Impact of case-relevant and case-irrelevant communication within the surgical team on surgical-site infection

BACKGROUND Surgical-site infections (SSIs) are the most common complications after surgery. An influence from talking and distractions during surgery on patient outcomes has been suggested, but there is limited evidence. The aim of this prospective observational study was to assess the relationship between intraoperative communication within the surgical team and SSI, and between intraoperative distractions and SSI. METHODS This prospective observational study included patients undergoing elective, open abdominal procedures. For each procedure, intraoperative case-relevant and case-irrelevant communication, and intraoperative distractions were observed continuously on site. The influence of communication and distractions on SSI after surgery was assessed using logistic regressions, adjusting for risk factors. RESULTS A total of 167 observed procedures were analysed; their mean(s.d.) duration was 4·6(2·1) h. A total of 24 SSIs (14·4 per cent) were diagnosed. Case-relevant communication during the procedure was independently associated with a reduced incidence of organ/space SSI (propensity score-adjusted odds ratio 0·86, 95 per cent c.i. 0·77 to 0·97; P = 0·014). Case-irrelevant communication during the closing phase of the procedure was independently associated with increased incidence of incisional SSI (propensity score-adjusted odds ratio 1·29, 1·08 to 1·55; P = 0·006). Distractions had no association with SSI. CONCLUSION More case-relevant communication was associated with fewer organ/space SSIs, and more case-irrelevant communication during wound closure was associated with incisional SSI.

Effects of team Knowledge and ecological constraints on decisional processes in customized football game scenarios

Several theories assume that successful team coordination is partly based on knowledge that helps anticipating individual contributions necessary in a situational task. It has been argued that a more ecological perspective needs to be considered in contexts evolving dynamically and unpredictably. In football, defensive plays are usually coordinated according to strategic concepts spanning all members and large areas of the playfield. On the other hand, fewer people are involved in offensive plays as these are less projectable and strongly constrained by ecological characteristics. The aim of this study is to test the effects of ecological constraints and player knowledge on decision making in offensive game scenarios. It is hypothesized that both knowledge about team members and situational constraints will influence decisional processes. Effects of situational constraints are expected to be of higher magnitude. Two teams playing in the fourth league of the Swiss Football Federation participate in the study. Forty customized game scenarios were developed based on the coaches’ information about player positions and game strategies. Each player was shown in ball possession four times. Participants were asked to take the perspective of the player on the ball and to choose a passing destination and a recipient. Participants then rated domain specific strengths (e.g., technical skills, game intelligence) of each of their teammates. Multilevel models for categorical dependent variables (team members) will be specified. Player knowledge (rated skills) and ecological constraints (operationalized as each players’ proximity and availability for ball reception) are included as predictor variables. Data are currently being collected. Results will yield effects of parameters that are stable across situations as well as of variable parameters that are bound to situational context. These will enable insight into the degree to which ecological constraints and more enduring team knowledge are involved in decisional processes aimed at coordinating interpersonal action.

Team: Bee Me. A formulative evaluation of a negative eating attitudes and behaviors primary prevention curriculum targeted at 5 th grade elementary school girls

Objective. To evaluate a school-based intervention aimed at the primary prevention of negative eating attitudes and behaviors among preadolescent girls, and to revise curriculum lessons based on quantitative and qualitative findings. ^ Intervention Design. A formative evaluation was conducted on four Team: Bee Me curriculum lessons at a Houston elementary school. Evaluation focused on program satisfaction and short-term effect on knowledge and eating attitudes and behaviors. ^ Results. Sixteen girls participated in the five-day project. Statistically significant improvements in overall knowledge were observed (p<0.05), however only modest changes were observed in eating attitudes and behaviors. Program satisfaction was high among student participants and the teacher who implemented it. Insight for future modifications to this program and for similar interventions was provided by the students and teacher. ^ Conclusions. This program led to positive trends in outcome variables; however longer and more intensive testing of this program is needed to better evaluate its effectiveness.^

The effect of triage team on time-in-department in a pediatric emergency department

Objective. To determine whether the use of a triage team would reduce the average time-in-department in a pediatric emergency department by 25%.^ Methods. A triage team consisting of a physician, a nurse, and a nurse's assistant initiated work-ups and saw patients who required minimal lab work-up and were likely to be discharged. Study days were randomized. Our inclusion criteria were all children seen in the emergency center between 6p and 2a Monday-Friday. Our exclusion criteria included resuscitations, inpatient-inpatient transfers, left without being seen, leaving against medical advice, any child seen outside of 6p-2am Monday-Friday and on the weekends. A Pearson-Chi square was used for comparison of the two groups for heterogeneity. For the time-in-department analysis, we performed a 2 sided t-test with a set alpha of 0.05 using Mann Whitney U looking for differences in time-in-department based on acuity level, disposition, and acuity level stratified by disposition. ^ Results. Among urgent and non-urgent patients, we found a statistically significant decrease in time-in-department in a pediatric emergency department. Urgent patients had a time-in-department that was 51 minutes shorter than patients seen on non-triage team days (p=0.007), which represents a 14% decrease in time-in-department. Non-urgent patients seen on triage team days had a time-in-department that was 24 minutes shorter than non-urgent patients seen on non-triage team days (p=0.009). From the disposition perspective, discharged patients seen on triage team days had a shorter time-in-department of 28 minutes as compared to those seen on non-triage team days (p=0.012). ^ Conclusion. Overall, there was a trend towards decreased time-in-department of 19 minutes (5.9% decrease) during triage team times. There was a statistically significant decrease in the time-in-department among urgent patients of 51 minutes (13.9% decrease) and among discharged patients of 28 minutes (8.4% decrease). Urgent care patients make up nearly a quarter of the emergency patient population and decreasing their time-in-department would likely make a significant impact on overall emergency flow.^

Technical Reference Team Commodity: Misoprostol

http://www.rhsupplies.org/fileadmin/user_upload/CoLSC/Meeting_Documents/Dakar_2-5_July_2013/second_part/Global_conveners_brief_Misoprostol_Final.pdf

Technical Reference Team Commodity: Oxytocin

http://www.rhsupplies.org/fileadmin/user_upload/CoLSC/Meeting_Documents/Dakar_2-5_July_2013/second_part/Global_conveners_brief_Oxytocin_Final.pdf

Injury incidence in a Spanish sub-elite professional football team: A prospective study during four consecutive seasons

The aim of this study was to investigate the injury incidence and injury characteristics of a Spanish sub-elite professional football team during four consecutive seasons. A team was followed prospectively from the season 2003-2004 to 2006-2007 and individual player exposure and time loss injuries were recorded during all club training sessions and matches. A total of 313 time-loss injuries were recorded. The mean injury incidence was 10.9 injuries/1000 hours (5.2 injuries/1000 training hours and 44.1 injuries/1000 match hours). The injury incidence during competitive matches was higher (p < 0.001) than in friendly matches (55.8 vs. 22.6 injuries/1000 hours). The incidence of major injuries (>28 days absence) was 0.4 injuries/1000 hours. The thigh was the most commonly (35%) injured region and caused 29% of all competitive match absence. Muscle injuries in the four main groups of the lower limbs (hamstrings, adductors, quadriceps and calf muscles) caused 43% of competitive match unavailability. The results of this study show that the risk to sustain a major injury in the course of the season was low for sub-elite footballers in comparison to elite players. Thigh strains were the first cause of absence in competition due to injury.

Patrol team language identification system for DARPA RATS P1 evaluation

This paper describes the language identification (LID) system developed by the Patrol team for the first phase of the DARPA RATS (Robust Automatic Transcription of Speech) program, which seeks to advance state of the art detection capabilities on audio from highly degraded communication channels. We show that techniques originally developed for LID on telephone speech (e.g., for the NIST language recognition evaluations) remain effective on the noisy RATS data, provided that careful consideration is applied when designing the training and development sets. In addition, we show significant improvements from the use of Wiener filtering, neural network based and language dependent i-vector modeling, and fusion.

On the Degree of Team Cooperation in CD Grammar Systems.

In this paper, we introduce a dynamical complexity measure, namely the degree of team cooperation, in the aim of investigating "how much" the components of a grammar system cooperate when forming a team in the process of generating terminal words. We present several results which strongly suggest that this measure is trivial in the sense that the degree of team cooperation of any language is bounded by a constant. Finally, we prove that the degree of team cooperation of a given cooperating/distributed grammar system cannot be algorithmically computed and discuss a decision problem.

People and Facility Management. The team: the main asset of any management

From the moment we enter a large office building until we leave it, we receive a lot of attentions served by the management of services to the user. However, it is usually quite inappreciable the work that is being developed to keep things running smoothly.The services provided in a building are carried out by people. However, we often tend to forget these people when we talk about the tasks that make that a building operates properly 24 hours a day, 365 days a year.But, for example, what would happen if one day the service provided by the reception in a large building did not function as it should? What would it be like if one day the person performing the service of maintenance of the building's cleaning were not at his post? How would the working day develop if there were not a correct air handling system?People are the foundation of the proper functioning of a building. The work of the Facilities Manager and the Facility Management is the management of their functions: the responsible management of the team.

Managing team learning in a Spanish commercial bank

Purpose – The purpose of this paper is to analyze how team management affects team-learning activities. Design/methodology/approach – The authors empirically study 68 teams as they operate in the natural business context of a major Spanish bank. Quantitative research utilizing multiple regression analyses is used to test hypotheses. Findings – The leadership behaviour (consideration, initiation of structure) displayed by the team leader plays a key role in facilitating team learning. Team leader behaviour characterised by consideration and in particular by initiation of structure are both positively related to team-learning activities. Cross-training of team members also contributes to team-learning behaviour. Research limitations/implications – A specific setting may limit the generalizability of findings. Further research may accordingly investigate to what extent these results can be generalized to other settings or other aspects of team learning. Practical implications – The leadership style adopted by the team leader, as well as cross-training of members, affect team-learning activities. These results link leadership theory to collective learning in teams and organizations, and suggest ways leaders can contribute to improved learning. Originality/value – The study provides new insight into how management of teams facilitates team-learning activities. While consideration is somewhat related to team learning, initiation of structure as well as cross-training appear as key variables.