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The survey results can be used to develop strategies for increasing influenza vaccination rates.

By identifying the stages of the decision-making process and various challenges that caregivers experience, clinicians can enhance discussions with caregivers to decrease the decision-making burden. Clinicians might develop family-centered interventions for the decision-making process through the post-placement stage while taking into account cultural influences.

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Understanding and addressing gaps in research is essential to develop strategies to help nurses resolve ethical dilemmas and to avoid moral distress and burnout.

The degradation of three polycyclic aromatic hydrocarbons (PAH), pyrene (PYR), benz[a]anthracene (BAA), and benzo[a]pyrene (BaP), by Mycobacterium sp. strain RJGII-135 was studied. The bacterium was isolated from an abandoned coal gasification site soil by analog enrichment techniques and found to mineralize [ 14 C]PYR. Further degradation studies with PYR showed three metabolites formed by Mycobacterium sp. strain RJGII-135, including 4,5-phenanthrene-dicarboxylic acid not previously isolated, 4-phenanthrene-carboxylic acid, and 4,5-pyrene-dihydrodiol. At least two dihydrodiols, 5,6-BAA-dihydrodiol and 10,11-BAA-dihydrodiol, were confirmed by high-resolution mass spectral and fluorescence analyses as products of the biodegradation of BAA by Mycobacterium sp. strain RJGII-135. Additionally, a cleavage product of BAA was also isolated. Mass spectra and fluorescence data support two different routes for the degradation of BaP by Mycobacterium sp. strain RJGII-135. The 7,8-BaP-dihydrodiol and three cleavage products of BaP, including 4,5-chrysenedicarboxylic acid and a dihydro-pyrene-carboxylic acid metabolite, have been isolated and identified as degradation products formed by Mycobacterium sp. strain RJGII-135. These latter results represent the first example of the isolation of BaP ring fission products formed by a bacterial isolate. We propose that while this bacterium appears to attack only one site of the PYR molecule, it is capable of degrading different sites of the BAA and BaP molecules, and although the sites of attack may be different, the ability of this bacterium to degrade these PAH is well supported. The proposed pathways for biodegradation of these compounds by this Mycobacterium sp. strain RJGII-135 support the dioxygenase enzymatic processes reported previously for other bacteria. Microorganisms like Mycobacterium sp. strain RJGII-135 will be invaluable in attaining the goal of remediation of sites containing mixtures of these PAH.

The concept of social support as being directive or nondirective may help explain why helping can either boost or impede morale. The Inventory of Nondirective and Directive Instrumental Support (INDIS) was developed to investigate this question. The directive factor concerns others' attempts to dominate coping and the nondirective factor concerns others' attempts to facilitate but not dominate coping. Studies 1 and 2 identified and confirmed these factors. Study 3 showed predicted associations between INDIS subscales and measures of morale. Nondirective support (from a family member) was positively related to hope and optimism, and directive support (from either a family member or a friend) was positively related to depression and loneliness, even after controlling for other social support measures. Maintaining hope and morale is one of the most important and difficult challenges faced by people coping with serious problems. Events such as loss of loved ones, professional or interpersonal failure, and cata-691

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