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Postoperative pain management: Number-needed-to-treat approach versus procedure-specific pain management approach

Joshi, Girish P ; Schug, Stephan A ; Bonnet, Francis ; Fischer, H.B.J ; Neugebauer, Edmund A.M ; Rawal, Narinder ; Simanski, Christian J.P ; Kehlet, Henrik The Prospect Working Group (Corporate Author)

Pain, January 2013, Vol.154(1), pp.178-179 [Peer Reviewed Journal]

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Guidelines for perioperative pain management: need for re-evaluation

Joshi, G.P ; Kehlet, H ; Beloeil, H ; Bonnet, F ; Fischer, B ; Hill, A ; Joshi, G.P ; Kehlet, H ; Lavandhomme, P.M ; Lirk, P ; Pogatzki-Zhan, E.M ; Raeder, J ; Rawal, N ; Schug, S ; Van de Velde, M on Behalf of the Prospect Working Group (Corporate Author)

British Journal of Anaesthesia, October 2017, Vol.119(4), pp.720-722 [Peer Reviewed Journal]

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Welche orthopädischen Schmerzreduktionsmaßnahmen sind nach Hüft -TEP-Implantation gesichert? Eine systematisches Review nach dem Cochrane Protokoll

Simanski, C.J.P. ; Fischer, B.J. ; Jaschinski, T. ; Eikermann, M. ; PROSPECT Working Group Deutsche Gesellschaft für Unfallchirurgie ; Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie ; Berufsverband der Fachärzte für Orthopädie 2011

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APPENDIX B

Chief Judge Procter Hug, Jr.   I now have had an opportunity to carefully study the Report ; to receive memoranda ; comments from many of the judges ; lawyers, ; I thought it would be helpful to give my evaluation of the Report. The Report recommends that the Ninth Circuit not be split ; does acknowledge some important goals ; objectives.Some conclusions by the Commission are particularly important:There is one principle that we regard as undebatable: It is wrong to realign circuits (or not realign them), ; to restructure courts (or leave them alone) because of particular judicial decisions or particular judges. This rule must be faithfully honored, for the independence of the judiciary is of constitutional dimension ; requires no less.Any realignment of the circuits would deprive the west coast of a mechanism for obtaining a consistent body of federal appellate law, ; of the practical advantages of the Ninth Circuit administrative structure.Having a single court interpret ; apply federal law in the western United States, particularly the federal commercial ; maritime laws that govern relations with other nations on the Pacific Rim, is a strength of the circuit that should be maintained.The Commission also recommends some experimental innovations that could reduce the burden on the courts of appeals, such as district court appellate panels, two-judge circuit court of appeals panels, possible discretionary review of certain cases, ; the possible transfer of certain appeals to the Federal Circuit. The Commission also pointed out the additional burden on the courts of appeals if the Bankruptcy Commission's recommendation for direct appeals from the bankruptcy courts to the courts of appeals were adopted, ; recommended legislation to preserve the participation of the Bankruptcy Appellate Panels (BAP).The difficulty I find is with the recommendation that Congress enact a statute requiring the Ninth Circuit to adopt very specific adjudicatory divisions, composed in very specific ways, with significant changes in stare decisis rules ; en banc functions, rather than letting the circuit have the flexibility to achieve the objectives identified by the Commission in less disruptive ways. The Ninth Circuit has always been willing to reexamine its procedures ; to experiment in working out better methods of operation. The Commission has identified the Ninth Circuit as an experimental model for how a large circuit can best operate. Allowing the Ninth Circuit to work out the objectives of the Commission with flexibility, rather than a rigid statutory divisional structure, would provide the best model for the future. It also would not saddle the Ninth Circuit during the seven-year experimental period with a structure that gives up a proven successful process for intangible benefits that could be better achieved in less disruptive ways.Although the Commission does not recommend a split of the Ninth Circuit for administrative purposes, its draft recommendation goes very far in splitting the more-vital adjudicative functions to be performed within the circuit. The present recommendation is that Congress enact a statute, organizing the Ninth Circuit Court of Appeals into three regionally based adjudicative divisions, each division with a majority of its judges resident in its region but providing that judges from other regions will be assigned into the regional division. Each division is to have its exclusive jurisdiction over appeals from judicial districts within that division. Each division would function as a virtually autonomous decisional unit. There is no unifying circuit-wide en banc structure to maintain uniformity of the circuit decisions or to resolve questions of exceptional importance, as has been the traditional function of an en banc court under Rule 35 of the Federal Rules of Appellate Procedure. Instead, there are divisional en bancs, which will finally resolve for the division, all issues that do not conflict with another division's cases. Any further review of those determinations would be by the United States Supreme Court. The unifying adjudicative structure is designated as the Circuit Division, which is designed to resolve only conflicts between divisions. This Circuit Division panel is composed of seven judges, the Chief Judge, the presiding judge from each division, ; one other judge from each division. Thus, the traditional unifying function of an en banc court does not take place unless a conflict has been generated between the divisions. This unnecessarily complicates the adjudicative process, significantly deters the rational development of circuit law, ; presents particular problems for the State of California, which is divided into two divisions. The motivation for this adjudicative structure seems to be to accomplish three major objectives:1. To have a greater territorial connection between the judges deciding the appeals in the territory from which the appeals come.2. To allow for a smaller group of judges to work together as a court in developing the law applicable to a particular area of the country.3. To have more careful monitoring of the opinions of panels within the division, particularly to adopt the pre-filing review procedures that are used in some of the smaller circuits around the country.In my view, these objectives could be accomplished, to a large extent, in much less intrusive ways, which would not impinge upon the development ; maintenance of a consistent body of law throughout the circuit, ; without creating another tier of review with the attendant delay ; expense that would be involved.This virtually autonomous divisional structure was adopted despite the overwhelming support of the judges ; lawyers within our Ninth Circuit for the adjudicative structure that we have in place. This approval is confirmed by the survey of the judges of our court with 70% of the circuit judges ; 68% of the district judges opposing restructuring of the circuit. There was virtually no advocacy for divisions within the Ninth Circuit, although suggestions were made by Chief District Judge Terry Hatter ; attorney Sanford Svetcov about possible divisions. Neither of their suggestions would operate at all in the fashion suggested by the Commission Report.One might ask how the Commission arrived at this particular division of the circuit into these virtually autonomous divisional units. I think it is instructive to review the report of Professor John Oakley, who was asked to prepare a paper on this subject for the Commission. It discusses the California ; other state appellate systems. Sections III ; IV of that report discuss recent proposals for divisional organization of the Ninth Circuit. The paper discusses the proposals of Judge Weis, Sanford Svetcov, Professor Meador, ; Professor Oakley.These proposals differ significantly from the one adopted by the Commission, as I later discuss. The major differences are: they propose a circuit-wide stare decisis, an en banc process that deals with both conflict ; error correction, ; assignment of out-of-division judges to division panels, rather than long-term assignments as members of the division.I think it is important to note that Professor Oakley, after reviewing the other proposals, states in his Concluding Proposal the following:   3. In general, I share the perception of the majority of the judges of the Ninth Circuit that a large circuit of 20 or more judges can maintain a reasonable degree of collegiality ; consistency of decision, ; that the Ninth Circuit has to date been a successful experiment in the cohesive operation of such a large circuit. But I am skeptical that there is no outer limit to the practicable size of a single circuit, ; that this outer limit, whatever it may be, is indifferent to whether a circuit's adjudicative functions are divisionally organized.   Thus, in Professor Oakley's view, this divisional structure of the court of appeals is not necessary because of any deficiency in the operation of the Ninth Circuit, but rather is a experimental model that could be tried by the Ninth Circuit as a possible structure for it ; other circuits to try as the case load ; need for other judges grow. He also expresses the view that this might encourage other circuits that are taking unacceptable case loads per judge to avoid their fear of asking for additional judges because the court would be too large.From my viewpoint, the Ninth Circuit has been conducting an experiment with a large court, which Professor Oakley acknowledges has been successful, with the use of the limited en banc process. The Ninth Circuit has never been adverse to new ideas or new approaches to more effective case management or to special concerns with its operational procedures. Our view ; the view of a great majority of the judges ; lawyers in our circuit is that the experiment, as we have developed it, has worked very successfully. However, because of the criticisms ; perceived problems that are sought to be remedied by this divisional approach, I think that, we as the Ninth Circuit, should attempt to address the Commission's suggested improvements. If we are to be an experimental model for the country, we should be allowed much greater flexibility in determining how best a large circuit can operate. Major motivations for this divisional approach are as follows ; their objectives could be accommodated as I indicate.1. Appeals from a Particular Region to be Heard Principally by Judges from that Region. This could be accommodated by panels in a division being constituted with two judges from the region ; one judge from without. This would involve the great majority of the decisions that affect the area. The small percentage of cases that are taken en banc, as I later propose, would be before a limited enbanc panel that would have equal representation on the panel from the divisions.2. More Careful Monitoring of Panel Decisions, Perhaps Before They are Filed. This could ...

U.C. Davis L. Rev., Vol.34 pp.513-1129, 2000

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  7. the ultimate filing date of the opinion could be extended by a few days.3. Improvement of the Limited En Banc Process. There has been expression that the number of judges on our limited en banc court is too small. This number could be increased to 13 or 15 judges. If it were to be 13 judges, it could be 4 judges from each division, with the Chief Judge presiding. If it were to be 15 judges, it could be 5 judges from each division, with the presiding officer to be the senior active judge. Other suggestions have been made for improving the en banc process that could be adopted. For example, some judges have suggested frustration with having been the judge that did a great deal of work in calling for the en banc, but not being selected on the en banc court. Judge Hawkins suggests that the author of the panel opinion  (1)
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  16. expense that would be involved.This virtually autonomous divisional structure was adopted despite the overwhelming support of the judges  (1)
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