Chemotherapy outpatients have significant unmet needs following treatment, indicating an urgent need for improved continuity of care and better integration of primary and tertiary health care services.
The development of nurses' spiritual perspective early in their preparation for practice, and the articulation and documentation of spiritual caring may enhance their spiritual caring practice. Further research on barriers to spiritual caring in acute care nursing environments is recommended.
Aim. To identify residential aged care nurses' current knowledge of palliative care for older residents in need of end-of-life care. Background. Recently, there has been a growing interest in the delivery of palliative care in residential aged care facilities. While it is recognized that aged care nurses do possess palliative care knowledge the actual level of their knowledge has not been well documented. Design/method. An analytical study using a validated questionnaire tool - Palliative Care Quiz for Nursing, developed by Ross et al. [Journal of Advanced Nursing23 (1996) 126-137], combined with a demographic survey of Registered Nurses and assistants in nursing working in five high care residential aged care facilities in inner city region of Sydney, Australia. Results. The total Palliative Care Quiz for Nursing score possible was 20. The mean score for Registered Nurses was 11.7 (SD 3.1) and for AINs 5.8 (SD 3.3), the difference between scores being significant (t = 8.7, df 95, P = 0.000). Misconceptions in palliative care were identified for both the groups of carers. Conclusion. This research has highlighted the need for ongoing palliative care education for both the groups of primary carers. Relevance to clinical practice. The findings of this research highlight the existing palliative care knowledge of residential aged care nurses and provides evidence for education programmes.
We studied the transmission bandwidth required for accurate diagnoses when performing realtime fetal tele-ultrasound consultations. The study was divided into three phases. In phase I, three experienced clinicians evaluated the quality of ultrasound images transmitted at various bandwidths (internally looped back within Brisbane) using eight commercially available codecs at random. The two codecs that performed best proceeded to phase 2, in which a realtime video-link of up to 2 Mbit/s was set up between Brisbane and Townsville (1,500 km apart). Testing with a standard video-tape was performed at seven different bandwidths selected at random, with four clinicians (who were blinded to the equipment and bandwidths used). The optimum line rates for transmission were determined, and testing was then performed using these line rates for fetuses with various anomalies (phase 3). The results showed significant differences in performance according to bandwidths used, but not according to observers. Bandwidths were grouped into three levels. At level I (256 kbit/s) the performance was significantly worse than at level II (384, 512 or 768 kbit/s), which was in turn worse than that at level III (1, 1.5 or 2 Mbit/s). However, within each level, performance at one bandwidth was not significantly different from that at the others. The most cost-effective transmission rates therefore appeared to be 384 kbit/s and 1 Mbit/s. Further testing with fetuses affected by various anomalies confirmed that the majority could be diagnosed using a 384 kbit/s link, with slight improvement in evaluation when the bandwidth was increased to 1 Mbit/s.
Study objective: To derive methods of calculating confidence limits for the relative index of inequality, defined by Kunst and Mackenbach as a measure of the influence of socioeconomic status on an adverse health index, such as mortality rate. The methods may be used for a health outcome recorded on a continuous scale, as a Poisson count or as a binomial variable. Results and Conclusion: The confidence limits depend on the sampling variability of both the mean mortality rate and the slope of the regression line of mortality on the socioeconomic status scale variable. The best method for a continuous health outcome is based on Fieller's theorem but a good approximation is obtained by substituting the confidence limits for the slope of the regression line into the formula for the calculation of the index, or by using the variance of the logarithmic transform of the index. The last method is the most appropriate for the construction of significance tests comparing indices. The mortality rates may show statistically significant departure from linearity, while not suggesting that a linear relation is inappropriate, and the main decision is whether to base the confidence limits on the conventional standard error of the slope derived from the regression analysis or whether to use the standard deviation of the estimates of mortality rates.
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