How do surgical pathologists evaluate critical diagnoses (critical values)?

<p>Abstract</p> <p>Background</p> <p>After introduction of the concept of critical value (CV) in laboratory medicine, some efforts were performed to define possible critical values in surgical pathology. Critical diagnosis (critical value) is a concept recently established in surgical pathology and is a challenging issue among pathologists and clinical specialists. The concept may be the subject of variation according to the geographical or work setting differences. The current study was performed to bring the contribution of the Iranian pathologists to the evolving concept of critical diagnoses (critical values) in surgical pathology.</p> <p>Materials and methods</p> <p>During annual meeting of Iranian Pathologist Society, November 2006, Tehran, Iran, anonymous questionnaires were distributed among participants. They were requested to openly name conditions in which a pathologist should communicate the results immediately with clinicians.</p> <p>Results</p> <p>147 pathologists completed the questionnaire. They were varied in their level of experience and setting of workplace. Each participant referred to 1–7 (mean 3) conditions as CV. About 90 different conditions which were considered as CV by participants were extracted from the questionnaires.</p> <p>Discussion</p> <p>The list of conditions obtained through this survey as CVs in surgical pathology covered most items previously described in literature. Major differences are low number (or lack) of refers to some relatively routine and potentially important conditions and considering many unimportant conditions as CV by participants of present survey. Almost all conducted surveys have been performed on this issue so far (including the present survey) suffer from lack of supportive scientific evidences and based mainly on experience and common sense of participants in survey. Potential problems with application of CV concept in daily routine work flow of pathology, particularly in developing countries like Iran, were discussed.</p

Transparency in trading companies: should trading companies join the EITI, what are the issues and opportunities ?

This thesis explains the relationship between transparency and corruption in the trade and business universes, as well as analyses how it affects stakeholders closely linked to the problem. The first section sets out the context of the EITI standard and its history, scrutinizes and analyzes the different types of corruption, financial impact of corruption to trade and business, the link with transparency and possible avenues, if not to eradicate corruption but at least to derail and minimize opportunities for corruption. A statement of the current corruption situation will be made in order to understand where we stand. In considering the context of the subject matter, a detailed review of several real cases will demonstrate how corrupt practices emerge in real life. Furthermore, these real cases will enable to differentiate several stages where corruption can emerge. The second part of this thesis is an analysis of the distinction between physical and derivative trading in order to better grasp the concerned stakeholders. In addition, a review of the existing regulations, and an explanation of the differences between extracting and trading companies to understand concerned stakeholders will be undertaken. Examples such as payments to government reports attempting to uncover suspicious transactions and a comparison of the transactions will be carried out and explained individually. Not to forget that a detailed consideration will be given to the Trafigura Swap contract with Nigeria since it has been the focus of much media attention. Finally, after having contemplated the business rationale for these transactions, the paper will analyze the benefits and threats of being transparent from a trading company perspective. According to the findings, we will discuss if trading companies should join the EITI, and understand what their real fears are. The main aim of the thesis is to prove my initial hypothesis has been reached; namely: building stronger standards, laws, and regulations to minimize the phenomenon of corruption and promote transparency in the trading and business sectors

Advanced cardiac life support training by problem based method: effect on the trainees skills, knowledge and evaluation of trainers

Background: Cardiopulmonary-cerebral resuscitation (CPCR) training is essential for all hospital workers, especially junior residents who might become the manager of the resuscitation team. In our center, the traditional CPCR knowledge training curriculum for junior residents up to 5 years ago was lecture-based and had some faults. This study aimed to evaluate the effect of a problem-based method on residents’ CPCR knowledge and skills as well as their evaluation of their CPCR trainers. Methods: This study, conducted at Tehran University of Medical Sciences, included 290 first-year residents in 2009-2010-who were trained via a problem-based method (the problem-based group) - and 160 first-year residents in 2003-2004 - who were trained via a lecture-based method (the lecture-based group). Other educational techniques and facilities were similar. The participants self-evaluated their own CPCR knowledge and skills pre and post workshop and also assessed their trainers’ efficacy post workshop by completing special questionnaires. Results: The problem-based group, trained via the problem-based method, had higher self-assessment scores of CPCR knowledge and skills post workshop: the difference as regards the mean scores between the problem-based and lecture-based groups was 32.36 ± 19.23 vs. 22.33 ± 20.35 for knowledge (p value = 0.003) and 10.13 ± 7.17 vs. 8.19 ± 8.45 for skills (p value = 0.043). The residents’ evaluation of their trainers was similar between the two study groups (p value = 0.193), with the mean scores being 15.90 ± 2.59 and 15.46 ± 2.90 in the problem-based and lecture-based groups – respectively. Conclusion: The problem-based method increased our residents’ self-evaluation score of their own CPCR knowledge and skills

How do surgical pathologists evaluate critical diagnoses (critical values)?

Background. After introduction of the concept of critical value (CV) in laboratory medicine, some efforts were performed to define possible critical values in surgical pathology. Critical diagnosis (critical value) is a concept recently established in surgical pathology and is a challenging issue among pathologists and clinical specialists. The concept may be the subject of variation according to the geographical or work setting differences. The current study was performed to bring the contribution of the Iranian pathologists to the evolving concept of critical diagnoses (critical values) in surgical pathology. Materials and methods. During annual meeting of Iranian Pathologist Society, November 2006, Tehran, Iran, anonymous questionnaires were distributed among participants. They were requested to openly name conditions in which a pathologist should communicate the results immediately with clinicians. Results. 147 pathologists completed the questionnaire. They were varied in their level of experience and setting of workplace. Each participant referred to 1-7 (mean 3) conditions as CV. About 90 different conditions which were considered as CV by participants were extracted from the questionnaires. Discussion. The list of conditions obtained through this survey as CVs in surgical pathology covered most items previously described in literature. Major differences are low number (or lack) of refers to some relatively routine and potentially important conditions and considering many unimportant conditions as CV by participants of present survey. Almost all conducted surveys have been performed on this issue so far (including the present survey) suffer from lack of supportive scientific evidences and based mainly on experience and common sense of participants in survey. Potential problems with application of CV concept in daily routine work flow of pathology, particularly in developing countries like Iran, were discussed. © 2008 Mireskandari; licensee BioMed Central Ltd

Retrograde Laryngeal Block: A New Technique for Awake Intubation Compared With Conventional Regional Airway Block

Introduction: Retrograde laryngeal block is a new technique that blocks complete supraglottic and glottic area by introducing catheter retrograde from trachea to these regions. Methods and Materials: This is a clinical trial conducted on two groups each containing 15 patients, who were candidate for awake intubation. The first group (A) underwent conventional method of airway block, by multiple injections of local anesthetic. The second group (B) underwent retrograde laryngeal block as a new method of regional airway anesthesia. In this method the catheter is inserted from cricothyriod membrane through a flexible guide wire, and then local anesthetic drug will be administered by direct vision of tip of the catheter by employing glide scope. The catheter has three separate orifices; each will stay on distinct area of either supraglottic and glottis area which can be adjusted at any level through this area that is considered to be blocked. Result: Both groups had hemodynamic stability during performing block. In group A we had two incidences of laryngospasm due to pain of multiple needle insertion; in group B we had no incidence of laryngospasm (P=0.1). In group A we had 5 patients with partial airway block which needed further intervention during awake intubation but in group B all the cases had complete and perfect airway block (P=0.001). Patients comfort was better in group B with single injection than group A with multiple injections (P=0.005). Discussion: The advantage of this method is single injection and high quality of block performance in comparison with the other technique. It can be conducted for the patients with neck pathologies that make conventional airway block impossible. Conclusion: This method can be applied in patients with neck pathologies that make conventional block impossible

Leveraging Engaged Parties in SIP Domains of eTOM Framework by using ITSM Reference Model

the telecommunications industry plays an important role in providing ICT services to a wide range of customers. In addition to individual customers, corporate customers also are user of these services and have an important role to make return on investment for telecom companies (Telcos). Therefore, this group of customers should not be ignored by any reason. This is where the Telecom Companies provide special services that named B2B to these customers. The Business Process Framework eTOM is proposed as a telecom. Framework to standardize and mature B2B processes by a separate section called Engaged Parties. In this paper, by using the ITSM Reference Model, we aim to improve the B2B processes in the business process framework already named item. Hereby, considering the ever-increasing Demands and needs of customers (in this paper customers mostly are Enterprises and Companies), and declaring the power inherent while using Customer Relationship Processes of ITSM Reference Model, we aim to complete B2B processes of the eTOM framework while focusing on Telcos

Spinal vs General Anesthesia in patients undergoing urogenital surgery: A Randomized Clinical Trial

Background: This study aimed to evaluate the pain in the 24 hours after surgery, quality of life, and the outcome of surgery in patients undergoing urogenital surgery by spinal and general anesthesia. Materials and Methods: Women referring a candidate for urogenital surgery in Vali-e-Asr Hospital entered the study after their informed consent; in one of the two study groups: Spinal Anesthesia (SA) vs. General Anesthesia (GA). The pain scores around the clock were measured using the Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours postoperatively. Also, the two groups were compared regarding patient satisfaction at the time of ambulation. The surgery outcomes were measured using International Consultation on Incontinence Modular Questionnaires ICIQ. Data were entered and analyzed by SPSS software. Results: There was no significant relationship between parity, previous non-cesarean abdominal surgery, and urinary complications. However, there was a statistically significant difference between pain score in the two groups; while the postoperative days were not different in the two groups of anesthesia methods Conclusion: Considering the different influence of treatment methods for this disease, further research is needed to clarify, the results of anatomical, and anatomical outcomes after treatment for pelvic floor disorders in women