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S Heart, Lung and CirculationAbstracts S159 2011;20S:S156-S251 incentive survey with 65 multichoice questions covering all aspects of the service (indications, contraindications, image settings, safety, echo lab workforce and workflow issues and clinical relevance). These answers and a free text option were analysed to assess the program and to determine whether this survey method may be an adequate quality control measure. This survey was approved by the hospital's Human Research Ethics Committee.Results: Of the 54 staff invited to participate, 31 (55%) responded. Ninety-seven percent agreed contrast can improve image quality and improve assessment for LV non compaction (93%), LV thrombus (93%), LV morphology (90%), enhance spectral Doppler signals (70%) and RV function (44%). Seventy-four percent reported contrast results altered patient management. Eighty-two percent reported it increased confidence in echocardiographic findings. However, 60% felt contrast echo slowed down workflow through the department.Conclusion: The online survey technique proved an effective and efficient method to obtain, organise and interpret data in those who did respond. The 55% response rate was disappointing but higher than usual for comparable surveys (10%). The contrast program was interpreted positively with a high level of general knowledge and clinical relevance. Constructive feedback centred on disseminating the technique and recommendations to improve workflow through the department.

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Purpose This paper aims to explain how and why the philosophical changes to the pre-registration nursing standards by the UK’s Nursing and Midwifery Council (NMC) have resulted in a paradigm shift for mental health nursing. Design/methodology/approach This paper critically examines the changes to nursing education standards and offers an analysis of the problems associated with the shift towards a generic nursing syllabus. Findings The said shift prioritises physical health intervention, skills, procedures and tasks over the uniqueness of mental health nursing. Practical implications This paper argues that mental health nursing skills and qualities such as connection, genuine advocacy and therapeutic-use-of-self have been undervalued and under-represented by the new education standards. Originality/value This paper calls on the profession and service users to join the discourse and inform future mental health nursing identity. Ultimately, this paper calls on the NMC to reconsider the underpinning principles of the education standards and allot due consideration to the specific needs of the mental health nursing profession.

Summary. Recent finds of hoarded silver in Cisjordan present new material for the consideration of the conceptual history of coined metals. When the fundamental concepts associated with coinage are abstracted from the various objects that express them, it is possible to see that a kind of coined metal existed in Cisjordan and other parts of the Near East prior to the traditional ‘invention’ of coinage by the Lydians and Greeks c.600 BC.1Both hoards and written sources indicate that seals affixed to precious metals at times qualified them in a numismatic sense by guaranteeing weights set to standards as well as controlled composition. What has been characterized as the ‘invention’ of coinage was rather an adaptation of these same principal concepts. The frequency and size of silver hoards from Cisjordan point to a proliferation in the ‘monetary’ use of silver in that region during the Iron Age and suggest a relationship to the overwhelming preference for silver coinages among the Greeks.