There is limited experience of using tools to determine nurse staffing. No one tool is likely to suit every application. More information is needed to clarify the practicalities of using the tools.
The subject of identifying and supporting failing students in community nursing education programmes has been largely overlooked in the literature, yet is of great concern to practice teachers. This article discusses the views on the topic of a group of practice teachers in the light of existing, related research and proposes a number of indicators for good practice. It is suggested that of central importance is the need for higher education institutions and practice teachers to work together in identifying students causing concern at an early stage in their studies, based on both objective and subjective observations, and to have in place documented procedures to be followed when such situations arise.
It is commonly held that a normal electrocardiography (ECG) rules out heart failure (HF). In older populations with HF, 98% of patients have been reported to have major ECG abnormalities. Anecdotally, young patients with HF have been noted to have ECGs without major abnormalities. The aim of this study was to determine the proportion of patients aged under 65 years with HF lacking major ECG abnormalities. Data were collected for 100 consecutive admissions with HF (aged ,65 years) with echocardiogram and ECG available. ECGs were independently assessed by two cardiologists; disagreements were resolved by a third. Ejection fraction was quantified using the biplane Simpson's. Majorly abnormal ECGs contained !1 of Q waves, left ventricular hypertrophy, bundle branch block or atrial fibrillation. Minor abnormalities of ECG also recorded; these included atrial enlargement, bradycardia, tachycardia, broadening of QRS complex, poor R wave progression, left/right axis deviation, first-degree atrioventricular block and non-specific ST-T wave changes. The mean age was 50.0 years. Seventy-six had major abnormalities on ECG, 22 had minor abnormalities and two showed no abnormalities. Ejection fractions were similar across all groups (28.6 + 2.8%, 28.4 + 3.4% and 25.5 + 6.9%, respectively). Twenty-four percent of patients with HF (aged ,65 years) do not have major ECG abnormalities. Patients aged ,65 years with a clinical suspicion of HF but without major ECG abnormalities should undergo further investigation.
THE first formal attempts at sex education arose out of the great expansion of the Public Schools during the growth of the middle classes in the Nineteenth Century. This development was introduced by schoolmasters such as Dr. Arnold who became headmaster of Rugby in 1828, and several of his assistants who went off to found or reform other Public Schools. Arnold was convinced of the &dquo;natural imperfectness&dquo; of the schoolboy, and revitalised the chapel sermon as an admonitory agency of change. The basis of their source material appears to have been a literal acceptance of certain passages in the Bible, notably from the Epistles of Paul to the Galatians, the Ephesians, and the Corinthians, written incidentally against the context of the sexual licence of later-Roman civilisation at a time when the writer was convinced that the end of the world was imminent. One further Biblical derivation was to be of great importance, the term onanism as an alternative for masturbation-&dquo;the solitary and secret vice&dquo; which came to obsess the early sex educators. The story, from Chapter 38 of Genesis clearly refers to the method of birth-control known as coitus interruptus, and it is difficult to understand why this episode should have been taken to refer to masturbation. However, the wrath of God, and the penalty &dquo;wherefore he slew him also&dquo; has been re-directed upon the practitioners of masturbation, adding to the guilt of innumerable schoolboys, as various biographers have testified.Nineteenth-century books of sex education were hardly ideal by modern standards. Adolescent masturbation is stated to produce &dquo;sallow face, glassy eye, drooping form, without energy, force or purpose, a laggard at school,&dquo; and various other horrors including * A summary of this article which is based on work done for the, thesis for the Leicester University
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