ObjectivesTo improve communication, discharge readiness, and satisfaction of burn patients and their families.MethodsIn March 2009, the burn intensive care unit at University of Louisville Hospital, Louisville, Kentucky, incorporated family presence during dressing changes. Adverse family events during observation, measures of patient- and family-centered care according to a standardized patient satisfaction survey, infection rates, and staff members’ response to the intervention were tracked.ResultsThrough December 2011, no adverse family events occurred, patients’ satisfaction scores increased, and infection rates did not increase. Staff members responded positively to the project.ConclusionsAllowing family presence during dressing changes provides an opportunity to educate and include patients’ family members in care delivery.

OBJECTIVE To investigate the age‐stratified prevalence of erectile dysfunction (ED) and its comorbidities, and to assess the population’s knowledge, utilization, and general attitude towards the treatment for ED. SUBJECTS AND METHODS In all, 10 000 men received a 35‐item questionnaire including the International Index of Erectile Function (IIEF) and sociodemographic questions regarding life style, comorbidities, quality of sexual life and knowledge or experience of ED therapy. In all, 3124 responses were included (31.2%), 2499 men lived in well established partnerships and were assessed as the basic study group. RESULTS In the entire population the prevalence rate of ED was 40.1%. However, although known, medical treatment for ED is used only by a minority of affected men. The prevalence of ED was independently associated with age, peripheral arterial occlusive disease, hypertension, ischaemic heart disease, diabetes mellitus, and liver diseases. Correlations between sexual quality of life (QoL) and ED were statistically significant (P < 0.01) and moderate to strong (absolute values: Spearman’s ρ 0.35–0.76). Although 96% of the study population knew at least one phosphodiesterase type 5 (PDE5) inhibitor by name, only 53% considered taking the medication and only 9% of the men with ED had had experience with available PDE5 inhibitors. CONCLUSIONS The sexual QoL was significantly reduced by ED. Despite high levels of awareness and general acceptance of oral medication for ED, experience with PDE5 inhibitors was low. Further investigation is required to evaluate the general impact of ED on sexual QoL and the need or wish for treatment.

and location). DFS was estimated using the Kaplan-Meier method. Univariable and multivariable Cox proportional hazard regression models were fitted to determine associations between the PPCF, measured clinical features, and DFS. RESULTSFour of the variables emerged as statistically significant for DFS from the univariable analysis ( P < 0.001), i.e. clinical presentation, clinical tumour size, haemoglobin level and blood platelet count. In the multivariable analysis, only clinical tumour size and blood platelet count remained significant for DFS. By contrast, clinical presentation, used in the PPCF, had no significant influence. According to the PPCF we developed the preoperative Amissah Prognosis Score (PAPS) calculated as (0.19 × clinical size) + (0.492 × platelet count ( ≤ 400/nL = 0, > 400/nL = 1) with a threshold between the two resulting prognosis groups at 1.76. The multivariable hazard ratio (95% confidence interval, CI) for the PAPS was 2.98 (2.15-4.12) ( P < 0.001) compared to a hazard ratio for the PPCF of 1.36 (0.99-1.87) ( P = 0.061). Furthermore, the predictive ability was greater when using the PAPS (area under the curve 0.721; 95% CI, 0.680-0.763; P ≤ 0.001) than the PPCF (0.690; 0.647-0.734; P ≤ 0.001). CONCLUSIONSUsing preoperative prognostic models is reasonable to provide patients with pertinent information about their prognosis, and for tailoring the treatment to each patient's needs. Applying the PPCF allows a prediction of the outcome of patients with surgically treated RCC on the basis of preoperatively available variables. However, clinical presentation, included in this model, had no significant influence on DFS in the present patients. By contrast, using the PAPS resulted in an improvement in the predictive value and in a greater discrimination between patients subdivided into a good and a poor prognosis group and hence is suitable for preoperative risk assignment.

Introduction This study evaluates worry about sexual and relationship functioning, sexual desire, and sexual satisfaction as indicators of sexual quality of life in men of different age groups suffering from mild to severe erectile dysfunction (ED). Aim To increase insight in the mechanisms of some key indicators of sexual quality of life in different age groups. Methods The study sample consisted of 904 men with mild to severe ED. Mean age was 60.7 years (standard deviation [SD] = 12.4) and mean erectile function (EF) (International Index of Erectile Function [IIEF]) score was 14.5 (SD = 8.9). Multivariate analyses of variance were conducted to test the differences in outcomes among two age groups (65 ≤ age &gt; 65) and two levels of ED (16 ≤ EF &gt; 16). Main Outcome Measures We analyzed age, severity of ED, and interrelated indicators of sexual quality of life as worry about sexual or relationship functioning, sexual desire, and overall sexual satisfaction. Beyond, we aimed to see on which of these measures their interaction had specific independent effects. Results Younger men at a higher level of ED reported higher levels of worry about sexual and relationship functioning than older men with high ED. Older men reported slightly less sexual desire than younger men; also, more ED was associated with lower sexual desire. Finally, men with less severe ED reported higher sexual satisfaction than men with more severe ED, whereas at all levels of ED severity, older men reported more sexual satisfaction than younger men. Conclusions Indicators of sexual quality of life among men with ED are poorer in those with more severe ED. However, younger men with severe ED worries concerning sexual functioning were more pronounced than among their older counterparts. Independent of the degree of severity of ED, older men indicated lower sexual desire but higher overall sexual satisfaction. Observed age-group differences were very small, however.