History taking and physical examination of patients who present with cardiac pain are not generally regarded as part of an emergency nurse's role in the UK. However, a good knowledge of the anatomy of the heart and cardiac disease, and the ability to undertake effective cardiovascular examination, could enable nurses to highlight adverse findings earlier in a patient's journey and improve patient outcomes. This article reviews the anatomy of the heart and cardiovascular disease, and describes how to pick out the subjective and objective information from patient histories and cardiac examination to make differential diagnoses.
Corporal punishment (CP) is one aspect of BDSM play. While enjoyed by many at a low
level, some players indulge in heavier play, with the potential for skin and tissue damage. This paper presents the results of an exploratory quasi-ethnographic study into CP, examining the motivations and potential benefits and risks of playing in this way, with the aim of increasing understanding of why individuals engage in heavy CP. Data were gathered from scene observations and semi-structured interviews with participants, including three professional Dominatrices with a reputation internationally for CP. Thematic Analysis was used to assess the data. While sexual arousal was a motivator for some participants, it was not the motivator for the majority. The importance of the marks left on the body was a common theme, as was challenging oneself to increase the amount of CP received or given. This was either to demonstrate a progression along a journey of increasing severity, or to enhance the experience either sexually, bruises / marks wise, or psychologically. Despite allusions by participants to addiction, psychological benefits in mood and mental health were reported by all participants. The main negative aspect of participation was fear of stigma and the perceived inability to be open with others about their interests. Participation in CP is a positive experience for those involved. The importance of bodily marks is a new finding, as is the positive impact on mental health.
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