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To explore how sponsorship functions as a professional relationship in academic medicine.The authors conducted semistructured interviews with Johns Hopkins University School of Medicine faculty in 2016: department chairs (sponsors) and faculty participants of an executive leadership development program (protégés). Using editing analysis style, the authors coded interview transcripts for thematic content; a coding framework and themes were derived using an iterative process.Five themes were identified from 23 faculty interviews (12 sponsors, 11 protégés): (1) Mentorship is different: Sponsorship is episodic and focused on specific opportunities; (2) Effective sponsors are career-established and well-connected talent scouts; (3) Effective protégés rise to the task and remain loyal; (4) Trust, respect, and weighing risks are key to successful sponsorship relationships; (5) Sponsorship is critical to career advancement. Sponsorship is distinct from mentorship, though mentors can be sponsors if highly placed and well connected. Effective sponsors have access to networks and provide unequivocal support when promoting protégés. Effective protégés demonstrate potential and make the most of career-advancing opportunities. Successful sponsorship relationships are based on trust, respect, mutual benefits, and understanding potential risks. Sponsorship is critical to advance to high-level leadership roles. Women are perceived as being less likely to seek sponsorship but as needing the extra support sponsorship provides to be successful.Sponsorship, in addition to mentorship, is critical for successful career advancement. Understanding sponsorship as a distinct professional relationship may help faculty and academic leaders make more informed decisions about using sponsorship as a deliberate career-advancement strategy.

Objective: Superior hypogastric plexus neurolysis (SHP-N) has been shown in uncontrolled studies to provide intermediate-term benefit in a majority of patients with pain secondary to genitourinary, gynecologic, and colorectal cancers. The purpose of this is to determine factors associated with treatment outcome. Materials and Methods: Patients who underwent SHP-N after a positive prognostic block were identified based on diagnostic classification and procedural codes from databases at 2 large teaching hospitals. A host of demographic, clinical, and treatment factors were examined for their association with treatment success, which was defined as ≥50% pain relief lasting ≥1 month. Results: A total of 53.1% of 32 patients with sufficient medical records for analysis experienced a positive outcome. Those with a positive outcome were older (mean age 59.6 y, SD 13.1 vs. 47.8, SD 15.6; P=0.03), less likely to have pelvic pain (36.8% success rate, P=0.04), and more likely to have bladder cancer (88.9% success rate; P=0.01) than those with a negative outcome. In stratified analysis, female were more likely to have positive outcome if they did not have pelvic pain compared to those that did (P=0.008). This difference was not significant for males. Discussion: Selecting patients based on demographic and clinical variables may improve treatment outcomes for SHP-N. Larger, prospective studies are needed to confirm our results and better refine selection criteria better.

OBJECTIVE Quantifying pain intensity is challenging, particularly for patients with chronic pain. The visual analog scale (VAS) is limited by ceiling effects that often leave patients with no ability to quantify worsening pain. The goal of this study was to determine whether the general Labeled Magnitude Scale (gLMS) can be feasibly used to measure pain clinically while overcoming limitations of the VAS. DESIGN Eighty patients (mean age, 53.7 yrs) scheduled for evaluation of a painful complaint were asked to rate their current pain using the gLMS and the VAS. The time necessary to administer the gLMS was recorded to determine feasibility. The difference in rating between the two scales (VAS and gLMS) was the main outcome measure. RESULTS After scaling and rounding off the gLMS scores for direct comparison, it was found that the gLMS scores were significantly lower than the corresponding VAS scores by a mean of 1.78 (P < 0.001). The mean time to administer the gLMS was 2.66 mins. CONCLUSIONS These results suggest that the gLMS has great potential and can be feasibly used to measure pain intensity clinically. The gLMS scores were consistently lower than the VAS scores, thus reducing the ceiling effect and allowing range at the high end of the scale for rating worsening pain.

See related article, pages 1501–1507. According to the World Health Organization (WHO), approximately 15 million people experience a stroke each year, of which one third die and one third are permanently disabled. It was not until the mid-nineties that the advent of tissue plasminogen activator (tPA) offered a treatment option. One of the most important factors limiting the use of tPA is the 3-hour window of administration (up to 4.5 hours in select cases) recommended to prevent hemorrhagic complications. Because of the importance of seeking immediate medical care for tPA to be a treatment option, public health campaigns, such …