Background : The Government's nursing recruitment campaign has widened access for those wishing to enter the profession, resulting in some students entering university with clinical experience but little experience of academic writing or using libraries. For these students, the library and study advice staff have an important role to play in helping them acquire appropriate information literacy and study skills. Objective : To evaluate the impact of workshops supplementing online instruction in study skills on students' study and writing skills, and level of information literacy. Methods : A small group of pre-registration nursing students identified as needing support with information literacy and study skills participated in focus groups to identify areas of concern, and were offered four remedial workshops. A follow-up focus group explored whether the students' needs had been addressed. Further evaluation of the workshops' impact was completed by diagnostic testing within the University's information literacy programme, Skills Plus . Outcomes : The results showed that all students who attended at least one workshop improved their academic grade in their next assignment. Qualitative data indicated that the students' confidence level and information literacy, including referencing skills, had improved. Conclusion : Evaluating the impact of this intervention has provided the evidence to demonstrate the value of this additional support.

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BACKGROUND AND OBJECTIVES: Prospective data are lacking to determine which children might benefit from prompt neuroimaging after unprovoked seizures. We aimed to determine the prevalence of, and risk factors for, relevant intracranial abnormalities in children with first, unprovoked seizures.

Lovell ends by saying, "This epidemic disease of our time presents, above all else, a problem in preventive medicine." Can we not warn people of the circumstances which put them at increased risk through the usual media of communication ? It is very easy to say there is far too much doctor-induced illhealth among those who have suffered from cardiac infarction.2 We can think of examples of patients in hospital who have had their cards sent to them by their employers, and some of our patients, once they are ill, receive no pay apart from sickness benefit, since they are not staff members. Aren't these factors likely to produce neurotic ill-health ? Furthermore, it has been our experience that there are many patients who will inevitably fail under the stress of a coronary incident.-We are, etc.,

Summary A continuous epidural infusion offentanyl was used,for c,ontrol o f postoperatitle pain in a seriesThe identification of endogenous morphine-like peptides' and the identification and localisation of specific receptor sites in the central nervous system for these peptides and opiate analgesic^,"^ led to investigations by Yaksh and fellow workers in animals,"x and Wang and colleagues in human^,^ of the analgesic effects of low doses of opiates introducted into the subarachnoid space. Behar and othersI0 subsequently demonstrated Forum 1003 that morphine introduced into the epidural space could also confer considerable relief in chronic pain. Further reports using pethidine, phenoperidine, and fentanyl,"-I3 and also diamorphine by one of the authors (unpublished data) have demonstrated varying analgesic response in various special situations. Recently, control of postoperative pain for 6 hours or more has been reported with bolus doses of epidural r n~r p h i n e . '~ The authors have studied the feasibility of a method of epidural infusion of opiate (fentanyl) to provide postoperative analgesia on routine operating lists, in the environment of a general surgical ward. Puiieni seleciion and meihodsPatients undergoing general surgical procedures were studied in whom conventional local anaesthetic epidural techniques were used, either as the sole anaesthetic or together with light general anaesthesia. Consent for the postoperative procedure was obtained from the patients following pre-anaesthetic discussion. Operations performed were Caesarean section, pyeloplasty, abdominal hysterectomy, hip prosthesis ( 1 case each), cholecystectomy, herniorrhaphy (3 cases each), prostatectomy and large bowel surgery (10 cases each). Patients' ages ranged from 25 to 86 years.After the epidural space had been located, a catheter was introduced and left in siiu. A bacterial filter was attached to the catheter and all drugs were given through this filter. The L1/2 or L2/3 interspaces were used for lower abdominal operations, and the T6/7 interspace for upper abdominal operations.At the completion of the operative procedure, an infusion of fentanyl was started. Initially (first 20 patients), this consisted of a solution of 5 p g of fentanyl/ml, prepared by diluting 10 ml of the commercial solution to 100 ml with normal saline or Ringer lactate (BPC) solution in a paediatric type microdrop administration set. The rate of infusion was regulated either manually or by an infusion controller (Ivac series) to deliver between 4 and 10 ml per hour according to the anticipated analgesic requirements. This delivered fentanyl to the patients at approximately 0.5 pg/kg/hour. In a further 10 patients the strength of the fentanyl solution was reduced to 2.5 &ml. The method was otherwise identical, but fentanyl was delivered at only 0.25 pg/kg/hour. The burette was recharged with fentanyl solution as it became empty.The patients under study were also prescribed intramuscular analgesics for use if necessary should there be inadequate pain relie...