Enhancing resilience and self-efficacy in the parents of children with disabilities and complex health needs.

AIM: The principal aim of this study was to develop, pilot and evaluate an intervention intended to support the development of resilience and self-efficacy in parents of children with disabilities or complex health needs. BACKGROUND: Previous research has found that families often experience physical, social and emotional stress in the context of living with and caring for their disabled child. The literature indicates that a key factor in determining how well the parents of these children cope with their situation may be how resilient and self-efficacious they are. METHODS: A total of 16 parents of children with complex needs and disabilities were engaged in a series of guided conversations delivered during six contact visits with nurse co-researchers (community children's nurses who had received an intensive three-day preparation programme). The conversations, which were supported with additional material that was designed specifically for use in the study, were based around four key themes: emotional coping, practical coping, support networks and 'you and your child'. The impact of the intervention was evaluated using both qualitative and quantitative measures. FINDINGS: When interviewed, parents reported increased self-belief and self-confidence and indicated that they felt better supported and stronger as a result of the intervention. This was consistent with the quantitative evaluation which identified significant improvements on scores for active coping and self-blame on the brief COPE inventory scale and for empathy and understanding and self-acceptance on the TOPSE scale. Scores on the self-report distress thermometer demonstrated a significant reduction in self-reported distress scores at the end of the intervention period.

Eating disorders and concurrent psychopathology: a reconceptualisation of clinical need through Rasch analysis.

Therapies for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorder not otherwise specified (EDNOS) take as their focus, perhaps of necessity, the eating disorder symptomatology. However, there is increasing evidence of comorbidity of psychopathological mechanisms (e.g. perfectionism, depression) with eating disorders which, left untreated, may diminish any therapeutic effects. Thus identifying the extent of comorbidity in an eating disorder population and assessing the relationship between psychopathological mechanisms and the eating disorder is important. Rasch analysis was applied to the findings from questionnaires (EDI-2; SCL90-R) completed by 105 female patients referred to an eating disorder unit. General psychopathology was found to be more indicative of 'caseness' than eating disorder psychopathology. In particular, interpersonal sensitivity, depression and mild interpersonal aspects of psychoticism emerged as important factors across eating disorders. The comorbidity of psychopathological mechanisms needs to be given consideration in the successful treatment of eating disorders.

A comparative study of the efficiency of acridine orange and some Romanowsky staining procedures in the demonstration of Haemobartonella felis in feline blood.

A comparison of the relative efficiency of acridine orange with some Romanowsky staining procedures indicated that acridine orange is superior in demonstrating the presence of Haemobartonella felis in feline blood. Of the Romanowsky staining procedures, that of May-Grunwald-Giemsa was at least one and a half and about twice as efficient as the Giemsa and Leishman methods, respectively.

Comparison of staining and concentration techniques for detection of Cryptosporidium oocysts in cat faecal specimens.

Modified Ziehl-Neelsen (MZN), auramine-phenol (A-P) and fluorescein isothiocyanate-labelled (FITC-labelled) monoclonal antibody (MAb) techniques were compared for detection of Cryptosporidium parvum oocysts in cat faecal specimens inoculated with known numbers of C. parvum oocysts. Of the three techniques, the FITC-labelled MAb technique detected more oocysts than the MZN and A-P techniques (P < 0.05), but A-P was more efficient than MZN (P < 0.05). Comparison of sucrose flotation, zinc sulphate (ZnSO4) flotation and formol-ether (F-E) sedimentation techniques revealed that F-E was the most efficient of the three (P < 0.05) for concentration of C. parvum oocysts from cat faecal specimens. On average, the F-E technique recovered 37% of oocysts from the original sample, whereas the sucrose and ZnSO4 flotation techniques recovered 33% and 11%, respectively. The findings of this study suggest that MZN and A-P staining are both useful for screening C. parvum oocysts in cat faecal materials containing 10(6) oocysts or more, but FITC-labelled MAb should be used when the number of oocysts is low. Also, the F-E sedimentation technique is recommended for concentrating oocysts in cat faecal specimens.

Prevalence of specific anti-Cryptosporidium IgG, IgM and IgA antibodies in cat sera using an indirect immunofluorescence antibody test.

Sera from 258 healthy and sick domestic and feral cats were screened for specific anti-Cryptosporidium antibodies using an indirect immunofluorescence antibody test (IFA). Sera were positive for IgG, IgM and IgA antibodies in 192 (74%), 84 (32%) and 67 (26%) samples, respectively. Antibody was not detected at dilutions of 1:10 and 1:20 or greater in any of eight specific pathogen-free kittens. IgM and IgA antibody classes were more prevalent in sick than in healthy domestic cats. The presence of IgM and/or IgA antibodies indicated early infection. However, these antibody classes were present in sera from cats either positive or negative for Cryptosporidium infection by faecal examination. Pronounced polar fluorescence was observed in the sporozoites in positive samples under fluorescence microscopy. The higher prevalence of specific anti-Cryptosporidium antibodies and the absence of Cryptosporidium oocysts in faecal samples from some IFA-positive animals suggests that detection of these antibodies in sera from cats could be helpful for the diagnosis of feline cryptosporidiosis.

Experimental ampicillin glomerulonephropathy.

Eighteen dogs were given repeated doses (between 4 and 19) of ampicillin (7 mg per kg intramuscularly on 3 days a week). Fifteen of the dogs developed a subclinical glomerulonephropathy characterized by mesangial hypercellularity. While only 9 of the 18 dogs showed electron-dense deposits in the mesangium, 14 dogs had glomerular deposits of IgG and 11 of these had C3 deposits also.

Renal biopsy in the normal cat: development of a modified disposable biopsy needle.

A disposable biopsy needle was modified to reduce the length of the obturator tip and specimen notch. The modified needle was then used to take renal biopsy specimens at four sites from each kidney in four cats. Twenty-nine samples of renal tissue were obtained and the average numbers of glomeruli per specimen length compared favourably with similar studies using the standard needle.

Isoenzymes of canine plasma alkaline phosphatase: an investigation using isoelectric focusing and related to diagnosis.

The isoenzymes of canine alkaline phosphatase have been separated by isoelectric focusing on agarose gels. Alkaline phosphatase from normal tissue extracts gave heterogeneous focusing patterns with the following isoelectric points: liver pH 4.3, bone pH 4.0 to 4.9, kidney pH 4.4 to 4.7 and intestine pH 3.6 to 4.6. Plasma alkaline phosphatase isoenzymes were examined in 123 dogs with activities at least twice the normal maximum. The isoenzymes from these plasma samples had multiple bands at pH 4.3 to 4.6 but in 67 per cent of all cases, the predominant isoenzyme, named isoenzyme A, was a single band of isoelectric point pH 3.5. Isoenzyme A occurred in all dogs with diabetes mellitus or Cushing's syndrome and in 93 per cent of animals receiving steroid therapy. Increased activities of the pH 4.3 to 4.6 isoenzymes were more likely to occur in cases of hepatic degeneration.

Infectivity of a Cryptosporidium species isolated from a domestic cat (Felis domestica) in lambs and mice.

Two neonatal lambs were inoculated orally with purified Cryptosporidium species oocysts isolated from a farm cat. Oocysts first appeared in the faeces of the two lambs three and 10 days after infection. Two distinct sizes of oocysts were observed in the faeces of both the cat and the lambs, the smaller measuring approximately 5.0 x 4.5 microns and the larger measuring approximately 6.0 x 5.0 microns in diameter. The smaller type predominated. Histological examination of the alimentary tract of the lambs revealed endogenous stages of Cryptosporidium in the epithelial borders of the ileum. In addition, Cryptosporidium oocysts were detected in impression smears from the jejunum, ileum, caecum and colon. Suspensions of 10(3) oocysts from the faeces of the farm cat were inoculated into each of 10 newborn mice and 10(4) oocysts from the two experimentally infected lambs were inoculated into each of 20 newborn mice. Cryptosporidium oocysts were detected in gut homogenates from 19 of the 20 mice inoculated with oocysts from the lambs but in none of the mice inoculated with oocysts from the cat.

Experimental immune complex glomerulonephritis and the nephrotic syndrome in cats immunised with cationised bovine serum albumin.

Membranous nephropathy was induced in four cats by repeated intravenous injections of 120 mg cationic bovine serum albumin (BSA, pI 9.5). All four cats developed diffuse granular deposits of IgG and C3 along the glomerular capillary walls as early as five weeks which persisted until the end of the experiment at 17 weeks. Ultrastructural studies revealed many subepithelial electron dense deposits. Two cats developed severe proteinuria and the nephrotic syndrome characterised by hypoalbuminaemia and oedema. An additional four cats received repeated injections of unmodified native BSA (pI 4.5) and remained basically normal. This is the first report of membranous nephropathy and the nephrotic syndrome in an experimental animal model which, unlike other animal models, is subject to the spontaneously occurring disease.

Renal biopsy in the normal cat: examination of the effects of repeated needle biopsy.

Three healthy cats were subjected to percutaneous renal biopsy of the left kidney on three occasions at monthly intervals. Three other cats were subjected to three consecutive biopsy attempts on one occasion using the left kidney. Thereafter the six cats were monitored clinically and by means of laboratory analyses of blood and urine until euthanasia four weeks after the last biopsy. Cautious insertion of the biopsy needle in an attempt to avoid over penetration of the kidney resulted in failure to obtain renal tissue on six occasions but in all 12 specimens which did contain renal tissue, glomeruli were present. Major blood vessels were present in two biopsy specimens. At necropsy, radiographic and histological studies demonstrated renal parenchymal and vascular changes in the biopsied kidneys which were similar to but less severe than those produced by a single biopsy attempt. This confirmed that avoidance of damage to major renal vessels is important and suggested that, with care, repeated biopsies need be no more harmful to the kidney than a single biopsy.

Experimental immune complex glomerulonephritis in dogs receiving cationized bovine serum albumin.

Eight 16-week-old dogs were used to induce immune complex glomerulonephritis by daily intravenous injections of 120 mg highly cationized bovine serum albumin (pI9.5). Of four control dogs, two received unmodified native anionic bovine serum albumin (pI 4.5) while the other two received only phosphate buffered saline. The renal glomeruli were examined by light, electron (transmission and scanning) and immunofluorescence microscopy at intervals from five to 11 weeks after the start of the injections. Animals receiving cationic antigen all developed generalised diffuse granular deposits of IgG and C3 along the capillary walls; these were detected as early as five weeks and continued until the termination of the experiment at 11 weeks. Ultrastructural studies revealed many electron dense deposits along the subepithelial regions of the glomerular basement membrane. The experimental disease resembled in many respects naturally occurring membranous nephropathy, the most common form of immune complex glomerulonephritis in dogs.

Renal biopsy in the normal cat: an examination of the effects of a single needle biopsy.

Eleven healthy cats were subjected to a single, percutaneous renal biopsy with a disposable biopsy needle and thereafter monitored clinically and by means of laboratory analyses of blood and urine until euthanasia at intervals up to two months after biopsy. Biopsy specimens were obtained at each attempt and the specimen length and numbers of glomeruli compared favourably with results from normal dogs biopsied with Franklin-Silverman needles. At necropsy radiographic studies demonstrated renal vascular changes and histological examinations of the biopsied kidneys revealed lesions varying from barely discernible linear scars to extensive haemorrhage and wedge-shaped infarcts. A direct relationship was established between the severe renal lesions in seven cats and biopsy specimens containing medullary tissue and major renal blood vessels.

Haemobartonella felis infection in cats from the Glasgow area.

A survey of 155 cats for Haemobartonella felis infection in the Glasgow area revealed a prevalence of 23.2 per cent. The infection occurred in all age groups and there was no significant difference between sex or breed type. Infection with H felis was more prevalent among cats with fleas and those with feline leukaemia virus infection than among the other cats in the sample. H felis organisms identified were mainly coccoid with diameters between 0.63 micron and 1.73 micron. Rod forms, found in two cats, had lengths ranging from 0.79 micron to 1.1 micron and diameters between 0.17 micron and 0.24 micron.

Membranous nephropathy in sibling cats.

Membranous nephropathy was diagnosed in two sibling cats from the same household. Both cases presented with the nephrotic syndrome but 33 months elapsed before the second cat became ill, by which time the first cat had been in full clinical remission for over a year.

Phenytoin toxicity: a fatal case in a dog with hepatitis and jaundice.

Pheyntoin (Epanutin: Parke, Davis) is widely used for the control of chronic convulsive disorders in the dog because it exerts an anti-epileptic effect without causing general depression of the central nervous system. To our knowledge fatal cases of phenytoin sensitivity in the dog have not been reported. A case is described in which hepatitis, jaundice and death followed the administration of the drug.

Feline haemobartonellosis: clinical, haematological and pathological studies in natural infections and the relationship to infection with feline leukaemia virus.

Haemobartonella felis infection was demonstrated in 38 cats which could be divided into four groups as follows: group A, feline leukaemia virus (FeLV) free cats with H felis infection alone; group B, FeLV free cats with H felis infection and other clinical conditions; group C, FeLV positive cats with H felis infection but no clinical manifestation of FeLV related or any other intercurrent disease; and group D, FeLV positive cats with H felis infection and clinical manifestations of FeLV related or other diseases. Cats in group A were healthy carriers of the infection and none was anaemic, whereas some in group B had clinical haemobartonellosis and anaemia. This anaemia was mainly mild, normocytic and normochromic. Most of the cats in group C and all in group D were more severely ill and anaemic, the anaemia usually being macrocytic and hypochromic. Splenomegaly occurred only in groups C and D. Treatment with tetracyclines did not eliminate H felis from any of the cats and blood transfusions were ineffective in promoting long term recovery from anaemia in cats with intercurrent H felis and FeLV infections. The findings in the cats in groups C and D were further compared with those in a fifth group of cats which were infected with FeLV but free of H felis.

Unusual vascular ring in a cat: left aortic arch with right ligamentum arteriosum.

A young kitten was presented with regurgitation of food at weaning. Episodes of respiratory distress and cyanosis were also present. The cause of food regurgitation was a perioesophageal vascular ring caused by left descending aorta and a right ligamentum arteriosum. This type of vascular ring has not previously been described. There was also anomalous development of the right subclavian artery and a large ventricular septal defect. The respiratory distress and cyanosis was most probably caused by a combination of tracheal compression by the vascular ring and a polycythaemia associated with the ventricular septal defect. Surgical correction was not attempted.

The Key-Gaskell syndrome: the current situation.

During the past 12 months an apparently new disease of cats has occurred with increasing frequency throughout the United Kingdom causing high morbidity and mortality and arousing considerable interest both within and outside the profession. The purpose of this paper is to report what is known about the disease and to indicate lines of current research. As there is an urgent need to communicate information it will be appreciated that this paper is incomplete in certain areas such as pathology and epidemiology where studies are still in progress.

Primary autoimmune haemolytic anaemia in the dog.

Nineteen cases of primary autoimmune haemolytic anaemia are reported in the dog. The clinical features included pale mucous membranes, weakness, lethargy and collapse. The intravascular haemolytic type of the disease was seen in nine cases and was characterised by evidence of haemolysis (eg, marked bilirubinaemia). The other 10 cases were classed as the extravascular destructive type of autoimmune haemolytic anaemia. The presence of autoantibodies (of the IgG class) and complement (C3) on the red blood cells from affected patients was demonstrated by a commercial Coombs' (antiglobulin) test which, although it has disadvantages, is satisfactory providing it is interpreted in association with the clinical, haematological and biochemical features. Treatment of these 19 dogs was with prednisolone and was successful in most cases.