Search

This protocol for a Cochrane Review is out of date. The authors have abandoned it.

A critical need exists for collaboration and action by government, industry, and academia to address cyber weaknesses or vulnerabilities inherent to embedded or cyber physical systems (CPS). These vulnerabilities are introduced as we leverage technologies, methods, products, and services from the global supply chain throughout a system’s lifecycle. As adversaries are exploiting these weaknesses as access points for malicious purposes, solutions for system security and resilience become a priority call for action. The SAE G-32 Cyber Physical Systems Security Committee has been convened to address this complex challenge. The SAE G-32 will take a holistic systems engineering approach to integrate system security considerations to develop a Cyber Physical System Security Framework. This framework is intended to bring together multiple industries and develop a method and common language which will enable us to more effectively, efficiently, and consistently communicate a risk, cost, and performance trade space. The standard will allow System Integrators to make decisions utilizing a common framework and language to develop affordable, trustworthy, resilient, and secure systems.

Pancreatic surgery is a fascinating subspecialty of general surgery. It is considered a superspecialty, with pancreatic surgery limited to a number of tertiary centres around the country taking referrals from regional hospitals. However, surgical trainees will encounter pancreatic pathology on a day-to-day basis through the acute take, with emergency presentations arising from patients presenting with complications from acute and chronic pancreatitis and from locally advanced pancreatic cancers. In addition this chapter includes a case based discussion of pancreatic trauma to educate on its variable and often insidious nature. These cases aim to outline relevant information regarding each of the clinical cases, with a sensible and appropriate approach to investigation and management.

This chapter seeks to illustrate the interesting and diverse nature of adult colorectal surgery with a number of presentations of both benign and malignant conditions of the colon, rectum, and anus. The cases represent a wide variety of colorectal conditions that most junior surgical trainees will encounter from this specialty electively at outpatient clinic, including constipation, colorectal cancer, fissure-in-ano and fistulas, haemorrhoids, faecal incontinence, and pilonidal disease. Cases also feature emergency presentations commonly encountered on the acute surgical take such as acute diverticulitis, anorectal and pilonidal abscesses, large bowel obstruction, and rectal bleeding. Each case uses a question-based approach to cover relevant information about each complaint, including approaches to investigation and management.haemorrhoids, anal fissure, constipation, cancer, fistula, anorectal sepsis, rectal bleeding, prolapse, ischaemic bowel

Objective This study aims to explore the views of members of theater teams regarding the proposed introduction of a workplace-based assessment of nontechnical skills of surgeons (NOTSS) into the Intercollegiate Surgical Curriculum Programme in the United Kingdom. In addition, the previous training and familiarity of the members of the surgical theater team with the concept and assessment of NOTSS would be evaluated. Design A regional survey of members of theater teams (consultant surgeons, anesthetists, scrub nurses, and trainees) was performed at 1 teaching and 2 district general hospitals in South Yorkshire. Results There were 160 respondents corresponding to a response rate of 81%. The majority (77%) were not aware of the NOTSS assessment tool with only 9% of respondents reporting to have previously used the NOTSS tool and just 3% having received training in NOTSS assessment. Overall, 81% stated that assessing NOTSS was as important as assessing technical skills. Trainees attributed less importance to nontechnical skills than the other groups (p ≤ 0.016). Although opinion appears divided as to whether the presence of a consultant surgeon in theater could potentially make it difficult to assess a trainee's leadership skills and decision-making capabilities, overall 60% agree that the routine use of NOTSS assessment would enhance safety in the operating theater and 80% agree that the NOTSS tool should be introduced to assess the nontechnical skills of trainees in theater. However, a significantly lower proportion of trainees (45%) agreed on the latter compared with the other groups (p = 0.001). Conclusions Our survey demonstrates acceptability among the theater team for the introduction of the NOTSS tool into the surgical curriculum. However, lack of familiarity highlights the importance of faculty training for assessors before such an introduction.

Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments.The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments.A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units.Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant.TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support.

To examine the use of appreciative inquiry to promote the emergence of innovative ideas regarding the reorganization of health care services.With persistent employee dissatisfaction with work environments, experts are calling for radical changes in health care organizations. Appreciative inquiry is a transformational change process based on the premise that nurses and health care workers are accumulators and producers of knowledge who are agents of change.A multiple embedded case study was conducted in two interdisciplinary groups in outpatient cancer care to better understand the emergence and implementation of innovative ideas.The appreciative inquiry process and the diversity of the group promoted the emergence and adoption of innovative ideas. Nurses mostly proposed new ideas about work reorganization. Both groups adopted ideas related to interdisciplinary networks and collaboration. A forum was created to examine health care quality and efficiency issues in the delivery of cancer care.This study makes a contribution to the literature that examines micro systems change processes and how ideas evolve in an interdisciplinary context.The appreciative inquiry process created an opportunity for team members to meet and share their successes while proposing innovative ideas about care delivery. Managers need to support the implementation of the proposed ideas to sustain the momentum engendered by the appreciative inquiry process.

This excellent one day course is aimed at trainees in general surgery at core training year 1 to specialty training year 3 level. Trainees must have completed a basic surgical skills course and ideally should be doing a general surgical rotation so that the techniques covered in the course can be applied in clinical practice. The course is open to trainees from anywhere within the United Kingdom and is now becoming affiliated with the Association of Surgeons in Training. The course is run by the general surgery department of Doncaster Royal Infirmary and is led by consultant colorectal surgeon AB Harikrishnan, two consultant colleagues, and two registrars in general surgery. In future, the course will be held twice a year, with a maximum of 12 delegates on each course. Delegate numbers are limited to maintain a high trainer to trainee ratio. My course was …