Results. A Total Of 614 Patients Underwent Superficial

Results: A total of 614 patients underwent superficial parotidectomy by attending surgeons operating alone without resident assistance (AA group). There were 621 patients who underwent the procedure with participation by resident surgeons under direct supervision by an attending surgeon (AR group). The mean age was similar for the two groups (AA versus AR, mean age  ± standard deviation, 57.2  ± 15.0 versus 56.9  ± 15.2 years, p=0.21). There were 302 (49.2%) men in AA group and 292 (47.1%) men in AR group (p=0.46). A majority of patients in both groups were Caucasian (AA and AR, 479 [92.3%] and 479 [89.2%], p=0.17). Both groups demonstrated comparable body mass indices (mean BMI  ± standard deviation, 30.0  ± 8.6 and 29.7  ± 7.3, respectively†¦show more content†¦The risk of requiring a return trip to the operating room was similar and small in the two groups (AA versus AR, 5 [0.8%] versus 5 [0.8%], p=1.00). The mean length of hospital stay in the two groups (AA versus AR) was 1.3 versus 1.1 days (p=0.81) (Table 3). Information related to readmission within 30 days of the operation was available for procedures performed in years 2011 and 2012 (n=181). Incidence of readmission was infrequent in the two groups and the difference was insignificant (AA versus A R, 0 [0%] versus 2 [1.9%], p=0.52) (Table 3). Discussion: The composition of the surgical team may be a significant determinant of operative outcomes including operative time and associated burdens on resource utilization. Particularly, the impact of supervised resident participation in the operating room has been examined in a variety of specialties including urology, neurosurgery, gynecology, general surgery and otorhinolaryngology.3, 8-13 Since training in performance of superficial parotidectomy is a core component of surgical resident education, it is important to assess the effect of resident participation on operative time, resource utilization and outcomes in these procedures. In this study, resident participation in superficial parotidectomy resulted in prolongation of mean operative time by 17%. Similarly, total time in the operating room was increased by 18%. Our results parallel similar findings in urology, orthopedics, generalShow MoreRelatedCase Studies67624 Words   |  271 Pagesteaching tool.1 A key reason is that cases provide active learners with opportunities to use the strategic management process to identify and solve organisational problems. Thus, by analysing situations that are described in cases and presenting the results, active learners (that is, students) become skilled at effectively using the tools, techniques and concepts that combine to form the strategic management process. The cases that follow are concerned with actual companies. Presented within the casesRead MoreExploring Corporate Strategy - Case164366 Words   |  658 Pagesmarket. Barclaycard – a market leader’s strategic options for maintaining market domin ance. GSK – the wisdom of mergers for a global pharmaceutical giant. Brewery Group Denmark – how a small player survives in a globalising market. ST Electronics – total quality management for business excellence. Sony (A) – a diverse hi-tech multinational responds to change with repeated reorganisations. Arts Council – changes in structure and responsibilities in funding the arts in the UK. Tetra Pak – success throughRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagescan take the self-assessments an unlimited number of times, and they can save and print their scores for class discussion. Scoring key—The key to the self-assessments has been edited by Steve Robbins to allow students to quickly make sense of the results of their score. Instructor’s manual—An Instructor’s Manual guides instructors in interpreting self-asses sments and helps facilitate better classroom discussion. Acknowledgments Getting this book into your hands was a team effort. It took faculty

The Legalization Of Marijuana And Cannabis Programs

years before being struck down by the District of Columbia Court of Appeals. However, with so much publicity the legal process of the petition generated within the drug culture of the 1960 s through the 1970 s in America, it likely convinced state authorities to reassess the restrictions against marijuana (Huntington’s Outreach Project for Education at Stanford, 2012). In 1982, 31 states and the District of Columbia had passed legislation granting the prescription of marijuana. In 1996, California voters passed Proposition (215) making it the first state to allow medical marijuana, Since that time 22 states, the district of Columbia and Guam have enacted similar laws (National Conference of State Legislatures, 2015). Of the 23 States, the District of Columbia and Guam now allow for comprehensive public medical marijuana and cannabis programs (National Conference of state legislatures, 2015). Recently, there have been 17 states who have approved efforts to allow use of Ã¢â‚¬Ë œlow’ THC, high cannabinoid products for medical reasons in limited situations or as a legal defense (National Conference of State Legislatures, 2015). The Compassionate Access, Research Expansion and Respect States (CARERS) Act is the first-ever bill in the U.S. Senate to legalize marijuana for medical use and it is the most comprehensive medical marijuana bill ever introduced in Congress which will allow: †¢ States to legalize marijuana for medical use without federal interference †¢ Permit interstateShow MoreRelatedMarijuana Legalization : A Missed Opportunity For California1635 Words   |  7 PagesCannabis Legalization, A Missed Opportunity for California It has been estimated that the legalization and subsequent taxation (excise and sales tax) of cannabis in California could generate anywhere between $990 million and $1.4 billion annually in tax revenue. Additionally it has been estimated that legalization could reduce statewide enforcement costs by $150 million annually. Considering the number of human service agencies, departments, and programs that have had their budgets either significantlyRead Morelegalizing marijuana1044 Words   |  5 PagesLegalization of Marijuana Cannabis sativa or marijuana, is most known for its euphoric psychological effects when consumed. Many Canadians take part in the use of marijuana which has been illegal in Canada since the early 1900s. The topic of marijuana legalization in Canada has been a highly controversial topic over the last century. It has been discussed recently in the news due to Washington and Colorado both voting to legalize marijuana in November of 2012. The Liberal and Conservative partiesRead MoreShould Marijuana Be Legalized?1638 Words   |  7 PagesCannabis Should Be Legalized in the United States In 1920 when alcohol prohibition began the war against cannabis had been going strong for a decade. In 1910 the Mexican Revolution created a surplus of Mexican immigrants in the United States; American citizens were frightened by the Mexican culture, including their recreational use of cannabis (Marijuana Legalization, 2015, para 7). Politicians continued to use fear and racism to grow disapproval and hatred of cannabis. Beginning in 1915 twenty-nineRead MoreMarijuana Legalization1212 Words   |  5 PagesMarijuana Legalization COMP 1500 April 20th, 2009 Word Count: 807 Outline I. Introduction Thesis Statement: Although America is the land of the free you do not really have  too many  free choices you can make. Americans  should have  the right to  choose whether or not  marijuana should be legal. II. Background III. The tax benefits that can be created A. If legalized they can tax it how ever much they want B. Can be regulated IV. Drug enforcement money can be divertedRead MoreEssay on Legalizing Marijuana-Persuasive Outline941 Words   |  4 Pages Purpose: To persuade my audience to: support the legalization of marijuana, because of it being able to provide many medical as well as economic benefits for the United States if legalized. Thesis Statement: Marijuana has been regarded as a harmful plant that can endanger lives and is thought to be nothing more than an extra problem to be dealt with in today’s society. However, based on its economic value and medical benefits, the cannabis has proven to outweigh its negatives with numerousRead MoreLegalization Of Marijuana Should Be Regulated987 Words   |  4 PagesThe use of marijuana in the United States used to be a rather taboo subject. The infamous slogans of â€Å"Just Say No† and â€Å"Reefer Madness† filled the ears of society and many listened. 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Cannabis sativa is thought to have been grown for at leastRead MoreShould Marijuana Be Legalized For The Best Of Society?1742 Words   |  7 PagesMarijuana is one of the most controversial discussions to consider in various countries due to the numerous debates between citizens to legalize or criminalize the drug for the best of society. In countries such as Colombia, Netherlands, and various states in United States (Colorado, Washington, and Oregon), marijuana is legalized for recreational and medical purposes, which is obtainable to all citizens. How ever, in countries such as Canada, marijuana remains illegal for recreational use, whichRead MoreMarijuan The Pseudo Gate Way Drug924 Words   |  4 Pages Marijuana: The Pseudo Gate way Drug My thesis states that the federal government of United States of America should legalize marijuana. Legalizing would not only benefit the people of need for medical uses but also our economy for recreational use. 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Heart/ aP/ Nursing free essay sample

A flat macular hemorrhage is called a(n): Purpura Risk factors that may lead to skin disease and breakdown include: a lifetime of environmental trauma. What term refers to a linear skin lesion that runs along a nerve route? Zosteriform The components of a nail examination include: contour, consistency, and color. An example of a primary lesion is a(n): urticaria. A scooped out, shallow depression in the skin is called a/an: erosion. Chapter 19 The first heart sound is produced by the: closure of the AV valves. Which of the following guidelines may be used to identify which heart sound is S1? S1 coincides with the carotid artery pulse. Which of the following cardiac alterations occurs during pregnancy? An increase in cardiac volume and a decrease in blood pressure Which of the following is an appropriate position to have the patient assume when auscultating for extra heart sounds or murmurs? Roll toward the left side The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor. We will write a custom essay sample on Heart/ aP/ Nursing or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page chordae tendineae; papillary muscles The ability of the heart to contract independently of any signals or stimulation is due to: automaticity. When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates: an expected sound caused by nonclosure of the ductus arteriosus. A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by: turbulent blood flow through the carotid artery. The jugular venous pressure is an indirect reflection of the: hearts efficiency as a pump. The semilunar valves separate the: ventricles from the arteries. Chapter 20 One of the legs deep veins is the: popliteal. ?Arteriosclerosis refers to: thickening and loss of elasticity of the arterial walls. ?Palpable inguinal lymph nodes are: normal if small (less than 1 cm), movable, and nontender. In pulsus paradoxus: beats have weaker amplitude with respiratory inspiration and stronger amplitude with expiration. ?Lymphedema is: the swelling of an extremity caused by an obstructed lymph channel. ?A water-hammer Corrigan pulse is associated with: aortic valve regurgitation. The cervical nodes drain the: head and neck. In young children, the thymus gland: produces T lymphocytes. Claudication is caused by: arterial insufficiency. The patient has severe bila teral lower extremity edema. The most likely cause is: heart failure.

William ShakespeareS Othello Essays (691 words) - Othello, Iago

William Shakespeare'S Othello Iago's Justice In William Shakespeare's play Othello, there lurks an evil that far is surpasses the darkness of the devil, it lies in the antagonist Iago. Othello who passes Iago up for a promotion simply because Iago is not a arithmetician, swears to take his revenge and destroy the moor and every thing Othello holds dear. Through this Iago plays judge, jury, and executioner, but is Iago's justice justified or does his justice go far beyond the point of justice that he crosses the line. Once that line is crossed there is a point of no return. All barriers that may have at one point existed are now broken. Iago's justice can never be justified, by taking or causing the bloodshed of the innocent for his own personal gain is no more justified then murder in cold blood. What ever promotion Iago is entitled to or what ever rights he may have is gone when he decides to create his own law. Nor should he posses the power to influence and decide the fate of others. ?I hate the Moor;........Hell and night must bring this monstrous birth to the world's light? (I.ii.20). Iago intend to ?abuse Othello's ear? and convince Othello his wife Desdemona is an adultress, ?framed to make women false? (I.i.20). Iago plans to bring the devils evil to earth in order to get his revenge on Othello. Although Iago's justice can never be justified his anger pointed towards Othello can be. Despite all the rage, fury, resentment, prejudice, and anger Iago feels towards Othello; Iago feels all this and more to the appointed lieutenant Michael Cassio. For Cassio has never had experience on the battle field, ?A fellow almost damn'd in a fair wife; That never set a squadron in the field, Nor the division of a battle knows? (I.i.1). Iago also points out that ?preferment goes by letter and affection? (I.i.2). Iago is well aware of the fact that he is more qualified for the position but choices are based upon brain and not achievements on the field. In Iago's pursuit of destroying the Moor and achieving his rightful position he destroys so many lives. Michael Cassio is soon striped of his position due to Iago's deceit. Othello's fair wife Desdemona is murdered by her own husband after Othello's mind is poisoned by the ?honest? Iago. Iago leads Othello to believe that Cassio and Desdemona are having an affair, Iago not only accomplishes this by words of deceit but by providing ?proof?. After attaining the first gift Othello ever gave to Desdemona he plans ?in Cassio's lodging lose this napkin, and let him find it. Trifles light as air Are to the jealous confirmations strong as proofs of holy writ: this may do something. The Moor already changes with my poison: Dangerous conceits are in the natures poisons, Which at the first are scarce found to distaste but with a little act upon blood burn like the mines of sulphur? (III.iii.50). After deciding the fate of Michael Cassio, Desdemona, Othello, Roderigo, Emilia, and his own, Iago can no longer justify his actions or his revenge when confronted. Othello asks ?why hath thus ensnared my soul and body? all Iago could say in response is ?demand me nothing; what you know, you know: from this time forth I never will speak word? (V.ii.90). In Iago's silence and refusal to give ?justified? reasons to his crusade is speechlessness. If his reasons were in deed justified Iago would have spoken in his own defense. In the end of this Shakespeare tragedy order is restored, Iago is brought to justice. But not before the blood of the innocent is shed. Revenge by hurting and condemning the innocent while in pursuit of personal gain is never justified. Although Iago's anger towards Othello may have been, Iago's justice crosses the line. All barriers that separate the human race from man and animal have been broken down. For Iago to decide the fate of so many innocent in pursuit of hurting Othello makes him no different than Satan. English Essays