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Despite the many benefits of ambulatory surgery, there remain inherent risks associated with any surgical care environment that have the potential to jeopardize patient safety. This practice advisory provides an overview of the preoperative steps that should be completed to ensure appropriate patient selection for ambulatory surgery settings. In conjunction, this advisory identifies several physiologic stresses commonly associated with surgical procedures, in addition to potential postoperative recovery problems, and provides recommendations for how best to minimize these complications.

Approximately 56 percent of all currently active plastic surgeons in the United States are older than 50 years and are likely to retire in the next 10 to 20 years. The 2006 Survey of Plastic Surgeons Over the Age of 50 was designed to provide insight regarding the practice patterns, retirement plans, and issues of importance to plastic surgeons older than 50 to provide an indicator of future workforce needs for the specialty. The survey was part of a larger study of physicians older than 50 across all specialties conducted by the Association of American Medical Colleges Center for Workforce Studies, in collaboration with the American Society of Plastic Surgeons, the American Medical Association, the Council of Medical Specialty Societies, and seven additional medical specialty associations. Surveys were mailed to 1434 active and retired plastic surgeons aged 50 to 79 years; the response rate was 59.1 percent. Results were compared with responses from physicians of all specialties. Full-time reconstructive plastic surgeons older than 50 spend more hours per week practicing medicine (56.5 hours per week) than cosmetic plastic surgeons (49.7 hours per week) and all physicians (53.7 hours per week). Plastic surgeons retire slightly earlier than other physicians and cite rising malpractice costs, insufficient reimbursement, and increasing competition as important factors when considering retirement. There are significant differences in the practices, satisfaction, and factors influencing retirement plans for plastic surgeons that focus on cosmetic versus reconstructive surgery. Further study of these two components of plastic surgery may be warranted.

Following developmental attachment theory, we predicted a path in which nurturing parents affect young adults' self‐concepts and self‐esteem, which in turn predicts the image of a nurturing God. To ascertain how images of parents and images of self predict God images, 132 young adults aged 18–22 (M = 19) completed the Tennessee Self‐Concept Scale, and a six‐item measure of God's perceived involvement in their lives (religiosity scale). In a follow‐up interview, they rated their parents, God, and selves on scales of closeness, nurturing, power, and punishing/judging. For men, mothers were responsible, more than fathers, for creating a climate for sons' self‐esteem through nurturance and discipline, which in turn contributed to seeing God as nurturing, feeling close to God, and being more religious. For women, mothers and fathers created a model of nurturance and power, which contributed to seeing God as nurturing and powerful. Punishing/judging parents directly affected punishing/judging God images in these young adults. Men perceived God to be more punishing/judging than did women, while women perceived God to be more nurturing. Even in adulthood, parents, especially mothers, continue to exert influences on young adults' faith and images of God.