Transactions of the Southern Surgical and Gynecological Association.

Description based on: Vol. 18 (Dec. 13, 14, and 15, 1915); title from cover.

The Surgical clinics of Chicago.

Each number has separate title page.

The life of John Collins Warren, M.D. : compiled chiefly from his autobiography and journals /

Added t.p. is engraved.

The Southern medical and surgical journal [serial].

Vols. for 18 - include the Annual announcement of the Medical College of Georgia.

Palliative care training: a survey of physicians in Australia and Europe

The purpose of this paper is to present data about the level and background characteristics of physicians' training in palliative care in Australia (AU), Belgium (BE), Denmark (DK), Italy (IT), the Netherlands (NL), Sweden (SE) and Switzerland (CH) (n=16,486). The response rate to an anonymous questionnaire differed between countries (39%-68%). In most countries approximately half of all responding physicians had any formal training in palliative care (median: 3-10 days). Exceptions were NL (78%) and IT (35%). The most common type of training was a postgraduate course. Physicians in nursing home medicine (only in NL), geriatrics, oncology (not in NL), and general practice had the most training. In all seven countries, physicians with such training discussed options for palliative care and options to forgo life-sustaining treatment more often with their patients than did physicians without. Irrespective of earlier palliative care training, 87%-98% of the physicians wanted extended training.

The role of spirituality in transformative learning

The purpose of this phenomenological study was to explore the role of spirituality in Mezirow's (1978, 1990, 1991, 1997, 1998, 2000, 2003) 10-phase process of transformative learning. This study used Mezirow's transformative learning theory as its theoretical framework. Semi-structured interviews were conducted, transcribed, and analyzed for 12 doctoral students and candidates who had a transformative learning experience and who identified themselves as being spiritual. Interview data were analyzed using inductive, deductive, and comparative analyses. Four themes emerged from the inductive analysis of the data: (a) the nature of spirituality, (b) the variety of emotions, (c) the influences of spirituality, and (d) the nature of personal changes. The theory's 10 phases were used as a guide in deductively analyzing data concerning the participants' experiences. The deductive analysis revealed that spirituality played a role in at least 7 of the 10 phases of transformative learning for each participant. Overall, from the participants' perspectives, the role of spirituality was that of a guide in influencing their cognition and behavior, and that of a supporter in influencing their emotions. The comparative analysis revealed that at least three of the four themes from the inductive analysis were reflected in each of the 10 phases of transformative learning used in the deductive analysis. Based on the findings from this study, the researcher proposed a modification of Mezirow's phases of transformative learning. An additional phase was identified: framing and naming the transformed perspective, and two phases were renamed. The findings from this study imply that given the importance of the role participants attributed to spirituality in their transformative learning in influencing their cognition, behavior, and emotions, the role of spirituality should be considered for inclusion in transformative learning theory. Recommendations for further research on the validation and replicability of the proposed modification to transformative learning theory are given.

Açude do cais: uma proposta de aplicação de uma sequência de atividades didáticas em um contexto real

Currently it is expected that science education will enable a more comprehensive conception of the world and of the relationship between scientific knowledge, technology and society. Thus, we seek the science teaching attend around contexts related to science, technology and society (STS). According CTS approaches, the science education should promote learning in the scientific, technological and social fields, from experienced real contexts, generating motivation to students, offering them tools to work as scientifically literate citizens. For this, it becomes crucial to resort to innovative activities and the various methodologies and appropriate teaching materials, and there is a lack of this perspective in general basic education, which drives the practice of an STS approach. Therefore, the aim of this research is the production of an instructional sequence for the exploration of the theme: "The quality of the water in the municipality of Cuité-PB," according to focus CTS in the 2nd year of high school. The choice of this topic is due to the problem caused by the quality of water in this municipality, with the concern to address an issue that came to work the critical / reflective understanding of a real context, in order to sensitize students to the importance of scientific / technological knowledge. The selection criteria of STS subjects were also observed. In this research the materials were produced and applied by the teacher / researcher. For data collection we used the observation and analysis of student records. The results were encouraging in the sense of participation, motivation and skill acquisition. This research contributes to the teaching of science with a focus STS, as well as encourage the use of perspective in new contexts with real questioning

An evaluation of paediatric medicines reconciliation at hospital discharge into the community

OBJECTIVE: A UK national survey of primary care physicians has indicated that the medication information on hospital discharge summary was incomplete or inaccurate most of the time. Internationally, studies have shown that hospital pharmacist's interventions reduce these discrepancies in the adult population. There have been no published studies on the incidence and severity of the discrepancies of the medication prescribed for children specifically at discharge to date. The objectives of this study were to investigate the incidence, nature and potential clinical severity of medication discrepancies at the point of hospital discharge in a paediatric setting. METHODS: Five weeks prospective review of hospital discharge letters was carried out. Medication discrepancies between the initial doctor's discharge letter and finalised drug chart were identified, pharmacist changes were recorded and their severity was assessed. The setting of the review was at a London, UK paediatric hospital providing local secondary and specialist tertiary care. The outcome measures were: - incidence and the potential clinical severity of medication discrepancies identified by the hospital pharmacist at discharge. KEY FINDINGS: 142 patients (64 female and 78 males, age range 1 month - 18 years) were discharged on 501 medications. The majority of patients were under the care of general surgery and general paediatric teams. One in three discharge letters contained at least one medication discrepancy and required pharmacist interventions to rectify prior to completion. Of these, 1 in 10 had the potential for patient harm if undetected. CONCLUSIONS: Medicines reconciliation by pharmacist at discharge may be a good intervention in preventing medication discrepancies which have the potential to cause moderate harm in paediatric patients.

Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure.

OBJECTIVE To use a unique multicomponent administrative data set assembled at a large academic teaching hospital to examine the risk of percutaneous blood and body fluid (BBF) exposures occurring in operating rooms. DESIGN A 10-year retrospective cohort design. SETTING A single large academic teaching hospital. PARTICIPANTS All surgical procedures (n=333,073) performed in 2001-2010 as well as 2,113 reported BBF exposures were analyzed. METHODS Crude exposure rates were calculated; Poisson regression was used to analyze risk factors and account for procedure duration. BBF exposures involving suture needles were examined separately from those involving other device types to examine possible differences in risk factors. RESULTS The overall rate of reported BBF exposures was 6.3 per 1,000 surgical procedures (2.9 per 1,000 surgical hours). BBF exposure rates increased with estimated patient blood loss (17.7 exposures per 1,000 procedures with 501-1,000 cc blood loss and 26.4 exposures per 1,000 procedures with >1,000 cc blood loss), number of personnel working in the surgical field during the procedure (34.4 exposures per 1,000 procedures having ≥15 personnel ever in the field), and procedure duration (14.3 exposures per 1,000 procedures lasting 4 to <6 hours, 27.1 exposures per 1,000 procedures lasting ≥6 hours). Regression results showed associations were generally stronger for suture needle-related exposures. CONCLUSIONS Results largely support other studies found in the literature. However, additional research should investigate differences in risk factors for BBF exposures associated with suture needles and those associated with all other device types. Infect. Control Hosp. Epidemiol. 2015;37(1):80-87.

Surgical Site Infection in a University Hospital in Northeast Brazil

We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital

An Enterprise Opportunity for Entrepreneurial Students: Student Enterprise Development and Experience Assessed through the Student Voice

Purpose: This research investigates the effectiveness of an experiential learning approach, available to students in all disciplines that combined a hands-on entrepreneurial and enterprise experience with professional consultant mentoring by using a competition to win business start-up funding. Design/methodology/approach: Students at a UK university had the chance to enter a competition in which they developed an entrepreneurial idea and then designed and presented a business plan to win business start-up capital. Students who were entrepreneurially motivated, but who lacked capital to start up their business, were targeted, as these students have been argued to benefit the most from a combination of business plan training and entrepreneurial development. Feedback and data was obtained from the students at each stage of the process and was thematically analysed to assess the development of students’ entrepreneurial skills and knowledge through the experience. Findings: The research found that the benefits gained from this approach included both enterprising and entrepreneurial skills, with the greatest impact being on student confidence and belief in their ability to start a business. The practical skills had a ‘demystifying’ effect on students that made them feel like entrepreneurship and enterprise start-up were attainable. Research limitations/implications: The research focused on students at one UK University and centered on entrepreneurship in a retail business. The competition thus appealed mainly to students who were interested in retail start-up, thus leaving out some enterprising students whose feedback may have been different. In addition, while entrepreneurial skills are assessed in the data, the students who would be interested in the competition would be assumed to be proactive, and this skill was not able to be analyzed. This research is a single case, and thus could be enhanced by more cases and looking at other enterprise start-up means beyond retail. Originality/value: This research makes a case that, in light of literature critical of the use of business plan training in entrepreneurship education, certain students are appropriate candidates for this approach. Specific skills and knowledge can be developed in university students using a live enterprise experience, supported by entrepreneurial mentoring. By making the event extracurricular, the study sought to capture the feedback of students who self-selected into the program, who can benefit most from combined entrepreneurial and business-plan development experience.

Exploring the Success of Student Experiential Learning through Entrepreneurial Opportunities

Academic literature has increasingly recognized the value of non-traditional higher education learning environments that emphasize action-orientated experiential learning for the study of entrepreneurship (Gibb, 2002; Jones & English, 2004). Many entrepreneurship educators have accordingly adopted approaches based on Kolb’s (1984) experiential learning cycle to develop a dynamic, holistic model of an experience-based learning process. Jones and Iredale (2010) suggested that entrepreneurship education requires experiential learning styles and creative problem solving to effectively engage students. Support has also been expressed for learning-by-doing activities in group or network contexts (Rasmussen and Sorheim, 2006), and for student-led approaches (Fiet, 2001). This study will build on previous works by exploring the use of experiential learning in an applied setting to develop entrepreneurial attitudes and traits in students. Based on the above literature, a British higher education institution (HEI) implemented a new, entrepreneurially-focused curriculum during the 2013/14 academic year designed to support and develop students’ entrepreneurial attitudes and intentions. The approach actively involved students in small scale entrepreneurship activities by providing scaffolded opportunities for students to design and enact their own entrepreneurial concepts. Students were provided with the necessary resources and training to run small entrepreneurial ventures in three different working environments. During the course of the year, three applied entrepreneurial opportunities were provided for students, increasing in complexity, length, and profitability as the year progressed. For the first undertaking, the class was divided into small groups, and each group was given a time slot and venue to run a pop-up shop in a busy commercial shopping centre. Each group of students was supported by lectures and dedicated class time for group work, while receiving a set of objectives and recommended resources. For the second venture, groups of students were given the opportunity to utilize an on-campus bar/club for an evening and were asked to organize and run a profitable event, acting as an outside promoter. Students were supported with lectures and seminars, and groups were given a £250 budget to develop, plan, and market their unique event. The final event was optional and required initiative on the part of the students. Students were given the opportunity to develop and put forward business plans to be judged by the HEI and the supporting organizations, which selected the winning plan. The authors of the winning business plan received a £2000 budget and a six-week lease to a commercial retail unit within a shopping centre to run their business. Students received additional academic support upon request from the instructor, and one of the supporting organizations provided a training course offering advice on creating a budget and a business plan. Data from students taking part in each of the events was collected, in order to ascertain the learning benefits of the experiential learning, along with the successes and difficulties they faced. These responses have been collected and analyzed and will be presented at the conference along with the instructor’s conclusions and recommendations for the use of such programs in higher educations.

Social Theory and Nursing

Despite noteworthy exceptions, nursing’s literature largely disregards the ways in which social and sociological theory permeates, guides and shapes research, education, and practice. Likewise, social theory’s ability to position nursing within wider structures of healthcare and educational provision is similarly and puzzlingly downplayed. The questions nurses ask and the problems they face cannot however, adequately be addressed without engaging with social and sociological theory and, to progress this engagement, contributors to this book explore how social theories are used by and might apply to nursing and nursing practice. This work brings together leading international nursing and non-nursing scholars to stimulate thought and debate around a fascinating and enduring topic.

Reprint: Learning With a Strategic Management Simulation Q2 Game: A Case Study

The use of simulation games as a pedagogic method is well established though its effective use is context-driven. This study adds to the increasing growing body of empirical evidence of the effectiveness of simulation games but more importantly emphasises why by explaining the instructional design implemented reflecting best practices. This multimethod study finds evidence that student learning was enhanced through the use of simulation games, reflected in the two key themes; simulation games as a catalyst for learning and simulation games as a vehicle for learning. In so doing the research provides one of the few empirically based studies that support simulation games in enhancing learning and, more importantly, contextualizes the enhancement in terms of the instructional design of the curriculum. This research should prove valuable for those with an academic interest in the use of simulation games and management educators who use, or are considering its use. Further, the findings contribute to the academic debate concerning the effective implementation of simulation game-based training in business and management education.