Search

AIM: This paper is a report of a study to determine the transferability of the Management of Aggression and Violence Attitude Scale to European mental health inpatient settings. BACKGROUND: Incidents of patient aggression and violence are common in psychiatric in-patient facilities, and nurses' attitudes may play a part in how they are managed. METHODS: Nursing staff from acute psychiatric in-patient units in Switzerland and the United Kingdom completed the Management of Aggression and Violence Attitude Scale. Data were collected in the UK in 2001 and Switzerland in 2003. The Swiss sample comprised 75 respondents: 45 female, mean age 36.24, mean experience 7.35 years, 60 Registered Nurses. The United Kingdom sample was 75 respondents: 58 female, mean age 32, mean experience 5.25 years, 48 Registered Nurses. T-tests identified differences between the groups in their responses to each Management of Aggression and Violence Attitude Scale statement. RESULTS: There was 66% concordance of views between the groups. Swiss nurses were, however, more likely to regard factors internal to the patient as contributory to aggression while United Kingdom nurses perceived environmental factors to be more important. Both groups endorsed physical means of aggression management, Swiss nurses more so. CONCLUSION: There are both commonalities and differences between the attitudes of Swiss and United Kingdom nursing staff regarding patient aggression. Differences may relate to rates of aggression, variations in management approaches, training and policy. The Management of Aggression and Violence Attitude Scale is a potentially effective tool for making comparisons about perspectives on patient aggression. [ABSTRACT FROM AUTHOR]

Aim: To examine the experience of being an outreach teacher of undergraduate restorative dentistry; to describe the desirable characteristics of such teachers; and to consider the management of outreach teaching. Design: A three year pilot of an outreach course in fourth year restorative dentistry began in 2001. Students spent one day per week treating adults in NHS community dental clinics, run by Primary Care Trusts (PCTs). Action research involved monitoring meetings with students, clinic staff (dental teachers and nurses), and PCT clinical service managers. These data are supplemented by an independent evaluation involving interviews with dental school academic staff, and an account by an outreach teacher. Results: Outreach is a different and more demanding context for teaching restorative dentistry than the dental hospital, characterised by isolation, management responsibility, pressure, a steep learning curve, and stress. The desirable characteristics of outreach teachers are those which enable them to cope in this environment, together with a student-centred teaching style, and the appropriate knowledge. Management of teaching passed to the PCTs and this created an additional workload for them in relation to staffing, risk, and service-based issues. Four teaching surgeries were the maximum for a satisfactory level of patient care and student supervision. A key issue for the dental school is quality. The changes to teaching and the teaching environment introduced during and after the pilot to address problems identified are described. Conclusion: In developing facilities to enable students to benefit from the advantages of outreach, dental schools should recognise that the characteristics of the outreach environment need to be taken into account during planning, that staff selection is a critical success factor, and that an ongoing proactive approach to organisational arrangements and to the support of teaching staff is necessary. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study of staff and patient perspectives on the causes of patient aggression and the way it is managed. BACKGROUND: The incidence of aggression in healthcare is reportedly on the increase, and concerns about the management of this problem are growing. METHOD: A convenience sample of 80 patients and 82 nurses from three inpatient mental healthcare wards were surveyed using The Management of Aggression and Violence Attitude Scale. A further five patients and five nurses from the same sample participated in a number of follow-up interviews. RESULTS: Patients perceived environmental conditions and poor communication to be a significant precursor of aggressive behaviour. Nurses, in comparison, viewed the patients' mental illnesses to be the main reason for aggression, although the negative impact of the inpatient environment was recognized. From interview responses, it was evident that both sets of respondents were dissatisfied with a restrictive and under-resourced provision that leads to interpersonal tensions. CONCLUSION: There are differences between the views of staff and patients about reasons for aggression and its management. Future approaches therefore need to be developed that address these opposing views. For example, training in the use of fundamental therapeutic communication skills was advocated by patients, whilst the need for greater attention to organizational deficits was advocated by nurses. A move away from reliance on the use of medication was also felt to be necessary. Evaluation of local needs and practices must be an integral part of this process. [ABSTRACT FROM AUTHOR]

Accurate reference maps are important in the use of stable-isotopes to track the movements of migratory birds. Reference maps created by the analysis of samples collected from young at the nest site are more accurate than simply referring to naturally occurring patterns of hydrogen isotope ratios created by precipitation cycles. Ratios of hydrogen isotopes in the nutrients incorporated early in the development of young birds can be derived from endogenous, maternal sources. Base-maps should be created with the analysis of tissue samples from hatchlings after local the isotopic signature of exogenous nutrients is dominant. Migratory species such as Peregrine Falcons are known to use endogenous sources in the creation of their eggs, therefore knowledge of what plumage stage best represents the local hydrogen ratios would assist in the planning of nest visits. We conducted diet manipulation experiments involving Japanese Quail and Peregrine Falcons to determine the plumage stage when hydrogen isotope ratios were indicative of a switch in their food source. The natal down of both the quail and falcons reflected the diet of breeding adult females. The hydrogen isotope ratios of a new food source were dominant in the juvenile down of the young falcons, although a further shift was detected in the final juvenile plumage. The juvenile plumage is grown during weeks 3-4 after hatch on Peregrine Falcons. Nest visits for the purpose of collecting feathers for isotope-base-map creation should be made around 4 weeks after the presumed hatch of the young falcons. [ABSTRACT FROM AUTHOR]

Perhaps due to the complexities of the problem of aggression and violence, and to ethical issues relating to the mental health areas where much of the work is focused, it is the perspective of staff working in those areas that is most commonly sought in research studies. In contrast, tools to examine the patient's view are rare. In this paper Joy Duxbury describes the piloting and development of a new tool, which aimed to survey the views of both patients and staff about the broader approaches used to manage patient aggression. This became the 'Management of Aggression and Violence Attitude Scale' (MAVAS), and the testing of this tool is the focus of this paper. [ABSTRACT FROM AUTHOR]

The total arsenic content of 150 paddy rice samples collected from Barisal, Comilla, Dinajpur, Kaunia, and Rajshahi districts, and from the BRRI experimental station at Rajshahi city in the boro and aman seasons of 2000 was determined by hydride generation-inductively coupled plasma emission spectroscopy (ICP). Arsenic concentrations varied from 10 to 420 µg/kg at 14% moisture content. Rice yields and grain arsenic concentrations were 1.5 times higher in the boro (winter) than the summer (monsoon) season, consistent with the much greater use of groundwater for irrigation in the boro season. Mean values for the boro and aman season rices were 183 and 117 µg/kg, respectively. The variation in arsenic concentrations in rice was only partially consistent with the pattern of arsenic concentrations in drinking water tube wells. There was no evidence from yield or panicle sterility data of arsenic toxicity to rice. Processing of rice (parboiling and milling) reduced arsenic concentrations in rice by an average of 19% in 21 samples collected from households. Human exposure to arsenic through rice would be equivalent to half of that in water containing 50 µg/kg for 14% of the paddy rice samples at rice and water intake levels of 400 g and 4 L/cap/day, respectively. [ABSTRACT FROM AUTHOR]

Multiple soil micronutrient deficiencies along the Indogangetic plains (IGP) of South Asia are one of many factors limiting rice and wheat yields. Zn deficiency is widespread in the IGP. Deficiencies of Fe, Mn, and B have increased in many parts of the IGP within the last three decades, while deficiencies of Cu and Mo have been localized. To address this problem, micronutrients were applied to the wheat crop to obtain micronutrient-enriched seeds at harvest. Two treatments were imposed on wheat variety PBW138 planted at the research station of Punjab Agricultural University, Punjab, India: spraying the crop at fourcrop growth stages with a micronutrient solution containing Zn, Cu,Mn, and Fe, and comparing it to a non-enriched control seed lot. Spraying increased seed micronutrient content at harvest by 63, 60, 22, and 48% of Zn, Cu, Mn, and Fe, respectively. These enriched seeds were then planted in pots containing three different soil types representing different soil physico-chemical properties and compared to the performance of non-enriched control seeds of the same variety. The grain and straw yield of plants from the enriched seeds were significantly higher (p < 0.001) compared to the non-enriched seeds. It was therefore concluded that the selection and planting of micronutrient-enriched cultivars of wheat could be a long-term strategy for addressing the widespread soil micronutrient deficiencies in the IGP. [ABSTRACT FROM PUBLISHER]

Recent reports have questioned the long-term sustainability of the rice-wheat cropping system. Evaluation of yield trends in fifteen long-term rice-wheat experiments found that rice yields usually declined with time but that wheat yields were more stable. Nutrient response curves indicated that insufficient N was added to achieve maximum yield in some experiments, suggesting that crop lodging prevent genetic yield potential from being reached. Substantial decreases in response of rice to N were observed in some experiments, indicating constraints to productivity other than N supply. Organic inputs used in integrated nutrient management strategies generally substituted for fertilizer nutrients but occasionally increased yield potential. Neither organic inputs nor increased soil organic matter contents markedly affected the sustainability of the rice-wheat system. Wheat yields in the northwest Indian States of Haryana and Punjab increased linearly between 1965 and 1998 and are the major reason for increased wheat production in these States. In contrast, rice yields follow a curvilinear pattern, have stagnated in many districts, and are showing signs of possible decline. Increased area in production has been the major factor behind increased production of rice in Punjab State since about 1975. [ABSTRACT FROM PUBLISHER]

Until relatively recently, aggression and violence in nursing has been an area of little discussion (Poster & Ryan 1993). Today, concerns are rising about escalating levels of violence towards nurses (Wykes 1994, Whittington 1997). In response, this paper explores registered nurses' experiences of patient aggression encountered in the acute inpatient general and mental health settings. Critical incidents from registered nurses in both areas are examined and analyzed in relation to existing literature. The aim of the research is to ascertain if differences exist or similarities prevail. Findings reveal that the two areas have similar problems in terms of types of aggression. Verbal and 'minor' types of aggression are the most problematic. Also, the 'biomedical model' of care is evident in both settings and possibly underpins chosen approaches to aggression management. The repeated use of chemical and physical restraint is apparent. The main comparison identified between the two groups relates to nursing control over situations involving violent patients. Mental health nurses seem to consistentlv take control of aggressive situations whilst general nurses tend to rely more heavily upon the input of others (medical staff, mental health teams and the police) when intervening. These two nursing specialties therefore have much to learn from each other in terms of nursing experience and possible future approaches to the management of aggressive patients. [ABSTRACT FROM AUTHOR]

This study aims to explore the administration of prn night sedation by qualified night nurses on primary nursing and team nursing wards using a quasi-experimental design. The purpose of the study was to examine the attitudes of qualified nurses (n = 20) about sleep problems in hospital and sleep medication and compare these attitudes with behaviour (the administration of prn night sedation) reporting any differences between wards using team and primary nursing philosophies of care. Ten nurses from team nursing wards and 10 nurses from primary nursing wards were interviewed about the amount of night sedation they had administered during one night shift. This was followed by a questionnaire aimed at examining their attitudes about sleep and night sedation using several visual analogue scales. Findings proved to be significant in that results confirmed that team nurses gave out almost three times as much prn night sedation as nurses in primary nursing wards and held attitudes that closely correlated with more of a 'medical model' approach such as an emphasis on the advantages of night sedation and the need for its continued use in the clinical area. [ABSTRACT FROM AUTHOR]

Myeloma is a disease of the bone marrow in which there is malignant proliferation of plasma cells. Myeloma is usually associated with the accumulation of a monoclonal immunoglobulin or light chains in plasma and subsequently an increase in light chains in the urine (Bence-Jones proteins). Renal failure can occur and bone destruction in the axial skeleton may ensue with pain and fractures. Amyloidosis associated with multiple myeloma is a relatively common finding. The most frequently reported oral sign of amyloidosis is macroglossia. There are numerous cases in the literature of amyloid deposition in tongues related to multiple myeloma. However, none of these cases describe amyloid deposition surrounding arteries in the oral cavity. We therefore report a case of an innocuous lower labial swelling, which subsequently led to the diagnosis of amyloid deposition surrounding an artery, the cause of which was later shown to be multiple myeloma. [ABSTRACT FROM AUTHOR]