The role of emotion identification skill in the formation of male and female friendships: A longitudinal study

The present study explored the relationship between emotion identification skill (EIS) and friendships in adolescence. Students from five Australian high schools completed questionnaires annually from Grade 8 to Grade 12 including subjective measures of EIS and a peer-based objective measure of social functioning (e.g., friendship nominations). The total sample of participants was 795 (406 males; 389 females) with 468 (225 males; 243 females) completing questionnaires in Grade 12. EIS in early adolescence was predictive of friendships for females in late adolescence. Specifically, girls starting out with low EIS in Grade 8 tended to have fewer female friendships and more male friendships in Grade 12. There were no effects for males. Lower initial EIS was associated with significant improvements in awareness over time, but these improvements had no effect on friendships in Grade 12. The EIS that girls enter high school with may influence their friendship composition into late adolescence.     

Results of a Surgeon-Directed Quality Improvement Project on Breast Cancer Surgery Outcomes in South-Central Ontario

Background

Gaps in breast cancer (BC) surgical care have been identified. We have completed a surgeon-directed, iterative project to improve the quality of BC surgery in South-Central Ontario.

Methods

Surgeons performing BC surgery in a single Ontario health region were invited to participate. Interventions included: audit and feedback (A&F) of surgeon-selected quality indicators (QIs), workshops, and tailoring interviews. Workshops and A&F occurred yearly from 2005–2012. QIs included: preoperative imaging; preoperative core biopsy; positive margin rates; specimen orientation labeling; intraoperative specimen radiography of nonpalpable lesions; T1/T2 mastectomy rates; reoperation for positive margins; sentinel lymph node biopsy (SLNB) rates, number of sentinel lymph nodes; and days to receive pathology report. Semistructured tailoring interviews were conducted to identify facilitators and barriers to improved quality. All results were disseminated to all surgeons performing breast surgery in the study region.

Results

Over 6 time periods, 1,828 BC charts were reviewed from 12 hospitals (8 community and 4 academic). Twenty-two to 40 participants attended each workshop. Sustained improvement in rates of positive margins, preoperative core biopsies, specimen orientation labeling, and SLNB were seen. Mastectomy rates and overall axillary staging rates did not change, whereas time to receive pathology report increased. The tailoring interviews concerning positive margins, SLNB, and reoperation for positive margins identified facilitators and barriers relevant to surgeons.

Conclusions

This surgeon-directed, regional project resulted in meaningful improvement in numerous QIs. There was consistent and sustained participation by surgeons, highlighting the importance of integrating the clinicians in a long-term, iterative quality improvement strategy in BC surgery.     

Treatment of Failed Allograft Prosthesis Composites Used for Hip Arthroplasty in the Setting of Severe Proximal Femoral Bone Defects

This study assessed failures of allograft prosthesis composites (APC) and revisions with a new APC. Twenty-one patients with failed APC’s after revision hip arthroplasty with severe proximal femoral bone loss underwent revision with a new APC. Causes of failure were aseptic loosening (18 patients), infection (3 patients). Of these 21 APC revisions, two patients failed (after 60, 156 months). The 5 and 10 year survival rates were 83.5% (95% CI, 79–100%, number at risk 12 and 6 accordingly). In addition, two patients had non-union at the host-allograft bone junction and were augmented with bone autograft and plate. These results suggest that failed APCs may be revised to a new APC with a predictable outcome.     

A program to educate school nurses about mental health interventions.

Concerned with the increasing incidence of mental health problems in children and adolescents and the impact of these problems on students' school success and predisposition to self- and other-directed violence, the Multnomah Education Service District Department of School Health Services determined to become proactive by providing preventive interventions for students experiencing actual or potential mental health problems. An educational program was designed to assist school nurses in the identification of potential mental health problems. In addition, information about appropriate interventions for students at risk for aggression, violence, and other mental health pathology was presented. The program involved education on mental health assessment and intervention, as well as expert psychiatric clinical support for the development of student support groups. School nurses were then challenged to develop practice improvement projects incorporating this knowledge for a group of students in their work setting. This introductory article describes the project's general rationale and implementation process. The four articles following in this issue of The Journal of School Nursing describe the goals, implementation, and outcomes of the practice improvement projects developed for early intervention with students exhibiting attention disorders, school absenteeism, social withdrawal, and depression.     

A study of nurses'' attitudes towards associate degree nursing students

The purpose of this study was to examine the attitudes of staff nurses towards associate degree (AD) nursing students. The null hypothesis stated there will be no significant difference in the attitudes of staff nurses towards AD nursing students and associated concepts (nursing education, patient, physician, work, nurse.) The staff nurse's value as a role model is held in high regard yet little regard is given to her attitudes towards students. Through better understanding of staff nurses' attitudes, nurse educators can better plan, develop and coordinate clinical activities to provide an optimum learning environment. The findings showed the concept AD nursing student was significantly different from the rest, indicating a less positive attitude towards the AD nursing student than the related concepts. Implications for nursing practice are threefold. Nurse administrators must create an atmosphere and a philosophy which support the educational process within their institution, and recognize nurses' attitudes towards students. Practising nurses should examine their attitudes and willingness to work with students if their hospital offers their agency as a clinical facility. Educators must look closely at the units they assign students to, continually maintaining the lines of communication between staff nurses and clinical instructors. As service and education work together a quality environment can be provided in which there is optimum learning for the student. Both groups then contribute to the future of professional nursing.     

The Opportunity Loss of Boarding Admitted Patients in the Emergency Department

Objectives: Boarding admitted patients in emergency department (ED) treatment beds has been recognized as a major cause of ED crowding and ambulance diversions. When process delays impede the transfer of admitted patients from the ED to inpatient units, the department's capacity to accept new arrivals and to generate revenue from additional patient services is restricted. The objective of this study was to determine the amount of functional ED treatment capacity that was used to board inpatients during 12 months of operations at a community hospital and to estimate the value of that lost treatment capacity.
Methods: Historical data from 62,588 patient visits to the ED of a 450-bed nonprofit community teaching hospital in south central Pennsylvania between July 2004 and June 2005 were used to determine the amount of treatment bed occupancy lost to inpatient holding and the revenue potential of utilizing that blocked production capacity for additional patient visits.
Results: Transferring admitted patients from the ED to an inpatient unit within 120 minutes would have increased the functional treatment capacity of the ED by 10,397 hours during the 12 months of this study. By reducing admission process delays, the hospital could potentially have accommodated another 3,175 patient encounters in its existing treatment spaces. Providing emergency services to new patients in ED beds formerly used to board inpatients could have generated $3,960,264 in additional net revenue for the hospital.
Conclusions: Significantly higher operational revenues could be generated by reducing output delays that restrict optimal utilization of existing ED treatment capacity.