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Accurate Needle Insertion and Tissue Sampling in Biopsy

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Mechanics of Needle Insertion in Soft Tissues

• October 2022
• Conference: Society of Engineering Science Annual Technical Meeting (SES 2022)
• At: Texas A&M, College Station, Texas

• Temple University

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Ubc theses and dissertations, mechanics of needle insertion and deep penetration in soft solids fregonese, stefano --> -->.

This thesis examines the mechanical problem of piercing a soft solid body with a needle. This process is initiated by the critical condition of needle insertion and continued by deep penetration. This work describes both phenomena, in relation to material properties and needle size, with simple mechanical models and compares them against experiments. Needle insertion is characterized by physical and geometrical nonlinearities and a complex failure mechanism. To overcome the complexity of the problem, needle insertion is modelled as a sharp transition between two needle-specimen configurations, namely ‘indentation’ and ‘penetration’. The configurational transition is driven by minimum energy, where ’penetration’ becomes favoured over ’indentation’ at larger depths. The mechanism of penetration is strongly influenced by friction and adhesion, which provide a linear increase in penetration force with needle tip depth. This thesis finally reports some experimental observations related to the above phenomena, with some discussions about the stability of needle penetration.

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Permanent URL: https://dx.doi.org/10.14288/1.0421022

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Tissue cutting mechanics of dynamic needle insertion

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• v.8(2); 2019 Feb

Study of needle stick injuries among healthcare providers: Evidence from a teaching hospital in India

Shyamkumar sriram.

1 Department of Health Services Policy and Management, University of South Carolina, Columbia, South Carolina, USA

Background:

Needle stick injuries (NSIs) are the injuries that are caused by needles, such as hypodermic needles, blood collection needles, intravenous stylets, and needles used to connect parts of intravenous delivery systems. NSIs are very common and in many instances unavoidable among healthcare providers when they are delivering patient care. Around 75% of the NSIs in developing countries are not reported. This study aimed to estimate the prevalence and other correlates and attributes of NSIs among healthcare providers in a tertiary care teaching hospital in South India.

This is a cross-sectional study conducted in Narayana Medical College and Hospital in Nellore, Andhra Pradesh, between June 2012 and February 2013. Data using a structured questionnaire were collected among all the 1525 healthcare providers working in the teaching hospital.

Around 10.81% of the total healthcare providers in the teaching hospital were exposed to NSIs. Syringe needles (75%) were the most common devices leading to NSIs. Majority of NSIs took place in the wards of the different departments (75%). Morning shift (70%) was the most common time of the day for the occurrence of NSIs. Only 65% of the healthcare providers were wearing gloves at the time of injury. Majority (82%) took immediate treatment after NSIs.

Conclusions:

Establishment of formal reporting mechanisms, immediate reporting of NSIs, and the establishment of a comprehensive NSI prevention program will help in the reduction in the occurrence of NSIs and help in taking immediate remedial action in the form of prophylaxis and treatment.

Introduction

Needle stick injuries (NSIs) are the injuries that are caused by needles such as hypodermic needles, blood collection needles, intravenous stylets, and needles used to connect parts of intravenous delivery systems.[ 1 ] NSIs are very common and in many instances unavoidable among healthcare providers when they are delivering patient care. In the healthcare sector, NSIs are one of the most preventable occupational hazards among healthcare providers.[ 2 ] Centers for Disease Control (CDC) of the United States of America estimated that exposure to blood and body fluids by sharps and NSIs affect around three million health workers annually with an estimated occurrence of six million NSIs every year.[ 3 ] The occupational exposures to NSIs are considered to be much higher in the developing world and much of the cases are not even reported.[ 4 ] It is expected that around 75% of the NSIs in developing countries are not reported.[ 4 ] Globally, there is gross under-reporting of NSI with the actual incidence of NSIs being much higher than those reported.[ 5 ] Healthcare institutions must be careful not to interpret or understand the low reporting rate as low rate of injury. Studies have shown that the NSIs that are reported through the normal hospital reporting systems are underreported to the extent of 10 times lower in many instances.[ 6 ]

NSIs lead to a risk of developing various types of infections and healthcare providers are always under serious threat. The main problem because of underreporting of NSIs is that the people who are exposed could not be given postexposure prophylaxis (PEP) at appropriate time to prevent the development of infection in the person who has experienced NSI. For example, PEP for HIV is shown to be 80% effective in preventing the development of the infection.[ 7 ] The risk of transmission of blood-borne infections, such as Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV), are common in NSIs, and thus, safety practices and guidelines must be practiced by all healthcare providers to protect themselves from infection.[ 2 ] The risk of infection for different diseases varies highly. Due to NSI the risk of infection varies from 0.5% to 40% for HIV and HBV infections, respectively.[ 8 ]

There is evidence of best practices that should be followed to avoid NSIs. However, the knowledge about them among the healthcare providers and their implementation seems to be very less. Although published evidence recommend that contaminated needles should not be recapped, but studies from developed countries, such as the United States, showed that recapping of needles is occurring commonly among the healthcare workers.[ 3 , 9 ] There are no national reporting systems for NSIs in India, but a report in 2006 showed that around 63% of the 3–6 billion injections given every year are unsafe.[ 10 ] NSIs have the potential to affect the health system both directly and indirectly. In developing countries with limited human resources for health, there are higher restrictions in the number of available doctors and nurses. NSIs and other health-related occupational injuries affect the health services provided by increasing the number of work days lost due to injuries and the emotional distress, which are caused to the healthcare providers due to NSIs.[ 11 ]

The Ministry of Health and Family Welfare of the Government of India recommends that the healthcare providers must be made aware of the safety precautions that must be followed for the prevention of NSIs. Adequate training to the healthcare workers to handle the sharp objects is also equally vital.[ 12 ] In addition to provision of information to healthcare providers and adequate training to them, effective reporting systems should be placed in all healthcare facilities for early reporting of cases and immediate actions to be taken to address the issue by providing adequate PEP and treatment.[ 12 ] PEP can be initiated only if there is adequate and fast reporting of data. Some institutions in India maintain a staff health service facility, which registers all cases of NSIs and holds a record for them and have safety protocols in place to manage them and adequately monitor if the cases are being reduced.[ 12 ] Safety protocols should be always in place in all hospitals and healthcare facilities to prevent the risk of NSIs and for the enforcement of safety precautions and immediate actions to be taken in the case of any exposures.[ 12 ] There are limited data about the prevalence and attributes of NSIs in the different healthcare settings in India. This study aimed to estimate the prevalence, other correlates, and attributes of NSIs among the healthcare providers in a tertiary care teaching hospital in South India.

This is a cross-sectional study conducted in Narayana Medical College and Hospital in Nellore, Andhra Pradesh, India, between June 2012 and February 2013. A structured questionnaire was developed for the study and it was pretested before the study. The questionnaire was distributed among all the 1525 healthcare providers working in the teaching hospital in various locations of the hospital, namely, wards of the different medical and surgical departments, intensive care units (ICUs), operation theatres, outpatient departments, and in the outpatient sample collection center. Healthcare providers included the physicians, staff nurses, operation theater personnel, and other support healthcare personnel. The study included both the full-licensed physicians, nurses, other support personnel working in the hospital, and also the medical, nursing, and other interns who were working under the supervisory advice of a fully licensed medical provider. A data enumerator was used to collect the data from the healthcare providers working in the hospital. Data regarding injuries by needle stick injuries including sharps such as cannulas, broken vials, and splashes on cuts, and mucous membranes by potentially infectious materials such as blood and other body fluids were collected. For the study, NSI was defined as “any cut or prick to the respondents by a needle previously used on a patient is work related and sustained within the hospital premises.”[ 11 ] Data were entered into computer-based spreadsheets and analyzed using SPSS software.

The results of the study showed that around 10.81% of the total healthcare providers in the teaching hospital were exposed to NSIs at work as shown in [ Table 1 ]. The area of the hospital where most of the NSIs took place were the ward and bedside of the different medical and surgical departments (75%), followed by the emergency department (9%), outpatient departments of various specialties (7%), ICU (5%), and followed by the procedure rooms of the different departments (4%). No NSI was observed in the operation theaters as shown in [ Table 2 ].

Needle stick injury (NSI) reported by healthcare providers

Area of the hospital where the needle-stick injury takes place

NSIs were caused by several different devices. Syringe needles (75%) were the most common devices leading to NSIs, followed by ampoule (12%), intravenous canula (10%), and suture needle (3%) [ Table 3 ]. The time of occurrence of NSIs were before procedure (30%), during procedure (40%), and after procedure (23%) [ Table 4 ]. The most common part of the body experiencing NSIs were fingers (93%), other parts of the hand without fingers (5%), and other parts of the arm except the hand (2%) [ Table 5 ].

Device leading to injury

Time of occurrence of needle stick injuries

Parts of the body experiencing needle stick injuries

The most type of injury was pricks (98%), followed by cut (2%) [ Table 6 ]. Morning shift (70%) was the most common time of the day wherein NSIs are taking place, followed by evening shift (15%), and night shifts (5%) having the lowest number of NSIs [ Table 7 ]. The knowledge about NSIs and the preparedness and prophylactic measures for NSIs were studied using several criteria. Around 65% of the health workers were wearing gloves at the time of injury, but only 18% of the health workers stopped procedure immediately to take care of the injury, and majority 58% of them informed superiors regarding the incident, and most of them (82%) took precautions and treatment after NSIs. Around 90% of them immune status checked after the injury, and most of the healthcare providers (90%) were aware of the steps to be followed after injury. Around 17% of the healthcare providers left work immediately after the injury as shown in Table 8 .

Nature of the injury

Work shift and needle stick injuries

Knowledge, Prophylactic measures and Preparedness to tackle Needle Stick Injuries

The results of our study showed that around 10.81% of the total healthcare providers were exposed to NSIs at work. Studies done in India showed that the prevalence of NSIs among healthcare workers was between 57% and 73%.[ 13 , 14 ] Various studies done internationally showed different prevalence of NSIs. A study in Pakistan showed that the prevalence of NSIs was 54.2%,[ 15 ] 63.3% in Iran,[ 16 ] and 74% in Saudi Arabia.[ 17 ] This shows that the prevalence of NSIs in our study was much lesser compared with other studies done both in India and internationally. In our study, the area of the hospital where most of the NSIs took place were the ward and bedside of the different medical and surgical departments, followed by the emergency department, outpatient departments of various specialties, ICU, and followed by the procedure rooms of the different departments. No NSIs were observed in the operation theaters. A study done in North India showed that the most common area where NSIs occurred were the emergency wards and ICUs.[ 4 ] Some studies showed that operation theaters were the most common areas where NSIs occurred.[ 11 , 18 ] Another study showed findings consistent with the findings of our study that medical and surgical wards were the common areas where NSIs occurred.[ 19 ]

NSIs were caused by several different devices. In our study, the common type of devices causing NSIs are syringe needles, followed by ampoule, intravenous canula, and suture needle. Other studies showed that the most common device causing NSIs was the hollow bore needles, followed by suturing needle.[ 13 , 20 , 21 ] Some studies showed that majority of NSIs occurred during sharps disposal.[ 21 ] The findings of our study are consistent with the findings of other studies. In our study, majority of the healthcare providers were wearing gloves at the time of injury. A study in Iran showed that around 74% were using gloves when they experienced NSIs.[ 22 ] Another study in India showed that around 39% were not wearing gloves at the time of NSIs.[ 13 ] Although the findings of our study show that significant number of healthcare providers were wearing gloves at the time of NSIs, still the proportion is lesser compared with the studies done in other countries. In our study, 58% of healthcare providers informed superiors regarding the occurrence of NSI. Another study in India showed that around 85% of the health workers did not report NSIs and the reporting was lowest among doctors.[ 13 ] Another study showed that around 32% of the health workers reported NSIs to their superiors in the hospital.[ 21 ] Another study in Iran showed that around 82% of all NSIs went unreported.[ 23 ] A study in Malaysia showed that only 40.8% of NSIs were reported.[ 24 ] Although the proportion of healthcare providers who reported the NSIs to their superiors were relatively higher compared with other studies done in different parts of the world, but still huge gaps exist in the reporting of NSIs with around 42% of the NSIs going unreported.

In our study, the majority (82%) of healthcare providers took prophylaxis and treatment after NSIs. A study in India showed that only around 3% of healthcare providers experiencing NSIs took PEP for HIV,[ 21 ] while another study in India showed that around 21.6% of healthcare providers took PEP for HIV after having an NSI.[ 25 ] Another study from India showed that around 62.8% the doctors working in a hospital did not have information about the availability of HIV PEP in the hospital.[ 26 ] The results of our study show that the high proportion of the healthcare providers in the study hospital took PEP after NSIs and this was higher compared with other studies done in India.

Conclusions

Prevention of NSIs is vital for the practice of family physicians including primary care providers who provide injections in their clinics and other outpatient services. Evidence obtained from this study will be particularly useful for them in their area of work and protect them NSIs if they take the adequate precautions. Preventing NSIs is the most effective way to protect healthcare providers including family physicians from the infectious diseases that are transmitted by accidents due to injury by needle sticks. The prevalence of NSIs in our study was relatively lesser compared with other studies done in India and internationally, but steps needed to be taken to prevent the occurrence of NSIs and early prophylaxis and treatment of every single case of NSI. Adequate preventive care protocols need to be established in the medical and surgical wards where most of the NSIs are taking place. Specific information should be provided to all healthcare providers regarding the care that should be taken during provision of injections and recapping of needles, since they constitute the highest proportion of NSIs in the hospital. Protocols for immediate formal reporting of NSIs need to be established in the hospital and this will address the gaps in reporting of NSIs. Immediate reporting of NSIs will help in the early initiation of post-PEP and treatment. It is important to have a comprehensive NSI prevention program in the hospital that includes employee training, safe recapping procedures, and effective surveillance.

Limitations

Primary data for the study were collected from the individual healthcare providers in the hospital. There are possibilities of recall bias and social desirability bias.

Ethical approval

The study was approved by the Institutional Ethics Committee of Narayana Medical College, Nellore, Andhra Pradesh, India, and the Tamil Nadu Open University, Chennai, India.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

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BIOINSPIRED SURGICAL NEEDLE INSERTION MECHANICS IN SOFT TISSUES FOR PERCUTANEOUS PROCEDURES

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Dissertation Structure & Layout 101: How to structure your dissertation, thesis or research project.

By: Derek Jansen (MBA) Reviewed By: David Phair (PhD) | July 2019

So, you’ve got a decent understanding of what a dissertation is , you’ve chosen your topic and hopefully you’ve received approval for your research proposal . Awesome! Now its time to start the actual dissertation or thesis writing journey.

To craft a high-quality document, the very first thing you need to understand is dissertation structure . In this post, we’ll walk you through the generic dissertation structure and layout, step by step. We’ll start with the big picture, and then zoom into each chapter to briefly discuss the core contents. If you’re just starting out on your research journey, you should start with this post, which covers the big-picture process of how to write a dissertation or thesis .

*The Caveat *

In this post, we’ll be discussing a traditional dissertation/thesis structure and layout, which is generally used for social science research across universities, whether in the US, UK, Europe or Australia. However, some universities may have small variations on this structure (extra chapters, merged chapters, slightly different ordering, etc).

So, always check with your university if they have a prescribed structure or layout that they expect you to work with. If not, it’s safe to assume the structure we’ll discuss here is suitable. And even if they do have a prescribed structure, you’ll still get value from this post as we’ll explain the core contents of each section.  

Overview: S tructuring a dissertation or thesis

• Acknowledgements page
• Abstract (or executive summary)
• Table of contents , list of figures and tables
• Chapter 1: Introduction
• Chapter 2: Literature review
• Chapter 3: Methodology
• Chapter 4: Results
• Chapter 5: Discussion
• Chapter 6: Conclusion
• Reference list

As I mentioned, some universities will have slight variations on this structure. For example, they want an additional “personal reflection chapter”, or they might prefer the results and discussion chapter to be merged into one. Regardless, the overarching flow will always be the same, as this flow reflects the research process , which we discussed here – i.e.:

• The introduction chapter presents the core research question and aims .
• The literature review chapter assesses what the current research says about this question.
• The methodology, results and discussion chapters go about undertaking new research about this question.
• The conclusion chapter (attempts to) answer the core research question .

In other words, the dissertation structure and layout reflect the research process of asking a well-defined question(s), investigating, and then answering the question – see below.

To restate that – the structure and layout of a dissertation reflect the flow of the overall research process . This is essential to understand, as each chapter will make a lot more sense if you “get” this concept. If you’re not familiar with the research process, read this post before going further.

Right. Now that we’ve covered the big picture, let’s dive a little deeper into the details of each section and chapter. Oh and by the way, you can also grab our free dissertation/thesis template here to help speed things up.

The title page of your dissertation is the very first impression the marker will get of your work, so it pays to invest some time thinking about your title. But what makes for a good title? A strong title needs to be 3 things:

• Succinct (not overly lengthy or verbose)
• Specific (not vague or ambiguous)
• Representative of the research you’re undertaking (clearly linked to your research questions)

Typically, a good title includes mention of the following:

• The broader area of the research (i.e. the overarching topic)
• The specific focus of your research (i.e. your specific context)
• Indication of research design (e.g. quantitative , qualitative , or  mixed methods ).

For example:

A quantitative investigation [research design] into the antecedents of organisational trust [broader area] in the UK retail forex trading market [specific context/area of focus].

Again, some universities may have specific requirements regarding the format and structure of the title, so it’s worth double-checking expectations with your institution (if there’s no mention in the brief or study material).

Acknowledgements

This page provides you with an opportunity to say thank you to those who helped you along your research journey. Generally, it’s optional (and won’t count towards your marks), but it is academic best practice to include this.

So, who do you say thanks to? Well, there’s no prescribed requirements, but it’s common to mention the following people:

• Your dissertation supervisor or committee.
• Any professors, lecturers or academics that helped you understand the topic or methodologies.
• Any tutors, mentors or advisors.
• Your family and friends, especially spouse (for adult learners studying part-time).

There’s no need for lengthy rambling. Just state who you’re thankful to and for what (e.g. thank you to my supervisor, John Doe, for his endless patience and attentiveness) – be sincere. In terms of length, you should keep this to a page or less.

Abstract or executive summary

The dissertation abstract (or executive summary for some degrees) serves to provide the first-time reader (and marker or moderator) with a big-picture view of your research project. It should give them an understanding of the key insights and findings from the research, without them needing to read the rest of the report – in other words, it should be able to stand alone .

For it to stand alone, your abstract should cover the following key points (at a minimum):

• Your research questions and aims – what key question(s) did your research aim to answer?
• Your methodology – how did you go about investigating the topic and finding answers to your research question(s)?
• Your findings – following your own research, what did do you discover?
• Your conclusions – based on your findings, what conclusions did you draw? What answers did you find to your research question(s)?

So, in much the same way the dissertation structure mimics the research process, your abstract or executive summary should reflect the research process, from the initial stage of asking the original question to the final stage of answering that question.

In practical terms, it’s a good idea to write this section up last , once all your core chapters are complete. Otherwise, you’ll end up writing and rewriting this section multiple times (just wasting time). For a step by step guide on how to write a strong executive summary, check out this post .

Need a helping hand?

Table of contents

This section is straightforward. You’ll typically present your table of contents (TOC) first, followed by the two lists – figures and tables. I recommend that you use Microsoft Word’s automatic table of contents generator to generate your TOC. If you’re not familiar with this functionality, the video below explains it simply:

If you find that your table of contents is overly lengthy, consider removing one level of depth. Oftentimes, this can be done without detracting from the usefulness of the TOC.

Right, now that the “admin” sections are out of the way, its time to move on to your core chapters. These chapters are the heart of your dissertation and are where you’ll earn the marks. The first chapter is the introduction chapter – as you would expect, this is the time to introduce your research…

It’s important to understand that even though you’ve provided an overview of your research in your abstract, your introduction needs to be written as if the reader has not read that (remember, the abstract is essentially a standalone document). So, your introduction chapter needs to start from the very beginning, and should address the following questions:

• What will you be investigating (in plain-language, big picture-level)?
• Why is that worth investigating? How is it important to academia or business? How is it sufficiently original?
• What are your research aims and research question(s)? Note that the research questions can sometimes be presented at the end of the literature review (next chapter).
• What is the scope of your study? In other words, what will and won’t you cover ?
• How will you approach your research? In other words, what methodology will you adopt?
• How will you structure your dissertation? What are the core chapters and what will you do in each of them?

These are just the bare basic requirements for your intro chapter. Some universities will want additional bells and whistles in the intro chapter, so be sure to carefully read your brief or consult your research supervisor.

If done right, your introduction chapter will set a clear direction for the rest of your dissertation. Specifically, it will make it clear to the reader (and marker) exactly what you’ll be investigating, why that’s important, and how you’ll be going about the investigation. Conversely, if your introduction chapter leaves a first-time reader wondering what exactly you’ll be researching, you’ve still got some work to do.

Now that you’ve set a clear direction with your introduction chapter, the next step is the literature review . In this section, you will analyse the existing research (typically academic journal articles and high-quality industry publications), with a view to understanding the following questions:

• What does the literature currently say about the topic you’re investigating?
• Is the literature lacking or well established? Is it divided or in disagreement?
• How does your research fit into the bigger picture?
• How does your research contribute something original?
• How does the methodology of previous studies help you develop your own?

Depending on the nature of your study, you may also present a conceptual framework towards the end of your literature review, which you will then test in your actual research.

Again, some universities will want you to focus on some of these areas more than others, some will have additional or fewer requirements, and so on. Therefore, as always, its important to review your brief and/or discuss with your supervisor, so that you know exactly what’s expected of your literature review chapter.

Now that you’ve investigated the current state of knowledge in your literature review chapter and are familiar with the existing key theories, models and frameworks, its time to design your own research. Enter the methodology chapter – the most “science-ey” of the chapters…

In this chapter, you need to address two critical questions:

• Exactly HOW will you carry out your research (i.e. what is your intended research design)?
• Exactly WHY have you chosen to do things this way (i.e. how do you justify your design)?

Remember, the dissertation part of your degree is first and foremost about developing and demonstrating research skills . Therefore, the markers want to see that you know which methods to use, can clearly articulate why you’ve chosen then, and know how to deploy them effectively.

Importantly, this chapter requires detail – don’t hold back on the specifics. State exactly what you’ll be doing, with who, when, for how long, etc. Moreover, for every design choice you make, make sure you justify it.

In practice, you will likely end up coming back to this chapter once you’ve undertaken all your data collection and analysis, and revise it based on changes you made during the analysis phase. This is perfectly fine. Its natural for you to add an additional analysis technique, scrap an old one, etc based on where your data lead you. Of course, I’m talking about small changes here – not a fundamental switch from qualitative to quantitative, which will likely send your supervisor in a spin!

You’ve now collected your data and undertaken your analysis, whether qualitative, quantitative or mixed methods. In this chapter, you’ll present the raw results of your analysis . For example, in the case of a quant study, you’ll present the demographic data, descriptive statistics, inferential statistics , etc.

Typically, Chapter 4 is simply a presentation and description of the data, not a discussion of the meaning of the data. In other words, it’s descriptive, rather than analytical – the meaning is discussed in Chapter 5. However, some universities will want you to combine chapters 4 and 5, so that you both present and interpret the meaning of the data at the same time. Check with your institution what their preference is.

Now that you’ve presented the data analysis results, its time to interpret and analyse them. In other words, its time to discuss what they mean, especially in relation to your research question(s).

What you discuss here will depend largely on your chosen methodology. For example, if you’ve gone the quantitative route, you might discuss the relationships between variables . If you’ve gone the qualitative route, you might discuss key themes and the meanings thereof. It all depends on what your research design choices were.

Most importantly, you need to discuss your results in relation to your research questions and aims, as well as the existing literature. What do the results tell you about your research questions? Are they aligned with the existing research or at odds? If so, why might this be? Dig deep into your findings and explain what the findings suggest, in plain English.

The final chapter – you’ve made it! Now that you’ve discussed your interpretation of the results, its time to bring it back to the beginning with the conclusion chapter . In other words, its time to (attempt to) answer your original research question s (from way back in chapter 1). Clearly state what your conclusions are in terms of your research questions. This might feel a bit repetitive, as you would have touched on this in the previous chapter, but its important to bring the discussion full circle and explicitly state your answer(s) to the research question(s).

Next, you’ll typically discuss the implications of your findings . In other words, you’ve answered your research questions – but what does this mean for the real world (or even for academia)? What should now be done differently, given the new insight you’ve generated?

Lastly, you should discuss the limitations of your research, as well as what this means for future research in the area. No study is perfect, especially not a Masters-level. Discuss the shortcomings of your research. Perhaps your methodology was limited, perhaps your sample size was small or not representative, etc, etc. Don’t be afraid to critique your work – the markers want to see that you can identify the limitations of your work. This is a strength, not a weakness. Be brutal!

This marks the end of your core chapters – woohoo! From here on out, it’s pretty smooth sailing.

The reference list is straightforward. It should contain a list of all resources cited in your dissertation, in the required format, e.g. APA , Harvard, etc.

It’s essential that you use reference management software for your dissertation. Do NOT try handle your referencing manually – its far too error prone. On a reference list of multiple pages, you’re going to make mistake. To this end, I suggest considering either Mendeley or Zotero. Both are free and provide a very straightforward interface to ensure that your referencing is 100% on point. I’ve included a simple how-to video for the Mendeley software (my personal favourite) below:

Some universities may ask you to include a bibliography, as opposed to a reference list. These two things are not the same . A bibliography is similar to a reference list, except that it also includes resources which informed your thinking but were not directly cited in your dissertation. So, double-check your brief and make sure you use the right one.

The very last piece of the puzzle is the appendix or set of appendices. This is where you’ll include any supporting data and evidence. Importantly, supporting is the keyword here.

Your appendices should provide additional “nice to know”, depth-adding information, which is not critical to the core analysis. Appendices should not be used as a way to cut down word count (see this post which covers how to reduce word count ). In other words, don’t place content that is critical to the core analysis here, just to save word count. You will not earn marks on any content in the appendices, so don’t try to play the system!

Time to recap…

And there you have it – the traditional dissertation structure and layout, from A-Z. To recap, the core structure for a dissertation or thesis is (typically) as follows:

• Acknowledgments page

Most importantly, the core chapters should reflect the research process (asking, investigating and answering your research question). Moreover, the research question(s) should form the golden thread throughout your dissertation structure. Everything should revolve around the research questions, and as you’ve seen, they should form both the start point (i.e. introduction chapter) and the endpoint (i.e. conclusion chapter).

I hope this post has provided you with clarity about the traditional dissertation/thesis structure and layout. If you have any questions or comments, please leave a comment below, or feel free to get in touch with us. Also, be sure to check out the rest of the  Grad Coach Blog .

Psst... there’s more!

This post was based on one of our popular Research Bootcamps . If you're working on a research project, you'll definitely want to check this out ...

36 Comments

many thanks i found it very useful

Glad to hear that, Arun. Good luck writing your dissertation.

Such clear practical logical advice. I very much needed to read this to keep me focused in stead of fretting.. Perfect now ready to start my research!

what about scientific fields like computer or engineering thesis what is the difference in the structure? thank you very much

Thanks so much this helped me a lot!

Very helpful and accessible. What I like most is how practical the advice is along with helpful tools/ links.

Thanks Ade!

Thank you so much sir.. It was really helpful..

You’re welcome!

Hi! How many words maximum should contain the abstract?

Thank you so much 😊 Find this at the right moment

You’re most welcome. Good luck with your dissertation.

best ever benefit i got on right time thank you

Many times Clarity and vision of destination of dissertation is what makes the difference between good ,average and great researchers the same way a great automobile driver is fast with clarity of address and Clear weather conditions .

I guess Great researcher = great ideas + knowledge + great and fast data collection and modeling + great writing + high clarity on all these

You have given immense clarity from start to end.

Morning. Where will I write the definitions of what I’m referring to in my report?

Thank you so much Derek, I was almost lost! Thanks a tonnnn! Have a great day!

Thanks ! so concise and valuable

This was very helpful. Clear and concise. I know exactly what to do now.

Thank you for allowing me to go through briefly. I hope to find time to continue.

Really useful to me. Thanks a thousand times

Very interesting! It will definitely set me and many more for success. highly recommended.

Thank you soo much sir, for the opportunity to express my skills

Usefull, thanks a lot. Really clear

Very nice and easy to understand. Thank you .

That was incredibly useful. Thanks Grad Coach Crew!

My stress level just dropped at least 15 points after watching this. Just starting my thesis for my grad program and I feel a lot more capable now! Thanks for such a clear and helpful video, Emma and the GradCoach team!

Do we need to mention the number of words the dissertation contains in the main document?

It depends on your university’s requirements, so it would be best to check with them 🙂

Such a helpful post to help me get started with structuring my masters dissertation, thank you!

Great video; I appreciate that helpful information

It is so necessary or avital course

This blog is very informative for my research. Thank you

Doctoral students are required to fill out the National Research Council’s Survey of Earned Doctorates

wow this is an amazing gain in my life

This is so good

How can i arrange my specific objectives in my dissertation?

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Masters' Dissertation: 'The Needle & the Damage Done - Does the World Anti-Doping Code Sufficiently Protect the Rights of the Athlete?'

This dissertation examines the World Anti-Doping Agency’s harmonised set of anti-doping rules, known as the World Anti-Doping Code. The predominant focus of this study is the consequences which an athlete faces when confronted with the accusation that he or she has committed an anti-doping rule violation. The fundamental principles and rights as articulated in international human rights instruments, namely the European Convention on Human Rights and the International Covenant on Civil and Political Rights, will be referred to throughout this study and are the barometer for determining whether the rules of the Code sufficiently protect the rights of the athlete. The rationales which underpin the World Anti-Doping Code will be critically analysed and an informed assessment will be made as to whether the myriad of justifications for these harmonised set of anti-doping rules are sufficiently compelling in light of the affects that an anti-doping rule violation has on inter alia the livelihood and reputation of the athlete. This study affirms that the World Anti-Doping Code is neither justifiable in its current format nor does it sufficiently protect the rights of the modern athlete.

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In this article doping-related offenses entrenched in Art. 2.6, 2.7, 2.8 of current World Anti-Doping Code are investigated within the terms of standards and methods of proving as well as the comprehensive system of sanctioning. The subtleties as well as innovations of such research are inter alia related to the application of the certain principles of human rights/due process of law/natural justice. The methods of proving said violations and the sanctions entrenched for them are close to the methods and sanctions those of criminal justice. Consequently, it is stated that the more serious allegation is made, the stricter sanction is entrenched, the stricter proving standard is to be applied. From the theoretical point of view it is conveyed that disciplinary sanctions undoubtedly inflict suffering and are both deterrent as well as retributive. CAS jurisprudence stipulates that harsh penalties within the World Anti-Doping Code could be consistent with human rights/due process of law/natural justice as long as there are clauses dealing with the problem of fault/intent and allowing for the elimination or reduction of the ineligibility periods. Such clauses pave the way for judicial discretion and, therefore, it is still an open question whether the anti-doping policy will turn itself into punitive one or, vice versa, to the policy which carefully takes into consideration each separate case with its own peculiarities.

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The Unique Burial of a Child of Early Scythian Time at the Cemetery of Saryg-Bulun (Tuva)

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Pages:  379-406

In 1988, the Tuvan Archaeological Expedition (led by M. E. Kilunovskaya and V. A. Semenov) discovered a unique burial of the early Iron Age at Saryg-Bulun in Central Tuva. There are two burial mounds of the Aldy-Bel culture dated by 7th century BC. Within the barrows, which adjoined one another, forming a figure-of-eight, there were discovered 7 burials, from which a representative collection of artifacts was recovered. Burial 5 was the most unique, it was found in a coffin made of a larch trunk, with a tightly closed lid. Due to the preservative properties of larch and lack of air access, the coffin contained a well-preserved mummy of a child with an accompanying set of grave goods. The interred individual retained the skin on his face and had a leather headdress painted with red pigment and a coat, sewn from jerboa fur. The coat was belted with a leather belt with bronze ornaments and buckles. Besides that, a leather quiver with arrows with the shafts decorated with painted ornaments, fully preserved battle pick and a bow were buried in the coffin. Unexpectedly, the full-genomic analysis, showed that the individual was female. This fact opens a new aspect in the study of the social history of the Scythian society and perhaps brings us back to the myth of the Amazons, discussed by Herodotus. Of course, this discovery is unique in its preservation for the Scythian culture of Tuva and requires careful study and conservation.

Keywords: Tuva, Early Iron Age, early Scythian period, Aldy-Bel culture, barrow, burial in the coffin, mummy, full genome sequencing, aDNA

Information about authors: Marina Kilunovskaya (Saint Petersburg, Russian Federation). Candidate of Historical Sciences. Institute for the History of Material Culture of the Russian Academy of Sciences. Dvortsovaya Emb., 18, Saint Petersburg, 191186, Russian Federation E-mail: [email protected] Vladimir Semenov (Saint Petersburg, Russian Federation). Candidate of Historical Sciences. Institute for the History of Material Culture of the Russian Academy of Sciences. Dvortsovaya Emb., 18, Saint Petersburg, 191186, Russian Federation E-mail: [email protected] Varvara Busova  (Moscow, Russian Federation).  (Saint Petersburg, Russian Federation). Institute for the History of Material Culture of the Russian Academy of Sciences.  Dvortsovaya Emb., 18, Saint Petersburg, 191186, Russian Federation E-mail:  [email protected] Kharis Mustafin  (Moscow, Russian Federation). Candidate of Technical Sciences. Moscow Institute of Physics and Technology.  Institutsky Lane, 9, Dolgoprudny, 141701, Moscow Oblast, Russian Federation E-mail:  [email protected] Irina Alborova  (Moscow, Russian Federation). Candidate of Biological Sciences. Moscow Institute of Physics and Technology.  Institutsky Lane, 9, Dolgoprudny, 141701, Moscow Oblast, Russian Federation E-mail:  [email protected] Alina Matzvai  (Moscow, Russian Federation). Moscow Institute of Physics and Technology.  Institutsky Lane, 9, Dolgoprudny, 141701, Moscow Oblast, Russian Federation E-mail:  [email protected]

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Communities of microorganisms and invertebrates in soil-like bodies of soccer fields in Moscow oblast

• Soil Biology
• Published: 06 November 2014
• Volume 47 , pages 1107–1115, ( 2014 )

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• O. V. Kutovaya 1 ,
• I. V. Zamotaev 2 &
• V. P. Belobrov 1  

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Artificially created soil-like technogenic formations (STFs) of soccer fields are developed under combined action of intense technogenic and natural factors and processes, which cannot but affect the structure and biological activity of their microbial communities and mesofauna. The microflora of the STFs is very similar to the microflora of the background soddy-podzolic soils of Moscow oblast with respect to the composition of the physiological groups of microorganisms. However, they are drastically different in their quantitative characteristics. The numbers of all the trophic groups of microorganisms, except for the microscopic fungi, in the STFs are much higher than those in the zonal soils. An increased biological activity of the STFs is due to regular watering, heating, application of sand and mineral fertilizers, and technogenic turbation processes. The mesofauna of the STFs is represented by several ecological groups of earthworms, including soildwelling (endogeic) earthworms ( Aporrectodea caliginosa ), epigeic earthworms dwelling at the soil-litter interface ( Lumbricus rubellus ), and litter-dwelling earthworms ( Eisenia foetida ).

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Original Russian Text © O.V. Kutovaya, I.V. Zamotaev, V.P. Belobrov, 2014, published in Pochvovedenie, 2014, No. 11, pp. 1315–1324.

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Kutovaya, O.V., Zamotaev, I.V. & Belobrov, V.P. Communities of microorganisms and invertebrates in soil-like bodies of soccer fields in Moscow oblast. Eurasian Soil Sc. 47 , 1107–1115 (2014). https://doi.org/10.1134/S1064229314110052

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Received : 25 February 2014

Published : 06 November 2014

Issue Date : November 2014

DOI : https://doi.org/10.1134/S1064229314110052

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However, this is just the upside case—businesses that don’t focus on initiatives to improve seller productivity will likely fail to see the growth they expected.

When did companies lose their focus on talent?

The pandemic and Great Resignation set off a chain of events in the business world. High job dissatisfaction in some sectors saw people quitting in droves. Some companies had to hire quickly just to fill the empty seats, so some paid less attention to who they were hiring. And since AI was on the rise, many turned to digital tools to enable their talent to do their jobs better.

Today, some of those companies are now realizing that no matter how much of the sales process is digitized and automated, they can’t "set it and forget it" when it comes to sales talent.

Why is talent at the center of growth?

SBI has worked with companies on thousands of projects to improve their go-to-market (GTM) performance and drive growth. From our experience, there are a few key observations that brought me to the conclusion that talent is crucial to a company’s growth—even more so than the GTM strategy or operating model:

1. Talent is one of the fastest ways to move the needle.

Let’s get this straight: optimal operating conditions, the best strategy and the right product-market fit ultimately make the largest impact on revenue growth, but these things take a long time before you see the returns. Today, there are many PE-backed portfolio companies that have been struggling in the slower economic conditions in the past year, and they’re all under pressure to make some decent returns quickly. Optimizing talent can be a faster way to get numbers high enough for the PE firms to make a respectable exit.

2. Great talent can make up for other shortcomings.

I’ve seen hundreds of companies that, by virtue of having the best salespeople in the market, were able to outperform competitors that had products superior to theirs. As I stated before, even without the best strategy or product-market fit, having the best talent will still help a company pull through.

3. The right talent profile can close bigger deals faster.

SBI recently conducted research on how different selling approaches fared in terms of average deal size and cycle times. The results were interesting—the most common approach, called narrowing (which focuses on driving buyer urgency), led to sales cycles 20% longer than the market average, performing the worst out of the four defined approaches. On the other hand, the best-performing approach not only resulted in sales cycles 12% shorter, but also deal sizes 11% larger.

This approach is defined by salespeople who can anticipate customer concerns in the buying process and reduce risk and prospect anxiety. Such a talent profile is well-equipped to perform well with current buying trends, where prospects are much more cautious in their decision-making.

4. The upside model may not bring results without a talent initiative.

Almost every growth-based value creation thesis I’ve seen assumes that each seller’s productivity increases over time. But when these companies don’t make it a point to have initiatives aimed at developing their talent, this assumption is less likely to come true. Without optimal seller productivity, companies may only achieve a fraction of the results they were hoping for.

So, where do we start to improve our talent?

First and foremost, CEOs would be doing their companies a favor by putting talent back at the forefront of their growth initiatives. Every company has a different starting point here, so it’s good to start by assessing their talent, identifying three to five of the most impactful skills and competencies present in their most successful sellers, and designing a comprehensive training plan to replicate these skills across the team.

Recent changes I’ve observed in buyer behavior where decisions are subject to greater scrutiny by an increasing number of cautious stakeholders has led to a decrease in the effectiveness of more traditional seller approaches. For sellers to do well in today's market, they must be trained to learn about and truly understand their prospects and their business challenges.

Once your sales talent understands this approach and why it works, this is where sales leaders have an opportunity to introduce generative AI as a powerful tool to assist with their efforts to secure sales meetings and learn everything they can about their prospects. The combination of these initiatives should enable your GTM talent to move the needle faster than other levers.

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Bankruptcy Judge Romance Probe Goes Too Far, Jackson Walker Says

By James Nani

A Texas law firm tied up in litigation related to the clandestine relationship between its onetime partner and a prominent bankruptcy judge is pushing back against questioning from the Justice Department.

Jackson Walker LLP is battling accusations from the Justice Department’s bankruptcy monitor, the US Trustee’s office, that it helped keep the romance under wraps for its own benefit. But the efforts to connect the firm with the “alleged secret affair” between former partner Elizabeth Freeman and former Houston bankruptcy judge David R. Jones are flawed, Jackson Walker said in court filings Monday.

“The U.S. Trustee’s motivating thesis has never changed: somehow, someway, this is JW’s fault,” Jackson Walker said.

The filing is part of the expanding tangle of litigation related to Jones, who resigned as a Houston bankruptcy judge last year after admitting to a relationship with Freeman. She left Jackson Walker at the end of 2022.

Jones, once a top judge in the country for large Chapter 11 cases, approved fees for Texas law firm Jackson Walker LLP without disclosing he was in a longstanding, live-in relationship with Freeman. The US Trustee is now attempting to disgorge at least $13 million in fees, in the form of a sanctions, that Jackson Walker earned in 33 bankruptcy cases tied to Jones and Freeman.

On Monday, Jackson Walker said the US Trustee hasn’t put forth a “cohesive legal theory” or enough facts to connect the relationship of Freeman and Jones to the value of the firm’s work or its role in several bankruptcy cases Jones oversaw.

The firm also reiterated its position that it took reasonable steps to address the relationship when it learned of it.

Freeman had insisted in 2021 that her relationship with Jones was over, the firm has said. But Jackson Walker says it found out in 2022 that Jones and Freeman were still in a romantic relationship.

“Ms. Freeman’s decision to conceal her relationship when she joined the firm is not a license to punish JW,” the firm said.

‘Fishing Expedition’

Jackson Walker criticized the US Trustee for embarking on a “a wide ranging fishing expedition in discovery in an attempt to find a needle in a haystack.”

That includes questions from US Trustee attorneys in several depositions about a photo of a man water-skiing in an elf suit who the office thinks may be Jones, according to the Monday filing.

Freeman and her ex-husband have said the man in the elf suit is Freeman’s brother, the firm said. It’s not clear from the Jackson Walker filing what the photo may have to do with the government’s investigation into the firm’s ties to the relationship.

Jackson Walker also said reports of a criminal investigation into the scandal less than two weeks before Freeman and Jones were scheduled to be deposed has prevented Freeman and perhaps others from providing sworn testimony that could support Jackson Walker’s arguments, the firm said.

Jones’ former judicial colleague, Chief Judge Eduardo V. Rodriguez of the Southern District of Texas bankruptcy court, is also considering the scope of questions the US Trustee and Jackson Walker can ask Jones and his former case manager to see if they tread too deeply into judicial activities.

Tom Kirkendall, Freeman’s attorney in the fee matters, declined comment. Attorneys for Jackson Walker and Jones didn’t immediately respond to requests for comment.

A Justice Department spokesman declined to comment.

Jones is represented by in the fee matters by Quinn Emanuel Urquhart & Sullivan LLP.

Jackson Walker is represented by Rusty Hardin & Associates LLP and Norton Rose Fulbright US LLP.

Elizabeth Freeman is represented in the fee matters by The Law Office of Tom Kirkendall.

The case is HONX, Inc. and Official Committee of Unsecured Creditors of HONX , Bankr. S.D. Tex., No. 22-bk-90035, sur-reply 8/12/24.

To contact the reporter on this story: James Nani in New York at [email protected]

To contact the editor responsible for this story: Maria Chutchian at [email protected]

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