Operating theatre time, where does it all go? A prospective observational study

Objective To assess the accuracy of surgeons and anaesthetists in predicting the time it will take them to complete an operation or procedure and therefore explain some of the difficulties encountered in operating theatre scheduling. Design Single centre, prospective observational study. Setting Plastic, orthopaedic, and general surgical operating theatres at a level 1 trauma centre serving a population of about 370 000. Participants 92 operating theatre staff including surgical consultants, surgical registrars, anaesthetic consultants, and anaesthetic registrars. Intervention Participants were asked how long they thought their procedure would take. These data were compared with actual time data recorded at the end of the case. Primary outcome measure Absolute difference between predicted and actual time. Results General surgeons underestimated the time required for the procedure by 31 minutes (95% confidence interval 7.6 to 54.4), meaning that procedures took, on average, 28.7% longer than predicted. Plastic surgeons underestimated by 5 minutes (−12.4 to 22.4), with procedures taking an average of 4.5% longer than predicted. Orthopaedic surgeons overestimated by 1 minute (−16.4 to 14.0), with procedures taking an average of 1.1% less time than predicted. Anaesthetists underestimated by 35 minutes (21.7 to 48.7), meaning that, on average, procedures took 167.5% longer than they predicted. The four specialty mean time overestimations or underestimations are significantly different from each other (P=0.01). The observed time differences between anaesthetists and both orthopaedic and plastic surgeons are significantly different (P<0.05), but the time difference between anaesthetists and general surgeons is not significantly different. Conclusion The inability of clinicians to predict the necessary time for a procedure is a significant cause of delay in the operating theatre. This study suggests that anaesthetists are the most inaccurate and highlights the potential differences between specialties in what is considered part of the “anaesthesia time.

A Study of the Recidivism Rate of First Offenders at Louisiana Correctional and Industrial School Who Completed Vocational Training Through L.C.I.S./Sowela Institute

T h e p i.i. r p 0 s e o f\u27 t h e s t \u27J. d y w a. •=• t o d e t e r rn i n & i t 1 n m a t e s r e 1 e a. s e d +\u27 r c\u3e rn i_ o u i s i a n a C o r r e c t i o n a. 1 a n d Industrial School who completed a v o c a t i o n a 1 t r a i n i n 9 p r 0 9 r a rn t h r 0 u. 9 h L • C • I • S ■ S 0 w e l a T e c h n i c a 1 I n s t i t u t 0 h a d a 1 o w e r r a t e o f 0 f r e c i d i v i s rn t h a n t h 0 s e w h 0 d i d n ot c 0 rn p 1 e t e t r a i ti i ti 9 j u. s i n 9 a 9 e a s a v a r i a b 1 e ■ The population for this study consisted of a r a n d o rn s a rn pie o f\u27 99 i n rn a t es r e 1 e a se d i n t o t h e 9 e n e r a 1 p o p u 1 a t i 0 n 0 f\u27 L o u. i s i a n a p r i o r t o 1 9 S 3- T h e s e s u b ,i ec t s o 1 a n t a r i 1 y c o rn p 1 e t e d oc a. t i o n a 1 t r a 1 n i n9 i n in e 1 d i. n 9 ? a u t o m e c h a n i c s ? o r t\u3c 0 d y a n d f e n d e r repair betweeri the years 1376-1982 • The control s a rn p 1 e c o ns i s t e d 0f 101 i n rn a tes selects d r a n d o rn 1 y + rom the tot a1 p r i so n p op u 1 a t i on at L • C ■ I • S ■ dur i n9 19,-b- and who were released into the general P o p u 1 a t i o n o t L o u. i s i a ti a p r i o r t o 1983. Three years were a 110wed f\u270r the reci d ivism period- R e c i d i v i s rn w a s 0 p e r a t i 0 n a 1 i z e d a s r e t u r n 1 n 9 t o p r i s 0 fi o r o b t a i n i ti 9 a n e w f e 1 o n y \u3e_ h a r 9 e ? v e r i f\u27 i e d fc\u3e y Loij. i s i a na Dep- a.r t rne r 11 of Correc t i o ns dat a. a. nd the FBI c 0 rn p u t e r s y s t e rn. C h i - s q u. a re t e s t s were p e r f\u27 0 r m e d t o deter rn i n e the re 1 a t i 0 n s h i. p b e t w e e n t r a i n i n 9 a n d r ec i d i v i srn , t he re 1 -at j r. nship be twee n a•?e a nd completing t r a i n i n y \u3e and between age at release and recidivism- T h e m e d i a n a 9 e o f\u27 t h e p o p u 1 a t1 o n w a s 2 4.3 9 years- The younger subgroup ranged in age + row ly y e a. r s t0 2 4 y e a r s ■ The aide r s u. b 9 r o u. p rn e rn b e r s w ere greater than 25 years old. Treatment alone was not significant in reducing recidivism- Of all prisoners c o m pie t i n 9 v o c a t i o n a 1 t r a i n i n 9 6 3.3 \u27\u3c w ere o 1 d e r t h a n 2 5 y e a r s • ft 9 e w a s s i 9 n i f i c a n t i n c o m p 1 e t i n 9 t r e a t m e n t 1.1.1 i t h a chi s q V. a re sc o r e o ft 3 • 3 3 ? a t t h e • ft 5 1 e v e 1 o f s i 9n i ft i ca nce• Age a t t i rne oft re 1 ea se wa s r e 1. a t o d to reduced recidivism. This variable was significant w i t h a ch i sq u.ar e va ]. ue of 5 • 3 5 . a t the • ft 2 1 e• e 1 oft s i9 n ift icanc e. Prison e r s ove r 25 y ears of a g e had a recidivism rate of £2*4 \u27. while those prisoners who w ere y ou. n9e r h a d a r ec i d i v 1 s m r a t e o ft 4ft ■ 2. • The combined effect of treatment and age was significant i n r e duc 1 n9 r ec i d i v ism, w i t h a chi- s q u. ar e v a 1 u. e o ft a t the ■ d 5 1 e e 1 o ft s i 9 n i ft 1 c a n c e

Oestrogen exposure and breast cancer risk

Epidemiological and experimental evidence implicates oestrogens in the aetiology of breast cancer. Most established risk factors for breast cancer in humans probably act through hormone-related pathways, and increased concentrations of circulating oestrogens have been found to be strongly associated with increased risk for breast cancer in postmenopausal women. This article explores the evidence for the hypothesis that oestrogen exposure is a major determinant of risk for breast cancer. We review recent data on oestrogens and breast cancer risk, consider oestrogen-related risk factors and examine possible mechanisms that might account for the effects of oestrogen. Finally, we discuss how these advances might influence strategies for reducing the incidence of breast cancer

Plum pox virus of stone fruits (2000)

"5M1/00NVO.""Penn State College of Agricultural Sciences. Cooperative Extension.

Glitz, Glamour, and the Farm: Portrayal of Agriculture as the Simple Life

Reality television has taken America by storm with programming ranging from extreme stunts to police adventures to spoofs on segments of society. Agriculture has been a participant in the reality television boom through a series called “The Simple Life” in which two Hollywood debutantes explore the “realities” of farm life in Arkansas. This study examines the impact of this portrayal of agriculture and its effects on viewers’ impressions of the industry. Four focus groups were used to investigate the potential effects of an agriculturally based reality television show on viewers’ attitudes, opinions, and perceptions of agriculture. Results indicated those with agricultural knowledge viewed the portrayal of farm life as inaccurate and disturbing, while those without agricultural literacy found the program entertaining, if not exactly “real.” Those viewers lacking in agricultural literacy realized that the program did not accurately portray real agricultural life, but could not discern where the program failed in its accurate representation. Viewers with agricultural backgrounds found the series did not accurately reflect the amount of labor and intellectual capacity needed to produce food and fiber. The portrayal of agriculture as “hickish” and “backwoodsy” reinforced traditional stereotypes. This study suggests that the agricultural industry may be well served in further exploration of the impact of broadcast entertainment programming on the public’s agricultural literacy

Entertainment and Agriculture: An Examination of the Impact of Entertainment Media on Perceptions of Agriculture

This study was conducted as a follow-up to Ruth, Park, and Lundy\u27s 2005 study, which found that the portrayal of agriculture in reality television programming reinforced traditional stereotypes of agriculture and corresponding schemas. Qualitative focus groups were conducted in July 2005 with undergraduate students at a large southern university. Participants responded to questions about their perceptions of agriculture and then reacted to a short clip from the 2004 film Napoleon Dynamite that featured agriculture. This study substantiated Ruth et al.\u27s findings that entertainment media have potential short -term and long-term effects on individuals\u27 perceptions of agriculture. While portrayals of agriculture in entertainment media may not actually create negative perceptions of agriculture, they may serve as significant reinforcement for existing negative stereotypes and perceptions. Since many young adults hold uninformed stereotypes about agriculture that are reinforced by entertainment media, agricultural communicators are challenged to communicate the significance of agriculture to this audience in a format they perceive as relevant

Lifestyle factors and prostate-specific antigen (PSA) testing in UK Biobank: Implications for epidemiological research

AbstractBackgroundThe central role of prostate-specific antigen (PSA) testing in the diagnosis of prostate cancer leads to the possibility that observational studies that report associations between risk factors and prostate cancer could be affected by detection bias. This study aims to investigate whether reported risk factors for prostate cancer are associated with PSA testing in a large middle-aged population-based cohort in the UK.MethodsThe cross-sectional association between a wide range of sociodemographic, lifestyle, dietary and health characteristics with PSA testing was examined in 212,039 men aged 40–69 years in UK Biobank.ResultsA total of 62,022 (29%) men reported they had ever had a PSA test. A wide range of factors was associated with a higher likelihood of PSA testing including age, height, education level, family history of prostate cancer, black ethnic origin, not being in paid/self-employment, living with a wife or partner, having had a vasectomy, being diagnosed with cancer or hypertension and having a high dietary intake of cereal, cooked and salad/raw vegetables, fresh fruit and tea. Conversely, socioeconomic deprivation, Asian ethnic origin, current smoking, low alcohol intake, high body-mass index, high coffee consumption and being diagnosed with diabetes, heart disease or stroke were associated with a lower likelihood of PSA testing.ConclusionsA variety of sociodemographic, lifestyle and health-related characteristics are associated with PSA testing, suggesting that observed associations of some of these traits with risk for prostate cancer in epidemiological studies may be, at least partially, due to detection bias

A Novel, Contactless, Portable “Spot-Check” Device Accurately Measures Respiratory Rate

Respiratory rate (RR) is an important vital sign used in the assessment of acutely ill patients. It is also used as to predict serious deterioration in a patient's clinical condition. Convenient electronic devices exist for measurement of pulse, blood pressure, oxygen saturation and temperature. Although devices which measure RR exist, none has entered everyday clinical practice. We developed a contactless portable respiratory rate monitor (CPRM) and evaluated the agreement in respiratory rate measurements between existing methods and our new device. The CPRM uses thermal anemometry to measure breath signals during inspiration and expiration. RR data were collected from 52 healthy adult volunteers using respiratory inductance plethysmography (RIP) bands (established contact method), visual counting of chest movements (established non-contact method) and the CPRM (new method), simultaneously. Two differently shaped funnel attachments were evaluated for each volunteer. Data showed good agreement between measurements from the CPRM and the gold standard RIP, with intra-class correlation coefficient (ICC): 0.836, mean difference 0.46 and 95% limits of agreement of -5.90 to 6.83. When separate air inlet funnels of the CPRM were analysed, stronger agreement was seen with an elliptical air inlet; ICC 0.908, mean difference 0.37 with 95% limits of agreement -4.35 to 5.08. A contactless device for accurately and quickly measuring respiratory rate will be an important triage tool in the clinical assessment of patients. More testing is needed to explore the reasons for outlying measurements and to evaluate in the clinical setting

The consequences of tree disease and pre-emptive felling on functional and genetic connectivity for woodland invertebrates

Funding FAP was funded by the Macaulay Development Trust and the Woodland Trust. RJM and JAS were supported by the Scottish Government’s Rural and Environment Research and Analysis Directorate 2016-2021 strategic research programme. Development by SCFP of the landscape genetics capability in the customised version of RangeShifter was funded by programme Blanc of l’Agence nationale de la recherche. JMJT was supported by NERC grant NE/T006935/1 ‘Wildlife Corridors: Do they work and who benefits?’ Acknowledgments We thank the Macaulay Development Trust and the Woodland Trust for funding FAP, the Scottish Government’s Rural and Environment Research and Analysis Directorate for funding RJM and JAS, programme Blanc of l’Agence nationale de la recherche for funding SCFP, and NERC for funding JT. We thank the Woodland Trust for access to the National Canopy Map for England and WalesPeer reviewedPublisher PD

Evaluation of Content and Accessibility of Orthopaedic Trauma Fellowship Websites

Background: Residents frequently use the internet to find material on fellowship programs. The Orthopaedic Trauma Association (OTA) website serves as a central hub for information on an orthopaedic trauma fellowship (OTF). This study aims to evaluate the accessibility, content, and perceived importance of OTF websites. Methods: We reviewed the 49 OTFs accredited by the OTA fellowship database as of January 2014. We searched for corresponding OTF websites by using the provided OTA hyperlinks and conducting a separate Google search of program location and institution. Links to websites of general orthopaedic programs were not counted. Content of OTF websites was analyzed by noting the presence or absence of specific items in fellow education (11 items) and recruitment (5 items). Results: Of 49 OTFs, a total of 39 (80%) websites specific to the fellowship were identified by searching the OTA database and Google browser. Seven (14%) programs listed on the OTA database provided links directly to fellowship programs. Most programs (28; 57%) did not provide links to specific OTFs or provided non-functional links on the OTA website. Of the 39 accessible OTF websites, a total of 24 (61%) had complete information regarding recruitment and 14 (36%) provided complete details on education. Conclusions: Most accredited OTFs do not adequately use the internet to provide easily accessible and complete information. Further details (especially regarding the role, education, and schedule) would help prospective candidates in thoroughly evaluating programs. The discrepancy in content and accessibility can hinder prospective fellows from appropriately investigating fellowship programs