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The medical records of six dogs treated by sub-total scapulectomy for tumours involving the scapula were reviewed. The mean age of dogs in this study was 8 years and 4 months. Clinical signs on presentation included lameness of the affected forelimb and a palpable mass over the scapular area on physical examination. Pre-operative chest and affected forelimb radiographs were taken in most cases in addition to a biopsy. Subtotal scapulectomy was performed, ensuring margins clear of neoplastic tissue of at least 2 cm, preservation of the glenoid cavity and thus retention of the scapulo-humeral joint. On histopathological examination the tumours where diagnosed as chondrosarcoma (one), haemangiosarcoma (two), anaplastic malignant neoplasia (one) and osteosarcoma (one). Limb function was found to be good in all cases postoperatively. Prognosis was related to histopathological diagnosis of the tumour, favourable with chondrosarcoma and poor with the other tumour types.

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The topic of family presence (FP) during cardiopulmonary resuscitation or invasive procedures has recently received attention and debate among healthcare professionals due to pioneering research in this field. Studies completed have included family perspectives on family presence, patients' feelings on family presence, and healthcare providers' views on family presence. Two key areas found to correlate with family presence acceptance among healthcare providers are education and experience. Senior nursing students in one baccalaureate program were introduced to this topic during a 3-hour class on death and dying. Comparisons between pretest and posttest scores revealed an increase in the acceptance of family presence as a priority in nursing care of the critically ill.

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All clinical nurses need to be prepared to recognize deterioration in a patient's clinical status and activate the rapid response team when appropriate. This article explores the clinical nurse's role in recognizing and responding to deterioration in a patient's condition with a focus on hospital-based nurses practicing on a medical-surgical unit.

Health literacy-"the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions"-has been identified as a cross-cutting quality-of-care issue by the Institute of Medicine. This article defines the scope of the health literacy problem, discusses the literacy demands of critical care, and offers strategies for nurses to improve the quality of health communication with patients and families in the critical care environment.