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The present study was conducted in the light of major reforms to nurse education which have taken place in the United Kingdom since 1989. The study aimed to identify initially perceived stressors and coping resources and subsequently, to compare these with actually reported stressors and available resources, during a critical period in nurses' careers. Three groups of nurses participated who were undertaking, or had recently completed, the first Project 2000 course at a university in the south of England. Participants were given an open-ended questionnaire and asked to describe potential difficulties, and the coping resources they anticipated using, in a subsequent 6-month period. Following analysis of the descriptors a structured questionnaire was developed to measure actually experienced difficulties and coping resources that were reported; this was completed by the three groups 6 months after the initial phase of the study. Both student and staff nurse groups reported fewer stressors and more resources than they had predicted. Students anticipated difficulties with competence but actually reported financial difficulties. They experienced support from mentors although this was not anticipated. Newly qualified staff nurses experienced fewer difficulties with meeting personal expectations of the role than they had anticipated. They reported more use of emotion-focused coping and less professional support than the student groups. The results are discussed in relation to training needs.

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Community nurses have a central role in the provision of palliative and end-of-life care; helping people to die with dignity is an important component of this care. To conserve dignity, care should comprise a broad range of actions addressing the distress that might impact on the patient's sense of dignity. These care actions need to be defined. This study aims to suggest care actions that conserve dignity at the end of life based on evidence from local experience and community nursing practice. Data were collected by focus group interviews and analysed by framework analysis using the Chochinov model of dignity as a predefined framework. Suggestions on care actions were given in relation to all themes. As part of a multi-phase project developing and testing a dignity care pathway, this study might help community nurses to conserve dying patients' dignity.

Recent discussions about the “feminisation of medicine” raise critical questions for how academic medicine deals with gender issues. Addressing the gender dimensions of enrolment, curriculum, and promotion practices in academic medicine may be a good starting point

Objective. To assess a comprehensive, intensive lifestyle intervention in combination with metformin extended release (MXR) or placebo on body mass index (BMI) and risk factors for type 2 diabetes and cardiovascular disease in obese adolescents. Study Design. Sixty-nineobese adolescents (mean BMI 32.5) received a comprehensive lifestyle intervention with structured dietary, physical activity, and behavioral components for 24 months. Subjects were randomized to 1 of 4 groups: MXR (33) 2,000 mg daily or placebo, with either moderate or vigorous intensity exercise for the first 3 months. Subsequently the exercise intervention was the same for all 4 groups. Results. Anthropometry measurements did not differ with initial exercise intensity at any time. At 3 months % body fat decreased in all 4 groups (P < 0.006). BMI and % body fat decreased in the MXR groups, but not the placebo groups, at 6 (−0.88, −3.16) and 12 months (−0.56, −2.34) (P < 0.05). Insulin resistance, fasting blood glucose, and leptin improved in all groups at 6 and 12 months. A high subject attrition rate (58%) occurred by 24 months. Conclusion. A comprehensive, intensive lifestyle intervention combined with MXR led to a decline in BMI and % body fat at 1 year independent of initial exercise intensity. This trial is registered with ClinicalTrials.gov NCT00934570 .