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Recent studies indicate that aerobic rice can suffer injury from ammonia toxicity when urea is applied at seeding. Urea application rate and soil properties influence the accumulation of ammonia in the vicinity of recently sown seeds and hence influence the risk of ammonia toxicity. The objectives of this study were to (i) evaluate the effects of urea rate on ammonia volatilization and subsequent seed germination for a range of soils, (ii) establish a critical level for ammonia toxicity in germinating rice seeds and (iii) assess how variation in soil properties influences ammonia accumulation. Volatilized ammonia and seed germination were measured in two micro-diffusion incubations using 15 soils to which urea was applied at five rates (0, 0.25, 0.5, 0.75 and 1.0 g N kg−1 soil). Progressively larger urea rates increased volatilization, decreased germination and indicated a critical level for ammonia toxicity of approximately 7 mg N kg−1. Stepwise regression of the first three principal components indicated that the initial pH and soil texture components influenced ammonia volatilization when no N was added. At the intermediate N rate all three components (initial pH, soil texture and pH buffering) affected ammonia volatilization. At the largest N rate, ammonia volatilization was driven by soil texture and pH buffering while the role of initial pH was insignificant. For soils with an initial pH > 6.0 the risk of excessive volatilization increased dramatically when clay content was <150 mg kg−1, cation exchange capacity (CEC) was <10 cmolc kg−1 and the buffer capacity (BC) was <2.5 cmolc kg−1 pH−1. These findings suggest that initial pH, CEC, soil texture and BC should all be used to assess the site-specific risks of urea-induced ammonia toxicity in aerobic rice. [ABSTRACT FROM AUTHOR]

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]

Aggression in healthcare systems poses a major problem for nurses because they are the most susceptible to suffer violence. Studies demonstrate that attitudes of nurses influence their behaviour regarding aggression and violence. Training programmes can positively change nurses’ attitudes. This quasi-experimental study aimed to examine the effects of a systematic training course in aggression management on mental health nurses’ attitudes about the reasons for patients’ aggression and on its management. Sixty-three nurses (29 in the intervention and 34 in the control group) participated in this quasi-experimental pre-test and post-test study. The attitude of the participants of a training course was recorded by the German version of the Management of Aggression and Violence Attitude Scale (MAVAS). No significant attitude changes occurred in the intervention group at post-test. It is concluded that trainings intending to influence attitudes regarding the reason for patient aggression should consider the impact of the pedagogical quality of the training course, organizational support, and the user's perception. Moreover, it remains questionable to what extent a single instrument of measurement can record attitude changes. [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]

This paper describes the patients treated by 4th year undergraduate students during the first year of a pilot outreach course to teach Restorative Dentistry in community clinics in 2001—02. Data were collected from 908 summaries of patient treatment completed by the students, and from 139 patient questionnaires. Some 75% of patients were aged between 16 and 64, 58% were female, and 16% had dental phobia or anxiety. Most lived locally to the clinic and 41% made their initial contact as an emergency or drop-in. Some 37% made only a single visit (including children treated as emergencies) but 22% made six or more visits. Did not attend (DNA) was a problem and 18% of patients DNA to complete their treatment. Students undertook the full range of restorative procedures, with the emphasis on direct restorations, preventive treatment and advice, scaling, extractions and emergency treatment. Patients’ main reasons for attending the clinic were lay recommendation, the need for treatment, convenience, free treatment, or the lack of access to a dentist. Some 30% said they did not have or did not know of an alternative source of dental care, and half had not seen a dentist for at least 2 years. The study demonstrates that despite difficulties related to attendance, a suitable patient base can be established offering students the opportunity to provide comprehensive care for adults in a primary care setting. [ABSTRACT FROM AUTHOR]

Summary. Background. There is evidence to suggest that the family is becoming a more democratic unit and that children are spending more on sweet snack items than ever before. A study was thus undertaken to investigate the influence of children on parental decision-making in relation to the use of sugary snacks. Methods. A cross sectional interview study; children aged 7–8 years from 20 inner-city Manchester primary schools were asked about their sweet eating, their pocket money and their perceived levels of influence or autonomy within the household. The parents of these children were also asked to fill in a questionnaire that mirrored the children's questions. Results. There was a moderate but significant correlation between the opinion of the parents and that of the children on the extent of influence (Pearson coefficient r = 0·25, P = 0·001). When the adults (n = 181) were split into age groups, ≤ 29 years (n = 33), 30–35 years (n = 61) and ≥ 36 years (n = 87), the study showed that the older the adult, the less the child seemed to get his or her own way. Spearman's rho = 0·16, P = 0·03 (children's view) and rho = 0·17, P = 0·02 (adult's view). The dominant factors were related to money in the children's opinion, although the adults’ data suggested that older mothers (≥ 36 years) may be trying to limit their children's access to sweet snacks. Conclusions. Adults’ efforts to limit their children's intake of sweet snacks and drinks are being undermined by earlier and earlier influences in the child's life and by access to money, which allows the child to out-manoeuvre his or her parents. This is compounded by the provision of additional income, mostly from grandparents. [ABSTRACT FROM AUTHOR]

Following an initial springboard study, a further more extensive piece of research was conducted to identify and evaluate approaches used to manage patient aggression and violence on three acute mental health wards. Data were gathered using an incident form, a questionnaire and interviews. The views of patients (n = 80), nurses (n = 72) and medical staff (n = 10) were explored. Findings revealed a clear distinction between the way staff and patients view both the problem and the response. Patients' view present staff approaches as 'controlling' and believe that environmental and poor communication factors underpin aggressive behaviour. Staff, conversely, attribute aggressive behaviour to internal patient and external factors, which may explain the reason for approaches used. A strong correlation was found between type of patient aggression and response (r = 0.36, P < 0.000) and a high percentage of incidents reported were of an aggressive, as opposed to violent, nature. For example 70% of incidents involved verbal abuse or threat. Despite this, 47% (n = 103) of approaches incorporated the use of medication, restraint or seclusion. These are commonly referred to as traditional methods. Patients clearly view this controlling style as a part of the problem and an emphasis upon control and symptom reduction may be inappropriate given the type of aggression encountered. Key issues were further analysed using an internal, external and situational model, each of which endeavour to explain reasons for patient aggression from different perspectives. It is this emphasis upon sole perspectives that may both contribute to and result in the use of a limited number of management approaches adopted in practice. The integration of all three models to examine the complex nature of patient aggression and violence from a variety of perspectives may be the way forward. As a result, approaches to deal with this problem could be more meaningful and subsequently effective. [ABSTRACT FROM AUTHOR]

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]

To determine whether agroforestry and silvopastoralism might be introduced more successfully into xeric or into mesic environments, the effects of isolated, mature trees of Acacia tortilis (acacia) and Adansonia digitata (baobab) on herbaceous-layer composition and productivity, soil properties, and microclimate in a moderately mesic savanna (c. 750 mm annual rainfall) were investigated and compared with an earlier study of the effects of the same two species in a more xeric savanna (c. 450mm annual rainfall) in Tsavo National Park (West), Kenya. Similar to the more xeric site, solar radiation was reduced by 45–65% and soil temperatures were reduced by 5–12 C° under both tree species. Except for early in the growing season, soil-moisture values were similar under tree canopies and in open grasslands. Compared to the more xeric site, where herbaceous-layer productivity was 95% higher under trees than in the open, productivity in the mesic site was 52% higher under acacia canopies (a mean of 808 g m-2) than in the open (553 g m-2), but only 18% higher under baobab canopies (569 g m-2) than in the open (484 g m-2). Concentrations of organic matter, total N, 15N, P, K and Ca were significantly higher, and C:N ratios and soil bulk density significantly lower under tree canopies than in the open at both sites. Mg concentrations were significantly higher in the open than under tree canopies at the mesic, but not the xeric, site. The contrast noted in 3 above between the herbaceous layer productivity below tree canopies and that in areas beyond them was attributed higher soil-N concentrations and to reduced evapotranspiration in these N-and water-limited systems. The contrast in forage production under tree canopies between xeric and mesic sites may be due to the greater importance of shade in reducing temperatures and evapotranspiration in more arid environments. [ABSTRACT FROM AUTHOR]

(I) The effects of isolated, mature trees of Acacia tortilis and Adansonia digitata on their environments in a semi-arid savanna in Tsavo National Park (West), Kenya., were investigated by studying herbaceous-layer composition and productivity, site microclimate, and soil fertility under the canopy and in the rooting zones of individual trees and in the surrounding grasslands. Herbaceous-layer productivity was determined by clipping shoots monthly and by extracting roots from soil cores. Chemical and physical properties of soils were analysed by standard techniques. Plant species composition and soil nutrient data were ordinated by detrended correspondence analysis and principal components analysis, respectively. (2) Compared to open grassland, tree canopies. of both A. tortilis and A. digitala reduced solar irradiance by 45-65%, soil temperatures by 5-11 °C, and rainfall by 0-50%. Soil water content was higher in the open grass! and immediately after the start of the two rainy seasons, higher tinder tree canopies during the first rainy season, but was equal in the two areas during the second rainy season. (3) Patterns of herbaceous-layer composition and above-ground net primary productivity (ANPP) under and near trees of A. tortillis and A. digitata were similar, with significantly greater ANPP in their canopy zones (705±39 g m-2) than in their root (430 ± 23 g m-22) or grassland (361 ± 21 g m-2) zones. Herbaceous-root biomass (0-30cm depth) was similar in all three zones around both tree species (range= 528-659 g m-2). (4) Mineralizable N and microbial biomass were significantly higher in soils from the canopy than from the root and grassland zones, whereas organic matter, P, K, and Ca (but not Mg) declined in soils from the base of the trees towards the open grassland. [ABSTRACT FROM AUTHOR]

Worldwide, oral cancer has one of the lowest survival rates. It is well recognized that survival rates are improved if the disease is treated in its early stages. The aim of this study was to assess the effectiveness of screening methods in decreasing the mortality of oral cancer. A systematic review on the effectiveness of oral cancer screening was performed using all publications in MEDLINE, CANCERLIT, EMBASE, and Cochrane CCTR between 1966 and September 2002. The evidence was evaluated using the standardized methodology of the Cochrane Collaboration. The search strategy revealed 1,389 citations. From these, 100 potentially relevant articles were selected for review. However, only one randomized controlled study using visual examination as the method for screening fulfilled the selection criteria. Given the limitation of evidence and the potential methodological weakness in the included study, it is valid to say that there is no evidence to recommend inclusion or exclusion of screening programs for oral cancer using visual examination in the general population. In addition, no robust evidence exists that indicates whether other screening methods including toluidine blue, fluorescence imaging, or brush biopsy are either beneficial or harmful. Further high-quality studies to assess the efficacy and effectiveness of screening are required. Additional investigations aimed at elucidating the natural history of oral cancer and evaluating the effectiveness of prevention and opportunistic screening in high-risk groups are needed. A greater understanding of the genetic basis of oral cancer is an essential prerequisite to the development of molecular markers for screening.