1) The document summarizes observations from a workshop about how to help tourists plan vacations in Reno, Nevada.
2) Attendees included retirees, convention attendees, an RV traveling family, and annual visitors with accessibility needs.
3) Local casinos and their representatives also attended, including the Grand Sierra Resort, El Dorado Casino, and John Ascuaga's Nugget.
4) Ideas were brainstormed for how to help Reno tell its story, differentiate itself, and rebrand its image.
This document discusses informed consent for geriatric hip fracture patients. It defines informed consent and notes that it is now required by guidelines. The consent process should involve multiple providers explaining risks, benefits, and alternatives to the elderly patient and family members. Obtaining consent from geriatric patients can be challenging due to medical conditions, social factors, and illiteracy. The consent discussion must be thorough, allow time for questions, and ensure the patient understands and consents voluntarily.
1) The document summarizes observations from a workshop about how to help tourists plan vacations in Reno, Nevada.
2) Attendees included retirees, convention attendees, an RV traveling family, and annual visitors with accessibility needs.
3) Local casinos and their representatives also attended, including the Grand Sierra Resort, El Dorado Casino, and John Ascuaga's Nugget.
4) Ideas were brainstormed for how to help Reno tell its story, differentiate itself, and rebrand its image.
This document discusses informed consent for geriatric hip fracture patients. It defines informed consent and notes that it is now required by guidelines. The consent process should involve multiple providers explaining risks, benefits, and alternatives to the elderly patient and family members. Obtaining consent from geriatric patients can be challenging due to medical conditions, social factors, and illiteracy. The consent discussion must be thorough, allow time for questions, and ensure the patient understands and consents voluntarily.
Post op rehabilitation pelvi acetabular fixationUday Bangalore
The document outlines post-operative rehabilitation guidelines following pelvic and acetabular fixation surgery. It recommends early mobilization following anatomical reduction and stable fixation. Exercises begin with static quadriceps exercises on day 1, progressing to dynamic exercises and passive range of motion by day 3. Toe-touch weight bearing with crutches is allowed by day 2-4, progressing to full weight bearing around 12 weeks once fracture healing is confirmed. The guidelines vary slightly depending on surgical approach and whether the fracture is unilateral or bilateral.
The document discusses the role of operative infrastructure in preventing infections. It covers:
1. The history of safe operating room practices beginning with Lister identifying airborne bacteria in 1867.
2. Guidelines for maintaining sterility in the operating room including using only sterile materials and properly sterilizing instruments.
3. Features of operating rooms that minimize infections such as laminar airflow systems, HEPA filters, temperature/humidity control, and zoning rooms by sterility levels.
4. The importance of thoroughly cleaning and disinfecting operating rooms through daily cleaning, weekly deep cleaning, and fumigation once a week using formaldehyde or other chemicals.
This document discusses the management of acute ankle fractures. It begins with the incidence, clinical features, evaluation and initial management of ankle fractures. It then describes the radiographic assessment including different x-ray views. Classification systems for ankle fractures are discussed. The document outlines indications and techniques for surgical management of ankle fractures including fixation of the lateral and medial malleoli, posterior malleolus and syndesmosis. Post-operative care is also summarized.
Hemiarthroplasty is generally recommended over open reduction and internal fixation (ORIF) for displaced femoral neck fractures in elderly patients, as ORIF has higher nonunion and failure rates. Cemented bipolar hemiarthroplasty has better outcomes than uncemented in terms of function, mobility, implant stability, and pain. Total hip replacement provides better function than hemiarthroplasty but is a more complex procedure. For patients aged 65-75 with femoral neck fractures, cemented bipolar hemiarthroplasty is preferable to ORIF, while patients over 75 are best treated with hemiarthroplasty.
Open pelvic trauma and associated injury managementUday Bangalore
This document discusses the management of open pelvic trauma from pelvic fractures. It notes that open pelvic fractures have a high mortality rate of 30-50% and require a multidisciplinary team approach and early, aggressive treatment. A key part of treatment is controlling hemorrhage through measures like external fixation, pelvic packing, angiography, and embolization to address bleeding from various pelvic arteries and veins. Other important aspects of treatment include antibiotics to prevent infection, debridement of soft tissue wounds, and repair of any associated injuries to organs like the bladder, urethra, bowel or vagina. Definitive treatment to stabilize the pelvis is done later, once the patient is stabilized.
1. Calcaneal fractures often result from high-energy injuries and are associated with long-term morbidity if not treated properly.
2. Operative treatment with open reduction and internal fixation can provide good outcomes, but complications must be avoided.
3. Treatment should be individualized based on the fracture pattern and characteristics of the patient.
Goldratt's Theory of Constraints - An IntroductionFred Wiersma
The Theory of Constraints (TOC) is a management philosophy developed by Eliyahu Goldratt to achieve continuous improvement by identifying the constraint holding a system back and exploiting it. A constraint is anything that prevents a system from achieving higher performance. TOC provides tools to identify constraints, determine how to exploit them, and elevate the system. It has been applied successfully across various business areas like production, distribution, marketing, and finance. Companies can develop a "Viable Vision" using TOC to achieve a profit equal to their current turnover within four years.
Critical Chain Project Management (CCPM) addresses problems with traditional scheduling methods by focusing on completing the critical chain of tasks rather than individual tasks. It moves scheduling safety from task levels to the project level and prevents multitasking by requiring resources to focus on one task until its completion. CCPM identifies the critical chain of dependent tasks and establishes buffers to protect the project schedule from uncertainties.
Post op rehabilitation pelvi acetabular fixationUday Bangalore
The document outlines post-operative rehabilitation guidelines following pelvic and acetabular fixation surgery. It recommends early mobilization following anatomical reduction and stable fixation. Exercises begin with static quadriceps exercises on day 1, progressing to dynamic exercises and passive range of motion by day 3. Toe-touch weight bearing with crutches is allowed by day 2-4, progressing to full weight bearing around 12 weeks once fracture healing is confirmed. The guidelines vary slightly depending on surgical approach and whether the fracture is unilateral or bilateral.
The document discusses the role of operative infrastructure in preventing infections. It covers:
1. The history of safe operating room practices beginning with Lister identifying airborne bacteria in 1867.
2. Guidelines for maintaining sterility in the operating room including using only sterile materials and properly sterilizing instruments.
3. Features of operating rooms that minimize infections such as laminar airflow systems, HEPA filters, temperature/humidity control, and zoning rooms by sterility levels.
4. The importance of thoroughly cleaning and disinfecting operating rooms through daily cleaning, weekly deep cleaning, and fumigation once a week using formaldehyde or other chemicals.
This document discusses the management of acute ankle fractures. It begins with the incidence, clinical features, evaluation and initial management of ankle fractures. It then describes the radiographic assessment including different x-ray views. Classification systems for ankle fractures are discussed. The document outlines indications and techniques for surgical management of ankle fractures including fixation of the lateral and medial malleoli, posterior malleolus and syndesmosis. Post-operative care is also summarized.
Hemiarthroplasty is generally recommended over open reduction and internal fixation (ORIF) for displaced femoral neck fractures in elderly patients, as ORIF has higher nonunion and failure rates. Cemented bipolar hemiarthroplasty has better outcomes than uncemented in terms of function, mobility, implant stability, and pain. Total hip replacement provides better function than hemiarthroplasty but is a more complex procedure. For patients aged 65-75 with femoral neck fractures, cemented bipolar hemiarthroplasty is preferable to ORIF, while patients over 75 are best treated with hemiarthroplasty.
Open pelvic trauma and associated injury managementUday Bangalore
This document discusses the management of open pelvic trauma from pelvic fractures. It notes that open pelvic fractures have a high mortality rate of 30-50% and require a multidisciplinary team approach and early, aggressive treatment. A key part of treatment is controlling hemorrhage through measures like external fixation, pelvic packing, angiography, and embolization to address bleeding from various pelvic arteries and veins. Other important aspects of treatment include antibiotics to prevent infection, debridement of soft tissue wounds, and repair of any associated injuries to organs like the bladder, urethra, bowel or vagina. Definitive treatment to stabilize the pelvis is done later, once the patient is stabilized.
1. Calcaneal fractures often result from high-energy injuries and are associated with long-term morbidity if not treated properly.
2. Operative treatment with open reduction and internal fixation can provide good outcomes, but complications must be avoided.
3. Treatment should be individualized based on the fracture pattern and characteristics of the patient.
Goldratt's Theory of Constraints - An IntroductionFred Wiersma
The Theory of Constraints (TOC) is a management philosophy developed by Eliyahu Goldratt to achieve continuous improvement by identifying the constraint holding a system back and exploiting it. A constraint is anything that prevents a system from achieving higher performance. TOC provides tools to identify constraints, determine how to exploit them, and elevate the system. It has been applied successfully across various business areas like production, distribution, marketing, and finance. Companies can develop a "Viable Vision" using TOC to achieve a profit equal to their current turnover within four years.
Critical Chain Project Management (CCPM) addresses problems with traditional scheduling methods by focusing on completing the critical chain of tasks rather than individual tasks. It moves scheduling safety from task levels to the project level and prevents multitasking by requiring resources to focus on one task until its completion. CCPM identifies the critical chain of dependent tasks and establishes buffers to protect the project schedule from uncertainties.
1. ARTICOLUL 1 (1) România este stat naţional, suveran şi independent, unitar şi indivizibil. (2) Forma de guvernământ a statului român este republica. (3) România este stat de drept, democratic şi social, în care demnitatea omului, drepturile şi libertăţile cetăţenilor, libera dezvoltare a personalităţii umane, dreptatea şi pluralismul politic reprezintă valori supreme, în spiritul tradiţiilor democratice ale poporului român şi idealurilor Revoluţiei din decembrie 1989, şi sunt garantate. (4) Statul se organizează potrivit principiului separaţiei şi echilibrului puterilor - legislativă, executivă şi judecătorească - în cadrul democraţiei constituţionale. (5) În România, respectarea Constituţiei, a supremaţiei sale şi a legilor este obligatorie. Romanian