Post-Operative Pain Scores and Level of Regional Anesthesia Expertise: Using Clinical Outcomes to Assess Procedural Proficiency

Background and Objectives: Peripheral nerve blockade requires regional anesthesia skills that trainees learn in several formats. Technical proficiency has shifted from a quota to comprehensive procedural evaluation. Successful nerve blockade is the clinical endpoint validating proficiency but patient, technical and procedural factors influence this result. The purpose of this study was to determine if procedural expertise for sciatic nerve blockade influenced postoperative pain scores and opioid requirements and if patient factors, technique and repetition influenced this outcome. Method: Sciatic nerve blockade by nerve stimulation and ultrasound guidance and training level of the resident performing the procedure were recorded. Patient obesity, trauma, chronic pain, opioid use and preoperative pain scores were compared to post-procedure pain scores and opioid analgesic requirements. Results: 102 patients received sciatic nerve blockade from 47 trainees over a 36 month interval. A significant relation between training level and improved pain scores was not demonstrated but transition from nerve stimulation to ultrasound guidance lowered scores in all groups. Nerve blockade failure was frequent with chronic opioid use and trauma. Conclusion: Analgesic outcomes should be an integral part of assessment of proficiency in regional anesthesia techniques. Evaluating outcomes of procedures throughout training will longitudinally assess technical expertise.

The impact of LMX differentiation on perceptions of team conflict and procedural justice climate

The fundamental tenet of Leader Member Exchange (LMX) theory is that leaders develop different quality relationships with each of their employees; however, to our knowledge, no study has investigated the impact of LMX differentiation on teams. Drawing upon the justice literature, we suggest that fostering different quality LMX relationships runs counter to principles of equality' and consistency, which are important for maintaining social harmony in groups, and perceptions of procedural fairness. We therefore propose that differential treatment of employees by the leader (as indicated by within-team variability in LMX relationships) will have a negative effect on team reladons, and percepdons of procedural jusdce climate. Two samples of employed individuals are used to invesdgate the hypothesized reladonships. Sample A consists of 74 individuals from a variety of occupadonal and organisadonal backgrounds, and Sample B consists of 152 individuals from an Australian organisadon dealing in the sale and service of heavy machiner)'. In both samples, high LMX variability within teams is associated with higher reports of team reladonal conflict, and lower reports of procedural jusdce climate. The results suggest that leaders may need to be caudous about fostering special relationships with only a select subset of employees.

Am I being treated fairly by my leaders? The roles of group identification and self-other comparisons in judgements of procedural justice

The current experiment focuses on the roles of social identity and social comparison in perceptions of procedural justice. Participants are randomly allocated to conditions in a 2 (whether the participant has the opportunity to voice an opinion), X 2 (whether the comparison other has the opportunity to voice an opinion), X 2 (whether the comparison other is an ingroup or an outgroup member), between subjects design. Participants are then asked to report the extent to which they perceive the procedure they are involved in to be fair. It is predicted that participants will have a strong feeling of procedural unfairness when they are not given an opportunity by the leader to voice their opinion, but learn that their comparison other is given that opportunity. It is also predicted that the feeling of unfairness should be stronger when the comparison other is an outgroup rather than an ingroup member. Additionally, participants receiving a fair treatment may regard the procedure as fair when their outgoup comparison other receives an unfair treatment. Results support these predictions and reveal that how people make judgments of procedural justice through social comparison is qualified by the social identities of the parties involved.

Exchange fairness and employee performance:An examination of the relationship between organizational politics and procedural justice

Data obtained from a manufacturing firm and a newspaper firm in India were used to examine the relationship between organizational politics and procedural justice in three separate studies. Study 1 constructively replicated research on the distinctiveness of the two constructs. Confirmatory factor analyses in which data from the manufacturing firm served as the development sample and data from the newspaper firm served as the validation sample demonstrated the distinctiveness of organizational politics and procedural justice. Study 2 examined the antecedents of the two constructs using data from the manufacturing firm. Structural equation modeling (SEM) results revealed formalization and participation in decision making to be positively related to procedural justice but negatively related to organizational politics. Further, authority hierarchy and spatial distance were positively related to organizational politics but unrelated to procedural justice. Study 3 examined the consequences of the two constructs in terms of task and contextual performance using data from the newspaper firm. Results of SEM analysis revealed procedural justice but not organizational politics to be related to task performance and the contextual performance dimensions of interpersonal facilitation and job dedication. © 2004 Elsevier Inc. All rights reserved.

A comprehensive solution to procedural knowledge acquisition using information extraction

Procedural knowledge is the knowledge required to perform certain tasks. It forms an important part of expertise, and is crucial for learning new tasks. This paper summarises existing work on procedural knowledge acquisition, and identifies two major challenges that remain to be solved in this field; namely, automating the acquisition process to tackle bottleneck in the formalization of procedural knowledge, and enabling machine understanding and manipulation of procedural knowledge. It is believed that recent advances in information extraction techniques can be applied compose a comprehensive solution to address these challenges. We identify specific tasks required to achieve the goal, and present detailed analyses of new research challenges and opportunities. It is expected that these analyses will interest researchers of various knowledge management tasks, particularly knowledge acquisition and capture.

Automatically Extracting Procedural Knowledge from Instructional Texts using Natural Language Processing

Procedural knowledge is the knowledge required to perform certain tasks, and forms an important part of expertise. A major source of procedural knowledge is natural language instructions. While these readable instructions have been useful learning resources for human, they are not interpretable by machines. Automatically acquiring procedural knowledge in machine interpretable formats from instructions has become an increasingly popular research topic due to their potential applications in process automation. However, it has been insufficiently addressed. This paper presents an approach and an implemented system to assist users to automatically acquire procedural knowledge in structured forms from instructions. We introduce a generic semantic representation of procedures for analysing instructions, using which natural language techniques are applied to automatically extract structured procedures from instructions. The method is evaluated in three domains to justify the generality of the proposed semantic representation as well as the effectiveness of the implemented automatic system.

Procedural justice in procurement management and inclusive interorganizational relations:An institutional perspective

This paper applies the concept of procedural justice to one of the most important focal points of interorganizational relations: the purchaser-supplier relationship. The few extant studies of the concept in the purchaser-supplier domain have overlooked an important aspect of this key relationship: that is, inclusiveness in procurement. This is despite the fact that interest in the specific empirical context of supply chain links between large purchasing organizations (LPOs) and ethnic minority suppliers (EMSs) from disadvantaged communities proceeds apace on both sides of the Atlantic. Institutional theory is used to examine the form that procedural justice takes in eight case studies of LPOs from the private and public sectors, which actively engage with inclusive procurement management initiatives in England. The guiding question is twofold: 'What may LPO approaches to installing procedural justice in procurement management entail?' and 'How are these approaches shaped?' This paper identifies specific approaches to installing procedural justice for inclusive procurement and submits theoretical propositions about how these are shaped. The study contributes to a macro-level assessment of procedural justice, i.e. interorganizational procedural justice, as a significant aspect of inclusive interorganizational relationships, which is a domain in need of theoretical development.

Review and Outlooks of the Means for Visualization of Syntax Semantics and Source Code. Procedural and Object Oriented Paradigm – Differences

In the article, we have reviewed the means for visualization of syntax, semantics and source code for programming languages which support procedural and/or object-oriented paradigm. It is examined how the structure of the source code of the structural and object-oriented programming styles has influenced different approaches for their teaching. We maintain a thesis valid for the object-oriented programming paradigm, which claims that the activities for design and programming of classes are done by the same specialist, and the training of this specialist should include design as well as programming skills and knowledge for modeling of abstract data structures. We put the question how a high level of abstraction in the object-oriented paradigm should be presented in simple model in the design stage, so the complexity in the programming stage stay low and be easily learnable. We give answer to this question, by building models using the UML notation, as we take a concrete example from the teaching practice including programming techniques for inheritance and polymorphism.

Verification of Procedural Programs via Building their Generalized Nets Models

Магдалина Василева Тодорова - В статията е описан подход за верификация на процедурни програми чрез изграждане на техни модели, дефинирани чрез обобщени мрежи. Подходът интегрира концепцията “design by contract” с подходи за верификация от тип доказателство на теореми и проверка на съгласуваност на модели. За целта разделно се верифицират функциите, които изграждат програмата относно спецификации според предназначението им. Изгражда се обобщен мрежов модел, специфициащ връзките между функциите във вид на коректни редици от извиквания. За главната функция на програмата се построява обобщен мрежов модел и се проверява дали той съответства на мрежовия модел на връзките между функциите на програмата. Всяка от функциите на програмата, която използва други функции се верифицира и относно спецификацията, зададена чрез мрежовия модел на връзките между функциите на програмата.