scholarly journals Episodes of strain experienced in the operating room: impact of the type of surgery, the profession and the phase of the operation

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sandra Keller ◽  
Steven Yule ◽  
Douglas S. Smink ◽  
Vivian Zagarese ◽  
Shawn Safford ◽  
...  
Keyword(s):  
Operating Room ◽  
Single Phase ◽  
Trauma Surgery ◽  
Linear Modeling ◽  
High Concentration ◽  
Team Members ◽  
Professional Groups ◽  
Time Patterns ◽  
Different Types ◽  
Or Team

Abstract Background Strain episodes, defined as phases of higher workload, stress or negative emotions, occur everyday in the operating room (OR). Accurate knowledge of when strain is most intense for the different OR team members is imperative for developing appropriate interventions. The primary goal of the study was to investigate temporal patterns of strain across surgical phases for different professionals working in the OR, for different types of operations. Methods We developed a guided recall method to assess the experience of strain from the perspective of operating room (OR) team members. The guided recall was completed by surgeons, residents, anesthesiologists, circulating nurses and scrub technicians immediately after 113 operations, performed in 5 departments of one hospital in North America. We also conducted interviews with 16 surgeons on strain moments during their specific operation types. Strain experiences were related to surgical phases and compared across different operation types separately for each profession in the OR. Results We analyzed 693 guided recalls. General linear modeling (GLM) showed that strain varied across the phases of the operations (defined as before incision, first third, middle third and last third) [quadratic (F = 47.85, p < 0.001) and cubic (F = 8.94, p = 0.003) effects]. Phases of operations varied across professional groups [linear (F = 4.14, p = 0.001) and quadratic (F = 14.28, p < 0.001) effects] and surgery types [only cubic effects (F = 4.92, p = 0.001)]. Overall strain was similar across surgery types (F = 1.27, p = 0.28). Surgeons reported generally more strain episodes during the first and second third of the operations; except in vascular operations, where no phase was associated with significantly higher strain levels, and emergency/trauma surgery, where strain episodes occurred primarily during the first third of the operation. Other professional groups showed different strain time patterns. Conclusions Members of the OR teams experience strain differently across the phases of an operation. Thus, phases with high concentration requirements may highly vary across OR team members and no single phase of an operation can be defined as a “sterile cockpit” phase for all team members.

scholarly journals Current practice and perceptions of safety protocols for the use of intraperitoneal chemotherapy in the operating room: results of the IP-OR international survey

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Daniel Clerc ◽  
Martin Hübner ◽  
K.R. Ashwin ◽  
S.P. Somashekhar ◽  
Beate Rau ◽  
...  
Keyword(s):  
Operating Room ◽  
Intraperitoneal Chemotherapy ◽  
Current Practice ◽  
High Volume ◽  
International Survey ◽  
Protection Measures ◽  
Team Members ◽  
Cleaning Staff ◽  
The Individual ◽  
Or Team

Abstract Objectives To assess the risk perception and the uptake of measures preventing environment-related risks in the operating room (OR) during hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). Methods A multicentric, international survey among OR teams in high-volume HIPEC and PIPAC centers: Surgeons (Surg), Scrub nurses (ScrubN), Anesthesiologists (Anest), Anesthesiology nurses (AnesthN), and OR Cleaning staff (CleanS). Scores extended from 0–10 (maximum). Results Ten centers in six countries participated in the study (response rate 100%). Two hundred and eleven responses from 68 Surg (32%), 49 ScrubN (23%), 45 Anest (21%), 31 AnesthN (15%), and 18 CleanS (9%) were gathered. Individual uptake of protection measures was 51.4%, similar among professions and between HIPEC and PIPAC. Perceived levels of protection were 7.57 vs. 7.17 for PIPAC and HIPEC, respectively (p<0.05), with Anesth scoring the lowest (6.81). Perceived contamination risk was 4.19 for HIPEC vs. 3.5 for PIPAC (p<0.01). Information level was lower for CleanS and Anesth for HIPEC and PIPAC procedures compared to all other responders (6.48 vs. 4.86, and 6.48 vs. 5.67, p<0.01). Willingness to obtain more information was 86%, the highest among CleanS (94%). Conclusions Experience with the current practice of safety protocols was similar during HIPEC and PIPAC. The individual uptake of protection measures was rather low. The safety perception was better for PIPAC, but the perceived level of protection remained relatively low. The willingness to obtain more information was high. Intensified, standardized training of all OR team members involved in HIPEC and PIPAC is meaningful.

scholarly journals Organizing Entrepreneurial Teams: A Field Experiment on Autonomy over Choosing Teams and Ideas

2021 ◽  
Author(s):  
Viktoria Boss ◽  
Linus Dahlander ◽  
Christoph Ihl ◽  
Rajshri Jayaraman
Keyword(s):  
Field Experiment ◽  
Organizational Design ◽  
Team Members ◽  
Different Types ◽  
Entrepreneurial Team ◽  
Causal Mediation Analysis ◽  
Or Team ◽  
Performance Gains ◽  
Main Effects ◽  
Shed Light

Scholars have suggested that autonomy can lead to better entrepreneurial team performance. Yet, there are different types of autonomy, and they come at a cost. We shed light on whether two fundamental organizational design choices—granting teams autonomy to (1) choose project ideas to work on and (2) choose team members to work with—affect performance. We run a field experiment involving 939 students in a lean startup entrepreneurship course over 11 weeks. The aim is to disentangle the separate and joint effects of granting autonomy over choosing teams and choosing ideas compared with a baseline treatment with preassigned ideas and team members. We find that teams with autonomy over choosing either ideas or team members outperform teams in the baseline treatment as measured by pitch deck performance. The effect of choosing ideas is significantly stronger than the effect of choosing teams. However, the performance gains vanish for teams that are granted full autonomy over choosing both ideas and teams. This suggests the two forms of autonomy are substitutes. Causal mediation analysis reveals that the main effects of choosing ideas or teams can be partly explained by a better match of ideas with team members’ interests and prior network contacts among team members, respectively. Although homophily and lack of team diversity cannot explain the performance drop among teams with full autonomy, our results suggest that self-selected teams fall prey to overconfidence and complacency too early to fully exploit the potential of their chosen idea. We discuss the implications of these findings for research on organizational design, autonomy, and innovation.

The Relationship Between Leader–Member Exchange and Employees’ Proactive Behaviors

2019 ◽  
Vol 18 (2) ◽  
pp. 106-111
Author(s):  
Fong-Yi Lai ◽  
Szu-Chi Lu ◽  
Cheng-Chen Lin ◽  
Yu-Chin Lee
Keyword(s):  
Hierarchical Linear Modeling ◽  
Future Research ◽  
Leader Member Exchange ◽  
Voice Behavior ◽  
Linear Modeling ◽  
Team Members ◽  
Member Exchange ◽  
Multi Temporal ◽  
The Relationship ◽  
Practical Implications

Abstract. The present study proposed that, unlike prior leader–member exchange (LMX) research which often implicitly assumed that each leader develops equal-quality relationships with their supervisors (leader’s LMX; LLX), every leader develops different relationships with their supervisors and, in turn, receive different amounts of resources. Moreover, these differentiated relationships with superiors will influence how leader–member relationship quality affects team members’ voice and creativity. We adopted a multi-temporal (three wave) and multi-source (leaders and employees) research design. Hypotheses were tested on a sample of 227 bank employees working in 52 departments. Results of the hierarchical linear modeling (HLM) analysis showed that LLX moderates the relationship between LMX and team members’ voice behavior and creative performance. Strengths, limitations, practical implications, and directions for future research are discussed.

From whom do we learn group norms? Low-ranking group members are perceived as the best sources

2020 ◽  
Author(s):  
Jennifer E Dannals ◽  
Emily Reit ◽  
Dale T. Miller
Keyword(s):  
Social Norms ◽  
Correlation Study ◽  
Team Members ◽  
Norm Perception ◽  
Lower Ranking ◽  
Group Members ◽  
Groups And Teams ◽  
Or Team ◽  
And Behavior ◽  
To Receive

Social norm perception is ubiquitous in small groups and teams, but how individuals approach this process is not well understood. When individuals wish to perceive descriptive social norms in a group or team, whose ad- vice and behavior do they prefer to rely on? Four lab studies and one Teld survey demonstrate that when in- dividuals seek information about a team’s social norms they prefer to receive advice from lower-ranking indi- viduals (Studies 1–4) and give greater weight to the observed behavior of lower-ranking individuals (Study 5). Results from correlation (Study 3) and moderation (Study 4) approaches suggest this preference stems from the assumption that lower-ranking team members are more attentive to and aware of the descriptive social norms of their team. Alternative mechanisms (e.g., perceived similarity to lower-ranking team members, greater honesty of lower-ranking team members) were also examined, but no support for these was found.

scholarly journals A Survey on Robotic Technologies for Forest Firefighting: Applying Drone Swarms to Improve Firefighters’ Efficiency and Safety

2021 ◽  
Vol 11 (1) ◽  
pp. 363
Author(s):  
Juan Jesús Roldán-Gómez ◽  
Eduardo González-Gironda ◽  
Antonio Barrientos
Keyword(s):  
Augmented Reality ◽  
Access To Information ◽  
Team Leaders ◽  
Team Members ◽  
Multiple Tasks ◽  
Different Types ◽  
Complete Survey ◽  
Virtual And Augmented Reality ◽  
Robotic Technologies

Forest firefighting missions encompass multiple tasks related to prevention, surveillance, and extinguishing. This work presents a complete survey of firefighters on the current problems in their work and the potential technological solutions. Additionally, it reviews the efforts performed by the academy and industry to apply different types of robots in the context of firefighting missions. Finally, all this information is used to propose a concept of operation for the comprehensive application of drone swarms in firefighting. The proposed system is a fleet of quadcopters that individually are only able to visit waypoints and use payloads, but collectively can perform tasks of surveillance, mapping, monitoring, etc. Three operator roles are defined, each one with different access to information and functions in the mission: mission commander, team leaders, and team members. These operators take advantage of virtual and augmented reality interfaces to intuitively get the information of the scenario and, in the case of the mission commander, control the drone swarm.

EFFECT OF MEAN ION SIZE AND SPATIAL SPIN DISORDERS FOR (La1-xYx)2/3Ca1/3MnO3 MANGANITES

2004 ◽  
Vol 18 (26) ◽  
pp. 3451-3464 ◽  
Author(s):  
JINCANG ZHANG ◽  
YUFENG ZHANG ◽  
SHIXUN CAO ◽  
CHAO JING
Keyword(s):  
Single Phase ◽  
Bond Angle ◽  
Gradual Increase ◽  
High Concentration ◽  
Magnetic Studies ◽  
Metal Insulator Transition ◽  
Metal Insulator ◽  
Average Ionic Radius ◽  
Lower Temperature ◽  
Ion Size

The structure and transport properties of perovskite ( La 1-x Y x)2/3 Ca 1/3 MnO 3 (0≤x≤0.3) systems are systematically investigated. It is found that all the specimens show a single-phase structure and reveal a direct relationship between the Curie temperature Tc and the average ionic radius <rA> of La site. With increasing Y 3+ doped content, the metal-insulator transition temperature T MI (M-I) shifts to lower temperature. While the relevant resistivity peak ρp is sharp increased, for the specimens with large doping content, x=0.3, it has enhanced eight orders of magnitudes larger than the non-doped samples (x=0.0). At high concentration area, that is to say, when x>0.1, magnetic studies show a gradual increase of antiferromagnetic interaction with an increase of x, ultimately leading to a spatial-spin disorders, that is, spin-glass-like state for x=0.2 and x=0.3 compounds at about 35 K. The results show that it has connected a reduction of Tc and an increase in magnetoresistance with a decrease in the microstructural Mn - O - Mn bond angle.

scholarly journals Audit on induction time delays in operating room at Kibogora District Hospital: A quality improvement project

2021 ◽  
Vol 9 (2) ◽  
pp. 163-168
Author(s):  
Jean Claude Uwimana
Keyword(s):  
Operating Room ◽  
Induction Time ◽  
Time Delays ◽  
High Rate ◽  
Improvement Project ◽  
Study Results ◽  
Induction Times ◽  
Or Team ◽  
Causes Of Delays ◽  
Operating Unit

Background: Induction time delays in Operating room (OR) is an issue that affects the productivity of an operating unit especially in a setting with limited resources. It can also results in providing inappropriate services to the patients and their families. The aim of this study was to determine the causes of induction time delays and to propose solutions on how to avoid the reasons of delays. Methods: A prospective observational study was conducted. It focused on elective general surgeries and orthopedic surgeries as they were mainly being performed during the study period. The data on the type of operation, the type of anesthesia, delay or no delay of induction (DOI) of anesthesia, causes of DOI were collected. DOI was considered as the time between the previous patient out of the OR and the next one in of more than 30 minutes. Emergency surgeries and elective obstetric surgeries were excluded from the study. Results: 24.8% of surgeries were done after delays of induction of anesthesia as opposed to 75.2% surgeries for which anesthesia was induced without delay. 48.6% of delays of induction to anesthesia were due to the hospital issues followed by anesthesia provision related issues. (40.0%). The surgery related and patient related issues accounted each one 5.7%. Conclusions: There was a high rate of surgeries that had delays in induction times. The OR managers need to work more with the hospital administration and the OR team to correct causes of delays.

scholarly journals Comparative investigations on different types of inductors in single-phase inverter

2021 ◽  
Vol 2107 (1) ◽  
pp. 012051
Author(s):  
M. Z. Aihsan ◽  
A. M. Yusof ◽  
Hasliza A Rahim ◽  
B. Ismail ◽  
W. A. Mustafa ◽  
...  
Keyword(s):  
Pulse Width ◽  
Single Unit ◽  
Single Phase ◽  
Pulse Width Modulation ◽  
Bridge Circuit ◽  
Experimental Assessment ◽  
Phase Inverter ◽  
Different Types ◽  
Single Phase Inverter ◽  
Validation Of Results

Abstract This article organized in two sections where it compares the performance of single-phase inverters using various types of inductors with differences modulation technique of pulse width modulation (PWM). Not all inductors perform the same function, even the inductance value is the same. The study will investigate the capability of each inductor on its performance to convert the unfiltered AC voltage into filtered sinusoidal AC voltage. The drum core and toroidal core inductors were used in this investigation. For both inductors, the performance will be analyzed based on Bipolar and Unipolar switching schemes in a single unit H-bridge circuit. The validation of results are through experimental assessment only and it will be evaluating the shape of sinusoidal AC voltage and the content of total harmonics distortion in the AC voltage for both inductors.

Fading Time Study on Prepared Thymolphthalein, Phenolphthalein and their Mixture Disappearing Ink

2008 ◽  
Vol 12 (1) ◽  
pp. 9-18
Author(s):  
S.A. Shama ◽  
M.M. El-Molla ◽  
Riad F. Basalah ◽  
S. El-Sayed Saeed
Keyword(s):  
Thermal Effect ◽  
Time Study ◽  
High Concentration ◽  
Different Types ◽  
The Stability ◽  
Fading Time

Disappearing ink was prepared using different concentrations of thymolphthalein, phenolphthalein and their mixture, applying to different types of handwriting surfaces such as cotton, polyester and polyamide. The effects of thymolphthalein, phenolphthalein and alkali concentrations (i.e. pH) on the fading time were studied. The handwriting stability increased when the concentration of thymolphthalein or phenolphthalein was increased. At a high concentration of alkali with phenolphthalein and its mixture with thymolphthalein, the handwriting stability decreased with polyester or polyamide handwriting surfaces and the stability increased in the case of cotton. When the faded handwriting surfaces were subject to the thermal effect in a thermostatically controlled oven at 100°C for 10 minutes by hanging them with suitable hooks, there was no change in the faded handwriting. When they were at 150°C for 20 minutes, the faded phenolphthalein ink, which contained 0.5ml of 1N NaOH, was visible and shown red on the polyester and polyamide handwriting surfaces, but there was no change on the faded cotton handwriting surface.

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