Staff responses to challenging behaviour shown by people with dementia: an application of an attributional-emotional model of helping behaviour.

There is some evidence to suggest that staff beliefs and emotional responses to challenging behaviour shown by clients are critical factors in guiding their responses to such behaviour. The purpose of this paper was to apply Weiner's cognitive-emotional model of helping behaviour to staff working with people with dementia who exhibit challenging behaviour. The paper also aimed to explore the impact of staff burnout and professional group upon participants' responses to real-life experiences of challenging behaviour. The participants were 25 nurses and 26 psychologists. Methods included questionnaire measures and coding of spoken attributions using the Leeds Attributional Coding System. Non-parametric tests measured between-group differences and correlations between the key variables. There were few differences between the two professional groups for the key variables. Optimism and sympathy were generally associated with willingness to help, and burnout was associated with less willingness to help, low optimism and negative emotional responses to clients' behaviour. No consistent or robust role was found for attributions. The results are discussed in relation to alternative factors, which may promote or reduce staff helping behaviour in the context of services for people with dementia.

An integrated approach to prenatal smoking cessation interventions.

This article encourages the incorporation of smoking cessation activities into routine nursing care in the prenatal period. A brief background is given regarding the problem of smoking in women--especially pregnant women and adolescents. A model is suggested that integrates the Stages of Change framework with a program for planning, implementing, and evaluating smoking cessation activities in the clinical setting. The use of biochemical testing for cotinine, a biomarker of nicotine, is also explored as an evaluation tool and a method of self-report confirmation. The nurse is uniquely poised to reduce both the healthcare and economic burden of smoking during pregnancy. Because cigarette smoking is a major public health problem in the United States today, it is important for nurses to have a background in smoking assessment, cessation, and evaluation methods. It is critical for all nurses in obstetric, pediatric, hospital, and clinic settings to use this knowledge to assist vulnerable clients in achieving lifetime abstinence from cigarettes.

Preventing youth use of tobacco products: the role of nursing.

In the 1997 Youth Risk Behavior Survey (Centers for Disease Control and Prevention [CDC], 1998a), 70.2% of high school students reported cigarette use, 36.4% were current cigarette smokers, and 16.7% reported frequent cigarette use (as measured by more than 20 in the last 30 days). Current tobacco use by all racial and ethnic groups is 42.7% (48.2% male, 36.0% female). Preventing youth tobacco use requires nurses to be active in many different domains. Public health experts agree that tobacco control efforts must target youth, with the goal of preventing tobacco product use and dependence. Nurses need to be actively involved in directing resources and talents toward public awareness and tobacco prevention programs, formulating public policy initiatives to control youth access to tobacco, and initiating cessation programs for youth. Efforts can be targeted at the schools, community, and health care system, as well as the public policy arena and media campaigns.

Comparison of rapid immunofluorescence procedure with TestPack RSV and Directigen FLU-A for diagnosis of respiratory syncytial virus and influenza A virus.

A rapid immunofluorescence format requiring 20 min for completion was as effective as conventional indirect and direct immunofluorescence procedures for detecting respiratory syncytial virus and influenza A virus antigens in clinical specimens. Rapid immunofluorescence was more sensitive than TestPack RSV and comparable to Directigen FLU-A immunosorbent assays, which require 20 min for completion.

Comparison of Directigen FLU-A with viral isolation and direct immunofluorescence for the rapid detection and identification of influenza A virus.

Directigen FLU-A, an enzyme immunoassay membrane test, was compared prospectively to isolation in cell culture and direct immunofluorescence (IF) for the detection of influenza A virus. One hundred ninety specimens were evaluated by Directigen FLU-A and cell culture; 184 of these specimens were also tested by direct IF. The sensitivity of Directigen FLU-A compared to isolation in cell culture and direct IF was 100%. The specificities of Directigen FLU-A compared to isolation and direct IF were identical, 91.6%. Fourteen specimens that were positive by Directigen FLU-A did not yield virus in culture; two of the specimens, however, were positive by direct IF, and four other specimens were not specimens of choice for the test. A positive Directigen result had positive predictive values of 62.6 and 75.0% compared to isolation and direct IF, respectively; a positive Directigen result with an intensity reading of 2+ or greater, however, had positive predictive values of 85 and 100% compared to isolation and direct IF, respectively. In all comparisons, the negative predictive value was 100%. There was no evidence that cross-reactivity occurred with non-influenza A antigens. Directigen FLU-A should serve as a convenient screening test for influenza A and as a rapid test supported by isolation in cell culture during an influenza outbreak.

Comparison of directigen RSV with viral isolation and direct immunofluorescence for the identification of respiratory syncytial virus.

An enzyme immunoassay membrane test (Directigen RSV) for the detection of respiratory syncytial virus in clinical specimens was compared prospectively with isolation in cell culture and direct immunofluorescence (IF). A total of 315 nasopharyngeal wash specimens from pediatric patients were examined. Directigen RSV was 86.1% sensitive and 91.3% specific for specimens positive by isolation in cell culture and/or IF, with 88.6% agreement. The false-positive rate was 16%; 2 of 20 specimens giving false-positive reactions by Directigen RSV were true-positives by blocking assay. Twenty-seven specimens (8.5%) whose results were initially uninterpretable by Directigen RSV due to filtration difficulties were diluted and upon retesting produced acceptable results. Sixty-three viral isolates and/or IF identifications of virus antigens representing seven virus groups other than respiratory syncytial virus were also found; cross-reactions between Directigen RSV and other viruses were not observed. Directigen RSV will be useful as an immediate procedure and in facilities lacking a comprehensive virology laboratory.

Zinc absorption in alcoholics using zinc-65.

Alcoholism is occasionally complicated by zinc deficiency. We have assessed the possibility that malabsorption of zinc may be a potential cause. Using a dual isotope absorption technique the absorption of 65Zn in 18 alcoholic patients was 37% (13 +/- SD) and 56% (10 +/- SD) in a normal control group (p less than 0.001). The mean serum zinc in 55 alcoholic patients was 11.6 mumol/l (3.0 +/- SD) and in 36 normal volunteers the mean serum zinc was 13.6 mumol/l (1.8 +/- SD; p less than 0.001). This study suggests that chronic alcohol abuse will decrease the absorption of zinc and this may contribute towards the zinc deficiency occasionally associated with alcoholism.