The usefulness of the distress thermometer in the management of cancer patients: a mixed methods approach

Objective: The aim of this study was to investigate the usefulness of the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List in identifying distress levels and psychosocial concerns over the cancer trajectory using a mixed-methods approach.
Method: Eighty-five cancer patients from the Barwon South West region of Victoria participated in this study by completing the NCCN Distress Thermometer and Problem List over three time periods. Three case studies were also conducted to add a qualitative dimension.
Results: Emotional concerns decreased as psychological distress levels decreased and a high level of physical concerns were consistent with a high level of psychological distress. Cancer patients’ narrative accounts also supported
the usefulness of the NCCN Distress Thermometer and Problem List as a screening tool.
Conclusions: Findings are discussed with reference to implications for psychological/emotional support of cancer patients, the provision of supportive care services and directions for future research.

Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: Nurses’ emotional talk and sources of discomfort. A mixed methods study

BACKGROUND: The majority of in-hospital deaths of children occur in paediatric and neonatal intensive care units. For nurses working in these settings, this can be a source of significant anxiety, discomfort and sense of failure.

OBJECTIVES: The objectives of this study were to explore how NICU/PICU nurses care for families before and after death; to explore the nurses' perspectives on their preparedness/ability to provide family care; and to determine the emotional content of language used by nurse participants.

METHODS: Focus group and individual interviews were conducted with 22 registered nurses from neonatal and paediatric intensive care units of two major metropolitan hospitals in Australia. All data were audio recorded and transcribed verbatim. Transcripts were then analysed thematically and using Linguistic Inquiry to examine emotional content.

RESULTS: Four core themes were identified: preparing for death; communication challenges; the nurse-family relationship and resilience of nurses. Findings suggested that continuing to provide aggressive treatment to a dying child/infant whilst simultaneously caring for the family caused discomfort and frustration for nurses. Nurses sometimes delayed death to allow families to prepare, as evidenced in the Linguistic Inquiry analysis, which enabled differentiation between types of emotional talk such as anger talk, anxiety talk and sadness talk. PICU nurses had significantly more anxiety talk (p=0.018) than NICU nurses.

CONCLUSION: This study provided rich insights into the experiences of nurses who are caring for dying children including the nurses' need to balance the often aggressive treatments with preparation of the family for the possibility of their child's death. There is some room for improvement in nurses' provision of anticipatory guidance, which encompasses effective and open communication, focussed on preparing families for the child's death.

Nursing care of the family before and after a death in the ICU - an exploratory pilot study

This qualitative descriptive study was undertaken in two metropolitan ICUs utilising focus groups to describe the ways in which ICU nurses care for the families of dying patients during and after the death. Participants shared their perspectives on how they care for families, their concerns about care, and detailed the strategies they use to provide timely and person-centred family care. Participants identified that their ICU training was inadequate in equipping them to address the complex care needs of families leading up to and following patient deaths, and they relied on peer mentoring and role-modelling to improve their care. Organisational constraints, practices and pressures impacting on the nurse made ‘ideal’ family care difficult. They also identified that a lack of access to pastoral care and social work after hours contributed to their concerns about family care. Participants reported that they valued the time nurses spent with families, and the importance of ensuring families spent time with the patient, before and after death.

The 'dis-ease' of dying: challenges in nursing care of the dying in the acute hospital setting. A qualitative observational study

BACKGROUND: Changes in health care and an ageing population have meant that more people are dying in the acute hospital setting. While palliative care principles have resulted in quality care for the dying, many patients die in an acute care, still receiving aggressive/resuscitative care. AIMS: The aims were to explore nurses' 'recognition of' and 'responsiveness to' dying patients and to understand the nurses' influence on end-of-life care. DESIGN: A qualitative approach was taken utilising non-participant observation to elicit rich data, followed by focus groups and individual semi-structured interviews for clarification. SETTING/PARTICIPANTS: This study was conducted in two acute medical wards in one health service, identified as having the highest rates of death, once palliative care and critical care areas were excluded. Twenty-five nurses consented to participate, and 20 episodes of observation were conducted. RESULTS: Nurses took a passive role in recognising dying, providing active care until a medical officer's declaration of dying. Ward design, nurse allocation and nurses' attitude to death impacts patient care. End-of-life care in a single room can have negative consequences for the dying. Nurses demonstrated varying degrees of discomfort, indicating that they were underprepared for this role. CONCLUSION: When patients are terminally ill, acknowledgement of dying is essential in providing appropriate care. It should not be assumed that all nurses are adequately prepared to provide dying care. Further work is necessary to investigate how the attitudes of nurses towards caring for dying patients in the acute hospital setting may impact care of the dying patient.

Reproducibility of the online food4me food-frequency questionnaire for estimating dietary intakes across Europe

BACKGROUND: Accurate dietary assessment is key to understanding nutrition-related outcomes and is essential for estimating dietary change in nutrition-based interventions. OBJECTIVE: The objective of this study was to assess the pan-European reproducibility of the Food4Me food-frequency questionnaire (FFQ) in assessing the habitual diet of adults. METHODS: Participants from the Food4Me study, a 6-mo, Internet-based, randomized controlled trial of personalized nutrition conducted in the United Kingdom, Ireland, Spain, Netherlands, Germany, Greece, and Poland, were included. Screening and baseline data (both collected before commencement of the intervention) were used in the present analyses, and participants were included only if they completed FFQs at screening and at baseline within a 1-mo timeframe before the commencement of the intervention. Sociodemographic (e.g., sex and country) and lifestyle [e.g., body mass index (BMI, in kg/m(2)) and physical activity] characteristics were collected. Linear regression, correlation coefficients, concordance (percentage) in quartile classification, and Bland-Altman plots for daily intakes were used to assess reproducibility. RESULTS: In total, 567 participants (59% female), with a mean ± SD age of 38.7 ± 13.4 y and BMI of 25.4 ± 4.8, completed both FFQs within 1 mo (mean ± SD: 19.2 ± 6.2 d). Exact plus adjacent classification of total energy intake in participants was highest in Ireland (94%) and lowest in Poland (81%). Spearman correlation coefficients (ρ) in total energy intake between FFQs ranged from 0.50 for obese participants to 0.68 and 0.60 in normal-weight and overweight participants, respectively. Bland-Altman plots showed a mean difference between FFQs of 210 kcal/d, with the agreement deteriorating as energy intakes increased. There was little variation in reproducibility of total energy intakes between sex and age groups. CONCLUSIONS: The online Food4Me FFQ was shown to be reproducible across 7 European countries when administered within a 1-mo period to a large number of participants. The results support the utility of the online Food4Me FFQ as a reproducible tool across multiple European populations. This trial was registered at clinicaltrials.gov as NCT01530139.

Effects of the Use of the Educreations Application in the Reading Comprehension of an Adolescent with Autism and Speech Delay

This paper is the final proposal that accompanies the poster presentation of the action research "Effects of the Use of the Educreations Application in the Reading Comprehension of an Adolescent with Autism and Speech Delay" in the 2015 South Florida Research Education Conference.

Identification of differentially expressed genes in the heart precursor cells of the chick embryo

Genetic evidence has implicated several genes as being critical for heart development. However, the inducers of these genes as well as their targets and pathways they are involved with, remain largely unknown. Previous studies in the avian embryo showed that at HH4 Cerberus (cCer) transcripts are detected in the anterior endomesoderm including the heart precursor cells and later in the left lateral plate mesoderm. We have identified a promoter element of chick cCer able to drive EGFP expression in a population of cells that consistently exit from the anterior primitive streak region, from as early as stage HH3+, and that later will populate the heart. Using this promoter element as a tool allowed us to identify novel genes previously not known to potentially play a role in heart development. In order to identify and study genes expressed and involved in the correct development and differentiation of the vertebrate heart precursor cell (HPC) lineages, a differential screening using Affymetrix GeneChip system technologies was performed. Remarkably, this screening led to the identification of more than 700 transcripts differentially expressed in the heart forming regions (HFR). Bioinformatic tools allowed us to filter the large amount of data generated from this approach and to select a few transcripts for in vivo validation. Whole-mount in situ hybridization and sectioning of selected genes showed heart and vascular expression patterns for these transcripts during early chick development. We have developed an effective strategy to specifically identify genes that are differentially expressed in the HPC lineages. Within this set we have identified several genes that are expressed in the heart, blood and vascular lineages, which are likely to play a role in their development. These genes are potential candidates for future functional studies on early embryonic patterning.

Effectiveness of Depression-Suicidal Behaviour Gatekeeper training among police officers in three European regions: outcomes of the Optimising Suicide Prevention Programmes and their Implementation in Europe (OSPI-Europe) study

Background: Gatekeeper training for community facilitators, to identify and respond to those at risk of suicide, forms an important part of multi-level community-based suicide prevention programmes. Aims: This study examined the effects of gatekeeper training on attitudes, knowledge and confidence of police officers in dealing with persons at risk of suicide. Methods: A total of 828 police officers across three European regions participated in a 4-hour training programme which addressed the epidemiology of depression and suicidal behaviour, symptoms of depression, warning signs and risk factors associated with suicidal behaviour, motivating help-seeking behaviour, dealing with acute suicidal crisis and informing bereaved relatives. Participants completed internationally validated questionnaires assessing stigmatising attitudes, knowledge about depression and confidence in dealing with suicidal persons pre- and post-training. Results: There were significant differences among countries in terms of previous exposure to suicidal persons and extent of previous training. Post-training evaluation demonstrated significant improvements in stigmatising attitudes, knowledge and confidence in all three countries. Conclusion: The consistently positive effects of gatekeeper training of police officers across different regions support inclusion of this type of training as a fundamental part of multi-level community-based suicide prevention programmes and roll-out, nationally and internationally.

MySchool:whose school? an Australian investigation of the mediatization of educational policy

In investigating how three Australian newspapers and six school principals interacted with a significant policy initiative, namely the MySchool website, this research argues against homogenous views of both print-media and mediatization. It further argues that while press reporting on education policy is often an opportunity for newspapers to present newspaper-specific views of what policy ought to be, mediatization is not a one-way process. Rather, it is a dynamic one, defined and shaped by struggle and contestation, through which the press may also be subject to change. The research further suggests that strong school leaders play a crucial role in enabling schools to resist mediatized efforts to alter their practice and autonomy.

Evolution and significance of the regeneration reserve heritage landscape of Broken Hill: history, values and significance

In 1991, the National Trust of NSW classified the Regeneration Reserves surrounding the City of Broken Hill as an essential cultural heritage asset of the City of Broken Hill, and in 2015 the City of Broken Hill, including the reserves, were elevated to the National Heritage List under the Commonwealth's Environment Protection and Biodiversity Conservation Act 1999. This tract of land, and its proponents, Albert and Margaret Morris, are recognised as pioneers of arid zone revegetation science in Australia; a point noted in the National Heritage List citation. They created at Broken Hill a unique revegetation ‘greenbelt’ of national ecological, landscape architectural and town planning significance. The Morris’ led the advancement of arid zone botanical investigation and taxonomic inquiry, propagation innovation, and revegetation sciencein the 1920s-40s in Australia and applied this spatially. Their research and practical applications, in crafting the regeneration reserves around Broken Hill, demonstrated the need for landscape harmonisation to occur to reduce erosion and dust damage to human and mining activities alike. This pioneering research and practice informs and underpins much arid zone mine reclamation and revegetation work in Australia today. This paper reviews the historical evolution of this cultural landscape, its integral importance to the cultural heritage and mining history of the City of Broken Hill, and its inclusion as part of the Broken Hill National Heritage List citation.

The Proceedings of the South Carolina Historical Association

Annually, the association publishes a journal, The Proceedings, which consists of papers presented at the annual meeting. Antislavery Presbyterians in the Carolina Piedmont by Margaret B. DesChamps A Brief Outline of the South Carolina Colonial Militia System by David Cole

The Proceedings of the South Carolina Historical Association

Annually, the association publishes a journal, The Proceedings, which consists of papers presented at the annual meeting. The United States and Austria, 1918-1919: The Problem of National Self-Determination by Duane Myers The German Economy during World War II: Petroleum by Peter W. Becker Tillman’s Lieutenant: John Laurens Manning Irby by Jerry Slaunwhite Tillman’s Lieutenant: John Lowndes McLaurin by Rodger Stroup