Defining Staff Injury Due to Client Behavior in the Behavioral Health Care Setting

Continuous Quality Improvement programs require organizations to assess staff related injuries as they correspond to client restrictive procedures. This study compares a three level staff injury system (Mild, Moderate, Severe) against the type of situation in which the injury occurred defined as unintentional, weapon or device used, and during the process of a restrictive procedure. There were 5,685 injuries over a 6-year period: 8.4% of injuries were unintentional, 10.0% involved the use of a device, and 30.7% of injuries occurred as the result of a restrictive procedure. Staff injury at moderate level was associated with restrictive procedures (p < .001).     

Renal cell carcinoma containing abundant non-calcified fat

Renal masses found to contain macroscopic fatty elements on CT or MRI imaging can generally be classified as benign angiomyolipomas. Rarely, renal cell carcinomas may also contain evidence of macroscopic fat. When true adipocytic elements are present, this is generally due to a process of osseous metaplasia in which both fat cells and calcification are co-localized within the mass. We present a patient with a large papillary renal cell carcinoma containing abundant fat with sparse, punctate calcification remote from the fatty elements on imaging. This report highlights the need for radiologists to maintain caution when diagnosing renal angiomyolipomas on the basis of macroscopic fat and reviews the current literature on fat-containing renal masses.     

Coming to Grips with Breast Cancer: The Spouse's Experience with His Wife's First Six Months

This study examines the experiences of 48 spouses of wives newly diagnosed with local or regional breast cancer. Their reported experiences were organized into the core construct of coming to grips reflected by four domains: (1) feeling nailed by the breast cancer, (2) changing us, (3) taking care of me, and (4) making things work. Prior studies have underestimated the extent to which the assumptive world and day-to-day lives of spouses are shattered by the diagnosis of breast cancer and the work they do to guess how to be supportive to their wives. Interventions are needed that directly assist spouses add to their ways of managing the intrusion of their wife's breast cancer in their lives.