Impact of Team Familiarity in the Operating Room on Surgical Complications

Background: The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery. Methods: A retrospective analysis was performed to compare the surgical outcomes of patients who underwent major abdominal operations between the first month (period I) and the last month (period II) of a 6-month period of continuous teamwork (stable dyads of one senior and one junior surgeon formed every 6months). Of 117 patients, 59 and 58 patients underwent operations during period I and period II, respectively, between January 2010 and June 2012. Team performance was assessed via questionnaire by specialized work psychologists; in addition, intraoperative sound levels were measured. Results: The incidence of overall complications was significantly higher in period I than in period II (54.2 vs. 34.5%; P=0.041). Postoperative complications grade <3 were significantly more frequently diagnosed in patients who had operations during period I (39.0 vs. 15.5%; P=0.007), whereas no between-group differences in grade ≥3 complications were found (15.3 vs. 19.0%; P=0.807). Concentration scores from senior surgeons were significantly higher in period II than in period I (P=0.033). Sound levels during the middle third part of the operations were significantly higher in period I (median above the baseline 8.85dB [range 4.5-11.3dB] vs. 7.17dB [5.24-9.43dB]; P<0.001). Conclusions: Team familiarity improves team performance and reduces morbidity in patients undergoing abdominal surgery

The METCRAX II Field Experiment: A Study of Downslope Windstorm-Type Flows in Arizona\u2019s Meteor Crater

The second Meteor Crater Experiment (METCRAX II) was conducted in October 2013 at Arizona\u2019s Meteor Crater. The experiment was designed to investigate nighttime downslope windstorm 12type flows that form regularly above the inner southwest sidewall of the 1.2-km diameter crater as a southwesterly mesoscale katabatic flow cascades over the crater rim. The objective of METCRAX II is to determine the causes of these strong, intermittent, and turbulent inflows that bring warm-air intrusions into the southwest part of the crater. This article provides an overview of the scientific goals of the experiment; summarizes the measurements, the crater topography, and the synoptic meteorology of the study period; and presents initial analysis results

Individual and group-level job resources and their relationships with individual work engagement

OBJECTIVES: This study adds a multilevel perspective to the well-researched individual-level relationship between job resources and work engagement. In addition, we explored whether individual job resources cluster within work groups because of a shared psychosocial environment and investigated whether a resource-rich psychosocial work group environment is beneficial for employee engagement over and above the beneficial effect of individual job resources and independent of their variability within groups. METHODS: Data of 1,219 employees nested in 103 work groups were obtained from a baseline employee survey of a large stress management intervention project implemented in six medium and large-sized organizations in diverse sectors. A variety of important job resources were assessed and grouped to an overall job resource factor with three subfactors (manager behavior, peer behavior, and task-related resources). Data were analyzed using multilevel random coefficient modeling. RESULTS: The results indicated that job resources cluster within work groups and can be aggregated to a group-level job resources construct. However, a resource-rich environment, indicated by high group-level job resources, did not additionally benefit employee work engagement but on the contrary, was negatively related to it. CONCLUSIONS: On the basis of this unexpected result, replication studies are encouraged and suggestions for future studies on possible underlying within-group processes are discussed. The study supports the presumed value of integrating work group as a relevant psychosocial environment into the motivational process and indicates a need to further investigate emergent processes involved in aggregation procedures across levels

No signs of check-list fatigue - introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study.

The team timeout (TTO) is a safety checklist to be performed by the surgical team prior to incision. Exchange of critical information is, however, important not only before but also during an operation and members of surgical teams frequently feel insufficiently informed by the operating surgeon about the ongoing procedure. To improve the exchange of critical information during surgery, the StOP?-protocol was developed: At appropriate moments during the procedure, the leading surgeon briefly interrupts the operation and informs the team about the current Status (St) and next steps/objectives (O) of the operation, as well as possible Problems (P), and encourages questions of other team members (?). The StOP?-protocol draws attention to the team. Anticipating the occurrence of StOP?-protocols may support awareness of team processes and quality issues from the beginning and thus support other interventions such as the TTO; however, it also may signal an additional demand and contribute to a phenomenon akin to "checklist fatigue." We investigated if, and how, the introduction of the StOP?-protocol influenced TTO quality. This was a prospective intervention study employing a pre-post design. In the visceral surgical departments of two university hospitals and one urban hospital the quality of 356 timeouts (out of 371 included operation) was assessed by external observers before (154) and after (202) the introduction of the StOP?-briefing. Timeout quality was rated in terms of timeout completeness (number of checklist items mentioned) and timeout quality (engagement, pace, social atmosphere, noise). As compared to the baseline, after the implementation of the StOP?-protocol, observed timeouts had higher completeness ratings (F = 8.69, p = 0.003) and were rated by observers as higher in engagement (F = 13.48, p &lt; 0.001), less rushed (F = 14.85, p &lt; 0.001), in a better social atmosphere (F = 5.83, p &lt; 0.016) and less noisy (F = 5.35, p &lt; 0.022). Aspects of TTO are affected by the anticipation of StOP?-protocols. However, rather than harming the timeout goals by inducing "checklist fatigue," it increases completeness and quality of the team timeout

A robust, low- to medium-throughput prnp genotyping system in sheep

BACKGROUND: In many countries breeding programs for resistance to scrapie in sheep are established. Therefore, the demand on genotyping capacities of the polymorphisms of the prion protein gene (prnp) relevant to presently known disease associations and EU regulations is steadily increasing. Most published typing methods are not well suited for routine typing of large sample numbers in smaller service laboratories for different reasons: they require partly manual data processing, sophisticated and sensitive protocols, high efforts regarding time and manpower, multiple step reactions or substantial hardware investments. To overcome these drawbacks, we developed a prnp typing method that is based on a `multiplex amplification refractory mutation system' (ARMS) reaction. METHODS: In this study we combined the amplification refractory mutation system (ARMS) with standard fluorescent based fragment length analyses method to develop a prnp genotyping method (PRNP ARMS). RESULTS: By optimised primer design it was possible to type the 4 relevant single nucleotide polymorphisms (SNPs) in the prnp simultaneously in one multiplex reaction. Automated fragment length analysis enabled automated allele designation. Suitability of the PRNP ARMS for routine application was proven by typing samples with known genotypes and larger sample numbers from half-sib families. CONCLUSION: The ARMS PRNP typing method established in this study is universally suited for a broad range of typing projects with different requirements. It provides an efficient and inexpensive diagnostic mutation analysis that will improve the quality of prnp genotyping compared with other low-cost methods. It can be implemented by most molecular genetic laboratories using standard equipment

Behavioural ambidexterity: effects on individual well-being and high performance work in academia

Academic work demands behavioural ambidexterity: the ability to simultaneously demonstrate exploration (creativity in research and/or in innovative teaching and learning practice) and exploitation (compliance with quality assurance). However, little is known about the effects of behavioural ambidexterity on the well-being of individual employees. We explore the experiences of men working in academic roles at universities in Sweden and the UK. More specifically, we examine the relations between behavioural ambidexterity and perceptions of well-being using an interpretative approach based on narrative analysis. Despite societal differences between Sweden and the UK, academics in both countries felt ill-equipped to fulfil the demands for ambidexterity. This resulted in mixed performance outcomes with serious implications for well-being. We identify and discuss the influence of personal circumstances and the role of agency in work design as two key antecedents of positive well-being outcomes

Female gamers’ experience of online harassment and social support in online gaming: a qualitative study

Female gaming is a relatively under-researched area, and female gamers often report experiencing harassment whilst playing online. The present study explored female experiences of social support while playing online video games, because of the previous research suggesting that females often experience harassment and negative interactions during game play. Data were collected from an online discussion forum, and comprised posts drawn from 271 female gamers. Thematic analysis of the discussions suggested that a lack of social support and harassment frequently led to female gamers playing alone, playing anonymously, and moving groups regularly. The female gamers reported experiencing anxiety and loneliness due to this lack of social support, and for many, this was mirrored in their experiences of social support outside of gaming. The female gamers frequently accepted the incorporation into their gaming of specific coping strategies to mitigate online harassment, including actively hiding their identity and avoiding all forms of verbal communication with other players. These themes are discussed in relation to relevant research in the area, along with recommendations for future research and consideration of possible explanations for the themes observed

Burnout in Organizational Life

Burnout is a psychological response to work stress that is characterized by emotional exhaustion, depersonalization, and reduced feelings of personal accomplishment. In this paper, we review the burnout literature from 1993 to present, identifying important trends that have characterized the literature. We focus our attention on theoretical models that explain the process of burnout, the measurement of burnout, means of reducing burnout, and directions for the future of burnout research.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline