Psychological adjustment, knowledge and unmet information needs in women undergoing PGD.

BACKGROUND: Women often enter preimplantation genetic diagnosis (PGD) treatment following traumatic reproductive and genetic histories, the detrimental psychological effects of which are known to be long lasting in some cases. In addition, attempting IVF with PGD requires an in-depth understanding of the aspects of the technology. The level of information that is required and retained by women entering treatment is important for clinicians to understand. To date, neither of these issues has been explored empirically. To address this, we assessed mood and information-seeking behavior in a sample of women entering PGD. METHODS: Fifty women entering PGD treatment completed self-administered questionnaires that assessed anxiety, depression, knowledge of technical aspects of PGD, expectancy of establishing a pregnancy and unmet information needs. RESULTS: Anxiety and depression rates were similar to normal population data. State anxiety was associated with degree of financial worry [beta = 0.36, t = 2.60, P = 0.01, 95% confidence interval (CI): 0.03-0.23], and living in an inner metropolitan area (beta = 0.30, P = 0.03, 95% CI: 0.32-10.81). Unmet information needs were positively associated with women's education (beta = 0.97, P = 0.01, 95% CI: 0.22-1.73). Lastly, expectancy of establishing a pregnancy was above that of what clinicians provide as realistic PGD pregnancy chances and, unexpectedly, was also associated with degree of financial worry (beta = 0.36, P = 0.01, 95% CI: 0.07-0.56). CONCLUSIONS: Women entering PGD are emotionally well adjusted although the financial costs associated with PGD are associated with increases in anxiety. The study is limited by its small sample size and the fact that partners were not assessed.

The health of overseas-born Australians, 1994-1996.

Analysis of mortality, hospital separations and self-reported health indicators by country of birth group has confirmed that overseas-born populations are generally in better health than their Australian-born contemporaries. The better health of the overseas-born may be reflected in both the willingness and eligibility of individuals to emigrate. Overseas-born individuals were placed into one of four groups according to place of birth. These included the United Kingdom and Ireland, Other Europe, Asia and Other. All population groups reported lower mortality and hospitalisation rates for all causes of disease combined. The Asian-born population had the lowest mortality rates with 38% less mortality for males and 30% less for females. Hospitalisation rates were also lower for the Asian-born, with males and females having 46% and 37% fewer hospital separations compared to the Australian-born population. However, diabetes mortality was greater for males and females from Other Europe, Asia and Other regions. Both males and females from the United Kingdom and Ireland group showed increased mortality from lung cancer. Mortality and hospitalisation for cervical cancer was also significantly higher for Asian-born and Other females. The mortality and hospitalisation data corresponded well with self-reported prevalence of health-related risk factors. For example, self-reported diabetes prevalence was higher for the Other Europe, Asia and Other groups. Asian and Other females reported significantly less use of regular Pap smear tests, reflecting their increased mortality and hospitalisation for cervical cancer. These results support the finding of past studies that the health of migrants is generally better than that of the Australian-born population and reflects a 'healthy migrant' effect.

Nursing home medication costs.

The cost of discarded drugs at a level-III nursing home was calculated for a four-year period. A significant percentage of the cost seemed to be the result of poor prescribing practices. Prescriptions for antibiotics and for psychotropic drugs (particularly PRN orders) are discussed in some detail. Medication policies were developed to improve physicians' prescribing habits in order to reduce these costs without jeopardizing the quality of care.

Nurses' notes on nursing home patients: are they effective?

The notes written by nurses in a level-III nursing home were reviewed in detail. They were found to be neither pertinent nor meaningful in most cases. The daily writing of these notes required a large percentage of the nurses' time but they were seldom, if ever, read by physicians. An alternate system of writing notes on a weekly basis is suggested.