Objective-To determine the eYcacy and safety of trained cardiac technicians independently performing treadmill exercise stress tests as part of the assessment of patients with suspected angina pectoris. Design-Retrospective comparison of 250 exercise tests performed by cardiac technicians and 225 tests performed by experienced cardiology clinical assistants (general practitioners who perform regular NHS cardiology duties), and consultant cardiologists over the same time period. Setting-Regional cardiac centre with a dedicated cardiac chest pain clinic. Patients-All patients were referred by their general practitioners with a history of recent onset of chest pain, which was suspected to be angina pectoris. Outcome measures-Peak workload achieved, symptoms, indications for termination, complications. Results-The diagnostic yield of technician supervised tests (percentage positive or negative) was similar to that of medically supervised tests (76% v 69%, NS). The average peak workload achieved by patients was less by 1.2 mets (p < 0.005). This was probably due to more tests being terminated earlier due to chest pain and ST segment depression in the technician group compared with doctors (10% and 16% v 5% and 11% respectively, p = 0.06 and 0.07). One patient in the technician supervised group developed a supraventricular tachycardia during the recovery phase of the exercise test. Conclusions-Technician supervised stress testing is associated with a high diagnostic rate and low complication rate in patients with suspected ischaemic heart disease. Its eYcacy is comparable to tests supervised by experienced doctors and its use should be encouraged. (Heart 1998;79:613-615)
The global nursing shortage has caused competition and cooperation between countries desperate for registered nurses (RNs), and has led to an increase in migration and international recruitment of nurses. Some nursing diplomas or degrees earned in one country may not be transferable to another. As a result, there is growing interest in common standards and competencies of entry-level nurses to guide future registered nurse agreements between countries or multi-country licensure programs. An exploratory study was conducted to investigate how entry-level nurses are educated throughout the world. The researchers sent a nursing education questionnaire to nurse educators in eleven countries inviting them to participate in the study. Nurse educators from The People's Republic of China, Japan and Turkey were the first to agree to participate in the study. They responded to questions about their country's nursing history, types of nursing programs, use of national nursing licensing examination, and social and political influences on nursing education. The nurse researchers did an analysis and comparison of the nursing education in each country.
A global registered nursing (RN) shortage has caused an increase in migration and international recruitment of nurses. There is growing interest among some countries of having common standards and competencies for entry-level registered nurses to guide future registered nurse agreements between countries or multi-country licensure programs. Nursing education in one country may not be accepted as equivalent for a nurse to become licensed in another country. An exploratory study was conducted to gain a better understanding of how nurses are educated in various countries. Nurse researchers sent a nursing education questionnaire to nurse educators in eleven countries inviting them to participate in the study. Nurse educators from six countries agreed to participate in the study. They provided information about their country's nursing history, types of nursing programs, use of national nursing licensing examination, and political influences on nursing education. The People's Republic of China, Japan and Turkey nurse educators' responses were the first to be analyzed and the results were published in the July/August 2005 issue of Contemporary Nurse (volume 19/1-2). This second article (in Contemporary Nurse volume 20/2) provides information about and a comparison of nursing programs in Canada, Finland and the United States.
CONCLUSIONS: hDrop average values were closely related to weight loss changes and tracked with subjects who consumed fluid versus those who did not during exercise in a thermoneutral environment. This data suggests that hDrop is a valid measure of real time hydration changes during exercise.
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