Implementing a critical care course for ward nurses.

This article describes the setting up and evaluation of a course for ward-based nurses, which is designed to improve their skills in caring for highly dependent patients. The authors suggest such courses can increase nurses' confidence and competence and, as well as enhancing care, can improve communication with senior staff about issues of concern.

Developing services for people with dangerous and severe personality disorders.

This paper describes the conflicting attitudes that exist within wider society and the people who deliver services for people with dangerous and severe personality disorder. The importance of recognizing the nature of these conflicting attitudes that are based on the desire for ' punishment', ' keeping society safe' and ' treatment and care' is discussed. Potential ways of resolving these conflicts at an organizational and practice level are explored.

Method of lactate elevation does not affect the determination of the lactate minimum.

Purpose: The aim of the study was to examine the effects of different lactate elevation protocols on the determination of the lactate minimum (Lac(min)) point.

Methods: Eight highly trained racing cyclists each completed four continuous ramp lactate minimum tests using the following blood lactate elevation protocols: 1) continuous ramp maximal aerobic power (RMP(max)) assessment, 2) 30-s maximal sprint, 3) 40-s maximal sprint, and 4) two 20-s maximal sprints separated by a 1-min recovery. Each blood lactate elevation protocol was followed by a 5-min active recovery leading into a continuous ramp test commencing at a power of 60% of RMP(max), using a 6 W x min ramp rate, lasting 15 min.

Children's perceptions of who controls their food.

BACKGROUND: The purpose of this study was to explore children's perceptions of who controlled the quality and quantity of their food during the week. METHODS: Semi structured interviews were carried out with 98 9-year-old children. The children were asked to describe who chose what they ate during a typical week day.

Is a CCN degree the only way to develop children's nursing in the community?

Semi-structured interviews were carried out with convenience samples 10 CCN students completing a community children's nursing (CCN) degree programme and with five practice educators. In addition, focus group interviews were held with 28 child branch students who had undertaken community experience. The objective was to find out the perceived value of undertaking a community children's nursing degree.

Why nurses choose not to undertake clinical supervision--the findings from one ICU.

A two-year action research study explored the implementation of clinical supervision in an intensive care unit (ICU). This paper focuses on one aspect of that study--the lack of uptake of clinical supervision. The themes that emerged from interview data focused on: resources, the purpose of clinical supervision, having good enough support elsewhere and personal issues.

The nutritional needs of the older person.

Older people have particular nutritional requirements that are different from other groups. The nutritional status of many older people is poor in respect of some key nutrients. Older people are at higher risk of malnutrition if they are ill, live alone or have difficulty in eating.

Nutritional screening and older adults.

Nutrition is rarely included in the screening programmes of older people. However, nutritional screening of this population is important to distinguish between deterioration in their health status due to the physical decline of ageing and that due to nutritional deficiency.

The concept of total pain: a focused patient care study.

This article considers the care of a patient admitted into a hospice environment for pain management and respite care. The concept of 'total' pain is discussed together with the need for a multidimensional assessment of pain to enable effective management to be accomplished. A multiprofessional approach to care along with inclusion of both the patient and her husband in decision making achieved the best possible quality of life for them both.

The perceived benefits of singing: findings from preliminary surveys of a university college choral society.

Two exploratory studies are reported on the perceived benefits associated with active participation in choral singing. In the first study, 84 members of a university college choral society completed a brief questionnaire that asked whether they had benefited personally from their involvement in the choir and whether there were ways in which participation could benefit their health. A large majority of respondents agreed they had benefited socially (87%) and emotionally (75%), with 58% agreeing they had benefited in some physical way, and 49% spiritually.

Work-related stress: a brief review.

Work-related stress is a serious and growing problem in the UK and as such, is regarded as a significant health and safety issue. It is vital that this issue is addressed and that action is taken to address the problems that this may create both for individuals and the organisations in which individuals work. This paper reviews the concept of work-related stress showing how its deleterious impact may exert both direct and indirect effects on the workforce thus affecting both individual and organisational effectiveness.

Critical care outreach services and early warning scoring systems: a review of the literature.

Aim: The aim of this paper is to explore the literature relating to critical care outreach services and the use of early warning scoring systems to detect developing critical illness.

Background: Several studies have identified how suboptimal care may contribute to physiological deterioration of patients with major consequences on morbidity, mortality and requirement for intensive care. In a review of adult critical care services, the Department of Health (DOH) (England) recommended in 2000 that outreach services be established to avert admissions to Intensive Care, to enable discharges and to share critical care skills.

Reliability of mean power recorded during indoor and outdoor self-paced 40 km cycling time-trials.

The purpose of this study was to assess reliability of both indoor and outdoor 40 km time-trial cycling performance. Eight trained cyclists completed three indoor 40 km time-trials on an air-braked ergometer (Kingcycle) and three outdoor 40 km time-trials on a local course. Power output was measured for all trials using the SRM powermeter.

Differences between the sexes and age-related changes in orienteering speed.

The aim of this study was to assess the effects of the age and sex of the competitor on orienteering speed during competitive events. The results of the fastest three male and fastest three female competitors in each 5-year age band (21-79 years), from four national orienteering events, were analysed. The data for age and orienteering speed were log-transformed and regression analyses were conducted to determine the relationships between age and sex and orienteering speed.

Interventions in forensic psychiatry: the caregiver's perspective.

Although a number of official reports have identified the needs of the caregivers of mentally disordered offenders (forensic clients), there has been limited research in this area. However, some consistent themes have started to emerge from the literature. The burdens being faced by healthcare professionals working with forensic clients are distinct from that of those working with non-forensic clients, with levels of violence directed towards the former being much higher.

Quality and marketing issues in nursing education.

Two important issues in nursing education are quality and marketing. These issues both complement and support each other. The aim of this article is to highlight the concepts of quality and marketing as a valuable partnership in nursing education, a partnership that is capable of improving the quality of education provision and potentially of increasing student numbers.

The relevance of degree-level preparation for community nurses.

The most recent changes in the preparation of specialist community nurses assume that educational improvements automatically increase the skills and knowledge of the participants and thus the subsequent quality of care. The rapidly changing environment of community healthcare delivery has meant that the possession of degree-level qualification is now seen as necessary for flexibility and responsiveness to change. However, the philosophy behind this thinking is flawed--education does not always reflect the reality of care delivery.

The physiology of the highly trained female endurance runner.

Continuing improvements in the performance of female endurance runners and increasing levels of participation have generated the need to know more about the physiology of this group. Specific research is needed in this area, as data referring to male endurance runners cannot legitimately be applied to the female endurance runner because of their markedly different physiological and hormonal profiles. Recent developments in our understanding of an athlete's physiology (mainly in relation to the male endurance runner) have revealed new areas of interest that need to be assessed with specific reference to the female athlete.

Reliability of an air-braked ergometer to record peak power during a maximal cycling test.

Purpose: To assess the reliability of the Kingcycle ergometer, this study compared peak power recorded using a Kingcycle and SRMTM power meters during Kingcycle maximal aerobic power tests.

Methods: The study was completed in two parts: for part 1, nine subjects completed three maximal tests with a stabilizing kit attached to the Kingcycle rig and calibration of the Kingcycle checked against SRM (MAP(C)); and for part 2, nine subjects completed two maximal tests without the stabilizing kit and the Kingcycle calibrated using the standard procedure (MAP(S)). Each MAP(C) test was separated by 1 wk; however, MAPs tests were separated by 54 +/- 32 d, (mean +/- SD).

A review of violence and personal injury legal cases in psychiatric and mental health nursing to identify a practical framework for risk assessment.

Legal cases were analyzed that involved violence resulting in staff injury, patient assaults on staff, accidents involving the elderly, and patient self harm or injury where there was also an alleged breech in the duty of care. The study resulted in recommendations for: improved systems of work, including a practical framework to anticipate and recognize risk, with a case management approach to individual care, and supervisory procedures for vulnerable staff, explicit consent from patients and carers, and integrated recording of interdisciplinary methods for care.

Factor XIIa and triacylglycerol rich lipoproteins: responses to exercise intervention.

Objectives: (a) To determine if factor XIIa (FXIIa) would be sensitive to change from exercise intervention in a group of previously sedentary/low active middle aged men and women; (b) to investigate further the previously reported relation between FXIIa and triacylglycerol (TAG) rich lipoproteins.

Methods: Thirty seven men (mean (SD) age 57 (7) years) and 60 women (mean age 54 (7) years) completed the study. Before the intervention, these subjects were randomly allocated to a group of walkers (n = 81) or controls (n = 16).

Peak power predicts performance power during an outdoor 16.1-km cycling time trial.

Purpose: To assess i) the reproducibility of peak power output recorded during a maximal aerobic power test (MAP), and ii) its validity to predict endurance performance during a field based 16.1-km time trial (16.1-km TT).