The following are worthy of further investigation: whether the pilot study findings hold in student samples from more diverse cultural backgrounds; whether students' perceptions of spirituality can be broadened to include the full range of spiritual needs patients may encounter and whether their competence can be enhanced by education to better equip them to deliver spiritual care; identification of factors contributing to acquisition of spiritual caring skills and spiritual care competency.

We have provided the first international evidence that perceived spiritual care competence is developed in undergraduate nursing and midwifery students and that students' perceptions of spirituality and personal spirituality contribute to that development. Implications for teaching and learning and student selection are discussed. The study is limited by attrition which is common in longitudinal research.

Background: The spiritual part of life is important to health, wellbeing and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. Aim: to explore factors contributing to undergraduate nurses'/midwives' perceived competency in giving spiritual care. Design: a pilot cross-sectional, multinational, correlational survey design. Method: Questionnaires were completed by 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 countries in 2010. Bivariate and multivariate analyses were performed. Results: Differences between groups were small. Two factors were significantly related to perceived spiritual care competency: perception of spirituality/spiritual care; student's personal spirituality. Students reporting higher perceived competency viewed spirituality/spiritual care broadly, not just in religious terms. This association between perceived competency and perception of spirituality is a new finding not previously reported. Further results reinforce findings in the literature that own spirituality was a strong predictor of perceived ability to provide spiritual care, as students reporting higher perceived competency engaged in spiritual activities, were from secular universities and had previous healthcare experience. They were also religious, practised their faith/belief and scored highly on spiritual wellbeing and spiritual attitude/involvement. Conclusions: The challenge for nurse/midwifery educators is how they might enhance spiritual care competency in students who are not religious and how they might encourage students who hold a narrow view of spirituality/spiritual care to broaden their perspective to include the full range of spiritual concerns that patients/clients may encounter. Statistical models created predicted factors contributing to spiritual care competency to some extent but the picture is complex requiring further investigation involving a bigger and more diverse longitudinal sample. 2006-10. British Journal of Nursing 20 (12), 743-749 Cockell, N., and McSherry, W., 2012. Spiritual Table 1 The tools need to include psychometric support with citations. Subscales need to be conceptually defined to provide further insight into the findings. ABSTRACT Background: The spiritual part of life is important to health, wellbeing and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. Aim: to explore factors contributing to undergraduate nurses'/midwives' perceived competency in giving spiritual care. Design: a pilot crosssectional, multinational, correlational survey design. Method: Questionnaires were completed by 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwives from 6 universities in 4 countries in 2010. Bivariate and multivariate analy...

INTRODUCTIONThe Nottingham Prognostic Index (NPI) is an established prognostication tool in the management of breast cancers (BCs). Latest ten-year survival data have demonstrated an improved outlook for each NPI category and the latest UK five-and ten-year survival from BC has been reported to be 85% and 77%, respectively. We compared survival of each NPI category for BCs diagnosed within the national breast screening service in Wales (Breast Test Wales (BTW)) to the latest data, and reviewed its validity in unselected cases within a screened population. METHODS All women screened between 1998 and 2001 within BTW were included. The NPI score for each cancer was calculated using the size, nodal status, and grade of the primary tumour. Survival data (all-cause) were calculated after ten years of follow-up. RESULTS In the three-year screening period, 199,082 women were screened. A total of 1,712 cancers were diagnosed, and 1,546 had data available for calculating the NPI. Overall five-year and ten-year survival was 94% and 82%, respectively. CONCLUSIONS Overall five-year and ten-year survival (all-cause) has improved even when compared with UK data for BC-specific survival. We found that the NPI remains valid for BC treatment, and that our data provide a reference for updating the allcause survival of women diagnosed with BCs within a screened population.

The extent to which people with intellectual disabilities have access to good quality end-of-life care is recognized as an important public health imperative given their increasing longevity and an allied growing incidence of life-limiting illnesses such as cancer and dementia