Abstract Background Long quiet eye (QE) duration is central to expertise in sports, while cognitive “slowing down” has been identified as a perceptual skill possessed by skilled surgeons. ...Eye-tracking evidence is lacking about the relationship of QE duration to slowing down in surgeons. The aim of this study was to examine QE duration, hand movement time (MT), fixation location, and fixation duration in highly experienced (HE) and less experienced (LE) surgeons. Methods A mobile eye tracker and camera recorded coupled gaze and hand movements. Performance was quantified by blinded review. Results HE surgeons were rated higher than LE surgeons but did not differ in operating time or MT. HE and LE surgeons differed in fixation duration on the ligament of Berry during phases 1 and 2 and QE duration on the recurrent laryngeal nerve in phase 2. Conclusions Long-duration fixation on the ligament of Berry and long-duration QE on the recurrent laryngeal nerve combined with no significant differences in MT provide empirical evidence that HE surgeons cognitively slow down more than LE surgeons during critical phases of the operation.
Although multidisciplinary cancer conferences have been reported to lead to improved patient outcomes, few studies have reported results of these for rectal cancer.
The purpose of this work was to ...assess the quality of multidisciplinary cancer conferences, the effect of the conference on the initial treatment plan, compliance with the conference treatment recommendations, and clinical outcomes for rectal cancer.
This was a prospective, longitudinal study.
The study was conducted at a tertiary care academic hospital.
Patients with primary rectal cancer were included in this study.
The intervention was a rectal cancer-specific multidisciplinary cancer conference.
The quality of the multidisciplinary cancer conference was assessed using the Cancer Care Ontario Multidisciplinary Cancer Conference standards score. A change in treatment plan was defined as a change from the initial treatment plan selected by the treating physician to an alternate treatment plan recommended at the conference.
Twenty-five multidisciplinary cancer conferences were conducted over a 10-month study period. The Cancer Care Ontario Multidisciplinary Cancer Conference standards score was 7 (from a maximum score of 9). Forty-two patients with primary rectal cancer were presented, and there was a 29% (12/42) change in the initial treatment plan. A total of 42% (5/12) of these changes were attributed to reinterpretation of the MRI findings. There was 100% compliance with the conference treatment recommendations. The circumferential resection margin was positive in 5.5% (2/36).
Selection bias may have led to an overestimate of effect, and there is no control group for comparison of clinical outcomes.
A high-quality rectal cancer-specific multidisciplinary cancer conference led to a 29% change in the treatment plan for patients with primary rectal cancer, with almost half of these changes attributed to reinterpretation of the magnetic resonance images.
Background We examined the effectiveness of traditional technical training (TT) and quiet eye training (QET) on the performance of 1-handed square knot tying among first-year surgery residents under ...normal and high-anxiety conditions. Methods Twenty surgery residents were assigned randomly to 1 of 2 groups and completed pretest, training, and simple and complex retention tests under conditions of high and low anxiety. The TT group received traditional instruction on improving hand movements; the QET group received feedback on their gaze behaviors. Participants wore an eye tracker that recorded simultaneously their gaze and hand movements. Dependent variables were knot tying performance (%), quiet eye duration (%), number of fixations, and total movement time (s). Results Both groups improved their knot tying performance ( P < .05) from pretest to the low anxiety conditions (mean difference: QET, 28%; TT, 17%); however, only the QET group maintained their knot tying performance under the high-anxiety conditions (mean difference: QET, 18%; P < .05), with the TT group decreasing their performance close to pretest levels ( P > .05). The QET group also demonstrated more efficient gaze and hand movements post training. Conclusion These data demonstrate the effectiveness of training gaze behaviors, not only to improve the effectiveness and efficiency of performance, but also to mediate negative effects of anxiety on performance. These findings may have important implications for medical educators and practitioners, as well as surgeons who may be (re)training or learning new procedures.
Abstract Background We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Methods Twenty ...surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). Results The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. Conclusions QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback.
Sport events are increasingly being recognized as integral to a destination's marketing strategy. Charity sport events are a type of event that can be leveraged by local businesses and destination ...marketers as a way of stimulating flow-on tourism, shaping an image and generating word of mouth. Yet, little research has been conducted in this area. Previous research has shown that length of stay in a destination and group composition can impact subsequent tourist behaviors. Thus, visitors' push and pull motivations and their influences on participants' choice of event and mode of participation (team versus individual) were assessed as a way of developing this line of research. The motives of supporting others, learning about the destination and cycling identity were predictive of event choice. Social motives and an identity tied to cycling predicted participants' mode of participation. Further, motives were distinguished between first-time and repeat visitors. First-time visitors were more motivated than repeat visitors by the physical aspects of the event and the opportunity to learn about the destination. Conversely, repeat visitors were more motivated by identities tied to the cause and the sport at hand than first-time visitors.
Omental free flaps have been described for reconstructive purposes in craniofacial and pharyngolaryngeal surgical oncology, plastic and reconstructive surgery, and in the context of destructive or ...persistent infections in various anatomic regions. Positive patient factors—slim body habitus, no prior abdominal operations or procedures, and hemodynamic stability—facilitated a minimally invasive approach to autologous omental harvest. In a combined operative procedure, the plastic surgery team prepared the skull and the left superficial temporal vessels for free flap transfer, while the acute care surgeons performed laparoscopic omentectomy with careful identification and preservation of the right gastroepiploic artery and vein (figure 2A).
PurposeThe purpose of this research is to explore how one unsanctioned community sport organization (CSO), AM Hockey, sought to acquire legitimacy in a highly institutionalized minor hockey ...marketplace at various points in its organizational life cycle.Design/methodology/approachThis study was guided by instrumental case study methodology. Twenty (20) AM Hockey stakeholders from a variety of roles (e.g. executives, program directors and coaches) were interviewed. Document analysis was also utilized to supplement the interviewees. Internal and public documents reflective of the CSO's creation and growth were obtained.FindingsFindings revealed that the CSO had to navigate distinct phases of evolution including the Building, Growth, Competition and Stabilization phases. Although the four life cycle phases identified in this study share similarities with the phases identified by Lester et al. (2003), findings indicated that institutional work mechanisms must be understood in their context as they can vary over the life cycle of an organization. Therefore, start-up sports organizations must approach the pursuit of legitimacy as a continual process rather than something acquired and defended through maintenance work.Originality/valueDeveloping legitimacy remains a central challenge for CSOs that seek to deliver alternative sport programming, yet it continues to be understudied. Ultimately, the long-term viability of an unsanctioned CSO in a federated sports system relies, in part, on its ability to continually determine the actions needed to achieve legitimacy within its environment.
Prise en charge de la diverticulite aigue Zondervan, Nathan; Snelgrove, Ryan; Bradley, Nori
CMAJ. Canadian Medical Association journal,
11/2022, Letnik:
194, Številka:
46
Journal Article
Prise en charge de la diverticulite aiguë Zondervan, Nathan; Snelgrove, Ryan; Bradley, Nori
Canadian Medical Association journal (CMAJ),
11/2022, Letnik:
194, Številka:
46
Journal Article
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