Effects of two intervention strategies on the behavior of nurses and nurse students related to advance directives

Advance directives are one mechanism for preserving the rights of individuals to exercise some control over their health care when serious illness may prevent them from direct participation. Nurses, as the health care providers with the closest and most sustained contact with critically ill and dying patients, are positioned to assist patients to plan for future health care needs. Although a majority of nurses favor the concept of advance directives for their patients and for themselves, they have not played a significant role in facilitating advance health care planning with their patients nor implemented advance health care planning for themselves.^ Research has also shown that differing forms of education and counseling increase the completion rates for advance directives in selected populations, mostly the elderly and seriously ill. Not yet developed are effective educational strategies to assist nurses and nurse students to make optimal contributions in assisting their clients' plans for future health care decision-making. This study sought to determine whether specific learning strategies (a) increased the involvement of nurses and nurse students in facilitating advance care planning with patients and (b) increased the percentage of the nurses' and nurse students' own personal advance care planning activities.^ The study compared two learning interventions and two populations, nurses and nurse students. The participants were randomly assigned to one of the two learning interventions, L1 or L2. Participants in L1 received a lecture, discussion and exploration of the forces impacting on advance directive behavior. Participants in L2 received the same intervention components with the additional component of group practice completing advance directives.^ Analysis of the data by chi-square and logistic regression did not support the hypotheses that the practice component would make a difference in the participants' facilitation of advance care planning with patients or in their own personal advance care planning activities. There were significant differences in post-intervention behavior between the nurse and nurse student groups. The nurses in the study did significantly more facilitation of advance care planning with patients and completed significantly more advance care documents than the nurse students post-intervention. However, the nurse students held more post-intervention family discussions than did the nurses. ^

Spatial and temporal variation of microbial properties in the water column of Florida Bay

Physical and biological properties of the water column of Florida Bay were examined at seven study sites over an eighteen month period. The results indicated seasonality in some parameters, but was not evident in others. The data displayed statistically significant (P < 0.05) differences between study sites indicating spatial variation. The presence of seagrass affected the overlying water column, especially with respect to the biological parameters: those areas overlying seagrass beds displayed statistically significantly higher values than those over sparsely covered or barren areas. During the period of the study, Florida Bay experienced a seagrass die-off event: microbial activity and numbers were statistically significantly higher over areas of dying seagrass than over healthy or dead areas. The results of this study pointed to phosphorus being the controlling, or limiting factor, for microbial activity in the water column of Florida Bay.