The Impact of a Commensality Intervention on Physician Burnout.

Commensality, the act of eating together, when organized around facilitated discussion is an evidence-based intervention that can promote engagement and reduce physician burnout. The purpose of this pilot study is to evaluate the feasibility, acceptance, and impact of a commensality intervention for physicians. The Commensality Intervention was based on a Mayo Clinic model that consisted of 6, 2-hour dinner meetings at local restaurants over 6 months with facilitated discussion.

Defining the need for faculty development in assessment.

Background: High-quality workplace-based assessments are essential for competency-based surgical education. We explored education leaders' perceptions regarding faculty competence in assessment.

Methods: Surgical education leaders were surveyed regarding which areas faculty needed improvement, and knowledge of assessment tools.

Potentials and pitfalls of increasing prosocial behavior and self-efficacy over time using an online personalized platform.

Background: This longitudinal mixed methods experimental study aimed to better understand the interplay between digital technology exposure over time, self-efficacy, and prosocial behavior in everyday contexts.

Methods: 66 psychology students tracked their daily prosocial behavior over three weeks. Additionally, half of the participants were randomly assigned to receive access to an online platform, which made personalized suggestions for prosocial actions to complete.

Identifying Sources of Stress Across Years of General Surgery Residency.

Stressors during surgical residency training are common and can contribute to impaired technical performance, medical errors, health problems, physician burnout, and career turnover. This survey of general surgery recent graduates and chief residents examined threats to resident health and well-being. An electronic survey composed of multiple-choice, checkbox, dropdown, and open-ended questions was developed to determine the most stressful general surgery residency year, sources of the stress, and potential interventions to manage resident well-being.

Unique Epidemiology of Spinal Cord Injury in Hawai'i: Wave-related Incidents.

Spinal cord injury remains one of the most devastating forms of traumatic injury. The purpose of this study was to characterize the clinical characteristics of spinal cord injury patients and the geographic location where the injury occurred in the state of Hawai'i. Spinal cord injury cases from 2009-2017 were identified using the State Trauma Registry, which included demographics, mechanism of injury, and outcomes.

An Uncommon Pairing of common Tumors: Case Report of Ductal Carcinoma Within Fibroadenoma.

Fibroadenomas are common benign tumors of the female breast. In the appropriate clinical setting, they are often managed expectantly without excision. Rarely, cancer may arise within a fibroadenoma, and this diagnosis mandates prompt treatment for malignancy.

Binge-eating disorder treatment goes online - feasibility, usability, and treatment outcome of an Internet-based treatment for binge-eating disorder: study protocol for a three-arm randomized controlled trial including an immediate treatment, a waitlist, and a placebo control group.

Background: Binge-eating disorder (BED) is characterized by recurrent episodes of loss of control over eating and is related to a higher prevalence of other mental disorders and somatic consequences associated with overweight and obesity. In community-based samples, 2-4% of women and 1-3% men are diagnosed with BED. Psychotherapeutic interventions focusing on maintenance factors of disturbed eating behavior have proven to be effective.

American College of surgeons /Association for Surgical Education Medical Student Simulation-based Surgical Skills Curriculum: Alignment with Entrustable Professional Activities.

Background: We hypothesized that medical experts would concur the American College of Surgeons/Association for Surgical Education Medical Student Simulation-based Surgical Skills Curriculum ("ACS/ASE Curriculum") could be used to teach and assess Entrustable Professional Activities (EPAs).

Methods: A "crosswalk" was created between ACS/ASE Curriculum modules and eight EPAs. Medical education experts participated in a Delphi process regarding feasibility of using the modules for teaching and assessing EPAs.

Rural Level III centers in an inclusive trauma system reduce the need for interfacility transfer.

Background: Development of Level III trauma centers in a regionalized system facilitates early stabilization and prompt transfer to a higher level center. The resources to care for patients at Level III centers could also reduce the burden of interfacility transfers. We hypothesized that the development and designation of Level III centers in an inclusive trauma system resulted in lower rates of transfer, with no increase in morbidity or mortality among the non-transferred patients.

Motor vehicle crash fatalaties and undercompensated care associated with legalization of marijuana.

Background: Half of the US states have legalized medical cannabis (marijuana), some allow recreational use. The economic and public health effects of these policies are still being evaluated. We hypothesized that cannabis legalization was associated with an increase in the proportion of motor vehicle crash fatalities involving cannabis-positive drivers, and that cannabis use is associated with high-risk behavior and poor insurance status.

Variation in training and use of the focused assessment with sonography in trauma (FAST).

Background: Training in ultrasound is variable among residents and practicing traumatologists. Focused Assessment with Sonography in Trauma (FAST) may be underused in non-urbanized areas, possibly due to lack of training.

Methods: State trauma registry data from January 2014-June 2016 were reviewed for FAST results.

Impact of Helmet Use on Injury and Financial Burden of Motorcycle and Moped Crashes in Hawai'i: Analysis of a Linked Statewide Database.

Helmet use reduces injury severity, disability, hospital length of stay, and hospital charges in motorcycle riders. The public absorbs billions of dollars annually in hospital charges for unhelmeted, uninsured motorcycle riders. We sought to quantify, on a statewide level, the healthcare burden of unhelmeted motorcycle and moped riders.

A needs assessment of education research topics among surgical educators in the United States.

Background: There are currently no courses that focus specifically on surgical education research. A needs assessment of surgical educators is required to best design these courses.

Methods: A cross-sectional survey-based study on all faculty members of the Association for Surgical Education was done to determine their education research needs.

Targeted and Untargeted Approaches Unravel Novel Candidate Genes and Diagnostic SNPs for Quantitative Resistance of the Potato (Solanum tuberosum L.) to Phytophthora infestans Causing the Late Blight Disease.

The oomycete Phytophthora infestans causes late blight of potato, which can completely destroy the crop. Therefore, for the past 160 years, late blight has been the most important potato disease worldwide. The identification of cultivars with high and durable field resistance to P.

Trauma team discord and the role of briefing.

Background: Briefing of the trauma team before patient arrival is unstructured in many centers. We surveyed trauma teams regarding agreement on patient care priorities and evaluated the impact of a structured, physician-led briefing on concordance during simulated resuscitations.

Methods: Trauma nurses at our Level II center were surveyed, and they participated in four resuscitation scenarios, randomized to "briefed" or "nonbriefed.

Role confusion and self-assessment in interprofessional trauma teams.

Background: Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses' teamwork self-assessment differs from experts', and that video debriefing might improve accuracy of self-assessment.

Methods: Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities.

Improved detection of anterior fibromuscular stroma and transition zone prostate cancer using biparametric and multiparametric MRI with MRI-targeted biopsy and MRI-US fusion guidance.

Background: The objective of this study was to analyze the potential of prostate magnetic resonance imaging (MRI) and MRI/transrectal ultrasound-fusion biopsies to detect and to characterize significant prostate cancer (sPC) in the anterior fibromuscular stroma (AFMS) and in the transition zone (TZ) of the prostate and to assess the accuracy of multiparametric MRI (mpMRI) and biparametric MRI (bpMRI) (T2w and diffusion-weighted imaging (DWI)).

Methods: Seven hundred and fifty-five consecutive patients underwent prebiopsy 3 T mpMRI and transperineal biopsy between October 2012 and September 2014. MRI images were analyzed using PIRADS (Prostate Imaging-Reporting and Data System).

Perioperative management in the patient with substance abuse.

Drug and alcohol use is a pervasive problem in the general population and in those requiring anesthesia for an operation. History and screening can help delineate those who may be acutely intoxicated or chronic drug and alcohol users. Both acute intoxication and chronic abuse of these substances present challenges for anesthetic management during and after an operation.

Helmet use among motorcycle and moped riders injured in Hawaii: Final medical dispositions from a linked database.

Background: Reports regarding helmets in motorcycle crashes have been limited by the lack of data across the spectrum of injury outcomes, generally excluding low-severity injuries that do not require further medical treatment. We hypothesized that the protective effect of helmets may be underestimated in studies that focused only on patients who arrive at a trauma center and that it may differ depending on whether the crash involved a motorcycle or moped.

Methods: The emergency medical service reports of 2,553 crash patients treated from 2007 to 2009 were linked to police crash reports, hospital billing data, death certificates, and the Fatal Analysis Reporting System for a more complete description of the crashes throughout the state.

Team size impact on assessment of teamwork in simulation-based trauma team training.

Non-technical skills (teamwork) assessment is used to improve competence during training for interprofessional trauma teams. We hypothesized non-technical skills assessment is less reliable for large size teams, and evaluated team size effects during teamwork training. Small-teams (n = 5; 5-7 members) and Large-teams (n = 6; 8-9 members) participated in three simulation-based trauma team training scenarios.

Comparative analysis of transperineal template saturation prostate biopsy versus magnetic resonance imaging targeted biopsy with magnetic resonance imaging-ultrasound fusion guidance.

Purpose: Multiparametric magnetic resonance imaging and magnetic resonance imaging targeted biopsy may improve the detection of clinically significant prostate cancer. However, standardized prospective evaluation is limited.

Materials And Methods: A total of 294 consecutive men with suspicion of prostate cancer (186 primary, 108 repeat biopsies) enrolled in 2013 underwent 3T multiparametric magnetic resonance imaging (T2-weighted, diffusion weighted, dynamic contrast enhanced) without endorectal coil and systematic transperineal cores (median 24) independently of magnetic resonance imaging suspicion and magnetic resonance imaging targeted cores with software registration (median 4).

Trocar-sharpened needles for image-guided prostate biopsy improve sample quality and performance: first clinical results.

Objective: To show the benefit of trocar-sharpened needles for image-guided prostate biopsy compared with standard bevelled needles in patients.

Materials And Methods: Twenty-four men underwent magnetic resonance imaging-targeted fusion-guided transperineal saturation prostate biopsy, each with half standard bevelled and half trocar-sharpened needles. All taken biopsies were scored (1=worse to 5=best) by one urologist for the following criteria.

Assessing teamwork in the trauma bay: introduction of a modified "NOTECHS" scale for trauma.

Background: A modified nontechnical skills (NOTECHS) scale for trauma (T-NOTECHS) was developed to teach and assess teamwork skills of multidisciplinary trauma resuscitation teams. In this study, T-NOTECHS was evaluated for reliability and correlation with clinical performance.

Methods: Interrater reliability (intraclass correlation coefficient) and correlation with the speed and completeness of resuscitation tasks were assessed during simulation-based teamwork training and during actual trauma resuscitations.