Optimizing the integration of advanced practitioners in a department of surgery: An operational improvement model

Physician assistants (PAs) and nurse practitioners (NPs) have established themselves as key members of the healthcare team to supplement practicing physicians in patient care. PAs and NPs are collectively referred to as “advanced providers” (APs) and work not only in primary care but in general surgery and surgical subspecialties. Studies have addressed AP integration into the profession of medicine and have examined cost and efficacy of APs, attitudes about APs among residents, and educational impact of APs, but very little literature exists that describes a formalized approach to AP integration into a department of surgery, specifically with AP/resident integration. The purpose of this paper is to describe an initiative for developing an operational improvement model for APs working with residents on surgical inpatient services in a large academic health center. The model consists of four components and each component is described in detail from discovery state towards continuous improvement. Formal professional development opportunities for APs as well as appointing a Clinical Director for Surgical APs have positively impacted AP integration into the department of surgery

Cadaveric simulation for improving surgical training in dermatology.

Simulation models are rapidly changing medical education, especially the training of dermatology residents. Various models are available, including cadaveric simulations. Our study evaluates the impact of a cadaveric simulation on the training of dermatology residents. Over a period of three years, cadaveric simulation was shown to increase the surgical knowledge of residents. Residents were more confident in their knowledge of surgical anatomy and also surgical skills. Cadaveric simulation may offer a positive impact on resident training in dermatology

Lasers in tattoo and pigmentation control: role of the PicoSure(®) laser system.

BACKGROUND AND OBJECTIVES: The use of picosecond lasers to remove tattoos has greatly improved due to the long-standing outcomes of nanosecond lasers, both clinically and histologically. The first aesthetic picosecond laser available for this use was the PicoSure(®) laser system (755/532 nm). Now that a vast amount of research on its use has been conducted, we performed a comprehensive review of the literature to validate the continued application of the PicoSure(®) laser system for tattoo removal. STUDY DESIGN AND METHODS: A PubMed search was conducted using the term picosecond combined with laser , dermatology , and laser tattoo removal . RESULTS: A total of 13 articles were identified, and ten of these met the inclusion criteria for this review. The majority of studies showed that picosecond lasers are an effective and safe treatment mode for the removal of tattoo pigments. Several studies also indicated potential novel applications of picosecond lasers in the removal of various tattoo pigments (eg, black, red, and yellow). Adverse effects were generally mild, such as transient hypopigmentation or blister formation, and were rarely more serious, such as scarring and/or textural change. CONCLUSION: Advancements in laser technologies and their application in cutaneous medicine have revolutionized the field of laser surgery. Computational modeling provides evidence that the optimal pulse durations for tattoo ink removal are in the picosecond domain. It is recommended that the PicoSure(®) laser system continue to be used for safe and effective tattoo removal, including for red and yellow pigments

The Role of PhD Faculty in Advancing Research in Departments of Surgery

OBJECTIVE: To determine the academic contribution as measured by number of publications, citations, and National Institutes of Health (NIH) funding from PhD scientists in US departments of surgery. SUMMARY BACKGROUND DATA: The number of PhD faculty working in US medical school clinical departments now exceeds the number working in basic science departments. The academic impact of PhDs in surgery has not been previously evaluated. METHODS: Academic metrics for 3850 faculties at the top 55 NIH-funded university and hospital-based departments of surgery were collected using NIH RePORTER, Scopus, and departmental websites. RESULTS: MD/PhDs and PhDs had significantly higher numbers of publications and citations than MDs, regardless of academic or institutional rank. PhDs had the greatest proportion of NIH funding compared to both MDs and MD/PhDs. Across all academic ranks, 50.2% of PhDs had received NIH funding compared with 15.2% of MDs and 33.9% of MD/PhDs (P < 0.001). The proportion of PhDs with NIH funding in the top 10 departments did not differ from those working in departments ranked 11 to 50 (P = 0.456). A greater percentage of departmental PhD faculty was associated with increased rates of MD funding. CONCLUSIONS: The presence of dedicated research faculty with PhDs supports the academic mission of surgery departments by increasing both NIH funding and scholarly productivity. In contrast to MDs and MD/PhDs, PhDs seem to have similar levels of academic output and funding independent of the overall NIH funding environment of their department. This suggests that research programs in departments with limited resources may be enhanced by the recruitment of PhD faculty

Senior Recital: Jennifer Torbeck, Flute

Kemp Recital Hall Saturday Evening December 2, 1995 7:30p.m

Simultaneous determination of iron and copper in children's sera by FAAS

Predložena je nova jednostavna metoda plamene atomsko-apsorpcijske spektrometrije (FAAS), za simultano određivanje željeza i bakra u serumu djece. Ona se temelji na predobradbi uzorka u jednom koraku (deproteinizacija s 3 mol L–3 HCl u odnosu 1:1) i kalibraciji u jednom koraku sa standardom pripravljenim u 1.5 mol L–3 HCl. Tijekom optimizacije metode primijenjen je multifaktorski dizajnirani eksperiment. Preporučena metoda osigurava ispravnost, osjetljivost i preciznost usporedljivu onima referentnih metoda. Novi je pristup jednostavan i brz; on štedi i vrijeme i reagense i uzorke, pri čemu je potonje posebno važno u dječjoj dijagnostici.A new and simple flame atomic-absorption spectrometric (FAAS) method is proposed for simultaneous determination of iron and copper in children's sera. It is based on single-step sample pretreatment (deproteinization with 3 mol L–1 HCl, ratio 1:1) and single-step calibration using 1.5 mol L–1 HCl standard. During method’s optimization a short multifactorial design experiment was used. The proposed method assures accuracy, sensitivity and precision comparable to that of the reference methods. The new approach is simple and time-, labour- and serum-saving, the latter being especially important in pediatric diagnostics

Junior Recital: Jennifer Torbeck, Flute

Kemp Recital Hall Saturday Evening November 20, 1993 8:30p.m