Unusual Cause of Methadone Poisoning

ABSTRACT. A child with respiratory distress was found to have been given an antibiotic which was reconstituted with methadone. A delay in standard emergency room management led to a delay in diagnosis and treatment.     

An initial evaluation of learning units to facilitate problem solving and self-directed study (portable patient problem pack)

This paper describes the initial evaluation of the portable patient problem pack, a learning unit designed to facilitate the development of problem-solving skills and stimulate self study.
A cross-over design using two neurological patient problems, each presented in two formats (simulated patient and P4), was used with a sample of twenty-nine volunteer nursing and medical students.
The results indicate that the P4 appears to be feasible and effective in stimulating problem solving and self-directed study. The suggested concurrent validity, low cost of production, and implementation make it a potentially potent tool for evaluation.     

Expression of the cell-cell adhesion molecule E-cadherin in squamous cell carcinoma of the head and neck

The expression of the cell-cell adhesion molecule E-cadherin has previously been shown to be reduced in poorly differentiated squamous cell carcinoma of the head and neck and absent in nodal metatases. Twenty-eight patients with previously untreated squamous cell carcinoma of the head and neck, 22 of whom had nodal metastses at presentation, were investigated for E-chdherin expression using the monoclonal antibody 6F9, specific for human E-cadherin. Reduced expression was seen in the poorly differentiated primary tumours, compared with well differented tumours, but this trend was not statistically significant. E-cadherin expression was present at reduced level in nodal metastases. It was also noted that, where both the primary tumour and corresponding nodal metastasis were investigated, E-cadherin expression was identical for both samples. The degree of E-cadherin expression did not correlate with survival. These data confirm a reduction in E-cadherin expression in poorly differentiated tumours. There was no correlation between E-cadherin expression and any of the host, tumour and treatment factors associated with malignacies of the head and neck region.     

Staff nurses' experiences as preceptors and mentors: an integrative review

omansky g.l . (2010) Journal of Nursing Management  18, 697–703
Staff nurses' experiences as preceptors and mentors: an integrative review Aim The aim of this integrative review is to describe staff nurses’ experience when functioning as a preceptor or mentor for student nurses. Background The preceptor’s role is to guide students from the theory of nursing to the application of nursing theory, teaching clinical skills and clinical thinking. Relatively few research studies focus on the staff nurses’ experience. Evaluation Research studies and topical articles from Australia, Canada, Sweden, the United Kingdom and the United States were drawn from databases. The theoretical framework for the analysis was the Kahn et al. (1964) role episode model. Key issues Reservations over the efficacy of preceptor experiences have been identified. Along with intrinsic rewards, there is considerable stress and responsibility associated with precepting or mentoring. Nurse preceptors experience role ambiguity, conflict and overload when interacting with students. Conclusions Research indicates what might reduce the amount of stress for the nurse preceptor and increase job satisfaction and nurse retention. Implications for nursing management Defining and formalising the preceptor role can improve the standing of this function. Adjustments can be made to decrease the stress of the role. Preceptors and mentors request recognition and support for the amount of work involved in teaching students.     

THE EFFECT OF ALCOHOL ON THE VISUAL AND OCULAR MOTOR SYSTEMS

Alcohol is generally considered to be a central nervous system (CNS) depressant. This effect is progressive from higher cortical centres through to fundamental body functions. The effect of alcohol ingestion on the visual and ocular motor systems of ten healthy subjects was the basis of this study. Significant changes in the following resulted from the ingestion of 0. 375 g/kg of 10% ethanol alcohol: prism measurements of deviations for near and distance, ocular movements, convergence near point, and visual acuity at six metres. No significant change was observed following testing of stereopsis or near visual acuity.