with N2 non-small-cell lung cancer (stage IIIA), as determined by mediastinoscopy, were entered into a preoperative neoadjuvant study of chemotherapy (platinum, 5-fluorouracil, vinblastine) and accelerated radiotherapy (150 cGy twice per day for 7 days) for two cycles. Surgical resection was then performed and followed up with an additional cycle of chemotherapy and radiotherapy. All patients completed preoperative therapy. A major clinical response was seen in 87% of patients. Thirty-five patients underwent resection (one preoperative death, one refused operation, one had deterioration of pulmonary function, and two had pleural metastases). Operative mortality rate was 5.7% (2/35). Sixty percent of patients had no complications. Major complications included pulmonary emboli (three), pneumonia (two), and myocardial infarction (one). Downstaging was seen in 46% of patients, with two patients (5.7%) having no evidence of tumor in the specimen, five patients having sterilization of all lymph nodes, and nine patients having sterilization of mediastinal nodes but positive N1 nodes. Median survival of 40 patients was 28 months, with a projected 5-year survival of 43%. Patients with downstaged disease had statistically significant improved survival compared with patients whose disease was not downstaged. (J THORAC CARDIOVASC SURG 1996;111:123-33

Anastomotic complications after tracheal resection: Prognostic factors and management

ObjectiveWe sought to identify risk factors for anastomotic complications after tracheal resection and to describe the management of these patients.MethodsThis was a single-institution, retrospective review of 901 patients who underwent tracheal resection.ResultsThe indications for tracheal resection were postintubation tracheal stenosis in 589 patients, tumor in 208, idiopathic laryngotracheal stenosis in 83, and tracheoesophageal fistula in 21. Anastomotic complications occurred in 81 patients (9%). Eleven patients (1%) died after operation, 6 of anastomotic complications and 5 of other causes (odds ratio 13.0, P = .0001 for risk of death after anastomotic complication). At the end of treatment, 853 patients (95%) had a good result, whereas 37 patients (4%) had an airway maintained by tracheostomy or T-tube. The treatments of patients with an anastomotic complication were as follows: multiple dilations (n = 2), temporary tracheostomy (n = 7), temporary T-tube (n = 16), permanent tracheostomy (n = 14), permanent T-tube (n = 20), and reoperation (n = 16). Stepwise multivariable analysis revealed the following predictors of anastomotic complications: reoperation (odds ratio 3.03, 95% confidence interval 1.69-5.43, P = .002), diabetes (odds ratio 3.32, 95% confidence interval 1.76-6.26, P = .002), lengthy (≥4 cm) resections (odds ratio 2.01, 95% confidence interval 1.21-3.35, P = .007), laryngotracheal resection (odds ratio 1.80, 95% confidence interval 1.07-3.01, P = .03), age 17 years or younger (odds ratio 2.26, 95% confidence interval 1.09-4.68, P = .03), and need for tracheostomy before operation (odds ratio 1.79, 95% confidence interval 1.03-3.14, P = .04).ConclusionsTracheal resection is usually successful and has a low mortality. Anastomotic complications are uncommon, and important risk factors are reoperation, diabetes, lengthy resections, laryngotracheal resections, young age (pediatric patients), and the need for tracheostomy before operation

Omentum is highly effective in the management of complex cardiothoracic surgical problems

AbstractObjectives: Vascularized, pedicled tissue flaps are often used for cardiothoracic surgical problems complicated by factors that adversely affect healing, such as previous irradiation, established infection, or steroid use. We reviewed our experience with use of the omentum in these situations to provide a yardstick against which results with other vascularized flaps (specifically muscle flaps) could be compared. Methods: A retrospective review was undertaken of 85 consecutive patients in whom omentum was used in the chest. In 47 patients (group I), use of omentum was prophylactic to aid in the healing of closures or anastomoses considered to be at high risk for failure. In 32 patients (group II), omentum was used in the treatment of problems complicated by established infection. In 6 patients (group III), omentum was used for coverage of prosthetic chest wall replacements after extensive chest wall resection. Results: Overall, omental transposition was successful in its prophylactic or therapeutic purpose in 88% of these difficult cases (75/85). Success with omentum was achieved for 89% of patients (42/47) in group I, 91% of patients (29/32) in group II, and 67% of patients (4/6) in group III. Three patients (3.5%) had complications of omental mobilization. Four patients (4.7%) died after the operation as a result of failure of the omentum to manage the problem for which it was used. Conclusions: Results with omental transposition compare favorably with published series of similarly challenging cases managed with muscle transposition. Complications of omental mobilization are rare. We believe that its unique properties render the omentum an excellent choice of vascularized pedicle in the management of the most complex cardiothoracic surgical problems.J Thorac Cardiovasc Surg 2003;125:526-3

GAMES INNOVATIVE AND COMMITTED: BETWEEN CONSUMER AFFAIRS PERSONALITY, ITS COMMITMENT TO THE BRAND AND ITS PROPENSITY TO COLLABORATE IN INNOVATION PROCESSES

Pesquisadores e gestores têm se deparado com desafios para prever o envolvimento efetivo dos consumidores em processos de inovação, uma vez que participar destes processos implica certos custos de recurso e esforço da parte do consumidor. Nesta pesquisa, voltamos nossa atenção para antecedentes da propensão do consumidor a colaborar em processos de inovação com a organização. Primeiramente, testamos a relação direta da orientação para a inovação do consumidor e a propensão a colaborar nos processos de inovação. Subsequentemente, avaliamos se esta relação pode ser mediada pelo comprometimento com a marca. Realizamos uma survey com entusiastas de jogos da Blizzard Entertainment, Inc. e analisamos os dados por meio de equações estruturais. Evidenciamos que o comprometimento exerce uma mediação parcial no modelo.Researchers and practitioners face challenges to predict effective customer involvement in innovation processes because the participation on these processes imply certain costs of resources and efforts from the customers. In the present research, we draw attention towards antecedents of customer propensity to collaborate in product development with the organization. First, we tested a direct relation between customer innovation orientation and propensity to collaborate in development processes. Subsequently, we assessed whether this relation can be mediated by commitment with the brand. We conducted a survey with enthusiasts of Blizzard Entertainment, Inc. and analyzed the data using structural equations. We evidenced that commitment has a partial mediation effect