[Early Pulmonary Rehabilitation after Long Term Mechanical Ventilation]. / Pneumologische Frührehabilitation nach Langzeitbeatmung.

BACKGROUND: The term early rehabilitation is defined as a rehabilitation that begins in the early phase after acute illness and is statutory positioned in §â€Š39SGB V. Aim of this investigation is to describe the quality of outcome of pulmonary early rehabilitation. METHOD: Prospective census of functional parameters, status of ventilation and discharge-disposition in a specialized unit for early pulmonary rehabilitation over a period of one year. RESULTS: Out of 190 patients 179 (94.2 %) were previously invasively ventilated. During the treatment period of 39 ±â€Š17 days, FAM-Index increased from 84.4 ±â€Š19.8 to 118.5 ±â€Š23.3 (Ci 30.9 - 37.3, Cohen'd 1.58; p < 0.001), Barthel-Index from 30.5 ±â€Š13.8 to 58.3 ±â€Š16.2 (Ci 25.4 - 33.8, Cohen's d 1.4; p < 0.001) six minute walking distance from 12.9 ±â€Š40.1 m to 131.4 ±â€Š85.2 m (Ci 105.6 - 131.4 m, Cohn's d 1.78; p < 0.001). Patients were less likely to be receive further post-discharge rehabilitation if they were ventilated. CONCLUSION: Patients admitted to the early pulmonary rehabilitation unit were severely compromised, however quality of outcome was favourable and independent of the breathing status (spontaneously breathing vs. non-invasive ventilation or invasive ventilation). Finding discharge dispositions appeared to be more difficult if patients were ventilated.

Applying community health principles to veterinary practice.

Primary healthcare is the preferred approach to addressing human health problems and reducing the costs of healthcare in communities. ERWIN HOHN: and ADI NELL: believe that these principles should also be applied to animal healthcare systems.

[Senior studies at the Mannheim University in the opinion of the faculty]. / Das Seniorenstudium an der Universität Mannheim im Urteil der Dozenten.

For over 15 years now, the University of Mannheim has offered studies for senior citizens, which are conceived as an integration model. The older students take regular courses together with the young students. Former surveys showed large satisfaction of the older students with this model. As a check of these results, 69 university teachers, who have older students in their classes, were asked about their experiences and their opinion on the senior citizens' studies by usage of a questionnaire which has been developed by Kolland for a similar purpose. Predominantly positive experiences are mentioned. The older students are seen as an enrichment rather than as a burden. Conflicts and difficulties have hardly appeared. The majority deny differences between older and younger students. A differential examination points out that older teaching staff have a more favorable opinion of senior citizens' studies than the younger ones. It is also pointed out that representatives of humanistic subjects have a more positive view of the older students than representatives of the empirical mathematical field. However, more research is needed in this area.

Ectoparasites of dogs belonging to people in resource-poor communities in North West Province, South Africa.

A total of 344 dogs belonging to people in resource-poor communities in North West Province, South Africa, was examined for ectoparasites, and all visible arthropods were collected from the left side of each dog. By doubling these numbers it was estimated that the dogs harboured 14,724 ixodid ticks, belonging to 6 species, 1,028 fleas, belonging to 2 species, and 26 lice. Haemaphysalis leachi accounted for 420 and Rhipicephalus sanguineus for 14,226 of the ticks. Pure infestations of H. leachi were present on 14 dogs and of R. sanguineus on 172 dogs. Small numbers of Amblyomma hebraeum, R. appendiciulatus, R. evertsi evertsi and R. simus were also collected. The predominance of R. sanguitneus accounts for the high prevalence of canine ehrlichiosis (Ehrlichia canis) within the survey region, compared to canine babesiosis (Babesia canis), which is transmitted by H. leachi, and is a much rarer disease.

An evaluation of the feasibility of using first-year veterinary students in animal health education programmes.

Awareness of the importance and relevance of community-oriented medical education is increasing. Although a number of medical faculties have already adopted this approach for their undergraduate training, this idea does not appear to have received the same degree of acceptance within veterinary schools. This study attempts to provide evidence in support of the feasibility of a community-oriented curriculum. First-year veterinary science students at the Medical University of Southern Africa received a very short orientation course on the social determinants of disease; the Primary Health Care (PHC) philosophy and how PHC differs from the basic health service approach; how to shift the locus of control for health away from the health professional and back into the community; dependency theory; basic pet care; sociology (including systems and conflict theory); problems with the application of a technological imperative within a systems perspective; social research; basic statistical concepts; health care systems and their evolution; marketing principles in relation to health education; the importance of positioning and how to effectively use communication skills within a classroom setting. After this course the students successfully participated in an animal health education programme within the community.

A quantitative study of the attitudes of members of a black developing community towards their dogs and veterinary services.

To further the study of human-companion animal interactions in black developing communities, the clients (n = 94) of a university-based animal hospital, serving primarily a developing community, were interviewed. The interviews covered demographics, socio-economic aspects, perceptions, values and attitudes of clients towards their dogs. Regular and new clients were compared. A profile of the hospital's black clientele was also constructed. The study showed that the majority of black clients value their dogs for the sake of security and protection. Attitudes towards pets parallelled improvements in socio-economic status. Most clients felt positive towards existing veterinary services. The results of this study support and highlight the value of a previous observational study and could prove to be invaluable in designing, implementing and planning socially relevant animal health services.

A qualitative study of the attitudes of members of a developing community towards their dogs and veterinary services.

A university-based hospital serving mainly a developing community readily appreciated that its clientele was from a very different sociological and cultural background than that of the professional staff and that developed and developing communities and their pets exhibit different patterns in their health status, with most diseases being predominantly related to socio-economic predicament. The need for a community-orientated service was recognised. From 1987 to 1988, the small animal outpatient clinic was used for an informal, unstructured sociological observation and interview-based study of the clientele and their pets. During this period, an informal educational programme was implemented to teach basic pet health care, and the efficacy of this programme was empirically gauged by comparing the knowledge and attitudes of first-time clients with those of regular clients. Regular clients appeared to become increasingly concerned about the health and management of their pets and the condition of their animals appeared to improve, with a corresponding decline in the degree of parasitism. The majority of clients however, still regarded the main reason for keeping dogs as the provision of some form of security. It also appeared as if improved attitudes towards household pets paralleled improvements in socio-economic status.

A comparison between the disease status of hospitalized dogs from developed and those from developing communities.

The health status of canine populations within developed and those within developing communities was studied in a retrospective survey and compared. There were significant differences in the prevalence of disease amongst the hospitalised dogs from the 2 communities. Dogs from developing communities were mainly young cross-bred dogs which suffered from infectious diseases (44%), trauma (22%) and parasitic diseases (11%). There was a high mortality rate (30%) and 82% of these patients suffered from diseases that could have been prevented. The dogs from developed communities were mainly adult or old pure-bred dogs that suffered mainly from organ diseases (57%). There was a low mortality rate (10%) while only 31% suffered from diseases that could have been prevented. Based on the epidemiological findings, it was evident that owners of dogs in the developing communities required education in primary and secondary prevention of disease.

Seeding of endothelial cells in perfused microporous glass capillaries.

The aim of the studies has been to develop an in vitro model which is suitable to study endothelial cell function, especially transendothelial transport phenomena under flow conditions. Microporous glass capillaries, inserted into specially designed perfusion chambers, served as carriers for endothelial cells (EC). A method is described, how to prepare and seed the capillaries in order to have them completely endothelialized. The capillaries were perfused for up to 6 days with 0.2-2.0 ml culture medium/min and wall shear stress was calculated as 0.05-0.5 N/m2. The cells inside the capillary lumen have been observed by phase contrast microscopy and photographed during flow. Our results show that both, vessel geometry and low flow influence the shape and the orientation of EC in vitro. Our model offers a new facility to observe and study a variety of EC functions during flow and under simultaneous microscopic observation.

A comparison of health parameters in two different canine populations. Part 1: Haematological data.

Blood samples were collected on a random basis from two canine populations. The haemoglobin concentration, erythrocyte count, haematocrit, leucocyte count and differential leukocyte count were investigated in a population of kennelled dogs and a population of dogs of a rural township in a developing country. The means of five of the nine haematological parameters evaluated were found to be statistically significantly different between the two groups. It is postulated that these differences were due to the difference in diet, type and severity of disease, parasites present in the population, and to a lesser extent to breed and age differences.