Acceptance, Prevalence and Indications for Robot-Assisted Laparoscopy - Results of a Survey Among Urologists in Germany, Austria and Switzerland

2015 ◽  
Vol 95 (3) ◽  
pp. 336-345 ◽  
Author(s):  
Florian Imkamp ◽  
Thomas R.W. Herrmann ◽  
Yuri Tolkach ◽  
Sebastian Dziuba ◽  
Jens U. Stolzenburg ◽  
...  
Keyword(s):  
Practice Patterns ◽  
Response Rate ◽  
Tertiary Care ◽  
High Volume ◽  
Robotic Systems ◽  
Survey Results ◽  
One Year ◽  
The One ◽  
Insight Into ◽  
Robotic Assisted Laparoscopy

Background: Robotic-assisted laparoscopy (RAL) is being widely accepted in the field of urology as a replacement for conventional laparoscopy (CL). Nevertheless, the process of its integration in clinical routines has been rather spontaneous. Objective: To determine the prevalence of robotic systems (RS) in urological clinics in Germany, Austria and Switzerland, the acceptance of RAL among urologists as a replacement for CL and its current use for 25 different urological indications. Materials and Methods: To elucidate the practice patterns of RAL, a survey at hospitals in Germany, Austria and Switzerland was conducted. All surgically active urology departments in Germany (303), Austria (37) and Switzerland (84) received a questionnaire with questions related to the one-year period prior to the survey. Results: The response rate was 63%. Among the participants, 43% were universities, 45% were tertiary care centres, and 8% were secondary care hospitals. A total of 60 RS (Germany 35, Austria 8, Switzerland 17) were available, and the majority (68%) were operated under public ownership. The perception of RAL and the anticipated superiority of RAL significantly differed between robotic and non-robotic surgeons. For only two urologic indications were more than 50% of the procedures performed using RAL: pyeloplasty (58%) and transperitoneal radical prostatectomy (75%). On average, 35% of robotic surgeons and only 14% of non-robotic surgeons anticipated RAL superiority in some of the 25 indications. Conclusions: This survey provides a detailed insight into RAL implementation in Germany, Austria and Switzerland. RAL is currently limited to a few urological indications with a small number of high-volume robotic centres. These results might suggest that a saturation of clinics using RS has been achieved but that the existing robotic capacities are being utilized ineffectively. The possible reasons for this finding are discussed, and certain strategies to solve these problems are offered.

scholarly journals Use of the Maternal Foetal Triage Index: Addressing the Third Delay in Obstetrics

2021 ◽  
Author(s):  
Nirzarini Mukul Vora ◽  
Nandita Krishnakant Maitra
Keyword(s):  
Tertiary Care ◽  
Vital Signs ◽  
High Volume ◽  
Tertiary Hospital ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Convenience Sample ◽  
The Third ◽  
Maternal And Neonatal Outcomes ◽  
One Year

Abstract PURPOSE: While several scales have been developed specifically for obstetric triage, the Maternal Foetal Triage Index (MFTI), a five-tier scale designed by Ruhl et al (2015) has been evaluated for women attending the triage area of a tertiary hospital. This study intends to evaluate the effect of MFTI score on third delay and maternal and neonatal outcomes.METHODS: A prospective observational study was conducted over a convenience sample of 1000 subjects who attended the Labour and Delivery Unit of a tertiary care hospital over a period of one year. Assessment included maternal history, baseline vital signs and obstetric examination. The woman was categorised as per the MFTI scale and directed to the appropriate area for further management. Evaluation of the MFTI score was assessed based on predefined maternal and neonatal outcomes within 24h of attendance.RESULTS: A priority wise distribution of subjects based on their clinical diagnosis was found to be statistically significant for anaemia, previous caesarean section, postpartum haemorrhage, miscarriage and hypertensive disorders. Sixty seven percent of the subjects belonged to Priority 3-4 and the mean hospital stay duration varied from 8.26±7.68 days for Priority 1 to 3.82±2.74 days for Priority 4 (p<0.0001). The average time spent in the triage room was 30±17minutes. Maternal and neonatal outcomes were analysed according to priority based on OBICU admissions, mortality, NICU admissions and stillbirths and found to be significant.CONCLUSION: The MFTI scale significantly reduced the third delay, which is crucial in a high-volume, low-resource emergency obstetric setting. This also simplified handover of subjects, improved documentation and decreased time to secondary healthcare provider assessment.

scholarly journals The Medical Library Association (MLA) voter: a survey of attitudes, perceptions, and voting practices in MLA national elections

2020 ◽  
Vol 108 (3) ◽  
Author(s):  
James Shedlock ◽  
Elizabeth Perkin McQuillen
Keyword(s):  
Survey Data ◽  
Response Rate ◽  
Personal Characteristics ◽  
Professional Associations ◽  
National Elections ◽  
Medical Library ◽  
The Board Of Directors ◽  
Survey Results ◽  
Insight Into ◽  
Question Survey

Objective: Voting in professional associations is critical for selecting leaders who will implement a desirable vision for an association. Members of the Medical Library Association (MLA) were surveyed to assess their attitudes and perceptions of the voting process to elect the MLA national offices of president and members of the Board of Directors and Nominating Committee. Survey data were also used to test the hypothesis that committed MLA members are more likely to always vote.Methods: SurveyMonkey was used to deliver a 46-question survey to 2,671 email addresses of MLA members who were eligible to vote. Survey data were analyzed using quantitative and qualitative approaches.Results: A total of 676 responses were received, resulting in a 25% response rate. Respondents indicated that the most desired qualities in candidates included experience in professional positions, contributions to MLA, and a vision for the association, whereas candidates’ personal characteristics were rarely considered. Respondents expressed doubts about the use of a single slate, had positive views of campaigning but were doubtful about its impact, and were generally accepting of the current voting process. Committed MLA members were significantly more likely to always vote in MLA national elections.Conclusions: The survey results provide insight into understanding the concerns and motivations of MLA voters and add to the limited literature on professional association voting.

scholarly journals KNOWLEDGE & AWARENESS OF HIV TESTING IN PREGNANT WOMEN AND THEIR HUSBAND ATTENDING OBSTETRICS & GYNAECOLOGY DEPARTMENT AT A TERTIARY CARE CENTRE IN CENTRAL INDIA DURING ANTENATAL CARE

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Preeti Suhas Deshpande
Keyword(s):  
Pregnant Women ◽  
Hiv Testing ◽  
Hiv Transmission ◽  
Tertiary Care ◽  
Transmitted Disease ◽  
Antiretroviral Drugs ◽  
Risk Of Infection ◽  
Tertiary Care Centre ◽  
One Year ◽  
The One

Background: 3.4 million people worldwide are estimated to be living with HIV in 2009. In 2007, only 33 percent of HIV-positive women received antiretroviral drugs to minimise the risk of infection from mother to child. Aims and Objective: To study Awareness of HIV testing in pregnant women and their husband during ANC attending in OBGY Department. Methodology: This was a cross-sectional analysis carried out over the one-year period of the ANC women attending the OBGY department. By taking the written consent included in the report, there were 108 ANC women in the one year period. By interviewing the pair, knowledge of HIV testing and HIV transmission was assessed. The responses were noted and evaluated by excel software for Windows 10 in the excel sheet. Result: In our study we have seen that the majority of the ANC women were in the age group of 26-30 were 32 %. The awareness regarding the various questions like Does HIV transmitted to foetus by mother?- 9 % were Yes, 22 %-No, 69 %-Don’t Know; Do you know tests are there for detection of HIV?- 7 %-Yes, 13 %-No, 80 %-Don’t know; Are you at a risk of Infection?- 4% were Yes, 52% -No, 44 % were Don’t know; Can the disease prevented ? 6 %- Yes, 22 % were No, 72 % were don’t know; Is HIV a Sexually transmitted disease? 33 %-Yes, 22 %-No, 45 %-Don’t know; Can HIV be transmitted by contaminated blood? 32 %-Yes, 20 %-No, 48 %-Don’t know; Can HIV be transmitted by Kissing ?-35 % say Yes, 17 % -No, 48 %-Don’t know; Can HIV be transmitted by sharing food ?- 24 % Yes , 35 %-No, 41 %-Don’t know. From our research, we found that while there is good understanding of the HIV disease, the availability of preventive services through HIV testing is very poor, so subsequent prevention administration drugs are very low, although some myths about the transmission of the disease still remain, such as transmitting through sharing food or transmitting casual hugging or shaking. Conclusion: From our research, it can be concluded that the awareness of the PPTCT services with respect to HIV testing during the ANC era was very low, so that the awareness of it should be increased so that HIV transmission from mother to foetus can be effectively carried out. Key words: HIV testing during pregnancy, PPTCT (Prevention of Parent to Child Transmission)

scholarly journals A Study of Faculty Data Curation Behaviors and Attitudes at a Teaching-Centered University

2012 ◽  
Vol 73 (4) ◽  
pp. 349-365 ◽  
Author(s):  
Jeanine Marie Scaramozzino ◽  
Marisa L. Ramírez ◽  
Karen J. McGaughey
Keyword(s):  
Response Rate ◽  
Reliable Information ◽  
Data Curation ◽  
State University ◽  
San Luis ◽  
Survey Results ◽  
Percent Response ◽  
And Mathematics ◽  
Percent Response Rate ◽  
Insight Into

Academic libraries need reliable information on researcher data needs, data curation practices, and attitudes to identify and craft appropriate services that support outreach and teaching. This paper describes information gathered from a survey distributed to the College of Science and Mathematics faculty at California Polytechnic State University, San Luis Obispo (Cal Poly), a master’s-granting, teaching-centered institution. There was a more than 60 percent response rate to the survey. The survey results provided insight into the science researchers’ data curation awareness, behaviors, and attitudes, as well as what needs they exhibited for services and education regarding maintenance and management of data. It is important that professional librarians understand what researchers both inside and outside their own institutions know so that they can collaborate with their university colleagues to examine data curation needs.

scholarly journals A study of the prevalence of gonadal dysfunction and its association with increasing disease severity in patients diagnosed with chronic kidney disease at a tertiary care center in Kolkata, West Bengal

2021 ◽  
Vol 9 (6) ◽  
pp. 1696
Author(s):  
Anant Parasher ◽  
Kunal Ranjan ◽  
Vanshika Munjal
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Serum Testosterone ◽  
Cross Sectional ◽  
Gonadal Dysfunction ◽  
Serum Lh ◽  
One Year ◽  
The One

Background: Hypergonadotropic hypogonadism is a well described hormonal derangement associated with chronic kidney disease, also known as uremic hypogonadism. The objective of this study was to assess the prevalence of gonadal dysfunction associated with chronic kidney disease and to study the co-relation of gonadal dysfunction with disease severity.Methods: In this cross-sectional observational study, 50 patients with diagnosed chronic kidney disease were included during the one-year period from May 2015 to April 2016. The clinical and biochemical parameters related to gonadal dysfunction were evaluated in these cases.Results: Out of the 28 male CKD patients, 19 (68%) patients had Serum Testosterone values less than 90 ng/dl, 18 (64%) patients had a serum leutinizing hormone (LH) level greater than 9 mIU/ml and 19 (68%) patients had a serum follicle stimulating hormone (FSH) level greater than 13 mIU/ml. Out of 22 female CKD patients, 14 (64%) patients had serum estradiol value less than 50 pg/ml, 12 (54%) patients had Serum LH level greater than 80 mIU/ml and 20 (91%) patients had a S. FSH level greater than 26 mIU/ml. Out of a total of 50 patients in this study, 34 patients showed evidence of gonadal dysfunction, the majority of them belonging to stage 5 CKD.Conclusions: Out of the 34 patients showing gonadal dysfunction, 5 (15%) patients were in stage 3 CKD, 11 (32%) patient were in stage 4 CKD and 18 (53%) were in stage 5 CKD. It may be proposed that gonadal dysfunction is very common in CKD patients and the frequency of sexual dysfunction increases as the renal function deteriorates.  

scholarly journals Formalizing a Residency Mentorship Program with a “Business of Medicine” Curriculum

2020 ◽  
Vol 7 ◽  
pp. 238212052095968
Author(s):  
Ajay Sampat ◽  
Danielle Larson ◽  
George Culler ◽  
Danny Bega
Keyword(s):  
Career Guidance ◽  
Pilot Project ◽  
Mentorship Program ◽  
Residency Programs ◽  
Faculty Mentor ◽  
The Core ◽  
One Year ◽  
The One ◽  
Academic Year ◽  
Insight Into

Background: Mentorship is critical for achieving success in academic medicine and is also considered one of the core professional competencies for residency training. Despite its importance, there has been a decline in the mentor-mentee relationship, largely due to time constraints and lack of clear guidelines for productive discussions. We provide a mentorship curriculum with an easily adoptable workbook which may serve as a guide for programs seeking more formalized mentorship opportunities. Methods: We created a mentorship curriculum that was divided into 4 quarterly sessions, each with topics to facilitate career guidance and development, and to provide insight into the practical aspects of business of medicine. The mentorship pilot curriculum was implemented during the 2017 to 2018 academic year. Specific questions were provided to stimulate reflection and appropriate discussion between resident mentee and faculty mentor. A post-curriculum survey was distributed to evaluate the effectiveness and satisfaction of the curriculum. Results: A total of 23 residents participated in this pilot project. A majority had not had any formal teaching related to the business aspects of medicine (82%). Upon completion of the curriculum, most residents felt several topics were sufficiently covered, and a majority were satisfied with the course and relationship developed with their mentor (87%). Conclusions: Our pilot curriculum provides a model to address a knowledge gap in the practical aspects of medicine while simultaneously enhancing residency mentorship. The one-year course was generally well-received by residents and can serve as a model to other academic residency programs with similar challenges and goals.

scholarly journals Effectiveness of minimum retesting intervals in managing repetitive laboratory testing: experience from a Croatian university hospital

2019 ◽  
Vol 29 (3) ◽  
pp. 531-558 ◽  
Author(s):  
Ivana Lapić ◽  
Dunja Rogić ◽  
Mirjana Fuček ◽  
Ružica Galović
Keyword(s):  
Complete Blood Count ◽  
Cost Savings ◽  
High Volume ◽  
University Hospital ◽  
Reactive Protein ◽  
Limited Effectiveness ◽  
Reagent Cost ◽  
Mri Protocol ◽  
One Year ◽  
The One

Introduction: Inappropriate laboratory retesting can be addressed by implementing minimum retesting intervals (MRI). The aim of our study was to assess the effectiveness of the implemented MRI protocol for inpatients. Materials and methods: Minimum retesting intervals were applied for 53 laboratory tests. The overall reduction of test requests, reduction in charges and reagent cost savings, frequency of MRI alert appearance as well as the rate of MRI acceptance and ignorance were calculated for a one-year period. Reasons for violating the MRI rule, hospital departments that contributed mostly to MRI rule violation, and the frequency of MRI violations between routine and emergency laboratory were evaluated. Results: During the one-year period, 106,780 requests violated the MRI rule, which corresponds to 14.8% of all requests received. 13,843 requests were cancelled, yielding a 1.9% reduction of requested tests. High-volume tests, namely complete blood count, C-reactive protein, alanine aminotransferase, gamma-glutamyltransferase and total bilirubin, accounted for 65% of all generated alerts and had the highest alert ignorance (>85%). The highest cancellation rate was observed for tumor markers and autoimmunity tests, for most being at least 50%. Annual charge reduction was 62,641 EUR while reagent cost savings were 11,408 EUR. Tests performed in the emergency laboratory had a higher alert appearance than the same routine tests. The most common reason for MRI violation was clinical justification based on the patient’s condition. Most frequently ignored MRI alerts were in the intensive care unit. Conclusion: MRI implementation showed limited effectiveness in reducing testing repetition and achieving financial savings, yet provided the basis for future improvements.

scholarly journals Study of Poisoning Cases in a Tertiary Care Hospital

2014 ◽  
Vol 10 (4) ◽  
pp. 70-73
Author(s):  
RK Karki ◽  
A Risal
Keyword(s):  
Public Awareness ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Duration Of Treatment ◽  
Incidence And Mortality ◽  
Study Results ◽  
One Year ◽  
The One

Background Poisoning is one of the leading causes of morbidity and mortality in Nepal and also a major public health problem worldwide. A thorough review of the risk factors helps to decrease the incidence and mortality. The study evaluates the cases admitted in Dhulikhel Hospital, Kavre, Various parameters like age, sex, marital status, time of ingestion, month of occurrence, agent responsible for incidence; type of poisoning, psychosocial problem, outcome and duration of treatment are analyzed. Objectives The objectives of this study are to determine the pattern and severity of poisoning cases admitted to Dhulikhel Hospital. Methods A hospital based study was carried out in the patient admitted to Dhulikhel Hospital with the history of poisoning for the period of one year between April 2011 to March 2012. Various parameters were analyzed and compared with other study. Results There were 137 cases during the one year duration and maximum case belonged to second and third decade of life. Most common manner of poisoning was suicidal and the incidence was mainly during evening hours. Organophosphorus was the most commonly abused substance. Most of the cases had arrived hospital after one hour of exposure and duration of hospital stay in many cases were less than four days. Conclusion Based on these findings preventive measures like precaution taken at various levels, restriction in free sale of the poisons and promoting Poison Information Centers along with public awareness and proper psychosocial management to decrease the incidence and mortality in poisoning cases can be suggested. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10999 Kathmandu Univ Med J 2012;10(4):70-73

A survey of vascular specialists’ practice patterns of inferior vena cava filter placement and retrieval

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 291-298 ◽  
Author(s):  
Anand Brahmandam ◽  
Laura Skrip ◽  
Bauer Sumpio ◽  
Jeffrey Indes ◽  
Alan Dardik ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Practice Patterns ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Vena Cava ◽  
High Volume ◽  
Filter Placement ◽  
Vena Cava Filters ◽  
Low Volume

Objectives The placement of inferior vena cava filters (IVCF) continues to rise. Vascular specialists adopt different practices based on local expertise. This study was performed to assess the attitudes of vascular specialists towards the placement and retrieval of IVCF. Methods An online survey of 28 questions related to practice patterns regarding IVCF was administered to 1429 vascular specialists. Vascular specialists were categorized as low volume if they place less than three IVCF per month and high volume if they place at least three IVCF per month. The responses of high volume and low volume were compared using two-sample t-tests and Chi-square tests. Results A total of 259 vascular specialists completed the survey (18% response rate). There were 191 vascular surgeons (74%) and 68 interventional radiologists (26%). The majority of responders were in academic practice (67%) and worked in tertiary care centers (73%). The retrievable IVCF of choice was Celect (27%) followed by Denali (20%). Forty-two percent used a temporary IVCF and left it in situ instead of using a permanent IVCF. Eighty-two percent preferred placing the tip of the IVCF at or just below the lowest renal vein. Thirty-one percent obtained a venous duplex of the lower extremities prior to retrieval while 24% did not do any imaging. There were 132 (51%) low volume vascular specialists and 127 (49%) high volume vascular specialists. Compared to low volume vascular specialists, significantly more high volume vascular specialists reported procedural times of less than 30 min for IVCF retrieval (57% vs. 42%, P = 0.026). There was a trend for high volume to have fewer unsuccessful attempts at IVCF retrieval but that did not reach statistical significance ( P = .061). High volume were more likely to have attempted multiple times to retrieve an IVCF (66% vs. 33%, P < .001), and to have used bronchoscopy forceps (32% vs. 14%, P = .001) or a laser sheath (14% vs. 2%, P < .001) for IVCF retrieval. In general, vascular specialists were not comfortable using bronchoscopy forceps (65%) or a laser sheath (82%) for IVCF retrieval. Conclusions This study underscores significant variability in vascular specialists practice patterns regarding IVCF. More studies and societal guidelines are needed to define best practices.

Bypassing Shame and Conversion Disorder

CNS Spectrums ◽  
2010 ◽  
Vol 15 (10) ◽  
pp. 607-611 ◽  
Author(s):  
Robert G. Bota ◽  
Walter F Ricci ◽  
Adrian Preda
Keyword(s):  
Speech Therapy ◽  
Response Rate ◽  
Conversion Disorder ◽  
Pharmacological Interventions ◽  
One Year ◽  
The One ◽  
Normal Speech

AbstractWe report a case of conversion disorder (partial aphonia) that was successfully treated with speech therapy. During the one year duration of this illness, the patient regained transiently (minutes) her normal speech on a few occasions, independently of concomitant pharmacological interventions. One year after recovery she developed aphonia for the second time, which responded again to speech therapy, although the response rate was slower. Several mechanisms of conversion disorder are reviewed as specifically applied to this case. The possible role of pertinent shame mechanisms in the conversion pathology is discussed.

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