Expectation and evaluation of occupational health nursing services, as perceived by occupational health nurses, employees and employers in the United Kingdom

A structured questionnaire was used to investigate the relationship between expectation and evaluation of occupational health nursing services as perceived by providers (nurses) and receivers (employers and employees) in the United Kingdom The response rate was 66·55% (254) from nurses, 5132% (194) from employees and 44 97% (170) from employers Data from 144 triads of nurse, employer and employee were used to test 13 null hypotheses, which were all rejected The strong positive correlation between nurses', employers' and employees' expectations and evaluations indicates that, on the whole, their expectations were met However, there were differences in the extent to which this was so and the level of expectation varied between groups Nurses perceived themselves as not meeting their high expectations as well in non-traditional (care-supportive) as in traditional (care-orientated) services On the whole, employers had significantly lower expectations than nurses, except in the area of care and treatment Employees had high expectations of preventive services, but their lower evaluations indicate that these were not met Discussion of these and other findings suggests that employers need education on the value and scope of occupational health nursing, and a model may assist nurses' conceptual understanding of it     

Subtle lung cancers: impact of edge enhancement and gray scale reversal on detection with digitized chest radiographs

The authors studied the impact of edge enhancement and gray scale polarity reversal on the detection of subtle lung cancers. Three experienced readers reviewed 46 biopsy-proved subtle lung cancers and 46 normal controls on chest radiographs that had been digitized into a 1,024 X 1,536-pixel matrix 8 bits deep. Receiver-operating characteristics (ROC) analysis of 1,656 pooled observations indicated that performance was best with the unmodified images (ROC area = 0.83), degraded by moderate enhancement of medium frequencies (ROC area = 0.80), and markedly impaired by severe enhancement of low frequencies (ROC area = 0.69). Gray scale polarity reversal further degraded performance (unenhanced ROC area = 0.74; moderately enhanced ROC area = 0.76; severely enhanced ROC area = 0.76). The authors conclude that edge enhancement and gray scale polarity reversal can impair the detectability of subtle lung cancers on digitized radiographs of medium resolution.