Colorectal surgical site infection reduction strategies.

OBJECTIVE: PeaceHealth Sacred Heart Medical Center at RiverBend is a 379 bed hospital; 15,060 surgical procedures were performed in 2014 with 254 being colorectal surgical cases. Using the ACS NSQIP program the hospital was identified as a high outlier for surgical site infection (SSI) in all cases and in colorectal procedures in our July 2012 semiannual report (SAR). METHODS: A best practice bundle to reduce SSI's and a colorectal enhanced recovery pathway were concurrently initiated RESULTS: After implementation of these best practice elements, our ACS NSQIP results showed a reduction in our colorectal SSI rate from 17.58% for 2011 to 5.11% (1st decile/low outlier) in the January 2015 SAR. Our SSI rate for all cases were reduced from 4.87% to 1.71% (1st decile/low outlier) during the same time period. A reduction in length of stay for our colorectal surgical patients was also noted. CONCLUSIONS: The ACS NSQIP program was essential to identify colorectal SSI as an area of concern and for providing data to drive quality improvement measures.

Proximity to coast is linked to climate change belief.

Psychologists have examined the many psychological barriers to both climate change belief and concern. One barrier is the belief that climate change is too uncertain, and likely to happen in distant places and times, to people unlike oneself. Related to this perceived psychological distance of climate change, studies have shown that direct experience of the effects of climate change increases climate change concern. The present study examined the relationship between physical proximity to the coastline and climate change belief, as proximity may be related to experiencing or anticipating the effects of climate change such as sea-level rise. We show, in a national probability sample of 5,815 New Zealanders, that people living in closer proximity to the shoreline expressed greater belief that climate change is real and greater support for government regulation of carbon emissions. This proximity effect held when adjusting for height above sea level and regional poverty. The model also included individual differences in respondents' sex, age, education, political orientation, and wealth. The results indicate that physical place plays a role in the psychological acceptance of climate change, perhaps because the effects of climate change become more concrete and local.

Resource allocation and fluid intelligence: insights from pupillometry.

Thinking is biological work and involves the allocation of cognitive resources. The aim of this study was to investigate the impact of fluid intelligence on the allocation of cognitive resources while one is processing low-level and high-level cognitive tasks. Individuals with high versus average fluid intelligence performed low-level choice reaction time tasks and high-level geometric analogy tasks. We combined behavioral measures to examine speed and accuracy of processing with pupillary measures that indicate resource allocation. Individuals with high fluid intelligence processed the low-level choice reaction time tasks faster than normal controls. The task-evoked pupillary responses did not differ between groups. Furthermore, individuals with high fluid intelligence processed the high-level geometric analogies faster, more accurately, and showed greater pupil dilations than normal controls. This was only true, however, for the most difficult analogy tasks. In addition, individuals with high fluid intelligence showed greater preexperimental pupil baseline diameters than normal controls. These results indicate that individuals with high fluid intelligence have more resources available and thus can solve more demanding tasks. Moreover, high fluid intelligence appears to be accompanied by more task-free exploration.