Objective Measures Of Success Research Articles

Association of changes in HerQLes scores with objective hernia outcomes: an analysis of the ACHQC database.

There are both objective and subjective measures of success following ventral hernia repair (VHR). Using the Abdominal Core Health Quality Collaborative (ACHQC) database, we sought to determine if there is an association between 30-day wound events (objective) and changes in the hernia-related quality-of-life (HerQLes) scores, (subjective). We hypothesized that patients who do not experience a 30-day wound event have a greater improvement in their HerQLes score over the short-term. All adult patients who underwent VHR with 30-day follow-up data available between 2013 and 2022 were identified within the ACHQC database. The 30-day wound events included surgical site infection (SSI), surgical site occurrence (SSO), and SSO requiring procedural intervention (SSOPI). The association between 30-day wound events and changes in HerQLes scores was measured using propensity matched score analysis. Further, regression analysis was used to determine if an improvement in HerQLes score at 30-days postoperatively was associated with the likelihood of experiencing a 30-day wound event. Following a 3:1 matched analysis, 17,796 patients were available for analysis; 4449 (25%) patients experienced a 30-day wound event. The most common SSI was a superficial SSI and the most common SSO was a seroma. A 10-point improvement in the HerQLes score was statistically associated with a 3% decrease in SSI and a 4% decrease in the odds of experiencing an SSO. While not statistically significant, a 10-point improvement in the HerQLes score was associated with a 2.4% decrease in the odds of experiencing an SSOPI. Subjective and objective measures of success following VHR seem to be correlated with one another over the short-term. Additional studies are needed to determine if this correlation exists with other subjective and objective measures of success and to determine if these correlations persist over the long-term. If present, these associations may help to guide patient counseling as experiencing a postoperative wound event following ventral hernia repair may not be detrimental to their quality-of-life over the long-term.

The prevalence of imposter syndrome among young neurosurgeons and residents in neurosurgery: a multicentric study.

Imposter syndrome (IS) occurs when high-achieving individuals have a pervasive sense of self-doubt combined with fear of being exposed as a fraud, despite objective measures of success. This is one of the main causes of burnout among professionals, threatening their mental health and general well-being. The prevalence and severity of IS among neurosurgery residents and young neurosurgeons has not been yet studied. The primary outcomes of this study were the prevalence and severity of IS. An anonymous cross-sectional survey including both a demographic questionnaire (Clance Imposter Phenomenon Survey) and compensatory mechanisms was distributed to young neurosurgeons and residents in neurosurgery in Italy. A total of 103 responses were collected. The prevalence rate was 81.6%. Among the respondents with IS, 42.7% showed moderate signs, 27.2% frequent, and only 11.7% had an intense symptomatology. Level of education, female sex, and academic achievements were all identified as predictive factors of IS. A total of 81.6% of respondents reported potentially significant levels. The implications of IS on both the outcomes in patients and the well-being of neurosurgeons should be evaluated in future studies.

Prevalence and Severity of Imposter Syndrome among Surgical and Medical Residents in Makkah, Saudi Arabia

Background and Aims: Imposter syndrome (IS) is defined by a persistent feeling of self-doubt combined with fear of being exposed as a fraud, despite objective measures of success, which threatens mental health and well-being. The prevalence and severity of IS have not been studied among surgical and medical residents on a large scale. Therefore, the primary objective of this study was to assess the prevalence and severity of IS among surgical and medical residents in Makkah hospitals, Saudi Arabia. Methods: A retrospective cross-sectional study was performed by using the Clance Imposter Phenomenon Scale (CIPS) on surgical and medical residents in Makkah hospitals. A total of 207 residents were collected by using an online version. The obtained data were statistically analyzed using SPSS version 24. Results: 207 residents fulfilling the inclusion criteria completed the study questionnaire. Only 3.9% of residents had a low level of imposter characteristics, 45.9% had a moderate level, 47.3% had a high level, while 2.9% had intense imposter feelings. In addition, high to intense imposter feelings were detected among 54.4% female residents compared to 42.3% of males. Surgical residents and residents in their first years of residency showed insignificantly higher imposter feelings than others (51%, 61.5% for R2 residents; P> 0.05 for all). All other factors were insignificantly affecting the resident’s imposter syndrome score. Conclusions: Imposter syndrome is prevalent among surgical and medical residents and was significantly higher in females than males in Makkah city hospitals, Saudi Arabia.

Imposter Syndrome in Surgical Trainees: Clance Imposter Phenomenon Scale Assessment in General Surgery Residents

Imposter syndrome occurs when high-achieving individuals have a pervasive sense of self-doubt combined with fear of being exposed as a fraud, despite objective measures of success. This threatens mental health and well-being. The prevalence and severity of imposter syndrome has not been studied among general surgery residents on a large scale. The primary outcomes of this study were the prevalence and severity of imposter syndrome. The Clance Impostor Phenomenon Scale was administered to residents at 6 academic general surgery residency programs. Multivariable analysis was performed to identify significant differences among groups and predictive characteristics of imposter syndrome. One hundred and forty-four residents completed the assessment (response rate 46.6%; 47.2% were male). Only 22.9% had "none to mild" or "moderate" imposter syndrome. A majority (76%) had "significant" or "severe" imposter syndrome. There were no significant differences in mean scores among male and female residents (p= 0.69). White residents had a mean score of 71.3 and non-White residents had a mean score of 68.3 (p= 0.24). There was no significant difference between PGY1 to PGY5 or research residents (p= 0.72). There were no significant differences based on US Medical Licensing Examination or American Board of Surgery In-Service Training Examination scores (p= 0.18 and p= 0.37, respectively). Imposter syndrome is prevalent among general surgery residents, with 76% of residents reporting either significant or severe imposter syndrome. There were no predictive characteristics based on demographics or academic achievement, suggesting that there is something either inherent to those choosing general surgery training or the general surgery training culture that leads to such substantive levels of imposter syndrome.

Bladder neck placement of a synthetic polypropylene sling for the treatment of stress urinary incontinence.

Pubo-vaginal sling placed at the bladder neck is the gold standard treatment for stress urinary incontinence (SUI). The synthetic mid-urethral sling (MUS) is now widely used, as morbidity rates with this technique are substantially reduced. This is an initial report on long-term outcomes of a polypropylene sling (PPS) placed in the traditional bladder neck location. A retrospective analysis of all patients who underwent PPS insertion at our institution between 2006 and 2014 was conducted. Patient and urodynamic demographics were recorded. Subjective and objective measures of success were determined by postoperative pad usage and validated incontinence questionnaires. A total of 170 patients were followed for a median of four years (range 1-8). The mean age was 51 years (±10). Subjective response was assessed in 57% of patients; the overall subjective cure rate was 85.3% (n=145), subjective improvement rate was 4.1% (n=7), and the subjective failure rate was 10.6% (n=18). The mean Urogenital Distress Inventory (UDI)-6 score was 6.5 (±5.6) out of a maximum score of 24 and the Incontinence Impact Questionnaire (IIQ)-7 score was 5.5 (±6.3) out of a maximum score of 28. There was no significant difference in objective outcome measures in those with an abdominal leak-point pressure (ALPP) < or >60 cmH2O. Bladder neck placement of a PPS resulted in cure rates of 85% in this series. SUI secondary to intrinsic sphincter deficiency (ISD) and urethral hypermobility were treated with equal success. Bladder neck PPS placement has a role in the treatment of SUI. Our data may well reassure rectus fascia sling (RFS) surgeons who wish to take advantage of faster postoperative recovery using the less invasive PPS placed at the bladder neck.

Trait correlates of success at work

AbstractIdentifying and developing high potential individuals is fundamental to successful companies and organizations. The present study focuses on the personality traits of high potential individuals. The High Potential Traits Inventory (HPTI) was used to investigate associations between personality traits and measures of career success, in a sample of 383 employed individuals. Results indicate HPTI personality traits relate to subjective and objective measures of success with Conscientiousness being the strongest predictor. The findings of the current study are consistent with previous research on High Flyers. Implications of the current study are discussed, suggesting a clearer operationalization of success is crucial for understanding the underlying mechanisms which lead from personality to potential.

The Park Chung Hee Era: The Transformation of South Korea

<i>The Park Chung Hee Era: The Transformation of South Korea</i>

PIH46 - Patient reported outcomes: are they relevant to u.s. Payers?

Identify the current and future relevance of Patient Reported Outcomes (PROs) among U.S. payers making patient access decisions for pharmaceuticals Double blind, semi-structured telephone interviews with 12 U.S. payers, including: National and regional commercial payers; Accountable Care Organizations; Pharmacy Benefit Managers; Self-insured employers; Actuaries; Veterans Affairs; and Department of Defense. Interviews included open-ended questioning and structured rating scales where 10=highest and 1=lowest possible score per concept. Payers perceive PROs as the, “Consequences of the disease and drug as assessed by the patient...” Average rating scale responses were: How relevant are PROs? today? = 3.7 in 5 years? = 6.4 Would you like to see more PRO evidence? today? = 6.1 in 5 years? = 6.6 Should pharmaceutical companies invest more in PROs? today? = 5.6 in 5 years? = 6.3 The sum of the 6 scales (min= 6, max = 60) ranged from 12 to 58, highlighting diversity across payers. PRO relevance was associated with the duration of enrollment and thus total amount of risk. DoD and ACOs reported the highest relevance, National Commercial Health plans the lowest. Education was consistently identified as a need to aid interpretation of PRO data to support patient access decisions. Payers’ reliance on PRO data will increase in the next five years, especially in symptomatic conditions without objective measures of success. PRO evidence is valued as a unique predictor of clinical and economic outcomes and as a key element of performance and quality ratings. Respondents showed interest in pharmaceutical companies’ increasing use of PROs in clinical trials, creation of real world evidence and supporting PRO education.

What makes a “great resident”: the resident perspective

Orthopedic surgery residency training is a difficult endeavor, and the selection of residents that will perform well in a rigorous training program is challenging for residency program directors. Even defining a "great" resident is a difficult endeavor. However, there are certain qualities that anecdotally are associated with high-performing residents, which include being trustworthy, hard-working and efficient, self-directed learners, detail-oriented, and personable. These qualities are difficult to teach and are likely learned by an individual during their early years of education and groomed during college and medical school. Individuals possessing these characteristics are more likely to bring a high-level of professionalism to their work as residents and to perform well on objective measures of success in residency such as high OITE scores, good faculty evaluations, and peer-reviewed publications. We discuss the available, but limited, literature on what makes a "great" resident and share the resident perspective on this topic.

Anterior o Postero-Lateral Surgical Approach: Can we Identify Parameters for the Choice in Noncemented Hip Arthroplasty?

Anterior o Postero-Lateral Surgical Approach: Can we Identify Parameters for the Choice in Noncemented Hip Arthroplasty?

The impact of employee perceptions on change in a municipal government

PurposeThe purpose of this paper is to investigate employees' reactions to a comprehensive change: to change aspects of the organization's working atmosphere at a mid‐sized municipal government located in Ontario, Canada. It aims to use the perception of success of the ongoing change effort as the main dependent variable.Design/methodology/approachThe study was cross‐sectional in nature. Data were collected via a survey, and correlational analysis and PLS were used to analyze the data.FindingsThe results showed that the relationship between perceptions of success of the ongoing change effort and perceived sense of competence; affective commitment; satisfaction with organizational members; opportunities to participate in decision making; opportunities for development and growth; and respect in the workplace was significant.Research limitations/implicationsFuture studies should include a more objective measure of success of the change efforts, such as absenteeism, turnover, levels of service provided, helping behavior and other organizational citizenship behaviors, and grievances filed.Practical implicationsIndividual and workplace variables explain significant variance in the perception of success to improve the working atmosphere at a municipal organization. These variables should be given consideration during the implementation of change. Anecdotal evidence often indicates that leaders faced with comprehensive change do things that conflict with increasing readiness for change and to create enthusiasm for the change.Originality/valueGovernment agencies face unprecedented change. It is imperative for these organizations to manage change in an effective and efficient manner in their pursuit of creating public value. Research on change in public sector organizations is sparse.

Editorial Comment

The authors report on a prospective, longitudinal cohort study of women undergoing Miniarc for the treatment of stress urinary incontinence. The premise behind the Miniarc and other “minislings” is that they should have similar efficacy and be associated with lower morbidity compared with traditional midurethral slings. In the case of the Miniarc, the comparator would be the transobturator midurethral slings. The authors report a subjective cure rate of 93.5% at 1 year, with 10% of patients lost to follow-up. If one considers the extremes of all lost-to-follow-up patients as all failed or all cured, the range is from 84% to 94%. This certainly compares favorably with subjective cure rates for other midurethral slings. However, looking more critically at the study design, I do not believe that one can say with certainty that the efficacy is comparable (although it certainly may be). I would have preferred to see more stringent, validated questions regarding subjective cure and improvement. “Direct questioning,” which can be a little different each time the question is asked, is not the best way to assess outcome. Also, validated global questions regarding overall improvement are helpful in these types of studies. Finally, some objective measures of success would be nice. Single Incision Mid-urethral Sling for Treatment of Female Stress Urinary IncontinenceUrologyVol. 77Issue 2PreviewTo present the longitudinal outcomes in an observational cohort of patients who had undergone treatment of stress urinary incontinence with a single incision mid-urethral sling (MUS). Full-Text PDF ReplyUrologyVol. 77Issue 2PreviewWe appreciate the reviewer's insight and sage commentary. Our study was designed specifically to address the early experiential outcomes with the MiniArc midurethral sling and was not meant to address its equivalence or superiority compared with the TVT-O or TVT. Certainly, a large, multicenter, randomized, controlled trial is needed to fully address these questions. Whether such a trial could be satisfactorily completed before the sling and/or technique is rendered obsolete by future slings or techniques remains speculative. Full-Text PDF

Status and Mating Success Amongst Visual Artists

Geoffrey Miller has hypothesized that producing artwork functions as a mating display. Here we investigate the relationship between mating success and artistic success in a sample of 236 visual artists. Initially, we derived a measure of artistic success that covered a broad range of artistic behaviors and beliefs. As predicted by Miller’s evolutionary theory, more successful male artists had more sexual partners than less successful artists but this did not hold for female artists. Also, male artists with greater artistic success had a mating strategy based on longer term relationships. Overall the results provide partial support for the sexual selection hypothesis for the function of visual art.

The Role of Suppliers in Market Intelligence Gathering for Radical and Incremental Innovation*

Drawing on transaction cost economics theory, this study addresses the following research questions: (1) Does supplier involvement in market intelligence gathering activities have a greater impact on innovation success in predesign or commercialization activities? and (2) Does supplier involvement in market intelligence gathering activities have a greater impact on success in radical or incremental product innovation? Hypotheses are tested using both subjective and objective measures of success from a study of 205 incremental and 110 radical new product development projects. Results from the estimation of a two‐group path model suggest that this theoretical framework is useful in providing guidance as to when product developers should emphasize the gathering of market intelligence through suppliers. Consistent with conventional wisdom, the findings suggest that supplier involvement in market intelligence gathering activities are positively related to success in incremental innovations across predesign and commercialization activities. However, supplier involvement in market intelligence gathering activities is found to have no significant impact on market share and is negatively associated with perceived product performance in radical innovations in predesign tasks. Also, while there was no significant difference in market share for supplier involvement in market intelligence gathering activities between radical and incremental innovation in commercialization activities, supplier involvement in these activities did have a greater impact on perceived product performance in radical innovation than it did in incremental innovation. Although current practice suggests that teams allocate fewer resources to the gathering of market intelligence through their suppliers during predesign activities in incremental innovation projects compared with radical innovation projects, the findings in this study suggest that they should do the opposite. Shifting resources allocated for engaging suppliers in market information gathering activities in predesign activities from radical innovation projects to incremental innovation projects could increase the return on these investments. Alternatively, these resources currently allocated to the gathering of market intelligence through suppliers in predesign activities of radical innovation projects could also provide greater benefits if allocated to commercialization activities of radical innovation projects, where they have the greatest positive impact.

Current techniques for laser prostatectomy-PVP and HoLEP

The objective of this review is to provide an evidence-based update on laser surgery for BPH with a focus on comparing Greenlight Photoselective Vaporisation of the Prostate (PVP) to Holmium Laser Enucleation of the Prostate (HoLEP). We reviewed all HoLEP and PVP papers identified by a Pubmed search using the keywords: laser, prostate, BPH, holmium, HoLE, PVP and greenlight. The published randomised trials investigating HoLEP and PVP are summarised. As there are no head to head randomised trials comparing HoLEP to PVP, we compare data from individual HoLEP and PVP papers. Data on multiple aspects of laser surgery for BPH are summarised and contrasted for the 2 procedures including: Perioperative management, subjective and objective measures of success, complications, sexual function, prostate volume reduction, durability, and surgery for men with large prostates and those in urinary retention. PVP and HoLEP are very different laser techniques. An important difference between the Greenlight laser and holmium and thulium is that its only urological application is prostate ablation. HoLEP is the most advanced laser technique currently available. In contrast to PVP, it has been rigorously evaluated in 8 randomised trials. It is a size independent procedure suitable for any prostate, and highly effective at treating urinary retention. HoLEP has been reported to be durable to periods up to 6 years. More tissue is removed with HoLEP than PVP and this raises concerns regarding the long term durability of PVP for which there is no comparable data. The increase in HoLEP expertise worldwide and the development of lasers that are faster at ablating tissue and have other urological uses (eg thulium) may threaten the longevity of Greenlight PVP.

Are We Closing the Disparities Gap?: Small-Area Analysis of Asthma in Chicago

Disparities in asthma outcomes in the Chicago area have been observed between geographic areas and ethnic and socioeconomic groups. As efforts to close this gap have moved beyond the initial characterization of the problem to implementation of concrete programs to address these disparities, objective measures of success are essential. We present a variety of data from the Chicago area to assess whether any improvement in previously reported disparities can be demonstrated. While some process outcomes such as medication usage have improved over time, death from asthma has failed to demonstrate an equivalent improvement. More importantly, the differential in asthma mortality and hospitalization rates between African Americans and European Americans has failed to close in the years following the release of the National Asthma Education and Prevention Program asthma guidelines.

Surgical management of chronic rhinosinusitis and nasal polyposis: a review of the evidence.

Functional endoscopic sinus surgery is a common adjunct to medical therapy in the management of chronic rhinosinusitis and nasal polyposis. As with most surgical procedures, there is a paucity of randomized, controlled clinical trials examining the use of functional endoscopic sinus surgery in the management of chronic rhinosinusitis and nasal polyposis. This is primarily a result of the physical and ethical conundrums faced in performing a study that involves comparing a surgical procedure with a placebo. However, there is documentation of the marked impact that chronic rhinosinusitis can have on the overall quality of life and evidence that this improves following combined surgical and medical intervention. There are many case series with large patient populations that have shown significant improvement in short- and long-term patient symptoms following surgery. These outcomes are expected to improve with even greater refinement of technology, experience, and instrumentation, and the quality of future studies may be improved by determining and using objective measures of success and, possibly, by the use of control groups.

Determinants of patient satisfaction after the tension-free vaginal tape procedure

Objective This study was undertaken to compare patient satisfaction with subjective and objective measures of success. Study design Satisfaction at 1-year was measured by using a self-administered written questionnaire. Success was assessed both subjectively and objectively by using the short form Urogenital Distress Inventory, stress testing, and multichannel urodynamics. Outcomes were compared to determine the relationship between satisfaction and success. Satisfied and dissatisfied patients were compared with respect to pre-, intra-, peri-, and postoperative characteristics. Student t and χ 2 tests were used for continuous and ordinal data, respectively. Results Of 66 (80%) patients, 53 were satisfied. These patients were more likely to achieve subjective cure (91% vs 62%, P = .009) but not statistically more likely to be objectively cured (92% vs 75 %, P = .08). Dissatisfied patients tended to have overactive bladder symptoms, voiding difficulty, and required sling release. Other patient characteristics did not influence satisfaction rates. Conclusion Satisfaction after tension-free vaginal tape procedure is highly dependent on normal bladder function. Dissatisfied patients deserve comprehensive evaluation, although objective measures may not reflect patient satisfaction.

Beyond Usability Evaluation: Analysis of Human-Robot Interaction at aMajor Robotics Competition

Human-robot interaction (HRI) is a relatively new field of study. To date, most of the effort in robotics has been spent in developing hardware and software that expands the range of robot functionality and autonomy. In contrast, little effort has been spent so far to ensure that the robotic displays and interaction controls are intuitive for humans. This study applied robotics, human-computer interaction (HCI), and computer-supported cooperative work (CSCW) expertise to gain experience with HCI/CSCW evaluation techniques in the robotics domain. As a case study for this article, we analyzed four different robot systems that competed in the 2002 American Association for Artificial Intelligence Robot Rescue Competition. These systems completed urban search and rescue tasks in a controlled environment with predetermined scoring rules that provided objective measures of success. This study analyzed pre-evaluation questionnaires; videotapes of the robots, interfaces, and operators; maps of the robots' paths through the competition arena; post-evaluation debriefings; and critical incidents (e.g., when the robots damaged the test arena). As a result, this study developed guidelines for developing interfaces for HRI.

User Developed Applications and Information Systems Success

DeLone and McLean’s (1992) model of information systems success has received much attention amongst researchers. This study provides the first empirical test of an adaptation of DeLone and McLean’s model in the user-developed application domain. The model tested was only partially supported by the data. Of the nine hypothesized relationships tested, four were found to be significant and the remainder not significant. The model provided strong support for the relationships between perceived system quality and user satisfaction, perceived information quality and user satisfaction, user satisfaction and intended use, and user satisfaction and perceived individual impact. This study indicates that user perceptions of information systems success play a significant role in the user-developed application domain. There was, however, no relationship between user developers’ perceptions of system quality and independent experts’ evaluations, and user ratings of individual impact were not associated with organizational impact measured as company performance in a business simulation. Further research is required to understand the relationship between user perceptions of IS success and objective measures of success, and to provide a model of IS success appropriate to end user development.