Clinical supervision: insider reports of a private world

An exploratory study, funded by the Department of Health, London and the Scottish Home and Health Department, Edinburgh, was conducted over an 18-month period to provide an informed view on possible assessment tools that could be used to assess the impact of clinical supervision (CS) in nursing and to report on the CS activities in 23 selected sites in England and Scotland. The study not only examined the utility of several standardized research instruments, to be reported separately, but also explored the experience of a small sub-sample of nurses ( n =34) engaged in CS, as supervisors and supervisees. Interviews were undertaken to help better understand some of the issues involved around the domains of structure, process and outcome. Respondents reported an enthusiasm for the opportunity to talk meaningfully to a trusted colleague about their personal circumstances at work. Such opportunities were particularly welcomed by nurses who wished to reflect upon their own practice with patients, especially when dealing with their clinical conditions which were upsetting, or otherwise challenging, and sometimes harrowing. Substantive and methodological areas of interest for future research are suggested.     

Stimulation of human cytotoxic T cells with HIV-1-derived peptides presented by recombinant HLA-A2 peptide complexes

HLA-A2 heavy chain and beta 2-microglobulin were expressed in Escherichia coli, and refolded in the presence of peptides derived from HIV-1 RT and gag proteins. When recombinant HLA-A2 molecules were attached to cells lacking HLA-A2, the cells became susceptible to lysis by HLA-A2-restricted cytotoxic T lymphocyte (CTL) clones specific for peptides derived from RT and gag proteins. Limiting dilution analyses of peripheral blood mononuclear cells from HIV-1-infected individuals showed that the recombinant HLA-A2 peptide complexes covalently immobilized on microspheres stimulated the development of HLA-A2 peptide-specific CTL. Preformed HLA-peptide complexes may provide an alternative to immunization procedures that depend upon intracellular processing of antigen to elicit T cell responses.      

Endoscopic treatment of cicatricial stenosis of the esophagus

On the basis of experience in the examination and treatment of 118 patients with cicatricial stenoses of the esophagus the authors came to the conclusion that endoscopic examination is the main method for identifying the character of the narrowing and that esophagoscopy should be performed in all cases of recognized or suspected cicatricial stenosis of the esophagus. Endoscopic methods of treatment were also applied: removal of foreign bodies from the cicatricially changed esophagus, the advancement of a guiding string during esophagoscopy for therapeutic bougienage, cutting the cicatricial tissue with an electric knife.     

A research-based method of selecting curriculum content

This paper reports on a study concerning the opinions of sisters and nurse teachers regarding the relevance of learning objectives for a specific teaching and learning course for hospital and community sisters. The respondents were 29 sisters who had attended the course, 32 sisters who had not attended the course but who were potential future 'consumers' and 25 nurse teachers. The results showed that a majority of the respondents rated 29 of the objectives as essential and these were suggested as the nucleus of the core curriculum for future courses. Responses to nine of the objectives showed statistically significant differences between the groups.     

The combined treatment of lung cancer with one-time large-fraction preoperative irradiation

A procedure of preoperative large single dose (7.5 Gy) irradiation of lung cancer was developed. Irradiation field included regional lymph node-bearing areas. Treatment was employed in 93 lung cancer patients. Postoperative complication and lethality rates were 14 and 2.2%, respectively. Patients presenting with metastases in the regional lymph nodes were postoperatively irradiated to the lung hilus and mediastinum (30 Gy in 10 fractions). The treatment was well tolerated. Eighty-eight patients were followed, of whom 43.3% survived 3 years. The above modality assured ablastics of surgery and allowed to minimize duration of preoperative radiotherapy.     

The nursing process: implications for curriculum planning

The focus of this paper is an exploration of the implications for curriculum planning of adopting the nursing process; which, it is suggested, represents the most far-reaching innovation in British nursing of recent years. An examination of the abilities required by nurses in order for them to deliver care in this way shows that to encompass the philosophy of the nursing process, fundamental changes need to be made in the way nurses are prepared in schools of nursing. In particular, to those elements of the curriculum dealing with content and teaching methods.