A Study of Women Who Appear to Default from Management of an Abnormal Pap Smear

A study of nonattendance at a Dysplasia Clinic found that 20% of women who had an appointment in 1988 failed to attend the clinic during the next 18 months. Most of the nonattendance was among women who had previously been assessed at the Dysplasia Clinic. Only 6% of the nonattending women had cytological/histological evidence of CIN which remained untreated. If all women who did not default from attendance at the Dysplasia Clinic were correctly managed, then 1% of all women who have appointments made for the Dysplasia Clinic were potentially receiving inadequate management for lesions considered to have a precancerous potential. A questionnaire to the women who failed to attend these appointments identified pregnancy and seeking management elsewhere as the most commonly stated reasons for the nonattendance.     

Women Who Spontaneously Quit Smoking in Early Pregnancy

EDITORIAL COMMENT: The takeaway message from this sophisticated audit of smoking behaviour of pregncny Seems to be that during pregnancy. seems to be that spontaneous quitters who lapse back to the habit should be identifed, since they comprise about 35% of smokers who a n likely to quit after counselling during pregnancy. This paper gives important insight into the logistics of planning a policy of prevention of smoking during prenancy. We await, with interest, the authors' findings in their randomized controlled trial of a smoking cessation intervention
Summary: Spontaneous quitters are prepregnancy smokers who quit by the time of their first antenatal visit. We recruited 192 self-declared spontaneous quitters and 407 smokers at their first visit to the antenatal clinic at the Royal Women's Hospital during April, 1994-May, 1995. Spontaneous quitters made up 23% of prepregnancy smokers. Information about self-declared quitters and smokers was collected by self-completed questionnaires. Urine samples collected at the first visit and in late pregnancy were assayed for cotinine to validate smoking status. A cut-off urinary concentration of >653 nmol/L cotinine was used to determine active smoking. At the first visit, 20% of the self-declared spontaneous quitters were smoking and by late pregnancy, regardless of their initial biochemically verified status, 27% were smoking. Spontaneous quitters were different from women who said they were still smoking at their first antenatal visit, in a range of demographic variables and measures of addictive behaviour.     

Focus on Feeding! Evaluation of a framework for maximizing mealtime in aged care facilities

Unintentional weight loss is a health risk for residents of aged care facilities, a concern for families and places demands on nursing staff. An existing weight loss framework to assess and manage residents' weight developed by a multidisciplinary team was implemented and evaluated with nurses and residents in aged care facilities within an area health service of Sydney, Australia. Thematic analysis generated seven binary concepts relating to relational, procedural, behavioural, physical, psychological, environmental and temporal aspects of feeding assistance provided by nurses to residents. Theoretical sampling was applied to the literature confirming those concepts which were organized as a model of feeding assistance labelled the Focus on Feeding! Decision Model. Nurses can play a pivotal role in the assessment of feeding difficulty and implementation of innovative mealtime programs. The Model aims to promote nurses' critical thinking and decision‐making to improve nutritional intake of residents and avoid preventable weight loss.