Pain during mammography: implications for breast screening programmes

Pain experienced during mammography can deter women from attending for breast cancer screening. Review of the current literature on pain experienced during mammography reveals three main areas of interest: reports of the frequency of pain, identification of predictors of pain and strategies for responding to pain. Implications of this literature for breast screening programmes include the need for appropriate measurements of pain during mammography that are valid for screening populations, a further understanding of organizational factors involved in screening programmes that may be predictors of pain and for the development of valid strategies for responding to pain within breast screening programmes.

Defining the scope of practice of the emergency nurse practitioner role in a metropolitan emergency department

This study examined the emergency nurse practitioner candidate (ENPC) scope of practice in a Victorian emergency department (ED). The emergency nurse practitioner (ENP) role is relatively new in Victoria and the scope of the ENP(C) practice is yet to be defined. International research literature regarding the ENP role has focused on outcomes such as patient satisfaction, waiting times and/or ED length of stay, accuracy and adequacy of documentation, use of radiography, and patient education, health promotion and communication issues. A prospective exploratory design was used to conduct this cohort study. There were 476 ENPC-managed patients between 14 July 2004 and 31 March 2005 with an average age of 29 years. The majority (77.2%) of ENPC-managed patients were discharged from the ED. The majority of the ENPC time was devoted to clinical practice (55%) and development of clinical practice guidelines (25%). Of patients managed by the ENPC, 49.6% required medications, 51% required diagnostic imaging and 8.6% required pathology testing during their ED stay. The most common discharge referrals were made to local medical officers (73.5%) and the most common referrals made for patients requiring admission were made to the plastic surgery (37.3%) and orthopaedic (35.5%) units. Extensions to the current scope of emergency nursing practice are pivotal to effective management of specific patient groups by ENP. The ENP model of care is an important strategy for the management of increased service demands in Victoria; however, little is known about the scope of the ENPC practice and many outcomes of the ENP care are yet to be defined. Further research to better understand the relationships between ENP outcomes is required if the contribution that ENPs make to emergency care is to be accurately quantified.

Inspection of drop-weight impact damage in woven CFRP laminates fabricated by different processes

The influence of manufacturing process on the drop-weight impact damage in woven carbon/epoxy laminates was inspected by visual observation, dyepenetrant X-ray technique, and optical microscopy observation. The MTM56/ CF0300 woven quasi-isotropic laminates were fabricated by two processes: the autoclave and the Quickstep processes. Quickstep^TM is a novel composite manufacturing process, which was designed for the out-of-autoclave production of high-quality composite parts at lower cost. It utilizes higher heat conduction of fluid other than gas to transfer heat to components, which results in much shorter cure cycles. The laminates cured by this fast heating process showed different impact failure modes from those cured by the conventional autoclave process. The residual indentation in the top side of the Quickstep-cured laminates had a bigger diameter, but a smaller depth at the same impact energy level. Dye-penetrant X-ray revealed more intense and connected impact damage regions in the autoclave-cured laminates. Optical micrography as a supplementary method showed less severe matrix damage in the quickstep-cured laminates indicating a more ductile property of the resin matrix cured at a faster heating rate.

Validation and development of a clinical prediction rule in clinically suspected community-acquired pneumonia

To develop a mathematical model to predict the probability of having community-acquired pneumonia and to evaluate an already developed prediction rule that has not been validated in a clinical scenario.