Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

BACKGROUND: One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. METHODS: Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. RESULTS: Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P < 0.001). CONCLUSION: Reductions in tardiness of first case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

Harris lines revisited: prevalence, comorbidities, and possible etiologies.

OBJECTIVES: The occurrence of transverse radiopaque lines in long bones-Harris lines (HLs)-is correlated with episodes of temporary arrest of longitudinal growth and has been used as an indicator of health and nutritional status of modern and historical populations. However, the interpretation of HLs as a stress indicator remains debatable. The aim of this article is to evaluate the perspectives and the limitations of HLs analyses and to examine their reliability as a stress indicator. METHODS: The study was conducted on 241 tibiae from a medieval Swiss skeletal material and was carried out using a standardized, semiautomated HL detection and analysis tool developed by the authors. We compared four different age-at-formation estimation methods and analyzed the correlation of HL occurrence to life expectancy, mean-age-at-death, stature, tibia length, and metabolic disorders as expressed by linear enamel hypoplasia and hypothyroidism. RESULTS: The evaluation of the age-at-formation estimation methods showed statistical significant differences. Therefore, a mathematical framework for the conversion between the methods has been developed. Remodeling had eliminated about half of the HLs formed during adolescence, and a further half of the remaining ones during early adulthood, whereas no association between the aforementioned conditions and HL prevalence could be determined. The peaks of high HL frequency among various populations were found to parallel normal growth spurts and growth hormone secretion. CONCLUSIONS: We suggest a reconsideration of HLs as more of a result of normal growth and growth spurts, rather than a pure outcome of nutritional or pathologic stress.

A comparison of the anatomical and the mathematical stature estimation methods on an ancient Greek population.

Stature is a key concept in the study of human past since along with the biological information it provides overall trends about the standards of living. However, stature data on historic and prehistoric populations are still limited, especially for key temporospatial settings of antiquity such as ancient Greece. We collected osteometric data from 35 male and 33 female individuals (n = 68) from a Roman Period necropolis (146 BC-330 AD) in northern Greece and we applied the anatomical stature estimation method (Raxter et al. 2006). We compared this estimation with the results of 20 regression equations (both ordinary least squares and reduced major axis methods) and we examined the factors that affect their accuracy such as body proportions and the chronology and geography of reference series. For our analyses, we calculated the percent prediction error (%PE) produced by each regression equation for males and females separately. We introduced the total %PE to evaluate each equation's effectiveness on both sexes simultaneously. We calculated long bone ratios and the Euclidean distance between the Greek dataset and the reference series. According to the anatomical method, males from Northern Greece had a mean stature value of 168.2 cm ± 5.38 and females of 156.9 cm ± 5.27. The regression equations of Vercellotti et al. (2009) provided the best estimations in both sexes. Estimation errors (%PE) were not statistically different between the ordinary least squares and reduced major axis equations. The chronological affinity in body proportions between the target population and the reference series could provide significant evidence for the prediction of the optimal regression formulae. With this paper we provide the first osteometric dataset for the anatomical stature estimation method from ancient Greece and we suggest the most suitable regression equations for this key region of the ancient World.

Body height estimation from post-mortem CT femoral F1 measurements in a contemporary Swiss population.

PURPOSE: The present study aimed at the comparison of body height estimations from cadaver length with body height estimations according to Trotter and Gleser (1952) and Penning and Riepert (2003) on the basis of femoral F1 section measurements in post-mortem computed tomography (PMCT) images. METHODS: In a post-mortem study in a contemporary Swiss population (226 corpses: 143 males (mean age: 53 ± 17 years) and 83 females (mean age: 61 ± 20 years)) femoral F1 measurements (403 femora: 199 right and 204 left; 177 pairs) were conducted in PMCT images and F1 was used for body height estimation using the equations after Trotter and Gleser (1952, "American Whites"), and Penning and Riepert (2003). RESULTS: The mean observed cadaver length was 176.6 cm in males and 163.6 cm in females. Mean measured femoral length F1 was 47.5 cm (males) and 44.1cm (females) respectively. Comparison of body height estimated from PMCT F1 measurements with body height calculated from cadaver length showed a close congruence (mean difference less than 0.95 cm in males and less than 1.99 cm in females) for equations both applied after Penning and Riepert and Trotter and Gleser. CONCLUSIONS: Femoral F1 measurements in PMCT images are very accurate, reproducible and feasible for body height estimation of a contemporary Swiss population when using the equations after Penning and Riepert (2003) or Trotter and Gleser (1952).