Mindful messages: surfing for spirituality

As it becomes clearer that spiritual concerns are very much part of the work of palliative care nurses, it is interesting to note the many ways in which patients express their needs and the different approaches adopted by carers in addressing them. This site, although not specific to palliative care, reflects many concerns familiar to those working with people whose illness may focus their thoughts on death or dying either at diagnosis, or as a longer-term source of distress.

Interpretations and variations of ISO 9000 in acute health care. International Organization for Standardization

OBJECTIVE

This paper aims to address two questions related to the implementation of the ISO 9000 Quality Management System standard in the acute health care sector: which countries have developed specific nationwide guidelines/interpretations? and what variances exist between the different interpretations of the ISO 9002 standard?

DESIGN

The study was carried out via an assessment of the available guideline documents for the use of ISO 9000 in the acute health care sector. The interpretation of each document was examined for common elements and deviations from the commonly agreed terms.

SETTING

Worldwide in the acute health care sector (excluding that of laboratories).

STUDY PARTICIPANTS

Eighty-two international ISO members and/or quality health care organizations.

RESULTS

The results showed variation in the interpretations of the ISO 9000 standard. In total, 16 of the clauses/subclauses note distinct variations, between one or more of the documents, which could alter the perception of the system.

CONCLUSION

From examination of the six identified guideline documents, the claim that ISO 9000 introduces quality systems which are comparable from one country to another is unfounded in the acute health care sector.

Male cancers: the great taboo

Linked as they are with taboos on age, sex and continence, it is perhaps no surprise that male cancers have not received the same exposure as, for instance, breast cancer. This is also the case on the Internet, which is often criticized for its male dominance. However, a growing number of efforts are being made to redress this balance.

Three words three shapes: A clinical test of memory

Three Words - Three Shapes was designed as an easy "bedside" test for elderly patients that assesses verbal and nonverbal memory within the same modality. In the present study, it was administered to patients with probable Alzheimer's disease (PRAD), a control group of non-demented older subjects (NC) and a group of patients with Korsakoff's amnesia (KA). Incidental recall and several other measures of learning, retention and recognition differentiated control from PRAD and KA subjects. PRAD and KA subjects' performance was similar, but there were some material-specific interactions. This test is relatively easy and some of the derived measures could prove useful in staging amnesia progression beyond the earliest stages of PRAD when more difficult tests yield floor effects.

Fatigue: online resources and advice

This site is a joint development by the Oncology Nursing Society and the Fatigue Coalition. Like many US sites, the content is also available in Spanish in order to reach the widest possible audience. The site allows the user to explore fatigue in detail, and includes information that patients may use to improve their ability to cope with this cancer symptom. For the professional, the site raises the challenge of considering fatigue in a new light; not just as an inevitable part of cancer, its treatment and progression but rather as a problem that needs to be addressed in a holistic fashion in much the same way as pain is.

Breast cancer: net gains for patients

Dominated by the pink ribbon logo now so clearly linked with breast cancer, this site offers a range of material and highlights the support services offered by this charity to the 1 in 11 women in the UK who develop the disease in any one year.

Paediatric palliative care comes of age

With its colourful layout and detailed explanations this site aims to raise the profile of children’s palliative care, which has emerged as a speciality in the last decade. Although some elements of this site remain under construction, if this area of nursing interests you then it is one for your hotlist.

User views of a regional secure unit--findings from a patient satisfaction survey

This paper includes key findings of a patient satisfaction survey, conducted within an English Medium Secure Unit, offering care and treatment for 45 male and female mentally disordered offenders. It aims to identify patients' perceptions of the quality of their care and other aspects of their lives within the secure unit. Following permission from the local Ethics Committee, two interviewers collected data within a two week period, using a semi-structured interview schedule. All but three of the respondents agreed to be interviewed. Talking to nurses was perceived as highly satisfying. However, provision for specific cultural and women's needs, facilities for visitors, opportunities to practise religious beliefs and access to care plans were highlighted as unsatisfactory. The study concludes with recommendations for improvement, some of which have already been considered and implemented.

Psychiatric comorbidity in methadone maintained patients

Diagnosing comorbid psychiatric disorders in methadone maintained patients may help to identify subgroups with different outcomes and needs for treatment. In this study, 75 methadone maintenance clinic patients in treatment longer than 30 days were assessed with the Addiction Severity Index, Global Assessment Scale and Mini-Mental Status Exam, and were interviewed for DSM-III-R psychiatric diagnosis using the computerized Diagnostic Interview Schedule. Psychiatric diagnoses were prevalent in the sample with depression, phobic disorders, antisocial personality and generalized anxiety the most common. Both number of DSM-III-R diagnoses and severity of psychopathology were correlated with outcome measures such as concurrent drug abuse, family-social problems and employment status.

Quality assurance and standards for red cells and platelets

Blood donations vary in composition because of considerable variation in donor cell counts and volume collected. In order to minimize the variation in end products produced, and reduce the likelihood of low quality products, a program called Quality Assurance (QA) is required. Agreement on minimal standards is useful, and a program of quality control (QC) is an important component of QA. However, while QC to ensure compliance with standards is desirable, the objective of manufacturing products of consistently high quality can only be achieved when attention is focused on total process control, self-auditing and the energetic management of errors.

Comparison of results of various methods used to determine the extent of modification of methoxy polyethylene glycol 5000-modified bovine cupri-zinc superoxide dismutase

The protein bovine cupri-zinc superoxide dismutase (SOD) was modified by the reaction of lysine residues with an active ester of methoxy polyethylene glycol 5000 (PEG). The extent of modification was determined by capillary zone electrophoresis, matrix-assisted laser desorption/ionization mass spectrometry, Fourier-transform infrared spectroscopy, and Raman spectroscopy and after removing PEG by alkaline hydrolysis of the linkages to SOD followed by quantification of the released PEG using gel-permeation chromatography. There was generally good agreement among the results obtained by these techniques on a typical sample of the PEG-modified protein. The results, extent of protein modification, determined by the preceding methods were compared to that found from the classical trinitrobenzene sulfonic acid (TNBS) procedure. In addition to providing alternatives to the TNBS procedure, results from the described methodologies strongly suggest that the extent of modification determined from the TNBS procedure is overestimated.