Support opportunities for second victims lessons learned: a qualitative study of the top 20 US News and World Report Honor Roll Hospitals

Background Second Victim Programs (SVPs) provide support for healthcare providers involved in a near-miss, medical error, or adverse patient outcomes. Little is known about existence and structure of SVPs in top performing US hospitals. Methods We performed a prospective study and interviewed individuals representing SVPs from 20 US News and World Report (USNWR) Honor Roll Hospitals. Telephone interviews were recorded, transcribed, and de-identified. To allow identification of both quantitative and qualitative themes that unified or distinguished programs with SVPs from each other, a content analysis approach was used. Results Of the Top 20 UNSWR hospitals, nineteen individuals with knowledge of or involvement in SVPs were identified. One individual represented two hospital systems for the same institution. Thirteen representatives agreed to participate, 12 declined, and 5 did not respond. One individual who initially agreed to participate did not attend the interview. Among twelve representatives interviewed, 10 reported establishment of SVPs at their hospitals between 2011 and 2016. Most program representatives reported that participants sought support voluntarily. Four domains were identified in the qualitative analysis: (a) identification of need for Second Victim Program (SVP); (b) challenges to program viability; (c) structural changes following SVP creation, and (d) insights for success. Driving SVP creation was the need support medical providers following a traumatic patient event. Poor physician participation due to the stigma associated with seeking support was commonly reported as a challenge. However, acceptance of the mission of SVPs, growing recognition of the value of the program across hospital departments, and systematic safety enhancements were cited as key advantages. To ensure success, participants suggested training a variety of volunteers and incorporating SVPs within quality improvement processes. Conclusions In this convenience sample, programs for healthcare providers that experience psychosocial or emotional trauma from clinical care were uncommon. Variation in structure, performance, and measures of success among SVPs was observed. A systematic approach to evaluating SVPs is needed to help inform institutions of how to best serve their second victims.

A cultura como valor na imagem de lugares: a influência cultural do Brasil

Este artigo visa posicionar o Brasil do ponto de vista de sua influência cultural. Para tanto, utilizamos dados de estudo viabilizados pela parceria entre o BAV Group, a Wharton School da Universidade da Pensilvânia e o U.S. News & World Report. A partir desses dados, procedeu-se com uma análise de cluster que colocou a influência cultural do Brasil em perspectiva e em relação aos países do estudo original, ao cluster a que o Brasil pertence e à América do Sul, destacando os elementos em que o país teve melhor ou pior desempenho. Os resultados foram confrontados com alguns dos conceitos discutidos na revisão de literatura, que focou nas discussões sobre as imagens de lugar e de cultura como valores, isto é, meios de exploração da conexão entre as conclusões e as possibilidades de desenvolvimento para o Brasil.

Which medical schools produce the most neurosurgery residents? An analysis of the 2014–2020 cohort

OBJECTIVE In this study, the authors sought to determine which US medical schools have produced the most neurosurgery residents and to evaluate potential associations between recruitment and medical school characteristics. METHODS Demographic and bibliometric characteristics were collected for 1572 residents in US-based and Accreditation Council for Graduate Medical Education (ACGME)–accredited neurosurgery programs over the 2014 to 2020 match period using publicly available websites. US medical school characteristics were collected, including class size, presence of a home neurosurgery program, number of clinical neurosurgery faculty, research funding, presence of a neurosurgery interest group, and a top 10 ranking via U.S. News & World Report or Doximity. Correlations and associations were then evaluated using Pearson’s correlation coefficient (PCC), independent-samples t-test, and univariable or stepwise multivariable linear regression, as appropriate. RESULTS Vanderbilt University produced the most neurosurgery residents as a percentage of medical graduates at 3.799%. Case Western Reserve University produced the greatest absolute number of neurosurgery residents (n = 40). The following factors were shown to be associated with a higher mean percentage of graduates entering neurosurgery: number of clinical neurosurgery faculty (PCC 0.509, p < 0.001), presence of a neurosurgery interest group (1.022% ± 0.737% vs 0.351% ± 0.327%, p < 0.001) or home neurosurgery program (1.169% ± 0.766% vs 0.428% ± 0.327%, p < 0.001), allopathic compared with osteopathic school (0.976% ± 0.719% vs 0.232% ± 0.272%, p < 0.001), U.S. News top 10 ranking for neurology and neurosurgery (1.923% ± 0.924% vs 0.757% ± 0.607%, p < 0.001), Doximity top 10 residency program ranking (1.715% ± 0.803% vs 0.814% ± 0.688%, p < 0.001), and amount of NIH funding (PCC 0.528, p < 0.001). CONCLUSIONS The results of this study have delineated which medical schools produced the most neurosurgery residents currently in training, and the most important independent factors predicting the percentage of graduates entering neurosurgery and the preresidency h-index.

LINGUISTIC PECULIARITIES OF INNOVATIONS IN AMERICAN ENGLISH

The article deals with linguistic peculiarities of innovations selected in texts of American news weeklies such as Newsweek and U.S. News and World Report. The author has identified and described innovations coined in the beginning of the 21st century in American journalistic texts. The innovations include lexical and grammatic coinages. The above-mentioned nonce words are coined by analogy of the existing word forming patterns. Lexical innovations reflect phenomena of American political and social life. Jargon is also an active sphere of communicative activity and serves as a foundation for producing nonce words. Grammatic innovations prove the tendency to violation of language standards and bear the characteristics of colloquial American English. In most cases the innovations are semantic nonce words and their analysis helps to realize semantic connection between the original meaning and the new one. Apart from semantic characteristics, identified innovations perform a set of functions, i.e. they are functionally oriented. They reflect social and political changes, and help native speakers precisely express their thoughts and emotions. Nonce words, as effective instruments of journalists’ influence, perform the following functions: informative, expressive, pragmatic, appealing etc. Nonce words are expressive, concise, attractive by their form and semantics. They affect readers.

Private Payer–Negotiated Prices for Outpatient Otolaryngologic Surgery

In January 2021, the Centers for Medicare & Medicaid Services began requiring hospitals to publish price transparency files listing all prices negotiated with payers. We performed a cross-sectional analysis of payer-negotiated prices for commonly performed outpatient otolaryngology surgery at all hospitals scored by the US News & World Report in otolaryngology. We compared prices among hospitals (across-center ratios) and among payers at the same hospital (within-center ratios). Price disclosure rates were low overall for otolaryngologic surgery (maximum, 26.7% for bronchoscopy). Across-center ratios ranged from 3.5 (adjacent tissue transfer/rearrangement <10 cm2; raw median price range, $1384-$7047) to 18.6 (cochlear implant placement; raw median price range, $2417-$60,255). Median within-center ratios ranged between 2.7 (intraoperative navigation) and 5.4 (total thyroidectomy). Although price variation may signal opportunities for cost savings, patients may have limited ability to comparison shop due to hospital nondisclosure. Further investigation is necessary to examine the factors affecting price variation for otolaryngologic procedures.

Összefogás a látás védelmében: körkép a látásromlás prevenciójának hazai és nemzetközi helyzetéről

Összefoglaló. Az Egészségügyi Világszervezet (WHO) Látásról szóló világjelentése (World report on vision 2019) szerint a népesség növekedése és elöregedése világszerte növekvő számban vezet mérsékelt vagy súlyosabb fokú látáskárosodáshoz. A WHO adatai szerint napjainkban 1,1 milliárd személy él a látáskárosodás valamely formájával, melyek mintegy 80%-a megelőzhető lenne. A látáskárosodott vagy látáskárosodással veszélyeztetett személyek 90%-a ugyan alacsony vagy közepes humán fejlettségű országban él, de a rövidlátás és a cukorbetegség miatti retinopathia okozta látáskárosodások száma a magas és a nagyon magas humán fejlettségű országok csoportjában is emelkedik. A WHO előrejelzései szerint ezzel a tendenciával 2050-re 61 millióan élnek majd vaksággal, és 1,7 milliárd személy lehet csökkentlátó világszerte. Riasztó adat, hogy az emberiség 23%-a rövidlátó, de a jelenlegi növekedési tendenciák alapján 2050-re az előfordulás már 50%-os lehet. A vakság, illetve a látáskárosodás megelőzése és a látásrehabilitáció fejlődése érdekében a WHO globális akcióprogramjainak (VISION 2020, World report on vision) ismertetésén túl tanulmányunk bemutatja a hazai intézkedéseket és a populációalapú felmérések nemzetközi és hazai eredményeit, köztük a látásromlás legfőbb kórokait és a látáskárosodáshoz leggyakrabban vezető szembetegségeket. Tanulmányunkban bemutatjuk a látáskárosodással élő gyermekek hazai, egészségügyi és pedagógiai szempontból releváns populációjellemzőit is. Összefoglalónk célja felhívni a figyelmet arra, hogy a látáskárosodás megelőzése és a kialakult látáskárosodással élő emberek komplex rehabilitációja nemcsak a szemészeti szakma feladata, hanem be kell, hogy épüljön az egészségügyi alapellátáson túl az oktatási és szociális rendszerekbe is. Orv Hetil. 2021; 162(30): 1187–1197. Summary. World Health Organization’s (WHO) World report on vision (2019) underlines that the increasing size and age of the population leads to a general growth in cases of vision impairment of varying severity (moderate and severe vision impairment). According to WHO data, globally 1.1 billion individuals live with vision impairment, and approximately 80% of all cases is preventable. While around 90% of people with vision impairment or at risk of vision impairment live in low- or middle-income countries, the prevalence of near vision impairment and diabetic retinopathy is increasing in high-income countries, too. WHO assumes that if this tendency is not interrupted, by 2050 61 million individuals will be blind and 1.7 billion individuals will have vision impairment. It is rather frightening that currently 23% of the world’s population is diagnosed with near vision impairment, and with this tendency by 2050 this number may reach 50%. Our study takes a closer look at global actions for preventing vision loss and vision impairment together with the joint efforts to improve vision rehabilitation services, and briefly introduces Hungarian measures, results of international and national population-centred research results, and the major causes of vision impairment. Then, the Hungarian population of children with vision impairment is characterised from both healthcare and pedagogical perspectives. The objective of this review is to point out that the prevention of vision impairment and comprehensive rehabilitation of persons with vision impairment requires joint efforts from ophthalmology, pedagogy and social services. Orv Hetil. 2021; 162(30): 1187–1197.