30 research outputs found
Innovation in surgical training and its impact on healthcare
No full textSurgical training is currently in a state of flux, with dramatic changes in the way it is structured and delivered. The greatest challenges to surgical training have come from the advent of minimally invasive surgery in the 1990’s and more recently the reduction in a doctors working hours. This has led to a significant decrease in training opportunities that are available to the surgical trainee. Simulation has been heralded as an effective adjunct to surgical training whilst ensuring high standards of patient safety. This thesis aims to investigate the factors influencing current surgical training methods and whether simulation can be used to improve the effectiveness of surgical training in a cost efficient manner.
The first part of this thesis investigates the impact that the reduction in working hours has had on surgical training, and whether the use of simulation can alleviate this. The reduction in working hours for doctors has led to a significant reduction in training opportunities. However, laboratory based simulation training can improve technical skills, provided it is used as part of a proficiency based technical skills curriculum.
The second part of this thesis investigates the impact that innovations in surgery have had on surgical training, and whether simulator technology can advance at a similar rate. The introduction of single incision laparoscopic surgery provides further challenges for the surgical trainee, and it is clear that a novice laparoscopic surgeon needs further technical skills curriculum based training before entering the operating room. In addition, advancement in simulator technology now allows senior surgeons to learn advanced techniques in the skills laboratory.
The final part of this thesis aims to assess the current costs of surgical training in the operating room, and whether simulation can improve operating room efficiency such that cost savings can be made. One of the main criticisms of simulation training is that it is expensive. However, the evidence in this thesis demonstrates that traditional training is also very expensive; and with prior training on simulation, operating times can be significantly reduced, providing sufficient cost savings that make simulation cost efficient.
Simulation works. This is clear from the literature and from evidence provided by this thesis. Although simulation alone is not sufficient to train surgeons to operating room proficiency, it can provide a useful adjunct to surgical training. It allows trainees to train in the safety of skills laboratory, and shorten the learning curve in the operating room which in turn improves patient safety. If appropriate simulators are selected and used correctly, it can provide benefits to the healthcare system by reducing costs through an improvement in operating room efficiency
Modelling and dynamic analyses of TLP-type floating wind turbine
No full textFixed support structures for offshore wind turbines are commonly used for shallow water (till 45 meters). In many countries shallow-waters are rare. Floating support structures may be the solution for these areas. Many concepts have been developed but three concepts have been analyzed (spar, semi-submergible and the tension leg platform (TLP)) in the literature. This study focuses on the TLP, which has the lowest weight of these concepts but the dynamic system is complex and has significant more risk than the other support structures, for example the risk of resonance of structural elements. The structural integrity of the total structure is important for the tension leg platform wind turbine (TLPWT). This study investigates the modelling techniques of the flexible TLPWT, with the aim to model the dynamics of floating wind turbine correctly. An Aero-hydro-elastic-servo model is implemented in Matlab, which includes aerodynamics of the wind turbine, hydrodynamic loads on the floating structure and mooring system, the flexibility of the total structure and the control system of the wind turbine. This model solves the equation of motion with the Houbolt numerical time integration method. In addition, the validity of the model is confirmed by validation using an Orcaflex model. The model is used to analyze the effect of the gyroscopic moments and the non-harmonic periodic load oscillations on the motion responses. Steel structures are vulnerable to cyclic loading. Small cracks may initiate and grow in the structure, this is called fatigue. Fatigue is stress driven and resonance drives stresses. The fatigue performance can be improved by avoiding resonance of structural elements. A method has been developed to find a design with the natural frequencies outside the wind, wave and passing blade frequencies. The method consists of two algorithms, mode tracking algorithm and the selection algorithm. The method is used for a North-Sea site and the result of this an improved design, which has the natural frequencies outside the frequencies where wave and wind have energy. This design has better dynamic characteristics, which indicate better fatigue performance, in comparison of the reference TLPWT, which is predominantly designed to prevent slack tendons. The approach has shown to be successful but the method can only assist in the preliminary design phase of a TLPWT for any given site. Offshore and Dredging Engineerin
„Patrzcie, oto jest film produkcji polskiej”. Przedwojenna polska komedia muzyczna jako musical
No full textThe article, “Look, here is a Polish film production.” Pre-war Polish musical comedy as a musical, is an attempt to prove that Polish musical comedies from the 1930s can be recognized as a local version of a classic film musical. Based on an analysis of two representative films from this period, Piętro wyżej (L. Trystan, 1937) and Zapomniana melodia (J. Fethke, K. Tom, 1938), the author proves that these productions are in line with the definition and determinants of the American genre. The historical context invoked allows the author to better describe the musical’s Polish variant and how it differs from the original. The article cites press reviews from the 1930s, based on which the author describes the evolving approach of critics and audiences to the changes in music present in these films as a result of drawing on American works. Finally, the article focuses on the importance of interwar musical comedies in Polish culture
Master thesis «Retrospective Interpretation of History of Ukraine in Radio Documentaries: from Concept to Broadcasting»
No full textТристан О.І. Ретроспективна інтерпретація історії України в документальних радіофільмах: від задуму до виходу в ефір / О.І. Тристан – Запоріжжя: НУ «Запорізька політехніка», 2023. – 86 с.UK: У кваліфікаційній роботі магістра здійснюється аналіз особливостей створення документальних радіофільмів.
Автором розглядаються жанрово-тематичні особливості радіофільмів, етапи їх створення, взаємодія вербальних й невербальних засобів, а також окреслюється специфіка використання документальних записів.
EN: The master's thesis analyzes the specifics of creating radio documentaries.
The author examines the genre-thematic features of radio films, the stages of their creation, the interaction of verbal and non-verbal means, and also outlines the specifics of using documentary recordings
Does previous laparoscopic experience improve ability to perform single-incision laparoscopic surgery?
No full text(Re-)exploring the link between decentralization and regional disparities in Italy
No full text\ua9 2015 The Author(s). Previous research has suggested that after 1996 devolution caused a reduction in regional disparities in Italy. However the analysis presented here suggests that the decline in regional disparities in Italy between 1996 and 2006 was driven by population dynamics and, to some extent, by the loss of competitiveness and consequent poor relative performance of northern regions. We conclude that links between devolution and the reduction of spatial disparities is unproven and its benefits are temporally and geographically uneven
In the Old Cinema. Stefan Grabiński and Expressionism
No full textStefan Grabiński, a famous Polish author of weird fiction, who is known especially for his collection of short stories Demon ruchu (The Motion Demon, 1919), lived and worked in a period marked by a new artistic style – expressionism. Although Grabiński came from Lviv, often regarded as a province in Poland after the Great War, he could have a contact with the latest ideas concerning art and philosophy. Indeed, both in his short stories and in his novels may be found some traits typical for the expressionist poetics as, for example, a subjective perspective, a color sensitivity or a tendency to violent and dynamic use of formal elements. Grabiński was fascinated by a German literature – he read Gustav Meyrink, E.T.A. Hoffmann and an expressionist magazine “Der Orchideengarten”. Moreover, he liked going to the cinema where he could watch, for example, a famous German expressionist film – The Cabinet of Dr. Caligari. The only text by Grabiński which was adapted into film in his life was a short story Kochanka Szamoty (Szamota’s Mistress, 1922). Although this seemed to be a great material for an expressionist film, the director – Leon Trystan – decided to realize it in an impressionist poetics
Making the West End modern: space, architecture and shopping in 1930s London.
No full textThis research explores the shopping cultures of the 1930s West End, arguing for the recognition of this as a significant moment within consumption history, hitherto overlooked in favour of the Victorian and Edwardian periods. The approach is interdisciplinary, combining in a new way studies of shopping routes and networks, retail architecture, spectacle, consumer types and consumption practices.
The study first establishes the importance of shopping geographies in understanding the character of the 1930s West End. It positions this shopping hub within local, national and international networks. It also examines the gender and class-differentiated shopping routes within the West End, looking at how the rise of new consumer cultures during the period reconfigured this geography.
In the second section, a case study of two new Modern shops, Simpson Piccadilly and Peter Jones, provides the focus for a discussion of retail buildings. Architecture is presented as an important way in which the West End was transformed and modernity articulated. Modernism was a significant arrival in the West End's retail sector: it provided a new architectural approach with a close, if often problematic, relationship with shopping. The study thus reassesses common assumptions about the fundamental irreconcilability of modernism with consumption, femininity and spectacle.
The third section makes a more detailed examination of the staging of shopping cultures within the West End street, looking at window display, the application of light and decoration to facades, and participation in pageantry. The study thus revisits retail spectacle, an important strand within histories of shopping and of the urban, looking at how established strategies were adapted and developed to stage modernity, emerging consumer cultures and the West End itself during the 1930s
A high fidelity model for single-incision laparoscopic cholecystectomy
No full textAbstractSingle-incision laparoscopic surgery (SILS) is a safe approach for cholecystectomy, with the potential to minimise the iatrogenic trauma sustained from the operation. However, a number of reports show SILS to be technically challenging and as such there is expected to be a significant learning curve for expert surgeons adopting the new technique, as well as for junior surgical trainees. There are inherent risks to patient safety associated with practicing and developing new skills in a real-life theatre environment. However, thus far, there have been no realistic SILS training models available. We tested the feasibility of conducting SILS cholecystectomies on a cadaveric porcine model with standard operating equipment, which may provide a platform to facilitate safe training and assessment protocols. In this paper we provide an account of the training model technique, and review the literature surrounding SILS training and performance evaluation
