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To study surgical teaching captured on film and analyze it at a fine level of detail to categorize physical teaching behaviors.We describe live, filmed, intraoperative nonverbal exchanges between surgical attending physicians and their trainees (residents and fellows). From the films, we chose key teaching moments and transcribed participants' utterances, actions, and gestures. In follow-up interviews, attending physicians and trainees watched videos of their teaching case and answered open-ended questions about their teaching methods. Using a grounded theory approach, we examined the videos and interviews for what might be construed as a teaching behavior and refined the physical teaching categories through constant comparison.We filmed 5 cases in the operating suite of a university teaching hospital that provides gynecologic surgical care.We included 5 attending gynecologic surgeons, 3 fellows, and 5 residents for this study.More than 6 hours of film and 3 hours of interviews were transcribed, and more than 250 physical teaching motions were captured. Attending surgeons relied on actions and gestures, sometimes wordlessly, to achieve pedagogical and surgical goals simultaneously. Physical teaching included attending physician-initiated actions that required immediate corollary actions from the trainee, gestures to illustrate a step or indicate which instrument to be used next, supporting or retracting tissues, repositioning the trainee's instruments, and placement of the attending physicians' hands on the trainees' hands to guide them. Attending physicians often voiced surprise at the range of their own teaching behaviors captured on film. Interrater reliability was high using the Cohen κ, which was 0.76 for the physical categories.Physical guidance is essential in educating a surgical trainee, may be tacit, and is not always accompanied by speech. Awareness of teaching behaviors may encourage deliberate teaching and reflection on how to innovate pedagogy for the teaching operating room.

Tujuan dilakukanm penelitian ini adalah untuk mengetahui bagaimana bentuk-bentuk perbuatan yang dilarang dilakukan oleh pelaku usaha dalam mempromosikan barang yang diperdagangkan bagi konsumen dan bagaimana aspek perlindungan hukum terhadap konsumen dalam hubungannya dengan promosi atas barang yang diperdagangkan. Metode penelitian yang digunakan ialah metode penelitian hukum normatif dan analisis terhadap bahan-bahan hukum yang tersedia untuk menyusun pembahasan yakni menggunakan analisis normatif untuk memberikan penjelasan mengenai ketentuan-ketentuan hukum berkaitan dengan permasalahan yang ada dan pembahasannya serta penyusunan kesimpulan secara sistematis dan dapat disimpulkan: Pertama bentuk-bentuk perbuatan yang dilarang bagi pelaku usaha dalam promosi barang bagi konsumen, baik melalui label, keterangan, iklan yaitu: promosi mengenai; kualitas, keamanan untuk digunakan, ukuran, harga, yang tidak sesuai dengan kondisi yang sebenarnya pada barang tersebut termasuk pemberian hadiah tertentu yang sebenarnya tidak akan dipenuhi oleh pelaku usaha. Kedua, Perlindungan konsumen adalah segala upaya yang menjamin adanya kepastian hukum untuk memberikan perlindungan kepada konsumen dari tindakan sewenang-wenang para pelaku usaha. Pengawasan terhadap penyelenggaraan perlindungan konsumen serta penerapan ketentuan peraturan perundang-undangannya diselenggarakan oleh pemerintah, masyarakat, dan lembaga perlindungan konsumen swadaya masyarakat. Pemberlakuan sanksi terdiri dari sanksi administrasi, sanksi pidana dan perdata apabila konsumen dirugikan oleh promosi yang merugikan. Kata kunci: Konsumen, Barang.

Our preclinical studies have shown that acidic and basic fibroblastic growth factors confer broad spectrum chemoresistance and that low concentrations (10-50 microM) of suramin, a nonspecific fibroblastic growth factor inhibitor, enhance the antitumor activity of paclitaxel in vivo. The present Phase I study evaluated low-dose suramin in combination with paclitaxel/carboplatin in advanced non-small cell lung cancer patients.Patients received suramin followed by paclitaxel (175-200 mg/m(2)) and carboplatin area under the concentration-time curve of 6 mg/ml/min, every 3 weeks. The initial suramin dose for the first cycle was 240 mg/m(2), and the doses for subsequent cycles were calculated based on the 72-h pretreatment plasma concentrations. The recommended suramin dose would yield plasma concentrations of 10-20 microM at 48 h inor=5 of 6 patients.Fifteen patients (11 stage IV, 4 stage IIIB, 9 chemonaive, and 6 previously treated) received 85 courses. The most common toxicities were neutropenia, nausea/vomiting, malaise/fatigue, and peripheral neuropathy. No treatment-related hospitalizations, adrenal dysfunction, or episodes of sepsis occurred. The initial suramin dose resulted in the targeted concentrations of 10-20 microM at 48 h in 5 of the first 6 patients treated but also resulted in peak concentrations50 microM in all patients. Dividing the suramin dose to be administered in two doses, 24 h apart, yielded the target concentrations and avoided undesirable peak concentrations. Discernable antitumor activity occurred in 7 of 10 patients with measurable disease, including 2 with prior chemotherapy. The median time to tumor progression is 8.5 months (range, 3-27+ months) for 12 evaluable patients.Low-dose suramin does not increase the toxicity of paclitaxel/carboplatin combination. The suramin dose can be calculated based on clinical parameters. Because of the preliminary antitumor activity observed, efficacy studies in chemonaive and chemorefractory patients are under way.