The chief scientist reports ... head injury and the rehabilitation professions in the West of Scotland.
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Biomedical subjects
Publications and source records attributed to A Beattie.
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Collecting information is an obsessional activity which can become an end in itself. Interpreting and presenting results in a way that others can learn from them requires reflection, selectivity and ability to accept criticism. In selecting the journal to which the article will be submitted, consider which has the most appropriate readership and ensure the article conforms to the requirements and style of that journal.
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The rate and prediction of return to work was examined in 98 severely head injured patients during the first seven years after injury. The employment rate dropped from 86% before injury to 29% after. Younger patients, and those with technical/managerial jobs before injury were more likely to return to work than those over 45 years of age, or in unskilled occupations. Physical deficits were not related to return to work, but the presence of cognitive, behavioural, and personality changes was significantly related to a failure to return to work.
The research examined the effects of alcohol and other variables on cognitive outcome after severe head injury. Alcohol consumption habitually and at the time of injury were strongly related, and both were related to age and educational level but not injury severity. Covariance analysis to remove the effects of age and education showed a reduction in the main effects, so that only alcohol consumption at injury was a significant predictor of memory, but not other cognitive areas late after injury. There were significant interactions between severity of injury (post-traumatic amnesia), and alcohol habitually or at time of injury, with increasing alcohol consumption increasing the size of the memory deficit. To have a short post-traumatic amnesia and have drunk heavily led to a worse memory score than that found in patients with a considerably longer post-traumatic amnesia who had drunk lightly or not at all.
The second article in our focus on initiatives in diabetes education for nurses describes a research project which aimed to identify the training needs of district nurses working in a community trust in Belfast. The research has enabled the authors to propose a programme of education to help bridge the skills and knowledge deficits the nurses identified.
This aim of this study was to assess the impact of the introduction of a standardised early warning scoring system (SEWS) on physiological observations and patient outcomes in unselected acute admissions at point of entry to care. A sequential clinical audit was performed on 848 patients admitted to a combined medical and surgical assessment unit during two separate 11-day periods. Physiological parameters (respiratory rate, oxygen saturation, temperature, blood pressure, heart rate, and conscious level), in-hospital mortality, length of stay, transfer to critical care and staff satisfaction were documented. Documentation of these physiological parameters improved (P<0.001-0.005) with the exception of oxygen saturation (P=0.069). The admission early warning score correlated both with in-hospital mortality (P<0.001) and length of stay (P=0.001). Following the introduction of the scoring system, inpatient mortality decreased (P=0.046). Staff responding to a questionnaire indicated that the scoring system increased awareness of illness severity (80%) and prompted earlier interventions (60%). A standardised early warning scoring system improves documentation of physiological parameters, correlates with in-hospital mortality, and helps predict length of stay.
The views of nurse and midwife teachers occupy a crucial role in discussions about the quality of educational provision. So far, however, little information has been available on what the members of the profession think about this issue. In the course of a two-year research project commissioned by the ENB on performance indicators for training institutions, we asked teachers and their colleagues in all the English NHS regions to describe the characteristics of a high standard school. The study was conducted in the spring of 1988, that is, following the clinical grading review and the initiative to amalgamate school but before the NHS review and the acceptance of Project 2000. The data provided are an account of what is valued in schools of nursing and midwifery, for which a high degree of consensus was found among respondents. Management issues emerged as the top concern, followed by resources. Curriculum issues ranked third, closely followed by service links and professional/teacher issues. External links were of low importance.
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