The kickoff return in football, in which athletes run at speed toward each other over a long distance with the potential for significant impacts, has been associated with a substantial number of concussions. 1 In 2015 in the Ivy League, a Division 1 conference of 8 private universities in the National Collegiate Athletic Association (NCAA), kickoffs accounted for 6% of all plays but 21% of concussions. 2 In response, Ivy League football coaches recommended a rule change. In 2016, the kickoff line was moved from the 35-yd to the 40-yd line and the touchback line was moved from the 25-yd to the 20-yd line. The intention was to have more kickoffs land in the end zone and thereby reduce the likelihood the receiving player will advance the ball, thus increasing touchbacks. However, moving the touchback line to the 20-yd line could cause receivers to try to advance the ball, possibly decreasing touchbacks. We investigated whether the experimental rule was associated with changes in the number of touchbacks and the rate of concussion in kickoffs in Ivy League football.

With the passage of the Affordable Care Act and as the number of aging and diverse individuals in society increases, access to health care will expand and the need for more competent and diverse nursing graduates will increase. An adequate number of nurse graduates is imperative to meet societal demands; however, this is complicated by high nursing student attrition rates. This article examines the need for more nurses (including those from diverse backgrounds), current attrition rates among schools of nursing, at-risk student characteristics, and previous attempts to increase student success. Applying the evidence to practice, findings from a multipronged approach to increase student success within an associate degree nursing program located within a historically Black college and university in the midwestern United States are discussed. The program's successes and opportunities for improvement are examined, as well as the recommendations for other nursing programs facing issues with student attrition.

No abstract

The potential impact of breast cancer-related lymphedema (LE) is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1) time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ); (2) referral to LE management with limb volume increase (LVI) and/or LBCQ symptoms; and (3) cost of LE management at lower LVI (≥5%–≤10%) versus traditional (≥10%). Findings revealed a visit timeframe mean of 40.3 min (range = 25–60); 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9). LBCQ symptoms and LVI were significantly (p < 0.001) correlated to LE referral; six of the nine patients referred (67%) displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings).

Workplace violence is highly prevalent for nurses, often going unreported. Regrettably, the very patients and visitors being cared for often perpetrate the majority of violence. This article's purpose is to describe how an institution implemented a workplace violence prevention training program designed to increase nurses' perception and confidence with aggressive and violent events. Evaluation of this quality improvement program posttraining was positive, suggesting this approach may influence nurses' abilities to prevent and manage these events.