Obesity in pre-school children: Issues and challenges for community based child health nurses

Childhood obesity is becoming a topical issue in both the health literature and the popular media and increasingly child health nurses are observing preschool children who appear to be disproportionately heavy for their height when plotted on standardised growth charts. In this paper literature related to childhood obesity in New Zealand and internationally is explored to identify current issues, and the implications of these issues for nurses in community based child health practice are discussed. Themes that emerged from the literature relate to the measurement of obesity, links between childhood and adult obesity and issues for families. A theme in the literature around maternal perception was of particular interest. Studies that investigated maternal perceptions of childhood obesity found that mothers identified their child as being overweight or obese only when it imposed limitations on physical activity or when the children were teased rather than by referring to individual growth graphs. The implications for nursing in the area of child health practice is discussed as nurses working in this area need an understanding of the complex and often emotive issues surrounding childhood obesity and an awareness of the reality of people's lives when devising health promotion strategies.

Rural and Isolated Practice Registered Nurse (RIPRN)-Emergency nurses of the Queensland `bush'

The Rural and Isolated practice endorsement for Queensland Registered Nurses has attracted interest from other state health authorities with respect to expanding the scope of practice of nurses working in rural and remote Australia. This discussion article outlines the endorsement program and sheds a spotlight on the program for the emergency and greater nursing community. The paper draws a similarity between rural and emergency nursing and stimulates the notion that other states could look to Queensland's model, for scope of practice expansion in other specialties such as emergency Nursing.

Cardiovascular risk estimation by professionally active cardiovascular nurses: Results from the Basel 2005 Nurses Cohort

Background Nurses play a key role in the prevention of cardiovascular disease (CVD) and one would, therefore, expect them to have a heightened awareness of the need for systematic screening and their own CVD risk profile. The aim of this study was to examine personal awareness of CVD risk among a cohort of cardiovascular nurses attending a European conference. Methods Of the 340 delegates attending the 5th annual Spring Meeting on Cardiovascular Nursing (Basel, Switzerland, 2005), 287 (83%) completed a self-report questionnaire to assess their own risk factors for CVD. Delegates were also asked to give an estimation of their absolute total risk of experiencing a fatal CVD event in the next 10 years. Level of agreement between self-reported CVD risk estimation and their actual risk according to the SCORE risk assessment system was compared by calculating weighted Kappa (κw). Results Overall, 109 responders (38%) self-reported having either pre-existing CVD (only 2%), one or more markedly raised CVD risk factors, a high total risk of fatal CVD (≥ 5% in 10 years) or a strong family history of CVD. About half of this cohort (53%) did not know their own total cholesterol level. Less than half (45%) reported having a 10-year risk of fatal CVD of < 1%, while 13% reported having a risk ≥ 5%. Based on the SCORE risk function, the estimated 10-year risk of a fatal CVD event was < 1% for 96% of responders: only 2% had a ≥ 5% risk of such an event. Overall, less than half (46%) of this cohort's self-reported CVD risk corresponded with that calculated using the SCORE risk function (κw = 0.27). Conclusion Most cardiovascular nurses attending a European conference in 2005 poorly understood their own CVD risk profile, and the agreement between their self-reported 10-year risk of a fatal CVD and their CVD risk using SCORE was only fair. Given the specialist nature of this conference, our findings clearly demonstrate a need to improve overall nursing awareness of the role and importance of systematic CVD risk assessment.

Knowledge, perceptions and expectations of nurses in e-health: results of a survey in a children's hospital

We surveyed all nurses working at a tertiary paediatric hospital (except casual staff and those who were on leave) from 27 hospital departments. A total of 365 questionnaires were distributed. There were 40 questions in six sections: demographic details, knowledge of e-health, relevance of e-health to nursing profession, computing skills, Internet use and access to e-health education. A total of 253 surveys were completed (69%). Most respondents reported that that they had never had e-health education of any sort (87%) and their e-health knowledge and skills were low (71%). However, 11% of nurses reported some exposure to e-health through their work. Over half (56%) of respondents indicated that e-health was important, very important or critical for health professions while 26% were not sure. The lack of education and training was considered by most respondents (71%) to be the main barrier to adopting e-health. While nurses seemed to have moderate awareness of the potential benefits of e-health, their practical skills and knowledge of the topic were very limited.

Residents' rights and nurses' ethics in the Australian nursing home

Background: This article is derived from a more extensive review of literature for a qualitative study that explored the meaning of truth-telling within the care provider-aged resident dyad in high-level (nursing home) aged care. Aim: This paper describes through the literature, work practices and the culture of the nursing home as promoting instrumental care, therefore prioritizing doing-for over being-with. The nursing home, starved of time and staff, silences and isolates the aged care resident in an environment that is, arguably, rarely homelike. Conclusion: The appraisal of the nursing home offered here means that a number of residents' rights are at risk and care providers (notably registered nurses and the personal care assistants) risk contravening the Code of Ethics for Nurses in Australia.