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The identification of sensitive neuro-psychological tests is crucial to further understanding of chemotherapy-induced cognitive impairments.

Adequate pain relief is vital to decreasing cancer morbidity and improving patients' quality of life. The PRO-SELF: Pain Control Program should be implemented in all settings where cancer care takes place.

The use of a structured paper-and-pencil questionnaire, such as the PES, as part of a psychoeducational intervention provides an effective foundation for patient education in cancer pain management. Oncology nurses can use patients' responses to this type of questionnaire to individualize the teaching and to spend more time on the identified knowledge deficits. This individualized approach to education about pain management may save staff time and improve patient outcomes.

Research-based evidence supports the importance of using a daily pain management diary in clinical practice.

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Study Design Descriptive, cross-sectional. Introduction Breast cancer (BC) treatments place the nervous system at risk, which may contribute to upper extremity (UE) mechanosensitivity. Purpose of the Study To evaluate elbow extension range of motion (EE-ROM) during upper limb neurodynamic testing (ULNT) post-BC treatment. Methods ULNT EE-ROM was measured for 145 women post-BC treatment. Women were sub-grouped by presence/absence of pain and lymphedema Results Mean EE-ROM during ULNT1 was −22.3° (SD: 11.9°) on the unaffected limb and −25.99° (SD 13.1°) on the affected limb. The women with pain and lymphedema had the greatest limitation in EE-ROM during ULNT1 testing, particularly of their affected limb (−33.8°, SD 12.9). Symptoms were reported more frequently in the affected chest, shoulder, arm, elbow, and hand. The intensity of symptoms was greater at the affected chest (p=0.046), shoulder (p=0.033) and arm (p=0.039). Conclusions Women with lymphedema and pain after BC treatment may present with altered neural mechanosensitivity.

Objective To audit the use of management algorithms for chest pain in an emergency department. Design and setting Prospective study of all patients with chest pain presenting to the emergency department of an urban teaching hospital between 12 January and 4 May 1997. Staff were asked to complete a standardised admission form that incorporated the risk stratification algorithms for managing patients with suspected acute coronary syndrome. Main outcome measures Compliance with the use of management algorithms; concordance with a cardiologist's review of the triage grouping and admission/discharge decision; and major cardiovascular events over four months. Results Emergency department staff documented the triage group in 223 of 503 cases (45%). Concordance with the group assigned by a cardiologist was 70% (κ = 0.73; SEκ=0.04). When the management algorithm was applied correctly, 92% of triage decisions were correct (95% confidence interval [CI], 87%–96%). The triage decision was less often correct when risk stratification was not done (78% [73%–83%], P<0.001), overestimated (77% [66%–88%], P<0.01), or underestimated (50% [18%–82%], P<0.001). The proportion of patients free of major cardiovascular events at four‐month follow‐up was 50% for those with myocardial infarction with ST‐segment elevation, 47% for those with a high short‐term risk of an adverse cardiac event, 82% for those with intermediate risk, and 99% for those with a low risk or non‐coronary chest pain (P<0.001). Conclusions Use of management algorithms by emergency staff was poor. When used, triage decisions were more likely to be correct. Subsequent outcome confirms that the NHMRC risk stratification algorithms are useful for prognostic stratification of patients with suspected acute coronary syndrome.