An Australian longitudinal pilot study examining health determinants of cardiac outcomes 12 months post percutaneous coronary intervention

Background Percutaneous coronary intervention (PCI) is a very common revascularisation procedure for coronary artery disease (CAD). The purpose of this study was to evaluate cardiac outcomes, health related quality of life (HRQoL), resilience and adherence behaviours in patients who have undergone a PCI at two time points (6 and 12 months) following their procedure. Methods A longitudinal pilot study was conducted to observe the cardiac outcomes across a cohort of patients who had undergone a percutaneous coronary intervention (PCI). Participants who had undergone PCI 6 months prior were invited. Those participants who met the inclusion criteria and provided consent then completed a telephone survey (time point 1). These participants were then contacted 6 months later (i.e. 12 months post-intervention, time point 2) and the measures were repeated. Results All patients (n = 51) were recorded as being alive at time point 1. The multiple model indicated that controlling for other factors, gender was significantly associated with a linear combination of outcome measures (p = 0.004). The effect was moderate in magnitude (partial-η2 = 0.303), where males performed significantly better than females 6 months after the PCI procedure physically and with mood. Follow-up univariate ANOVAs indicated that gender differences were grounded in the scale measuring depression (PHQ9) (p = 0.005) and the physical component score of the short form measuring HRQoL (SF12-PCS) (p = 0.003). Thirteen patients were lost to follow-up between time points 1 and 2. One patient was confirmed to have passed away. The pattern of correlations between outcome measures at time point 2 revealed statistically significant negative correlation between the PHQ instrument and the resilience scale (CD-RISC) (r = -0.611; p < 0.001); and the physical component score of the SF-12 instrument (r = -0.437; p = 0.054). Conclusions Men were performing better than women in the 6 months post-PCI, particularly in the areas of mood (depression) and physical health. This pilot results indicate gender-sensitive practices are recommended particularly up to 6 months post-PCI. Any gender differences observed at 6 month appear to disappear at 12 months post-PCI. Further research into the management of mood particularly for women post-PCI is warranted. A more detailed inquiry related to access/attendance to secondary prevention is also warranted

Patients' satisfaction with information at discharge

Background: Adequate patient knowledge and engagement with their condition and its management can reduce re-hospitalisations and improve outcomes after acute admission for circulatory system disease. Aim: To evaluate the perceptions of cardio- or cerebrovascular patients of their satisfaction with discharge processes and to determine if this differs by demographic groups. Methods: A sample of 536 eligible public hospital inpatients was extracted from a consumer experience surveillance system. Questions relating to the discharge process were analysed using descriptive statistics to compare patient satisfaction levels against demographic variables. Results: Dissatisfaction rates were highest within the ‘Written information provided’ (37.8%) and ‘Danger signals communicated’ (34.7%) categories. Women and people aged ≥80 were more likely to express dissatisfaction. Conclusion: Although respondents were largely satisfied, there are important differences in the characteristics of those that were dissatisfied. The communication of important discharge information to older people and women was less likely to meet their perceived needs

Is the Public willing to help the Nigerian Police during the Boko Haram crisis? A look at moderating factors.

This paper sought the opinion of 200 Nigerians on their willingness to cooperate with the Police during the Boko Haram crisis. Public perceptions of Police effectiveness during the crisis, residence location, gender and religious affiliation were used as moderators. Data was analysed using an explanatory factor analysis and structural equation modelling. Results indicated a strong association between perceived effectiveness and willingness to report to the Police with respondents who question the effectiveness of the Police being less likely to be willing to report criminal activity about Boko Haram. Further to this, the impact of religion on willingness to report was at least partially mediated by perceived effectiveness of the Police with the results showing that Christian respondents perceived the Police as less effective. Females and those living in the North were significantly less willing to report criminal activity to the Police The findings are then discussed in relation to the BH crises and directions for future research are given

Gendering the careers of young professionals: some early findings from a longitudinal study. in Organizing/theorizing: developments in organization theory and practice

Wonders whether companies actually have employees best interests at heart across physical, mental and spiritual spheres. Posits that most organizations ignore their workforce – not even, in many cases, describing workers as assets! Describes many studies to back up this claim in theis work based on the 2002 Employment Research Unit Annual Conference, in Cardiff, Wales

Police performance measurement: an annotated bibliography

This study provides information to assist those involved in performance measurement in police organisations. The strategies used to identify the literature are described. Thematic sections cover; general overviews; methodological issues; performance management in other industries; national, international and cross-national studies; frameworks (e.g. Compstat; the Balanced Scorecard); criticisms (particularly unintended consequences); crime-specific measures; practitioner guides; performance evaluation of individual staff; police department plans and evaluations; annotated bibliographies in related areas, and; other literature. Our discussion offers two conclusions: the measures best aligned with performance are typically more expensive, while most operational data should only provide contextual information; the philosophy of open governance should be pursued to promote transparency, accountability and communication to improve police performance

Gender and secondary risk assessment following an ST-elevation myocardial infarction

Elizabeth Scruth,1,3 Linda Worrall-Carter,1 Eugene Cheng2 1St Vincent&rsquo;s/ACU Centre for Nursing Research, School of Nursing and Midwifery, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia; 2Kaiser Permanente Medical Group, San Jose, CA, USA; 3Kaiser Permanente Northern California, Oakland, CA, USA Purpose: The Thrombolysis in Myocardial Infarction (TIMI) risk score, Global Register of Acute Coronary Events (GRACE) risk score, and the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) risk score are validated predictors of secondary events and death after an acute coronary syndrome (ACS). In our study, we sought to examine the predictability of the TIMI, GRACE, and the CADILLAC risk scores in women undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) for in-hospital, 1-year major cardiac events, nonmajor cardiac events, and mortality. A limited number of studies examining the secondary risk scores for use after STEMI in women have been conducted. Most studies have been conducted in both men and women without separating out the predictability in women in regard to the various risk scores. Patients and methods: In a subanalysis of women from a larger study of both men and women with STEMI, a 1-year follow up of 77 women with STEMI was undertaken using a retrospective approach and comparing the TIMI, GRACE, and CADILLAC risk scores for in-hospital and 1-year outcomes of major cardiac events, nonmajor cardiac events, and death. The predictive value of the models was assessed with evaluation of the area under the curve in receiver operating-characteristic analysis. Results: The study revealed that risk stratification of female patients with STEMI early after presentation using the TIMI risk score or after angiography using the CADILLAC risk score may provide important prognostic information and enable accurate identification of high-risk patients. Conclusion: Though limited by sample size and retrospective analysis, our study provided evidence into the validity of using existing secondary risk tools in women. Further studies are needed to determine the risk score that is most predictive for women presenting with STEMI and treated with percutaneous coronary intervention. It may be useful to incorporate the risk scores into clinical practice to guide short- and long-term follow-up after STEMI in women as a preventive strategy. Keywords: cardiovascular risk, acute coronary syndromes, nonmajor cardiac events, major cardiac event

Triaging women with acute coronary syndrome: A review of the literature

Aims and Objectives: This article analyzes the literature describing factors affecting nurses' triage of emergency department (ED) patients with potential acute coronary syndrome (ACS), with particular attention paid to gender-based differences. Introduction: Acute coronary syndrome is one of the most time-critical conditions requiring ED nurse triage. This literature review will provide examination of how triage nurses prioritize patients with possible ACS, reflecting on challenges specifically associated with evaluating women for ACS in the ED. The article presents a description of the research findings that may help improve the timely revascularization of ACS in women. Methods: An electronic search of EBSCOhost CINAHL, Health Source Nursing Academic Edition, MEDLINE, Psychology and Behavioral Sciences Collection databases, online theses, the Cochrane Library, the Joanna Briggs Institute, and National Guideline Clearinghouse resources were used to identify all relevant scientific articles published between 1990 and 2010. Google and Google Scholar search engines were used to undertake a broader search of the World Wide Web to improve completeness of the search. This search technique was augmented by hand searching these articles' reference lists for publications missed during the primary search. Results: Review of the literature suggests factors such as patient age, sex, and symptoms at ED presentation affect the accuracy of nurses' triage of ACS, particularly for women. However, research examining delays due to ED triage is scant and has predominantly been undertaken by one researcher. Little research has examined triage of ACS specifically in women. Conclusions: The literature search revealed a small number of articles describing challenges associated with nurse triage of women with ACS. Although most of this published research is North American, the themes uncovered are well supported by broader international research on acute assessment and management of women's ACS. These include the following: gender-based differences in the presentation of ACS can preclude early identification of ACS, advanced patient age often correlates with missed or delayed diagnosis of ACS, and there appears to be a general bias against managing women for ACS in parity with men's disease. Relevance to Practice: Early reperfusion therapy is critical for optimal health outcomes in ACS. Triage nurses are ideally placed to minimize time to treatment for ACS. An understanding of the issues related to clinical decision making and triage allocation of women with ACS at triage is necessary to ensure appropriate treatment. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins