Search

Summary Aims To determine the impact of a Parkinson's medicine education program on nurses' knowledge and practices in two settings where people with Parkinson's disease are cared for: hospitals and residential aged care facilities. The Parkinson's Disease Medication Protocol Program aimed to increase nurse knowledge of Parkinson's medication administration and safety in care management in order to improve health outcomes, function and well-being for the person with Parkinson's. Background The ageing demographic of the developed world is concomitant with an increase in chronic disease, with Parkinson's disease being one of the most debilitating and costly. Individually complex medication regimens and unique spectrums of symptoms require disease-specific knowledge in nurses. People with Parkinson's disease admitted to hospitals and/or living in residential aged care facilities often have multiple co-morbidities, rendering care more complex still. Nurse ignorance of Parkinson's disease medicines, their uses, side effects and administration regimens, and safe care practices, can cause unnecessary distress and dysfunction for the person. Method The two pilot studies employed an eighteen month pre/post-test/follow up design at different time frames, using a questionnaire developed by the study team and an expert panel to evaluate nurses' self-assessed ‘perceived’ knowledge and actual knowledge of Parkinson's disease, Parkinson's medicines and safe care practices, and satisfaction with the targeted Parkinson's education program. Results/findings Nurses in the hospital pilot (2006/8) revealed deficits in pre-test perceived and actual knowledge levels, which increased significantly at post-test and follow-up. In contrast, in the residential aged care pilot (2008/10) the nurses had higher perceived and actual (correct) knowledge relevant to experience at pre-test and these levels increased at follow-up. Both pilot study cohorts were very satisfied with the PDMPP as an education and support vehicle in Parkinson's management. Conclusion These study results concur with the international literature which identifies that without targeted clinical education nurses do not necessarily have sufficient knowledge to effectively manage Parkinson's medicines and avoid unnecessary negative outcomes arising from delays, errors and omissions, nor do they know how to provide safe and effective care for persons with Parkinson's. A well-developed and resourced Parkinson's medicine education program, such as the PDMPP, has the potential to improve deficits in clinical practice.

Aim. To identify the factors associated with better self-management in people with moderate to high levels of Parkinson’s disease following an acute illness event. Design and methods. A prospective, descriptive study conducted with 75 persons with Parkinson’s disease over the age of 55, collected twice: within a week of an acute event and 1 month later, after resuming usual life at home. Participants completed a questionnaire on self-rated health status, self-efficacy, sense of coherence, symptom monitoring and medication and general self-management. Background. Parkinson’s disease is a chronic neurological condition that affects many dimensions of life, including threats to self-identity and confidence in self-management. Self-management has the potential to reduce costs through decreased hospital admissions, disease progression and avoidance of complications. While evidence for the relationships between self-management and self-efficacy and sense of coherence has been demonstrated in some chronic illness groups, this has not previously been demonstrated in Parkinson’s disease. Results. The independent predictors of better self-management were not being hospitalized in the last 6 months, more frequent symptom checking and better self-efficacy for self-management. The influence of other factors on self-management, such as sense of coherence, was mediated through self-efficacy. Support of family and others was associated with better self-efficacy both directly and through an improved sense of coherence. Conclusions and relevance to nursing practice. The presence of informal support plays an important role in sustaining self-efficacy and sense of coherence and hence self-management in persons with Parkinson’s disease. Since these attributes are amenable to change, nurses are in a good position to encourage participation in Parkinson’s support groups, teach self-management skills through regular symptom monitoring and to assess and promote self-efficacy and sense of coherence.

Objectives: To determine the effectiveness of the health check log (HCL) in promoting health awareness, health monitoring skills and timely consultation with health professionals for persons aged 65 years and over. Methods: Thirty-five men and women aged 65 years and over volunteered to record the HCL for 12 months, participated in regular telephone interviews to discuss recordings and attended focus group discussions at the conclusion of the pilot. Results: The HCL raised participants' awareness of less tangible aspects of health, revealed gaps in their health knowledge base, improved self-assessment and prompted consultation for several physiological and a few psychosocial health concerns. Conclusion: When follow-up support was provided, the HCL proved to be a useful health promotion activity for participants aged 65 years and over. © 2006 COTA National Seniors Partnership.

Parkinson's disease (PD) is a degenerative neurological disorder growing at a rate of 1% per head of population. This disabling condition requires ongoing health support to maintain the person's function, well-being and social engagement, and to maintain the quality of life of the family carer. An outpatient rehabilitation program is being offered at the War Memorial Hospital, Sydney, Australia, to support these outcomes for individuals with PD and their family carers. Although achieving its aims, this multidisciplinary project has identified difficulties for the health team when conducting rehabilitation research with this particular group of people. The paper describes the PD program, outlines these difficulties and makes suggestions to help health staff when conducting research with vulnerable populations.

Objectives. To determine effectiveness of the health check log (HCL) in promoting health-related quality of life and health awareness, health monitoring skills and timely consultation with health professionals for a cohort of community-dwelling people over 45 years, compared with a similar cohort not recording the HCL. Design. An exploratory longitudinal study using a quasi-experimental methodology and data triangulation. Outcome measures included the SF-36 health survey; a semi-structured participant feedback survey and participant focus group discussions. Sample. A convenience sample (n = 309) of community dwellers over the age of 45 living in the South Eastern Sydney/Illawarra Area Health Service, Sydney, Australia. Results. The majority of participants recording the HCL reported health benefits. The SF-36 health survey found younger age is a predictor for positive change in ‘social functioning’ (β = −0.14, t = 2.25, P

This paper reports on an exploratory two-group, pre- and posttest design study, which employed data triangulation with a convenience sample (n = 120) of women over 45 years aged between 45 and 83 years, living and/or working within the South East Sydney and Illawarra areas of New South Wales. Sixty-nine women recorded the Health Check Log (HCL) (33 were health professionals) to assess and monitor their health over 12 months. The majority found the HCL greatly assisted in monitoring and maintaining their health, and the analyses of the SF-36 health survey suggest that women 45 years and over may benefit by regular use of the HCL.

The New Zealand Census-Mortality Study (NZCMS) previously demonstrated substantial undercounting of Maori and Pacific deaths on mortality data relative to census data for the 1980s and 1990s. The recent linkage of 2001-04 mortality data to 2001 census data allows us to determine whether any such 'numerator-denominator' bias persists.2001 census anonymously and probabilistically linked to 3 years of subsequent mortality data (82,404 eligible mortality records), allowing a comparison of ethnicity recording.Using a 'total' definition of ethnicity, there was a close agreement of census and mortality counts: 7419 Maori on the 2001 census compared to 7536 Maori according to mortality data--a census to mortality ratio of 0.98; Pacific--2451 and 2493, ratio 0.98; Asian--1236 and 1215, ratio 1.02; non-Maori non-Pacific non-Asian--73,089 and 72,051, ratio 1.01. Using a 'sole' definition of Maori ethnicity, census counts were only 86% of mortality counts, indicating that mortality data is not recording as many people with two or more ethnic groups as would be expected based on census data. This 'sole' bias was more pronounced in the South Island.There is now little bias in ethnic group counts between census and mortality data for a 'total' definition of ethnic group. Calculations of mortality rates by ethnicity using unlinked census and mortality data and a total definition of ethnicity should be unbiased. These results strongly support using the census definition of ethnicity on all health datasets.

Fusarin C was purified by semipreparation HPLC. Initial analytical HPLC of purified fusarin C produced a single peak, while subsequent analyses yielded as many as four peaks with retention times corresponding to known isometic forms of the compound. Sample levels of fusarin C were determined by measuring the UV absorbance at the retention times of the fusarin C isomers and comparing these values to those obtained from purified fusarin C under identical conditions

Background Women in sub-Saharan Africa play a key role in household food security. The income-generating activities of mothers are postulated to be related to the nutritional status of children. Objective The objective of the study was to examine whether maternal income-generating activities, maternal food production, and child care were determinants of the nutritional status of children in rural West Africa. The study hypotheses were that maternal income-generating activities and maternal food production are positively associated with children's dietary intake and anthropometry, and that maternal income-generating activities are not associated with child care. Methods Data were collected from a cross-sectional sample of mother–child pairs on maternal time use, child anthropometry, maternal food production, dietary intake, parasitic infection, and household, maternal, and child determinants of child nutritional status. The children were 12 to 36 months of age and included breastfed and nonbreastfed children. Food intake was assessed by the 24-hour recall method. The data were analyzed by multivariate regression and controlled for confounding variables. Results Time spent by the mother in income-generating activities was negatively associated with children's animal protein intake and height-for-age (p < .05). Maternal cash crop production was positively associated with children's weight-for-height, whereas maternal staple food production was negatively associated with energy intake from non-breastmilk foods (p < .05). The negative relationships observed for children's animal protein intake and children's height-for-age were not mediated by any child-care variable. Maternal supervision of feeding was a positive predictor of children's animal protein intake. Giardia infection was negatively related to children's weight gain (p < .05). Conclusions Own-account cash crop farming by mothers benefits children's nutrition. Maternal income-generating activities in the context of extended families, sibling caretaking, and prolonged breastfeeding do not adversely affect child care.

Partnering’ is a growing and increasingly active area of the pharmaceutical industry that R&D management can ill afford to ignore. This article explains how potential partners identify and evaluate each other, and explores the most important considerations of partnering in the light of recent partnering events.

Letters that shed new information about a strange controversy arising from the pivotal 1780 Revolutionary War Battle of Kings Mountain.