High-Value, High-Quality Perioperative Care—A Collaborative Opportunity for Hospitalists

2016 ◽  
Vol 5 (2) ◽  
pp. A9-A10
Author(s):  
Rachel E. Thompson
Keyword(s):  
Perioperative Care ◽  
High Quality

scholarly journals Hospital Medicine and Perioperative Care: A Framework for High-Quality, High-Value Collaborative Care

2017 ◽  
Vol 12 (4) ◽  
pp. 277-282 ◽  
Author(s):  
Rachel E Thompson ◽  
Kurt Pfeifer ◽  
Paul J Grant ◽  
Cornelia Taylor ◽  
Barbara Slawski ◽  
...  
Keyword(s):  
Collaborative Care ◽  
Perioperative Care ◽  
Hospital Medicine ◽  
High Quality

The effectiveness of the bone bridge transtibial amputation technique: A systematic review of high-quality evidence

2016 ◽  
Vol 41 (3) ◽  
pp. 219-226 ◽  
Author(s):  
Jason T Kahle ◽  
M Jason Highsmith ◽  
John Kenney ◽  
Tim Ruth ◽  
Paul A Lunseth ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Practice ◽  
Literature Review ◽  
Acute Care ◽  
Perioperative Care ◽  
Clinical Relevance ◽  
High Quality ◽  
Subjective Analysis ◽  
Bone Bridge ◽  
Quality Evidence

Background:This literature review was undertaken to determine if commonly held views about the benefits of a bone bridge technique are supported by the literature.Methods:Four databases were searched for articles pertaining to surgical strategies specific to a bone bridge technique of the transtibial amputee. A total of 35 articles were identified as potential articles. Authors included methodology that was applied to separate topics. Following identification, articles were excluded if they were determined to be low quality evidence or not pertinent.Results:Nine articles were identified to be pertinent to one of the topics: Perioperative Care, Acute Care, Subjective Analysis and Function. Two articles sorted into multiple topics. Two articles were sorted into the Perioperative Care topic, 4 articles sorted into the Acute Care topic, 2 articles into the Subjective Analysis topic and 5 articles into the Function topic.Discussion:There are no high quality (level one or two) clinical trials reporting comparisons of the bone bridge technique to traditional methods. There is limited evidence supporting the clinical outcomes of the bone bridge technique. There is no agreement supporting or discouraging the perioperative and acute care aspects of the bone bridge technique. There is no evidence defining an interventional comparison of the bone bridge technique.Conclusion:Current level III evidence supports a bone bridge technique as an equivalent option to the non-bone bridge transtibial amputation technique. Formal level I and II clinical trials will need to be considered in the future to guide clinical practice.Clinical relevanceClinical Practice Guidelines are evidence based. This systematic literature review identifies the highest quality evidence to date which reports a consensus of outcomes agreeing bone bridge is as safe and effective as alternatives. The clinical relevance is understanding bone bridge could additionally provide a mechanistic advantage for the transtibial amputee.

scholarly journals Why is reporting quality improvement so hard? A qualitative study in perioperative care

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030269 ◽  
Author(s):  
Emma Leanne Jones ◽  
Mary Dixon-Woods ◽  
Graham P Martin
Keyword(s):  
Quality Improvement ◽  
Perioperative Care ◽  
Reporting Quality ◽  
Qualitative Interview ◽  
High Quality ◽  
Research Reporting ◽  
Journal Editors ◽  
Suboptimal Care ◽  
Qualitative Interview Study ◽  
Study Participants

ObjectivesQuality improvement (QI) may help to avert or mitigate the risks of suboptimal care, but it is often poorly reported in the healthcare literature. We aimed to identify the influences on reporting QI in the area of perioperative care, with a view to informing improvements in reporting QI across healthcare.DesignQualitative interview study.SettingHealthcare and academic organisations in Australia, Europe and North America.ParticipantsStakeholders involved in or influencing the publication, writing or consumption of reports of QI studies in perioperative care.ResultsForty-two participants from six countries took part in the study. Participants included 15 authors (those who write QI reports), 12 consumers of QI reports (practitioners who apply QI research in practice), 11 journal editors and 4 authors of reporting guidelines. Participants identified three principal challenges in achieving high-quality QI reporting. First, the broad scope of QI reporting—ranging from small local projects to multisite research across different disciplines—causes uncertainty about where QI work should be published. Second, context is fundamental to the success of a QI intervention but is difficult to report in ways that support replication and development. Third, reporting is adversely affected by both proximal influences (such as lack of time to write up QI) and more distal, structural influences (such as norms about the format and content of biomedical research reporting), leading to incomplete reporting of QI findings.ConclusionsDivergent terminology and understandings of QI, along with existing reporting norms and the challenges of capturing context adequately yet succinctly, make for challenges in reporting QI. We offer suggestions for improvement.

scholarly journals Fluid management in patients undergoing neurosurgery

2021 ◽  
Author(s):  
Taeha Ryu
Keyword(s):  
Fluid Therapy ◽  
Perioperative Care ◽  
Management Practices ◽  
Fluid Management ◽  
Perioperative Period ◽  
High Quality ◽  
Serum Osmolarity ◽  
Neurosurgical Patients ◽  
Considerable Debate ◽  
Perioperative Fluid Management

Fluid management is an important component of perioperative care for patients undergoing neurosurgery. The primary goal of fluid management in neurosurgery is the maintenance of normovolemia and prevention of serum osmolarity reduction. To maintain normovolemia, it is important to administer fluids in appropriate amounts following appropriate methods, and to prevent a decrease in serum osmolarity, the choice of fluid is essential. There is considerable debate about the choice and optimal amounts of fluids administered in the perioperative period. However, there is little high-quality clinical research on fluid therapy for patients undergoing neurosurgery. This review will discuss the choice and optimal amounts of fluids in neurosurgical patients based on the literature, recent issues, and perioperative fluid management practices.

Some problems of objective-prism spectra classification

1966 ◽  
Vol 24 ◽  
pp. 51-52
Author(s):  
E. K. Kharadze ◽  
R. A. Bartaya
Keyword(s):  
Short Wave ◽  
High Quality ◽  
Stellar Spectra ◽  
Objective Prism

The unique 70-cm meniscus-type telescope of the Abastumani Astrophysical Observatory supplied with two objective prisms and the seeing conditions characteristic at Mount Kanobili (Abastumani) permit us to obtain stellar spectra of a high quality. No additional design to improve the “climate” immediately around the telescope itself is being applied. The dispersions and photographic magnitude limits are 160 and 660Å/mm, and 12–13, respectively. The short-wave end of spectra reaches 3500–3400Å.

A non-cyanide method of electropolishing silver

1978 ◽  
Vol 36 (1) ◽  
pp. 146-147
Author(s):  
R. L. Lyles ◽  
S. J. Rothman ◽  
W. Jäger
Keyword(s):  
Electron Microscopy ◽  
Sulphuric Acid ◽  
Methyl Alcohol ◽  
Health Hazards ◽  
Silver Alloy ◽  
High Quality ◽  
Silver Alloys ◽  
Free Sample ◽  
Specimen Quality ◽  
Standard Techniques

Standard techniques of electropolishing silver and silver alloys for electron microscopy in most instances have relied on various CN recipes. These methods have been characteristically unsatisfactory due to difficulties in obtaining large electron transparent areas, reproducible results, adequate solution lifetimes, and contamination free sample surfaces. In addition, there are the inherent health hazards associated with the use of CN solutions. Various attempts to develop noncyanic methods of electropolishing specimens for electron microscopy have not been successful in that the specimen quality problems encountered with the CN solutions have also existed in the previously proposed non-cyanic methods.The technique we describe allows us to jet polish high quality silver and silver alloy microscope specimens with consistant reproducibility and without the use of CN salts.The solution is similar to that suggested by Myschoyaev et al. It consists, in order of mixing, 115ml glacial actic acid (CH3CO2H, specific wt 1.04 g/ml), 43ml sulphuric acid (H2SO4, specific wt. g/ml), 350 ml anhydrous methyl alcohol, and 77 g thiourea (NH2CSNH2).

A High Resolution Scanning Microscope

1968 ◽  
Vol 26 ◽  
pp. 356-357
Author(s):  
A. V. Crewe ◽  
J. Wall ◽  
L. M. Welter
Keyword(s):  
High Resolution ◽  
Field Emission ◽  
Spherical Aberration ◽  
Focal Length ◽  
Spot Size ◽  
Emission Source ◽  
Field Of View ◽  
Scanning Microscope ◽  
Magnetic Lens ◽  
High Quality

A scanning microscope using a field emission source has been described elsewhere. This microscope has now been improved by replacing the single magnetic lens with a high quality lens of the type described by Ruska. This lens has a focal length of 1 mm and a spherical aberration coefficient of 0.5 mm. The final spot size, and therefore the microscope resolution, is limited by the aberration of this lens to about 6 Å.The lens has been constructed very carefully, maintaining a tolerance of + 1 μ on all critical surfaces. The gun is prealigned on the lens to form a compact unit. The only mechanical adjustments are those which control the specimen and the tip positions. The microscope can be used in two modes. With the lens off and the gun focused on the specimen, the resolution is 250 Å over an undistorted field of view of 2 mm. With the lens on,the resolution is 20 Å or better over a field of view of 40 microns. The magnification can be accurately varied by attenuating the raster current.

Quantitative defect studies in semiconductor TEM samples prepared by low angle ion milling

1995 ◽  
Vol 53 ◽  
pp. 512-513
Author(s):  
L. Mulestagno ◽  
J.C. Holzer ◽  
P. Fraundorf
Keyword(s):  
Sample Preparation ◽  
Milling Time ◽  
High Density ◽  
Low Density ◽  
Ion Milling ◽  
High Quality ◽  
Variable Angle ◽  
Major Disadvantage ◽  
Induced Defects

Due to the wealth of information, both analytical and structural that can be obtained from it TEM always has been a favorite tool for the analysis of process-induced defects in semiconductor wafers. The only major disadvantage has always been, that the volume under study in the TEM is relatively small, making it difficult to locate low density defects, and sample preparation is a somewhat lengthy procedure. This problem has been somewhat alleviated by the availability of efficient low angle milling.Using a PIPS® variable angle ion -mill, manufactured by Gatan, we have been consistently obtaining planar specimens with a high quality thin area in excess of 5 × 104 μm2 in about half an hour (milling time), which has made it possible to locate defects at lower densities, or, for defects of relatively high density, obtain information which is statistically more significant (table 1).

Structural changes in silicon-on-insulator material during post-implantation annealing

1986 ◽  
Vol 44 ◽  
pp. 736-737
Author(s):  
C. O. Jung ◽  
S. J. Krause ◽  
S.R. Wilson
Keyword(s):  
Integrated Circuits ◽  
Oxide Layer ◽  
High Speed ◽  
Structural Changes ◽  
Device Fabrication ◽  
Silicon On Insulator ◽  
High Quality ◽  
Radiation Hardened ◽  
Post Implantation ◽  
Very High

Silicon-on-insulator (SOI) structures have excellent potential for future use in radiation hardened and high speed integrated circuits. For device fabrication in SOI material a high quality superficial Si layer above a buried oxide layer is required. Recently, Celler et al. reported that post-implantation annealing of oxygen implanted SOI at very high temperatures would eliminate virtually all defects and precipiates in the superficial Si layer. In this work we are reporting on the effect of three different post implantation annealing cycles on the structure of oxygen implanted SOI samples which were implanted under the same conditions.

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