It is generally agreed in the nursing literature that the maintenance of patient dignity is an important element of nursing care that is highly valued by patients. Despite this, dignity is seldom defined and there are few guidelines that nurses may use in their practice to safeguard individual patients' dignity. This phenomenological study aimed to uncover patients' and nurses' perceptions of dignity, formulate a definition of dignity based on the experience of patients and nurses, and identify nursing practices that maintain or compromise patient dignity. The study found that the characteristics nurses associated with dignity were many and varied. Important elements in the meaning the nurses ascribed to the notion of patient dignity were the elements of respect, privacy, control, advocacy and time. The themes which emerged from the patient interviews were similar to those which emerged from the interviews with nurses. The characteristics that patients attributed to dignity and its maintenance included respect, privacy, control, choice, humour and matter-of-factness.

Concern is growing about the occurrence of malnutrition in hospitals throughout the developed world. Reduced involvement of nurses in patients' nutritional care may be one of the contributing factors. This study explored nurses' attitudes and knowledge about nutrition and food service in hospital. Semi-structured interviews were conducted with seven nurses from the internal medical service of a large Australian acute care hospital. Analysis of the interview transcripts revealed that many nurses lacked the in-depth knowledge needed to give proper nutritional care to their patients. Although nurses considered nutritional care to be important many had difficulty in raising its priority above other nursing activities, as a result of time constraints and multitasking issues. Several problems relating to food service arrangements were also highlighted. The findings suggest a need to raise nurses' awareness of the importance of nutrition in patient outcome. This study provides information which will guide in-service nurse education programs about nutrition, and suggests strategies for practice and organizational change.

Recombinant human tumour necrosis factor alpha (rHuTNFα) was shown to inhibit human neutrophil migration in the presence or absence of a chemotactic gradient generated with the tripeptide, N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP), at doses of 20–100 U/10⁶ cells. In contrast, neither recombinant human interleukin-1 alpha (rHuIL-1α), rHuIL-1β, human leucocyte-derived IL-lα (lHuIL-lα) nor lHuIL-1β contained neutrophil migration inhibition properties. However, both the interleukins (lHuIL-1α, lHuIL-1β and rHuIL-1α) and rHuTNFα stimulated a neutrophil respiratory burst and significantly elevated the neutrophil respiratory response to fMLP (measured as chemiluminescence and H₂O₂ production). The stimulatory effects were observed at doses of between 5 and 100 U/5 × 10⁵ cells. A characteristic feature of the effects of the cytokines was the range of variation observed in neutrophil responses from different individuals. However, a concentration-related effect was observed with each experiment, delineating suboptimal, optimal and supra-optimal cytokine concentrations. Neutrophils treated with rHuTNFα and rHuIL-1α and washed free of exogenous cytokine retained the capacity to show an enhanced response to fMLP. Pretreatment of cells with cytochalasin B enhanced their response to fMLP, and this response was further increased if the cells had also been pretreated with the cytokines. The response to phorbol myristate acetate was also enhanced by rHuTNFα and rHuIL-1α. The effects of these cytokines on neutrophils could be abolished by boiling the preparation but not by treating it with polymixin B, suggesting that bacterial lipopolysaccharide was not responsible for the activity of these preparations. The rHuIL-1α increased the release of lysozyme, β-glucuronidase and myeloperoxidase initiated by cytochalasin B/fMLP, while rHuTNFα only increased lysozyme release.

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In the current economic climate increasing numbers of hospitals are outsourcing arrangements for food preparation and service. There is debate among health professionals about the most appropriate role, if any, of nurses in feeding patients. This paper reports on a comprehensive review of the literature over the last 30 years pertaining to patient nutrition and food service in hospital. It is apparent that many patients are admitted in a malnourished state and that deterioration of nutritional status frequently occurs during hospitalization. At the same time there is evidence that appropriate and prompt attention to patient nutrition by nurses and other health professionals has a positive influence on patient outcome and hospital costs. The implications for nursing are discussed.