Associations Between Interparental Relationships and Experiences of Parenting Stress Among Mothers: The Mediating Role of Perceived Control

The current study investigated the potential benefits of relationships between parents whose children were friends (closure relationships) within a sample of 404 mothers. Associations between closure and three domains of parenting stress were explored. Mothers' perceived control was considered as a potential mediator of closure-stress associations. Hierarchical regression analyses revealed that higher mean levels of closure were associated with lower levels of parenting stress related to child problem behaviors. Perceived control mediated the association between closure and parenting stress. The benefits of cross-household parental relationships for mothers' psychological wellbeing are discussed.     

The influence of ethnicity on Gleason score

BackgroundTo determine if Gleason score exhibits any significant variation between African-Americans and Caucasian men with prostate cancer.MethodsWe conducted a retrospective cohort study. Inclusion required diagnosis of prostate cancer and reporting it to the TriHealth tumor registry from 1995–2005. We excluded individuals of any other ethnicity than the two of interest (N = 15) and individuals without a reported Gleason score (N = 82). For each patient we collected data on ethnicity, Gleason score, age, American Joint Committee on Cancer (AJCC) stage, insurance status, and surgery. Gleason score was divided into low-grade (1–6) and high-grade disease (7–10). Institutional Review Board approval was obtained prior to data collection.ResultsA total of 1916 patients, (1476 Caucasians, 440 African-Americans) were eligible for inclusion in the study. There was no significance difference between either ethnicity for age, insurance status, and the percentage of men needing a transurethral resection of the prostate (TURP). There was no difference between either ethnicity for stages 0, 1, and 4. African-Americans were more likely to have stage 2 disease, while Caucasian men possessed more stage 3 disease (p<0.05). African-Americans were significantly more likely to not have any prostate surgery (p<0.05). Caucasian men were more likely to have a prostatectomy. African-American men with prostate cancer were significantly more likely to have a high-grade Gleason score compared to Caucasian men (OR = 1.22, 95% CI = 1.11–1.35).ConclusionAfrican-American race is a predictor of more advanced Gleason score at the time diagnosis of prostate cancer.     

Pediatric patients who receive antibiotics for fever and neutropenia in less than 60 min have decreased intensive care needs

Background

Antibiotic delivery to patients with fever and neutropenia (F&N) in <60 min is an increasingly important quality measure for oncology centers, but several published reports indicate that a time to antibiotic delivery (TTA) of <60 min is quite difficult to achieve. Here we report a quality improvement (QI) effort that sought to decrease TTA and assess associated clinical outcomes in pediatric patients with cancer and F&N.

Procedure

We used Lean‐Methodology and a Plan‐Do‐Study‐Act approach to direct QI efforts and prospectively tracked TTA measures and associated clinical outcomes (length of stay, duration of fever, use of imaging studies to search for occult infection, bacteremia, intensive care unit (ICU) consultation or admission, and mortality). We then performed statistical analysis to determine the impact of our QI interventions on total TTA, sub‐process times, and clinical outcomes.

Results

Our QI interventions significantly improved TTA such that we are now able to deliver antibiotics in <60 min nearly 100% of the time. All TTA sub‐process times also improved. Moreover, achieving TTA <60 min significantly reduced the need for ICU consultation or admission (P = 0.003) in this population.

Conclusion

Here we describe our QI effort along with a detailed assessment of several associated clinical outcomes. These data indicate that decreasing TTA to <60 min is achievable and associated with improved outcomes in pediatric patients with cancer and F&N. Pediatr Blood Cancer 2015;62:807–815. © 2015 The Authors. Pediatric Blood & Cancer, published by Wiley Periodicals, Inc.