Careful and safe vascular access creation.

Morbidity and mortality are significant in hemodialysis patients, and every vascular access (VA) is prone to complications - some more, some less. The risk of complications rises from arteriovenous fistulae to arteriovenous grafts and peaks in nontunneled central lines. Strategies to achieve complete evaluation of the patient and precise planning mark the start of successful VA creation. Furthermore, preoperative considerations include safety checklists, team time-out procedures, and antibiotic prophylaxis. Intraoperative technical features and postoperative aspects of documentation and surveillance schemes complete careful and safe VA creation.

Better Lesion Creation And Assessment During Catheter Ablation

Permanent destruction of abnormal cardiac tissue responsible for cardiac arrhythmogenesis whilst avoiding collateral tissue injury forms the cornerstone of catheter ablation therapy. As the acceptance and performance of catheter ablation increases worldwide, limitations in current technology are becoming increasingly apparent in the treatment of complex arrhythmias such as atrial fibrillation. This review will discuss the role of new technologies aimed to improve lesion formation with the ultimate goal of improving arrhythmia-free survival of patients undergoing catheter ablation of atrial arrhythmias.

Value Creation in Family Firms: A Model of Fit

We propose a framework describing how family ownership can create or destroy value depending on the goals, resources, and governance of the family firm, which are each influenced by the family owners. Taking a contingency perspective, we suggest that a fit is required for all three elements – family- influenced goals, resources, and governance – for the family firm to flourish over generations. We conclude with a suggested research agenda indicating research opportunities at the nexus of these identified elements. Further we provide some guiding questions for practitioners that might stimulate fruitful discussions among family firm owners and managers about how to realize ‘‘fit.’’