Age at onset of inflammatory bowel disease and the risk of surgery for non-neoplastic bowel disease.

BACKGROUND: There is conflicting data regarding the response to medical and surgical therapy for inflammatory bowel disease with respect to age at disease onset. AIM: To determine if the age at onset of Crohn's disease and ulcerative colitis is a risk factor for surgery for non-neoplastic bowel disease. METHODS: This was a case-control study of patients evaluated between 1998 and 2001. Cases had undergone an initial operation for bowel disease. Controls were matched 1:1 for gender, disease subtype, date of first visit (+/-2 years), time from diagnosis prior to first visit (+/-3 years) and duration of follow-up. Association with age, disease extent, smoking history, medication use and co-morbidities vs. case/control status was assessed using multiple variable conditional logistic regression to estimate the odds ratio (OR) and 95% confidence intervals (CI) for undergoing surgery. RESULTS: Among 132 Crohn's patients, older patients had lower odds for surgery (OR per 5 years, 0.86; 95% CI: 0.75-0.98). The rate of surgery for non-neoplastic bowel disease was not significantly associated with disease distribution, co-morbidities or cigarette smoking. Among 234 ulcerative colitis patients, the rate of surgery was unrelated to age, disease extent, co-morbidities or cigarette smoking, CONCLUSIONS: For Crohn's disease, but not ulcerative colitis, the risk of surgery for non-neoplastic bowel disease decreases with increasing age at diagnosis, irrespective of disease distribution and history of cigarette smoking.

Interviewing techniques for hiring quality employees in the OR.

Today's OR requires high caliber employees to provide quality patient care and excellent service to their medical staff members. As such, there is clearly a need for some mode of identifying the appropriate individuals to fill specific vacant positions. A recent survey was conducted of OR directors and managers in Miami, Fla. The purpose of the survey was to identify exactly what types of education and/or training directors and managers had acquired with respect to interviewing techniques and to determine whether there was any consistency in their interview processes. Based on the surveys' findings it was found that there is a lack of relevant training amongst those directors and managers who conduct interviews. This training could include the implementation of standardized interview questions (for candidates of specific job descriptions) for use on a consistent basis, as well as a process of evaluation for the interview.