Emotional handicaps to learning in two cultures

Deteriorating academic performance in schoolchildren may be due to emotional rather than intellectual causes, but these are not always recognized. The problem is likely to be of increasing importance in African children in Rhodesia as the general level of education rises. Emotional problems in 11 European and 16 African schoolchildren are compared. Although no firm conclusions can be drawn, the evidence suggests that the same conceptual framework may be used for both groups; that physical symptoms may present more often in African children; and that 'over-driving' and peer group rejection may be more common. psychopathological factors in African children

Diencephalic Instability and Aggression

The EEG and clinical features of thalamic and hypothalamic epilepsy are reviewed. Comments are made on the physiology of the 14 and 6 per second positive spikes seen on EEG; comments are made on the diversity of the clinical features. Twelve cases of this kind of epilepsy seen at Ingutsheni Hospital during a 5-year period are reviewed; in 3 cases an 18-Hz temporal rhythm occurred in association with the positive spikes. The concept of 'diencephalic instability' is introduced to reconcile the diverse features of the syndrome. The relationship of diencephalic instability to aggressive behaviour and other EEG patterns is discussed; the particular significance of the 18-Hz pattern is discussed

A new peridol derivative in the treatment of chronic schizophrenia

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Depression in African patients

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Psychiatric services in matabeleland

Some of the difficulties experienced with the introduction of community psychiatry into developed countries are reviewed. The dangers of transplanting such concepts piecemeal into an African context are stressed. To provide some basis for planning psychiatric services in Matabeleland, a survey is made of patients at Ingutsheni Hospital, Bulawayo. The hospital populations at 31 December 1968 and 31 December 1971 are compared; and all patients discharged during the intervening 3 years are reviewed. From the review it appears that about 40% of patients in hospital and 50% of patients discharged are schizophrenic, while about 20% of patients in hospital and 18% of patients discharged are epileptic. At least 34% of patients discharged have been admitted more than once. From these figures it is suggested that a followthrough service aimed at reducing the number of schizophrenic and epileptic readmissions would be a practical first step towards improving services.S. Afr. Med. J., 48, 925 (1974)

Diurnal Range of the Barometer in Fine and in Cloudy Weather

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What difference does ("good") HRM make?

The importance of human resources management (HRM) to the success or failure of health system performance has, until recently, been generally overlooked. In recent years it has been increasingly recognised that getting HR policy and management "right" has to be at the core of any sustainable solution to health system performance. In comparison to the evidence base on health care reform-related issues of health system finance and appropriate purchaser/provider incentive structures, there is very limited information on the HRM dimension or its impact. Despite the limited, but growing, evidence base on the impact of HRM on organisational performance in other sectors, there have been relatively few attempts to assess the implications of this evidence for the health sector. This paper examines this broader evidence base on HRM in other sectors and examines some of the underlying issues related to "good" HRM in the health sector. The paper considers how human resource management (HRM) has been defined and evaluated in other sectors. Essentially there are two sub-themes: how have HRM interventions been defined? and how have the effects of these interventions been measured in order to identify which interventions are most effective? In other words, what is "good" HRM? The paper argues that it is not only the organisational context that differentiates the health sector from many other sectors, in terms of HRM. Many of the measures of organisational performance are also unique. "Performance" in the health sector can be fully assessed only by means of indicators that are sector-specific. These can focus on measures of clinical activity or workload (e.g. staff per occupied bed, or patient acuity measures), on measures of output (e.g. number of patients treated) or, less frequently, on measures of outcome (e.g. mortality rates or rate of post-surgery complications). The paper also stresses the need for a "fit" between the HRM approach and the organisational characteristics, context and priorities, and for recognition that so-called "bundles" of linked and coordinated HRM interventions will be more likely to achieve sustained improvements in organisational performance than single or uncoordinated interventions

High-Frequency Jet Ventilation During Cryoablation of Small Renal Tumours

AIM: To evaluate the effect of high-frequency jet ventilation (HFJV) in place of standard intermittent positive-pressure ventilation (IPPV) on procedure duration, patient radiation dose, complication rates, and outcomes during CT-guided cryoablation of small renal tumours. MATERIALS AND METHODS: One hundred consecutive CT-guided cryoablation procedures to treat small renal tumours under general anaesthesia were evaluated-50 with standard IPPV and 50 after the introduction of HFJV as standard practice. Anaesthesia and procedural times, ionising radiation dose, complications, and 1-month post-treatment outcomes were collected. RESULTS: HFJV was feasible and safe in all cases. Mean procedure time and total anaesthetic time were shorter with HFJV (p = <0.0001). The number of required CT acquisitions (p = 0.0002) and total procedure patient radiation dose (p = 0.0027) were also lower in the HFJV group compared with the IPPV group. There were a total of four complications of Clavien-Dindo classification 3 or above-three in the IPPV group and one in the HFJV group. At 1-month follow-up, two cases (both in the IPPV group) demonstrated subtotal treatment. Both cases were subsequently successfully retreated with cryoablation. CONCLUSION: By reducing target tumour motion during CT-guided renal cryoablation, HFJV can reduce procedure times and exposure to ionising radiation. HFJV provides an important adjunct to complex image-guided interventions, with potential to improve safety and treatment outcomes

'20 days protected learning' - students' experiences of an Overseas Nurses Programme - 4 years on: A retrospective survey

Background From September 2005 the Nursing and Midwifery Council (NMC) introduced new arrangements for the registration of non-EU overseas nurses which requires all applicants to undertake '20 days of protected learning' time in the UK and for some, a period of supervised practice. A survey was undertaken at Bournemouth University, which offers a '20 days protected learning only' programme, to elicit overseas nurses' demographic details, experiences in completing the programme and their 'final destinations' once registered. Methods An online survey was devised which contained a mixture of tick box and open ended questions which covered demographic details, views on the programme and final destinations This was uploaded to www.SurveyMonkey.com and sent out to nurses who had completed the Overseas Nurses Programme (ONP) with Bournemouth University (n=1050). Quantiative data were analysed using descriptive statistics and the qualitative data were coded and analysed using content analysis . Results There were 251 respondents (27.7% response rate). The typical 'profile' of a nurse who responded to the survey was female, aged 25-40 years and had been qualified for more than 5 years with a bachelors degree. The majority came from Australia on a 2 year working holiday visa and the key final destination in the UK, on registration with the NMC, was working for an agency. There were five key findings regarding experience of the programe. Of those surveyed 61.2% did not feel it necessary to undergo an ONP; 71.6% felt that they should be able to complete the programme on-line in their own country; 64.2% that the ONP should only contain information about delivery of healthcare in UK and Legal and professional (NMC) issues; 57% that European nurses should also undergo the same programme and sit an IELTS test; and 68.2% that the programme was too theory orientated; and should have links to practice (21%). Conclusions The NMC set the admissions criteria for entry to the register and Standards for an ONP. The findings of this survey raise issues regarding the percieved value and use of this approach for overseas nurses, and it may be helpful to take this into account when considering future policy