Hospital in the home: constructions of the nursing role - a literature review

• Acute medical and nursing treatment in the home is increasingly seen as an alternative to hospitalization. Models such as hospital in the home (HITH) or acute home care are said to provide a safe, comfortable environment for patients that is conducive to healing.

• A review of the literature reveals the embryonic nature of the research and discussion related to this alternative care delivery model. In general, the benefits of hospital in the home programmes are presented in an uncritical manner.

• Medical practitioners have embraced the move to home care as a means of expanding the use of advanced technologies and improved drug regimes beyond the hospital walls.

• The nursing response has been mechanistic and recipe-like while advancing the HITH nursing role as an opportunity for speciality practice by virtue of the increased autonomy and independence required.

• This review demonstrates the influence of a professional mandate for specialization, and the ideological and scientific interests that have influenced the role of the nurse.

Body image dissatisfaction among males across the lifespan- a review of past literature

Objective: Most past research has focused on body dissatisfaction among females. This paper provides a review and evaluation of studies that have examined body dissatisfaction among males. Body dissatisfaction in males has been associated with poor psychological adjustment, eating disorders, steroid use, exercise dependence, as well as other health behaviors. It is therefore important to understand the level of body dissatisfaction, as well as the factors that are related to this construct. Method: The review is divided into three sections: body dissatisfaction among children, adolescents and adults. Within each section, levels of body dissatisfaction are examined, as well as the research that relates to sociocultural influences on body dissatisfaction. Difficulties in drawing valid conclusions from the data due to methodological problems are highlighted. Results: From the current data, it would appear that there are strong similarities in the levels of body dissatisfaction of male and female children, with most children demonstrating high levels of body satisfaction. During adolescence, boys are about equally divided between wanting to lose weight and increasing weight, but there are few studies that have examined a desire for increased muscle size. In adulthood, men evidence a stronger desire to lose weight as they get older. Conclusion: Overall, past studies have primarily focused on questions that are relevant to females, and there is a need to conduct studies that evaluate areas of body dissatisfaction that have greater relevance for males. This will then allow a better understanding of the relationship between body dissatisfaction and psychological and behavioral problems experienced by males at all stages of the lifespan.

The impact of caring on caregivers' mental health : a review of the literature

This paper provides a brief overview of the literature on the impact of caring on the mental health of informal caregivers in the areas of aged care, disability and mental health. Factors discussed that may impact on caregivers' mental health include the relationship between the caregiver and care recipient, the nature of the care recipient's disability and the stage of the caregiving process. Several moderators of the impact of caring on mental health are described, including socio-economic factors, social support and coping strategies. This information provides a context within which to examine the type of interventions appropriate to assist caregivers in various situations.

Publication bias in the economic freedom and economic growth literature

The impact of institutions on economic performance has attracted significant attention from researchers, as well as from policy reformers. A rapidly growing area in this literature is the impact of economic freedom on economic growth. The aim of this paper was to explore publication bias in this literature by means of traditional funnel plots, meta‐significance testing, as well as by bootstrapping these meta‐significance tests. When all the available estimates are combined and averaged, there seems to be evidence of a genuine and positive economic freedom – economic growth effect. However, it is also shown that the economic freedom – economic growth literature is tainted strongly with publication bias. The existence of publication bias makes it difficult to identify the magnitude of the genuine effect of economic freedom on economic growth. The paper explores the differences between aggregate and disaggregate measures of economic freedom and shows that selection effects are stronger when aggregate measures are used.

Empirical evidence from the corporate collapse literature suggesting re-examination of accounting standards in relation to valuation of assets

This paper examines the recent spectacular corporate collapses of Parmalat in Europe, Enron and WorldCom in the USA and HIH in Australia and argues for a re-examination of corporate governance regulations, particularly in relation to accounting standards regarding the valuation of assets. The recommendation that is put forward in this regard is based upon empirical evidence arising from further examination of the empirical results in (Hossari and Rahman, 2004). Specifically, the recommendation is based upon the realization that, among the 48 financial ratios across the 50-plus refereed studies, five financial ratios, all of which contained assets as one of the variables, were a relatively robust indicator of corporate collapse. The five ratios are: Net Income/Total Assets, Current Assets/Current Liabilities, Total Liabilities/Total Assets, Working Capital/Total Assets, and Earnings Before Interest and Taxes/Total Assets. This paper suggests that it's not the failure of the corporate collapse prediction models, rather it's the erosion of the reliability of some key input data, namely assets and the valuation thereof, that is largely responsible for the apparent failure of these models in capturing impending collapses, such as those that we witnessed in the recent past. Such empirical findings support the argument that assets are soft targets for misrepresentation, because of the leeway granted in accounting standards with regards to their valuation.

Does successful treatment of constipation or faecal impaction resolve lower urinary tract symptoms? A structured review of the literature

Consensus guidelines advocate the treatment of constipation and faecal impaction in order to improve symptoms of urinary frequency, urgency and urinary incontinence and to promote bladder emptying in the absence of urinary tract obstruction. This structured review of the literature was undertaken to search for and appraise evidence to support or negate the hypothesis of this relationship. The search strategy was comprehensive and identified six relevant studies. Two of these had been conducted on an adult population and four studies involved children with constipation. These studies were appraised for methodological quality. It was found that sample sizes were small and evidence was inconsistent. Variable methods of reporting meant that data were not able to be pooled for meta-analysis.
Based on the limited and conflicting evidence, it is recommended that further research be undertaken to identify any correlation between bowel and bladder function.

The reliability of clinical indicators of oxygenation: a literature review

Despite oxygen being one of the most frequently administered substances in the hospital environment, there is little empirical data regarding its use. Review of the literature regarding the clinical assessment of hypoxia and hypoxaemia reveals inconsistency in the definition of terms and raises questions as to the reliability of the clinical indicators currently used to assess the need for supplemental oxygen. Assessment of the need for supplemental oxygen and continued re-evaluation of the patient's oxygen requirements is a nursing responsibility. Physical assessment, in combination with pulse oximetry, is the most common method used by nurses to assess oxygenation status. This paper critically appraises the literature to examine the reliability of clinical indicators of oxygenation used by nurses in acute care settings.

The role of nurses in preventing adverse events related to respiratory dysfunction: literature review

Aims. This paper reports a literature review examining the relationship between specific clinical indicators of respiratory dysfunction and adverse events, and exploring the role of nurses in preventing adverse events related to respiratory dysfunction.

Background. Adverse events in hospital are associated with poor patient outcomes such as increased mortality and permanent disability. Many of these adverse events are preventable and are preceded by a period during which the patient exhibits clearly abnormal physiological signs. The role of nurses in preserving physiological safety by early recognition and correction of physiological abnormality is a key factor in preventing adverse events.

Methods. A search of the Medline and CINAHL databases was conducted using the following terms: predictors of poor outcome, adverse events, mortality, cardiac arrest, emergency, oxygen, supplemental oxygen, oxygen therapy, oxygen saturation, oxygen delivery, assessment, patient assessment, physical assessment, dyspnoea, hypoxia, hypoxaemia, respiratory assessment, respiratory dysfunction, shortness of breath and pulse oximetry. The papers reviewed were research papers that demonstrated a relationship between adverse events and various clinical indicators of respiratory dysfunction.

Results. Respiratory dysfunction is a known clinical antecedent of adverse events such as cardiac arrest, need for medical emergency team activation and unplanned intensive care unit admission. The presence of respiratory dysfunction prior to an adverse event is associated with increased mortality. The specific clinical indicators involved are alterations in respiratory rate, and the presence of dyspnoea, hypoxaemia and acidosis.

Conclusions. The way in which nurses assess, document and use clinical indicators of respiratory dysfunction is influential in identifying patients at risk of an adverse event and preventing adverse events related to respiratory dysfunction. If such adverse events are to be prevented, nurses must not only be able to recognise and interpret signs of respiratory dysfunction, but must also take responsibility for initiating and evaluating interventions aimed at correcting respiratory dysfunction.

The unhallowed art : literature and literary fakes in Australia

The fiction of Peter Carey is peopled by the unhallowed; by ghosts and the ghostly. In Bliss (1981), Carey presents us with the Dantesque trials of an advertising executive after he has a heart attack on his front lawn. In The Unusual Life of Tristan Smith (1994), phantom nations are inhabited by simulacra. In True History of the Kelly Gang (2001), a dead bushranger talks. Carey's My Life as a Fake (2003), the subject of this essay, gives us an apotheosis of this literary habit of bringing the unliving to life. It presents us with the flesh-and-blood, machete-wielding, gladiatorial figure of Bob McCorkle, a poet created as a literary hoax.

The phenomenon of presence within contemporary nursing practice: A literature review

Nursing practice underpinned by humanistic values may promote presence experiences within nurse-patient interactions. These interactions are powerful and beneficial both to nurse and patient. However, the phenomenon of presence is surrounded by competing and confused definitions. Whilst presence is arguably a core aspect of nursing practice, current health care environments significantly influence nurses' opportunities to experience presence.

Construction of gender in computer magazine advertisements : confronting the literature

Previous studies (Sofia, 1998; 2002; Turner & Hovenden, 1997; Weinstein, 1998) discussed the power relations surrounding the advertisements for computers in computing magazines, in particular deconstructing the imagery and text which manifested the dominant digital discourse of power (Millar, 1998). In these studies, the authors found that women were positioned as incapable and impotent users of computers.  The authors examined a number of New Zealand and Australian home computing magazines published in 2003 and 2004, looking for evidence of the gendered nature of technology or examples of any form which would constitute discrimination against women or other identity categories. The purpose of this research was to determine whether previous arguments were still relevant and current, or whether advertisements had changed to accommodate populist understandings of gender and cultural equity, or reflect improved power relations between the sexes. In this paper we have explored the findings of a study, which, although small in scale, raises larger questions concerning the 'new' ways in which issues of gender influence advertising focused on computers. Whilst there has been a significant reduction in overtly sexist texts, hegemonic understandings of masculinity and femininity nevertheless continue to structure mainstream advertisements with women routinely positioned in passive, non-expert or very limited kinds of roles. The extent to which this imagery reflects broader social patterns regarding the re-emergence of traditional portrayals of women and men in the media more generally will be the subject of future studies.

Reflexivity, its meanings and relevance for social work: a critical review of the literature

The concept of "reflexivity" has become increasingly significant in social work literature in relation to social work education, theory and practice. However, our reading of the literature indicates that there is a lack of clarity about the concept in terms of who is being exhorted to be "reflexive," when and how. This article addresses these questions through a critical review of social work literature since the 1990s that discusses the concept of "reflexivity." Given that many authors seem to use the concepts of "reflexivity" and "(critical) reflection" interchangeably, we also apply this analysis to "reflection" and "critical reflection." This article raises important questions about how the concepts of "reflexivity," "critical reflection" and "reflectivity" are defined and the different consequences such definitions might have for social work education, theory and practice.

Do clinicians know how to use pulse oximetry? A literature review and clinical implications

Pulse oximerry has become one of the most commonly used tools in the clinical environment for assessing patients' oxygenation status. It is employed almost continuously in critical care areas and frequently in the general ward environment. Although it is a much better tool for determining hypoxia than the human eye, its use is limited if clinicians do not understand relevant physiological principles, such as the oxyhaemoglobin dissociation curve and the inherent limitations of the device. Furthermore, the risk for compromised patient safety is significant if clinicians fail to recognise the potential for false or erroneous readings. This paper explores the research which has examined clinicians' comprehension of pulse oximetry. Fourteen studies examining clinicians' knowledge of pulse oximerry were reviewed. These studies revealed significant knowledge deficits about pulse oximerry amongst nurses, doctors and allied health professionals, all of whom used this technology frequently. Alarmingly, those lacking an adequate understanding of pulse oximerry included senior, experienced clinicians. The studies were limited by their use of convenience sampling and small sample sizes. Further research is needed to better understand the significance of this problem and to examine how principles of pulse oximerry are taught to nurses and other health professionals at the undergraduate and postgraduate levels. Educators and clinicians alike must ensure that a safe level of knowledge for the use of pulse oximerry is maintained in order to ensure that patient outcomes are not compromised.