An evaluation of pharmacology curricula in Australian science and health-related degree programs.

BACKGROUND: Pharmacology is a biomedical discipline taught in basic science and professional degree programs. In order to provide information that would facilitate pharmacology curricula to be refined and developed, and approaches to teaching to be updated, a national survey was undertaken in Australia that investigated pharmacology course content, teaching and summative assessment methods. METHODS: Twenty-two institutions participated in a purpose-built online questionnaire, which enabled an evaluation of 147 courses taught in 10 different degrees. To enable comparison, degrees were grouped into four major degree programs, namely science, pharmacy, medicine and nursing. The pharmacology content was then classified into 16 lecture themes, with 2-21 lecture topics identified per theme. The resultant data were analysed for similarities and differences in pharmacology curricula across the degree programs. RESULTS: While all lecture themes were taught across degree programs, curriculum content differed with respect to the breadth and hours of coverage. Overall, lecture themes were taught most broadly in medicine and with greatest coverage in pharmacy. Reflecting a more traditional approach, lectures were a dominant teaching method (at least 90% of courses). Sixty-three percent of science courses provided practical classes but such sessions occurred much less frequently in other degree programs, while tutorials were much more common in pharmacy degree programs (70%). Notably, problem-based learning was common across medical programs. Considerable diversity was found in the types of summative assessment tasks employed. In science courses the most common form of in-semester assessment was practical reports, whereas in other programs pen-and-paper quizzes predominated. End-of-semester assessment contributed 50-80% to overall assessment across degree programs. CONCLUSION: The similarity in lecture themes taught across the four different degree programs shows that common knowledge- and competency-based learning outcomes can be defined for pharmacology. The authors contend that it is the differences in breadth and coverage of material for each lecture theme, and the differing teaching modes and assessment that characterise particular degree programs. Adoption of pharmacology knowledge-based learning outcomes that could be tailored to suit individual degree programs would better facilitate the sharing of expertise and teaching practice than the current model where pharmacology curricula are degree-specific.

Impact of low v. moderate intakes of long-chain n-3 fatty acids on risk of coronary heart disease.

The objective of the present study was to determine whether the consumption of ≥ 250 v. < 250 mg of the long-chain n-3 fatty acids (n-3 LCFA) per d is associated with a reduction in the risk of fatal and non-fatal CHD in individuals with no prior history of CHD. A comprehensive and systematic review of the published scientific literature resulted in the identification of eight prospective studies (seven cohorts and one nested case-control study) that met predefined inclusion criteria. Relative to the consumption of < 250 mg n-3 LCFA per d, the consumption of ≥ 250 mg/d was associated with a significant 35·1 % reduction in the risk of sudden cardiac death and a near-significant 16·6 % reduction in the risk of total fatal coronary events, while the risk of non-fatal myocardial infarction was not significantly reduced. In several meta-analyses, which were based on US studies, risk of CHD death was found to be dose-dependently reduced by the n-3 LCFA, with further risk reductions observed with intakes in excess of 250 mg/d. Prospective observational and intervention data from Japan, where intake of fish is very high, suggest that n-3 LCFA intakes of 900 to 1000 mg/d and greater may confer protection against non-fatal myocardial infarction. Thus, the intake of 250 mg n-3 LCFA per d may, indeed, be a minimum target to be achieved by the general population for the promotion of cardiovascular health.

Oral health in hospitalised patients: assessment and hygiene.

Maintaining oral health is an essential aspect of patient care. Good oral hygiene can reduce the risk of infection and improve patients' quality of life. This article provides an overview of oral care to enable nurses to undertake assessment of the mouth and deliver appropriate care as part of the patient's hygiene routine.

Bed bathing patients in hospital.

There are a number of circumstances that may affect an individual's ability to maintain personal hygiene. Hospitalised patients, and in particular those who are bedridden, may become dependent on nursing staff to carry out their hygiene needs. Assisting patients to maintain personal hygiene is a fundamental aspect of nursing care. However, it is a task often delegated to junior or newly qualified staff. This article focuses on the principles of bed bathing patients in hospital, correct procedure and the importance of maintaining patient dignity and respect in clinical practice.

Care of pin sites.

External fixation is a key component in orthopaedic management. However, the use of metal pins or wires may result in complications, such as pin site infections. To prevent infections pin site care must include effective assessment, monitoring and cleaning of the pin site. Differing methods of pin site management in clinical practice have resulted in inconsistencies in the literature relating to best practice. This article explores some of the variations in pin site care.

Measuring temperature.

Temperature measurement is an essential clinical skill and is recognised as being an important indicator in assessing the course of an illness. This article identifies temperature ranges and describes the procedures for taking temperature orally and via the tympanic canal in adult and paediatric patients.

Applying the key principles of nutrition to nursing practice.

This article outlines the importance of good nutrition in adults and children. With reference to adult nursing, the article highlights the benefits of nutritional screening of patients, identifies alternative foods for undernourished patients, and discusses why feeding and planning meal times are vital aspects of patient care. In terms of paediatric nursing, the article discusses the implications of childhood obesity and the importance of eating the right balance of foods.

Exploring the challenges and successes of the Lecturer Practitioner role using a stakeholder evaluation approach.

RATIONALE: Plans for NHS reform include strategies to reduce the gap between theory and the realities of clinical practice, with the aim of improving patient care. The role of Lecturer Practitioners (LPs) as educators for nurses who 'bridge' the theory-practice gap forms a central part of this strategy. Given the amount of investment in the role and its potential, this study sought to evaluate the impact of the LP role within the education and practice setting from the perspective of key stakeholders. METHODOLOGY: The study, which included five LPs from a range of backgrounds, followed the principles of stakeholder evaluation. Each LP and their line manager identified six informants who were familiar with the LP's role. The total sample consisted of 36 participants. Semi-structured interviews were used to gain the perceptions of stakeholders about the LP role. The emerging themes were then discussed, consensus reached, and a collaborative project report produced. FINDINGS: The findings were derived from the perceptions of the stakeholders. Minimally interpretive analysis of the data resulted in identification of five themes: (i) general overview of LP's individual qualities; (ii) preconceived notions of the post; (iii) reality of the post; (iv) areas of concern; and (v) developing the role. CONCLUSIONS: The findings indicated that the LP role provides a credible and valuable link between theory and practice and, as such, is an important contribution to the modernization agenda of the NHS. It was apparent, however, that there are a number of areas in which developments are needed, and that organizational and individual actions are necessary in order to achieve the most from these posts.

A guide to taking a patient's history.

This article outlines the process of taking a history from a patient, including preparing the environment, communication skills and the importance of order. The rationale for taking a comprehensive history is also explained.

Evaluating nurse consultants' work through key informant perceptions.

AIM: To evaluate the work of nurse consultants in the NHS by exploring the views of key informants and nurse consultants. METHOD: A multi-site evaluative study commissioned by and undertaken in four trusts. The evaluation was based on the 360 degree feedback process and used case study methodology, inviting key informants to provide information on their work with nurse consultants. FINDINGS: The findings are discussed in relation to the following themes: role aspirations and lived reality; challenging boundaries; impact and outcomes and leadership. The findings concur with previous studies demonstrating a series of common themes associated with leadership, clinical expertise, research and educational activity. These findings express the ways in which nurse consultants are working to develop unique services to meet patient needs. CONCLUSION: The nurse consultant has an important role in the modernisation of the NHS. The role's impact, in terms of the informants, is in leadership, clinical expertise, research and educational activity. The findings reveal an urgent need to support consultant nurses in developing their leadership potential and skills in researching practice.

Shared interests.

MANAGERS, IT HAS BEEN SAID, cannot read anything longer than two pages while academics cannot write anything less than 5,000 words ( Wistow 2001 ).

Long-chain omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid dose-dependently reduce fasting serum triglycerides.

The objectives of this review were to determine whether the long-chain omega-3 fatty acids eicosapentaenoic acid and/or docosahexaenoic acid dose-dependently reduce fasting serum triglycerides (TG) and, if so, to create a mathematical model that may be used to predict potential percent reductions in fasting serum TG levels at the recommended intakes of 200-500 mg/day. The assessment included 15 randomized controlled trials that met pre-defined inclusion and exclusion criteria. Across these 15 studies, the dose-response was modeled using a first-order elimination curve. The response variable was defined as percent change from baseline in fasting serum TG, adjusted for the placebo effect. A weighting factor equal to the product of each study's sample size and quality score was used. Using the equation of the dose-response curve, predicted reductions in fasting serum TG levels at the recommended long-chain omega-3 fatty acid intakes of 200-500 mg/day are 3.1 to 7.2%.

Glycogen is a preferred glutamate precursor during learning in 1-day-old chick: biochemical and behavioral evidence.

Bead discrimination training in chicks sets in motion a tightly timed series of biochemical events, including glutamate release, increase in forebrain level of glutamate and utilization of glycogen and glucose. Inhibition of glycogen breakdown by the glycogen phosphorylase inhibitor 1,4-dideoxy-1,4-imino-D-arabinitol (DAB) around the time of training abolishes the increase in glutamate 5 min posttraining in the left hemisphere, in spite of uninhibited glucose metabolism. It also reduces the contents of glutamate, glutamine, and aspartate in the right hemisphere. Behavioral evidence supports the conclusion that glucose breakdown serves to provide energy, whereas glycogen acts as a substrate for glutamate, glutamine, and aspartate formation, requiring both pyruvate dehydrogenation to acetyl coenzyme A and pyruvate carboxylation in astrocytes. Inhibition of memory consolidation caused by DAB or 2-deoxyglucose (2-DG), an inhibitor of glucose phosphorylation without effect on glycogen metabolism, was challenged by intracerebral administration of acetate, aspartate, glutamine, lactate or glucose. DAB-mediated memory inhibition was successfully challenged by administration at 0 or 20 min posttraining of acetate (an astrocyte-specific acetyl CoA precursor) together with aspartate, substituting for pyruvate carboxylation, or of glutamine at 0-2.5 or 30 min posttraining. 2-DG-mediated memory impairment was not challenged by acetate with or without aspartate at 0 time but was challenged by acetate without aspartate at 20 min. Lactate, a substrate for both dehydrogenation and pyruvate carboxylation challenged both DAB and 2-DG. Doses of DAB and 2-DG which, on their own were subeffective, were not additive, further supporting the existence of one pathway using glucose and another using glycogen.