A move to universal OR start times. A case study of leading change in an academic anesthesia department

Learn how leaders at Penn State Milton S. Hershey Medical Center successfully implemented universal operating room start times and the impact it had on patient flow.     

Competencies and problem behaviors of children in family foster care: variations by kinship placement status and race

Formal kinship foster care is an increasingly common form of out-of-home placement, and several important distinctions between kinship care and non-relative foster care have been identified. The present study evaluated the behavior of kinship foster children in comparison to non-relative foster children and children in the general population. A geographically and ethnically diverse sample of foster children (N=240) was assessed for competence and problem behaviors using the Child Behavior Checklist (CBCL: Achenbach, 1991). Kinship foster children closely resembled children in the general population but differed significantly from their counterparts in non-relative foster care, who consistently scored lower on competence and higher on problem behaviors. Substantial proportions of non-relative foster children were in the clinical range on most CBCL measures, but kinship foster children were no more likely than children from the general population to score above clinical cut-offs. Differences between kinship and non-kinship foster children became less dramatic after accounting for child race and gender, which were both associated with kinship status. Child race had a strong main effect for almost all types of problem behaviors, with children of color showing significantly less problematic behavior. Discussion of these results centers on potential explanations for the observed variations in child behavior by kinship status and race.     

The effectiveness of medical interventions aimed at preventing preterm birth: a literature review

Background

Preterm birth is a significant global health problem with serious short and long term consequences. This paper reviews the research literature to answer the question how effective are the medical interventions that aim to reduce the rates of preterm birth?

Methods

A systematic search was carried out in CINAHL, Cochrane, Medline and Embase in relation to following medical treatments aimed at preventing preterm births: anti-infective medications, tocolytics, progesterone and cervical cerclage. The research underpinning each type of intervention is critically analysed in order to establish the validity of knowledge claims that are made for each type of intervention.

Findings

In relation to reducing the rates of preterm births, anti-infectives are only effective in the presence of known infection. Screening for infections during pregnancy is ineffective. Tocolytic agents are not effective in decreasing the preterm birth rates. Progesterone seems to be effective in a select group of pregnant women at higher risk of preterm birth. Cervical cerclage plays a small and an occasional role in preventing some preterm births.

Conclusions

This literature review demonstrates that medical interventions aimed at preventing, not just delaying, preterm birth, are not effective at a population level. Providing holistic, antenatal midwifery care for women living in socio-economic disadvantage and/or with an increased risk of preterm birth seems to be a promising strategy to address the negative effects of the social determinants of disease and thus to reduce the rate of preterm births at an individual and a population level.     

The Variable Nature of the Gender Gap in Political Knowledge

ABSTRACT

Previous research demonstrates that long-standing gender gaps in political knowledge are often a function of measurement artifacts. This article examines two potential measurement issues – question content and format – to determine whether gender differences in knowledge are sensitive to decisions we make when choosing and constructing knowledge measures. Using an original survey from the 2014 Cooperative Congressional Election Study (CCES), we demonstrate that, while expected gender differences exist when we ask traditional knowledge questions, these gender gaps are ameliorated when we employ items that measure knowledge about women in politics. We also examine gendered response patterns regarding “don’t know” responses, which can deflate women’s knowledge levels. Finally, we examine the determinants of political knowledge for women and men, and uncover an important role for political interest in shaping women’s knowledge levels. These results suggest that scholars should take steps to create political knowledge measures that can most accurately gauge the political capacities of women and men.     

Teen Dating Violence Perpetration: Protective Factor Trajectories from Middle to High School among Adolescents

Protecting adolescents from the risk of teen dating violence (TDV) perpetration is critical to enhancing prevention efforts. This study examined longitudinal trajectories of four protective factors (i.e., empathy, social support, parental monitoring, and school belonging) across adolescence in relation to four TDV types (i.e., verbal, relational, physical, and sexual). Adolescents (n = 1,668) who reported being in a relationship or dating during high school completed self‐report measures from middle through high school. Results indicated that all protective factors differentiated between TDV perpetrators and nonperpetrators, although these trajectories varied for boys and for girls and across the different types of TDV. Overall, youth who did not perpetrate TDV in high school generally displayed higher protective factors across the TDV perpetration types.