Aims: The psychological outcome of family carers after bereavement is an important issue in evaluating palliative care services. Palliative care services have the potential to provide preventive psychosocial intervention to family carers prior to bereavement, but are faced with the need to identify those who may have greatest risk of adverse outcome. This prospective study examines predictors of psychological outcome for family carers of cancer patients following bereavement based on factors identified at referral to a palliative care agency. Methods: Cancer patients and their family carer were consecutively recruited and assessed on a range of clinical and psychological measures at referral to a palliative home care service in a metropolitan centre (Time 1). Carers were again assessed following the death of the patient, on average at 4 months post‐bereavement (Time 2), using measures of bereavement symptoms and psychological morbidity. Results: 178 carers were assessed on both occasions. The chief predictors of carer psychological symptoms and severity of grief at follow‐up were psychological symptom scores at the time of referral (Time 1). Factors also measured at Time 1 were significant predictors of symptoms and grief scores at Time 2: greater number of adverse life events, carer's coping responses, past bereavement and separation experiences, the relationship with the patient, and greater severity of patient's illness at the time of palliative care referral. Conclusions: The findings indicate clinical risk factors for adverse short‐term bereavement outcome that can be identified in family carers during palliative care treatment, that have implications for identifying the psychological needs of carers, and that form a potential basis for interventions to enhance the psychological outcome for family carers. Copyright © 1999 John Wiley & Sons, Ltd.

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Suggested methods for conducting website accessibility evaluations have typically focused on the needs of end-users who have disabilities. However, programmers, not people with disabilities, are the end-users of evaluations reports generated by accessibility specialists. Programmers' capacity and resource needs are seldom met by the voluminous reports and long lists of individual website fixes commonly produced using earlier methods. The rationale for the need to consider the whole website development process, and the social characteristics of programmers and project managers is presented. A new programmer-centric Streamlined Evaluation and Reporting Process for Accessibility (SERPA) is described in detail.

Interest in the field of patient safety incident reporting and analysis with respect to Health Information Technology (HIT) has been growing over recent years as the development, implementation and reliance on HIT systems becomes ever more prevalent. One of the rationales for capturing patient safety incidents is to learn from failures in the delivery of care and must form part of a feedback loop which also includes analysis; investigation and monitoring. With the advent of new technologies and organizational programs of delivery the emphasis is increasingly upon analyzing HIT incidents. This thematic review had two objectives, to test the applicability of a framework specifically designed to categorize HIT incidents and to review the Welsh incidents as communicated via the national incident reporting system in order to understand their implications for healthcare. The incidents were those reported as IT/ telecommunications failure/ overload. Incidents were searched for within a national reporting system using a standardized search strategy for incidents occurring between 1(st) January 2009 and 31(st) May 2011. 149 incident reports were identified and classified. The majority (77%) of which were machine related (technical problems) such as access problems; computer system down/too slow; display issues; and software malfunctions. A further 10% (n = 15) of incidents were down to human-computer interaction issues and 13% (n = 19) incidents, mainly telephone related, could not be classified using the framework being tested. On the basis of this review of incidents, it is recommended that the framework be expanded to include hardware malfunctions and the wrong record retrieved/missing data associated with a machine output error (as opposed to human error). In terms of the implications for clinical practice, the incidents reviewed highlighted critical issues including the access problems particularly relating to the use of mobile technologies.

This experiment examines the effect that computer experience and various combinations of feedback (auditory, haptic, and/or visual) have on the performance of older adults completing a drag-and-drop task on a computer. Participants were divided into three computer experience groups, based on their frequency of use and breadth of computer knowledge. Each participant completed a series of drag-and-drop tasks under each of seven feedback conditions (three unimodal, three bimodal, one trimodal). Performance was assessed using measures of efficiency and accuracy. Experienced users responded well to all multimodal feedback while users without experience responded well to auditory-haptic bimodal, but poorly to haptic-visual bimodal feedback. Based on performance benefits for older adults seen in this experiment, future research should extend investigations to effectively integrate multimodal feedback into GUI interfaces in order to improve usability for this growing and diverse user group.

PCPs are interested in partnering in models of shared care for pediatric cancer survivors. Effective educational initiatives include lectures within HCP's professional education constructs and web-based CE opportunities. PCP involvement in survivor care alleviates some barriers to care such as geographic distance to the the cancer center and ensures that more pediatric cancer survivors receive recommended coordinated surveillance for late effects of cancer therapy.