Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect

the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation Selleck BVD-523 and recording of the MDTs decision. LY2157299 solubility dmso Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients. (C) 2010 Elsevier Ltd. All rights reserved.”
“The intrinsic stress of carbon thin films deposited by filtered cathodic arc was investigated as a function of ion energy and Ar background gas pressure. The microstructure of the films was

analyzed using transmission electron microscopy, electron energy loss spectroscopy, and Raman spectroscopy. The stress at given substrate bias was reduced by the presence of an Ar background gas and by the

presence of a Cu underlayer deposited onto the substrate prior to deposition. Auger electron spectroscopy depth profiles showed no evidence of Ar incorporation into the films. A sharp transition from a sp(2) to sp(3) rich phase was found to occur at a stress of 6.5 +/- 1.5 GPa, independent of the deposition conditions. The structural transition at this value of stress is consistent with available data taken from the literature and also with the expected value of biaxial stress at the phase boundary between graphite and diamond at room temperature. The microstructure of films with stress in the transition LY411575 inhibitor region near 6.5 GPa was consistent with a mixture of sp(2) and sp(3) rich structures.”
“Adverse events in surgery have highlighted the importance of non-technical skills, such as communication, decision-making, teamwork, situational awareness and leadership, to effective organizational performance. These skills carry particular importance to surgical oncology, as members of a multidisciplinary team must work cohesively to formulate effective patient care plans. Several non-technical skills evaluation tools have been developed for use in surgery, without adequate comparison and consensus on which should be standard for training.