scholarly journals A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America

2017 ◽  
Vol 79 (03) ◽  
pp. 289-296 ◽  
Author(s):  
Jamie Van Gompel ◽  
R. Wiet ◽  
Nicole Tombers ◽  
Anand Devaiah ◽  
Devyani Lal ◽  
...  
Keyword(s):  
North America ◽  
Skull Base ◽  
Vestibular Schwannoma ◽  
North American ◽  
Management Practices ◽  
Current Practice ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Wide Range

Background Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons and 9% of otolaryngologists performed surgery alone. There was a wide range in the number of cases evaluated at each center annually. Similarly, there was wide variation in the number of patients treated with microsurgery and radiation at each center. Additional details regarding management preferences for microsurgery, stereotactic radiosurgery, stereotactic radiotherapy, and conservative observation are presented. Conclusion VS management practices vary between providers and centers. Overall, most centers employ a multidisciplinary approach to management with collaboration between otolaryngology and neurosurgery. Overall, survey responses concur with previous studies suggesting a shift toward conservatism in management.

scholarly journals Vestibular Schwannoma Management: Current Practice Amongst UK Otolaryngologists – Time for a National Prospective Audit

2006 ◽  
Vol 88 (5) ◽  
pp. 490-495 ◽  
Author(s):  
Shakeel R Saeed ◽  
Ranga Suryanarayanan ◽  
Attila Dezso ◽  
Richard T Ramsden
Keyword(s):  
Vestibular Schwannoma ◽  
Current Practice ◽  
Manpower Planning ◽  
Postal Questionnaire ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Wide Range ◽  
Collaborative Working ◽  
Computer Based ◽  
The Uk

INTRODUCTION It is generally agreed that the successful management of a vestibular schwannoma (VS) usually involves close collaboration between a neuro-otologist and neurosurgeon. In addition, it is accepted that the experience of the team managing such tumours is one of the key determinants of outcome after surgical intervention. The aim of this study was to identify current practice in the management of such tumours amongst otolaryngologists in the UK and to observe whether such collaborative working practices exist. MATERIALS AND METHODS A cross sectional postal questionnaire survey of consultant members of the British Association of Otorhinolaryngologists – Head and Neck Surgeons (n = 542). RESULTS A total of 336 replies were received (62%). Of respondents, 299 consultants referred their patients to another surgeon for further management; 242 referred to another ENT surgeon (80.9%), 29 to a neurosurgeon (9.7%) and 28 to a combined team (9.4%). Twenty-eight of the responding otolaryngologists (8.6%) managed the tumours themselves, of whom 22 worked with a neurosurgeon. Of these 28 neuro-otologists, nearly two-thirds (64%) had been undertaking VS surgery for more than 10 years. The total number of patients with a VS referred to these 28 consultants during 2001 was 775, with a mean caseload of 29.8, median 23 and a range of 4 to 102 per surgeon. Seven of the 28 otolaryngologists chose their surgical approach entirely based on the size of the tumour. Eight consultants preferred the sub-occipital (SO) approach, 10 the trans-labyrinthine (TL) approach, three chose between SO and TL approaches. The majority of surgeons had a prospective, computer-based data collection and were willing to give further information about their outcomes and complications. CONCLUSIONS Amongst the otolaryngologists surveyed in the UK, we have identified 28 neuro-otologists who undertake VS surgery. The majority work with neurosurgical colleagues, confirming collaborative practice. The wide range in caseload raises the issue of training and maintaining standards and in the first instance we recommend a prospective national audit of VS management and outcomes with our neurosurgical colleagues. This would also be of value in manpower planning particularly if a minimum caseload could be identified below which results were seen to be less good.

scholarly journals A Cross-Sectional Survey of the North American Skull Base Society Part 3: The State of Lateral Skull Base Surgery Training in North America

2018 ◽  
Vol 80 (04) ◽  
pp. 399-415
Author(s):  
Neil S. Patel ◽  
Jamie J. Van Gompel ◽  
Nicole M. Tombers ◽  
Michael J. Link ◽  
Matthew L. Carlson
Keyword(s):  
Decision Making ◽  
North America ◽  
Skull Base ◽  
North American ◽  
Training Programs ◽  
Case Volume ◽  
Cross Sectional ◽  
Training Requirements ◽  
The North ◽  
Fellowship Programs

Introduction Optimal management of vestibular schwannoma (VS) demands involvement of an experienced multidisciplinary team. As the number of training programs in neurotology and skull base neurosurgery continues to rise, ensuring that trainees are capable of evidence-based decision-making and treatment, whether microsurgical or radiosurgical, is of paramount importance. The purpose of this study is to characterize the landscape of neurotologic and neurosurgical fellowship training programs in North America, with special reference to VS management. Methods A 64-item web-based survey assessing VS practice trends was devised by members of the North American Skull Base Society (NASBS) Research Task Force and distributed electronically to NASBS membership via SurveyMonkey as a cross-sectional study. Participation was entirely voluntary and there was no remuneration for survey completion. The survey link was active from November 29 to December 14, 2016. Results Of 719 members of the NASBS who were emailed a survey link, a total of 57 were returned (8%) completed surveys. Of all respondents, 51 (89%) claimed to have formal training in skull base neurosurgery or neurotology. Thirty-three respondents (65%) were skull base neurosurgeons while the remainder were neurotologists (n = 18; 35%). Institutions with fellowship programs tended to have a higher surgical, radiosurgical, and overall case volume than those with a residency program alone. However, 20% of respondents at institutions with fellowship programs reported evaluating less than 50 new diagnoses of VS per year and 12% reported a surgical case volume of less than 10 cases per year. Conclusion As the number of skull base training programs expands, it is our duty to ensure that trainees gain sufficient experience to enter independent practice with the ability to exercise informed decision-making and safely perform VS surgery and radiosurgery. In the current training climate, implementing multidisciplinary care models, formalized training requirements, and emerging surgical simulators will support the development of minimum proficiencies in VS care.

scholarly journals A Cross-sectional Survey of the North American Skull Base Society on Vestibular Schwannoma, Part 2: Perioperative Practice Patterns of Vestibular Schwannoma in North America

2017 ◽  
Vol 79 (03) ◽  
pp. 297-301 ◽  
Author(s):  
Matthew Carlson ◽  
R. Wiet ◽  
Nicole Tombers ◽  
Anand Devaiah M ◽  
Devyani Lal ◽  
...  
Keyword(s):  
Skull Base ◽  
Vestibular Schwannoma ◽  
Supine Position ◽  
North American ◽  
Perioperative Care ◽  
Practice Patterns ◽  
Cranial Nerves ◽  
Thrombosis Prophylaxis ◽  
Cross Sectional Survey ◽  
The North

Introduction Perioperative care of vestibular schwannoma (VS) patients is extremely variable across surgeons and institutions making practice patterns difficult to standardize. No data currently exist detailing this practice variability. Methods The North American Skull Base Society membership was electronically surveyed regarding perioperative care of surgically operated VS patients. Results There were 87 respondents to the survey. Surgical positioning, surgical approach utilized, and perioperative medical adjuncts are quite variable. However, of those performing retrosigmoid approaches, 49% perform this in the supine position, while 33% use a park-bench position with only 2% using the sitting position. In those performing translabyrinthine approaches, 86% perform this in supine position. Although the use of neuromonitoring appears to be standard of care (98%), other than the seventh nerve, there is substantial variability between respondents regarding monitoring of additional cranial nerves. Postoperative antibiotics are used by 65%, postoperative steroids 81%, and postoperative chemical deep vein thrombosis prophylaxis in 68% of survey respondents. Conclusion Although the perioperative adjuncts to VS surgery are variable, there does appear to be a trend in common practice. Therefore, making surgeons aware of these trends may lead to standardized practice or alternatively trials of these variances to instruct which truly improve patient outcomes.

A Cross Sectional Survey of Chicken Astroviruses Antibody in Broiler and Sonali (Cross-Bred) Chickens in Selected Areas in Bangladesh

2020 ◽  
Vol 43 (1) ◽  
pp. 75-80
Author(s):  
Md Zulfekar Ali ◽  
Mohammad Moktader Moula ◽  
Zafar Ahmed Bhuiyan ◽  
Muhammad Tariq Javed
Keyword(s):  
Age Groups ◽  
Winter Season ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Blood Samples ◽  
Elisa Kit ◽  
Published Report ◽  
Poultry Birds ◽  
Wide Range ◽  
Group B

AbstractChicken astroviruses (CAstV) are enteric viruses of poultry causing gastroenteritis, malabsorption, gout and white chick disease commonly known as runting-stunting syndrome (RSS). It can affect the wide range of poultry birds, especially chicken, turkey and duck worldwide. To our best knowledge there is no published report on presence of antibodies against CAstV in Bangladesh. Therefore, the study aimed to detect the presence of CAstV antibodies in broilers and sonali chickens (a cross-bread) in Bangladesh through a cross-sectional survey. A total of 454 blood samples from 66 flocks of broiler (n=343) and sonali chickens (n=111) of different ages were obtained during 2017 from four districts. The birds were healthy but were not vaccinated against CAstV. The samples were tested for specific antibodies against CAstV Group B by using commercially available ELISA kit. Overall, 16.74% (76/454) samples and 34.84% (23/66) flocks were positive for CAstV antibodies. The seroprevalence of CAstV was significantly (p=0.001) higher in sonali chickens (36.96%) than broiler (10.20%), while it was significantly higher (p=0.001) in birds of Bogura district (36.94%) than the other three districts. Regarding the age groups, seroprevalence was insignificantly (p=0.192) higher in sonali chicken before laying age (45%) than during laying age (27.45%). Regarding the seasons, CAstV infection was prevalent significantly (p=0.001) higher in winter season. Thus, the present study indicated the presence of CAstV in poultry in Bangladesh, so further studies are required to find out the magnitude of the problem in the country.

Proposal for Improving Records Management Practices of Traditional Institutions in Ga Molepo, South Africa

Mousaion ◽  
10.25159/2054 ◽  
2017 ◽  
Vol 35 (1) ◽  
pp. 46-67
Author(s):  
Mahlaga Johannes Molepo ◽  
Linda M. Cloete
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Management Practices ◽  
Records Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Record Keeping ◽  
Local Municipalities ◽  
Management Procedures ◽  
Traditional Institutions

The way in which an institution treats its records is crucial for its survival in a rapidly changing society. The purpose of the study was to investigate the records management practices and challenges faced by traditional institutions of leadership and governance in Ga Molepo, Limpopo, South Africa. The researcher employed a cross-sectional survey in order to quantitatively examine the challenges faced by members of traditional councils. A researcher administered questionnaire was used as a data collection tool to study a stratified sample of 35 members from an estimated population of 350. The findings revealed patterns and trends of non-compliance with records management standards and guidelines. Although there were sporadic cases of record keeping, a greater number of respondents revealed that traditional institutions lack the facilities, equipment, education and trained/skilled personnel to apply correct records management procedures in their daily administration of their traditional communities. The main value of the study is to create awareness of records management as one of the neglected areas in traditional institutions – which are by current legislative arrangement, the closest form of leadership and governance for rural communities in light of their relationship with local municipalities and the Department of Cooperative Governance and Traditional Affairs.

scholarly journals Determinants of revenue management practices and their impacts on the financial performance of hotels in Kenya: a proposed theoretical framework

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Michael Murimi ◽  
Billy Wadongo ◽  
Tom Olielo
Keyword(s):  
Financial Performance ◽  
Revenue Management ◽  
Management Practices ◽  
Theoretical Framework ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Second Stage ◽  
Theoretical Structure ◽  
Proposed Model ◽  
Conceptual Paper

AbstractThis conceptual paper aims at identifying a theoretical framework for the determinants of revenue management (RM) practices and their impacts on the financial performance of hotels. To create this framework, a two-phased process is employed where the first stage involves an explicit examination of the literature related to practices of revenue management and their determinants and to hotel financial performance. The second stage involves an enhancement of the framework. The theoretical structure is developed based on past theoretical explanations, and empirical analysis is conducted in the fields of revenue management. The researchers propose a theoretical framework illustrating how revenue management practices and their determinants affect the financial performance of Kenyan hotels. The use of contingency theory and its justifications and inadequacies among studies on revenue management in hotels is highlighted. The methods highlighted by the reviewed theoretical framework may be utilized to organize revenue management (RM) practices and their determinants for Kenyan hotels. Measurements for the financial performance of hotels are also described. Last, the researchers call for empirical research that authenticates the proposed model using a cross-sectional survey. The present work can inspire scholars and specialists to determine how RM practices and their determinants impact the financial performance of hotels. By assimilating knowledge from numerous disciplines, this paper emphasizes aggregated awareness surrounding the conceptualization of RM, RM practices adopted in hotels, and the financial performance of hotels.

scholarly journals North American channel catfish, Ictalurus punctatus: a neglected but potentially invasive freshwater fish species?

2021 ◽  
Vol 23 (5) ◽  
pp. 1563-1576 ◽  
Author(s):  
Phillip J. Haubrock ◽  
Gordon H. Copp ◽  
Iva Johović ◽  
Paride Balzani ◽  
Alberto F. Inghilesi ◽  
...  
Keyword(s):  
North America ◽  
Ictalurus Punctatus ◽  
Channel Catfish ◽  
North American ◽  
Disease Transmission ◽  
Native Species ◽  
Assessment Protocol ◽  
South Italy ◽  
Wide Range ◽  
North And South

AbstractThe North American channel catfish Ictalurus punctatus has been introduced to several locations in Europe but has received little or no scientific study despite its invasive attributes, including prolific reproduction, tolerance to a wide range of conditions, opportunistic feeding, at least partial ‘predator release’, and some evidence of environmental impacts (e.g. disease transmission). To assess the species’ potential invasiveness and the likely risks to native species and ecosystems in Europe, available literature from both North America and Europe was reviewed and used to carry out risk screenings of the species for the risk assessment areas, North and South Italy, using the Aquatic Invasiveness Screening Kit (AS-ISK), which was followed by a more detailed evaluation (for both North America and Europe) of the species’ potential impacts using the Environmental Impact Classification of Alien Taxa (EICAT) assessment protocol. The AS-ISK score indicated that channel catfish is likely to pose a high risk of being invasive in both North and South Italy, with EICAT scores indicating “Major” impacts for both North America and Europe, at high and medium confidence levels, respectively. The present results emphasise the urgent need to carry out in-depth studies on introduced populations of this species to understand better its invasive potential so as to inform management decisions on the appropriate control or eradication measures for invaded water bodies.

scholarly journals HIV-1 seroprevalence in the general population of Salvador, Bahia State, Northeast Brazil

2007 ◽  
Vol 23 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Inês Dourado ◽  
Craig A. Milroy ◽  
Marco Antônio Gomes Mello ◽  
Geraldo Argolo Ferraro ◽  
Humberto Castro-Lima Filho ◽  
...  
Keyword(s):  
General Population ◽  
Minimum Wage ◽  
Family Income ◽  
Dna Amplification ◽  
Income Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Subtype B ◽  
Wide Range ◽  
Hiv 1

To estimate HIV-1 seroprevalence in the general population of Salvador, Bahia, Brazil, we conducted a cross-sectional survey of 3,437 residents from 1998 to 2000. Subjects were drawn from 30 sentinel areas representing a wide range of living conditions. Plasma samples were screened for HIV-1 antibodies by ELISA and confirmed by immunofluorescent assay. Subtype determination by HMA was performed after proviral DNA amplification. Phylogenetic analysis using parsimony was performed with the neighbor-joining method. Overall HIV-1 seroprevalence was 0.55% (19/3,446): 0.8% for men and 0.36% for women. Seroprevalence was higher in the 31-45-year age group (1%) and among persons with family income less than twice the minimum wage (0.78%) as compared to 0.33% for the higher income group. Syphilis was detected in 37% of HIV seropositive individuals. Phylogenetic inferences identified 10 samples as subtype B in the env region and 2 samples with Benv/Fgag/Fpol and Fenv/Bgag. Age > 30 years, male gender, and income < 2 times the minimum wage were identified as risk factors for HIV-1 infection. Extrapolating the proportion of seropositive individuals to Salvador, the number of HIV-1 infected individuals was estimated at 13,750.

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