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To establish agreement among nationwide experts through a Delphi process on the key components of perioperative ultrasound and the recommended minimum number of examinations that should be performed by a resident upon graduation.A prospective cross-sectional study.A survey on multiinstitutional academic medical centers.Anesthesiology residency program directors and/or experts in perioperative ultrasound.A list of components and examinations recommended for anesthesiology resident training in perioperative ultrasound was developed based on guidelines and 2 survey rounds among a steering committee of 10 experts. A questionnaire asking for a rating of each component on a 5-point Likert scale subsequently was sent to an expert panel of 120 anesthesiology residency program directors across the United States. An agreement of at least 70% of participants, rating a component as 4 or 5, was compulsory to list a component as essential for anesthesiology resident training in perioperative ultrasound.The nationwide survey's response rate was 62.5%, and agreement was reached after 2 Delphi rounds. The final list included 44 essential components for basic ultrasound physics and knobology, cardiac ultrasound, lung ultrasound, and ultrasound-guided vascular access. Agreement was not reached for abdominal ultrasound, gastric ultrasound, and ultrasound-guided airway assessment. Agreement for the recommended minimum number of examinations that should be performed by a resident upon graduation included 50 each for transthoracic and transesophageal echocardiography, and 20 each for lung ultrasound, ultrasound-guided central line, and ultrasound-guided arterial line placements.The recommendations outlined in this survey can be used to establish standardized training for perioperative ultrasound by anesthesiology residency programs.

Background The transition from internship to clinical anesthesiology (CA) training is often difficult given the differences in workflow, procedures, environment, and clinical situations. The primary aims of this study were to determine if a standardized introductory bootcamp could improve clinical knowledge and self-perceived comfort level of new anesthesiology residents in performing common operating room procedures and management of common intraoperative problems. The secondary aim of the study was to see if a standardized bootcamp could be replicated at other programs. Methods The introduction to anesthesiology resident bootcamp was developed at one institution in 2015 then expanded to a second program in 2019. The bootcamp was a one-day experience consisting of simulation and task trainers that all rising first-year CA residents (CA-1) participated in during their first month of anesthesiology training. All participating residents were given a survey immediately before and after the bootcamp. The average ratings of the questions were calculated and used as the primary measure. The Anesthesia Knowledge Test (AKT) was used as a surrogate measure of participant knowledge. Results From 2015 to 2020, a total of 105 residents completed the pre-survey and 109 completed the post-survey across the two sites. The improvement in average rating was significant (Pre: 2.04±0.46 versus Post: 3.09±0.52 p0.0001). Individual item analysis also showed significant improvement on all of the eight items (p0.0001). Analyses by site revealed the same results at both average score and item level. There was no significant cohort difference in either AKT-0 (Control: 57.84±26.86 versus Intervention 50.13±25.14, p=0.14) or AKT-1 (Control: 41.06±26.42 versus Intervention 41.70±26.60, p=0.90) percentile scores. Conclusions Incorporation of an introduction to anesthesia bootcamp for new residents significantly improves participant comfort level and is reproducible across institutions. However, it does not improve resident performance on standardized tests.

As a species, human beings are free-riders incentivized to adopt ‘rational’ short-term measures that assure long-term ecocide given increasing uncertainty due to the increasing speed of high-tech powered globalization. The financial crisis and displacement of employment by technological advances reinforce momentary opportunism. Policy-makers often frame ecopreneurship as a short-term solution for creating ‘green jobs’, with the potential to alleviate the environmental and unemployment crises simultaneously. Globalization has resulted in increasing public uncertainty and anxiety challenging overwhelmed state budgets and requiring supplementary individual investments. Understandable short-term ‘rent-seeking’ must be co-opted by firm green public policies transforming unbridled ‘casino capitalism’ into a regulated ‘green casino’, channeling inevitable human speculation and free-rider behavior toward sustainability. Ecopreneurship in this context is a Sisyphus ‘green-green’ job-creating process, a realistic, ...

Taking Silicon Valley as a “Weberian ideal type” of high-tech development, one can derive 10 key characteristics which together can be used to measure to what extent other regions of the world have been able to duplicate this “hot spot” of economic transformation. Comparisons of such synergistic entrepreneurship are illustrated by the case of Sophia Antipolis in France, characterized by initial large company involvement, a utopian environmental design by Pierre Laffitte and the process of high-tech innovation among small and medium-sized companies, particularly in the telecommunication sector.

This paper argues that the critical dynamic in creating the perception of an “economic miracle” is to target collective learning processes upon applied economic objectives that coordinate internal factors with external opportunities in order to position a nation to catch waves of global economic growth. Using annual GDP growth statistics over the past 50 years and the percent of GDP that goes for investment, “economic miracle” countries are identified, then characterized. Such countries have experienced one, two or three “waves” of extraordinary economic performance. External and internal factors which accompany economic miracles are identified, and related. “Post-authoritarian stability” is one internal condition often found in economic miracle countries. Key steps that need to be taken in order to engineer an “economic miracle” based on what past miracles have had in common are summarized. But these growth recipes are offset with illustrations of potential opportunity costs in terms of social and ecological responsibility and sustainable development.

The article reports on a study relating to export intermediation by trading firms in France. Researchers found that trading firms handled a greater percentage of French exports going to countries within the Latin European cluster than exports bound for countries in the Germanic and Anglo clusters. The percentage of French exports handled by intermediaries was three times as high as when exports were bound for non-French-speaking countries. The results indicated that the higher the commodity content of their products the more likely French companies were to use export intermediaries.