ABSTRACT
OBJECTIVE: To evaluate the impact of a standardized surgical technique for primary cesarean deliveries (CDs) on operative time and surgical morbidity. MATERIALS AND METHODS: Two-year retrospective chart review of primary CD performed around the implementation of a standardized CD surgical technique. The primary outcome was total operative time (TOT). Secondary outcomes included incision-to-delivery time (ITDT), surgical site infection, blood loss, and maternal and fetal injuries. RESULTS: When comparing pre- versus postimplementation surgical times, there was no significant difference in TOT (76.5 vs. 75.9 minutes, respectively; p = 0.42) or ITDT (9.8 vs. 8.8 minutes, respectively; p = 0.06) when the entire cohort was analyzed. Subgroup analysis of CD performed early versus late in an academic year among the pre- and postimplementation groups showed no significant difference in TOT (79.3 early vs. 73.8 minutes late; p = 0.10) or ITDT (10.8 early vs. 8.8 minutes late; p = 0.06) within the preimplementation group. In the postimplementation group, however, there was significant decrease in TOT (80.5 early vs. 71.3 minutes late; p = 0.02) and ITDT (10.6 early vs. 6.8 minutes late; p < 0.01). Secondary outcomes were similar for both groups. CONCLUSION: A standardized surgical technique combined with surgical experience can decrease TOT and ITDT in primary CD without increasing maternal morbidity.
Subject(s)
Cesarean Section/standards , Obstetrics/education , Operative Time , Postoperative Cognitive Complications/prevention & control , Quality Improvement , Adult , Attitude of Health Personnel , Cesarean Section/education , Cesarean Section/methods , Education, Medical, Continuing , Female , Humans , Obstetrics/standards , Postoperative Cognitive Complications/epidemiology , Pregnancy , Retrospective Studies , Surveys and Questionnaires , TexasSubject(s)
Hotlines , Smoking/epidemiology , Tobacco Use Disorder/epidemiology , Adult , Female , Humans , Male , Massachusetts/epidemiology , Middle Aged , Smoking CessationABSTRACT
Acoustic, ecological, perceptual and cognitive factors that are common in the identification of 41 brief, varied sounds were evaluated. In Experiment 1, identification time and accuracy, causal uncertainty values, and spectral and temporal properties of the sounds were obtained. Experiment 2 was a survey to obtain ecological frequency counts. Experiment 3 solicited perceptual-cognitive ratings. Factor analyses of spectral parameters and perceptual-cognitive ratings were performed. Identification time and causal uncertainty are highly interrelated, and both are related to ecological frequency and the presence of harmonics and similar spectral bursts. Experiments 4 and 5 used a priming paradigm to verify correlational relationships between identification time and causal uncertainty and to assess the effect of sound typicality. Results support a hybrid approach for theories of everyday sound identification.
