Effect of breast feeding time on physiological, immunological and microbial parameters of weaned piglets in an intensive breeding farm.

The aim of this work was to study the long-lasting consequences of different weaning age on physiological, immunological and microbiological parameters of weaned piglets. Piglets were weaned at 14 days (14W) or 21 days (21W). Blood samples were taken for IgG and cortisol determination on preweaning day and at 4; 20 and 40 post-weaning days. Three animals of each group were sacrificed. Small intestines for morphometric studies and secretory-IgA determination in fluid were taken. The cecum was obtained for enterobacteria, lactobacilli and total anaerobes enumeration. A significant decrease in piglet's plasma IgG concentrations was observed immediately after weaning and no differences were found between 14W and 21W. An increase in intestinal S-IgA was observed according to piglet's age. This increase was significantly higher in piglets 14W compared to piglets 21W. Animals from 14W group showed a decrease in villus length and in the number of goblet cells and intraepithelial lymphocytes. Other parameters were not affected by the weaning age. A short-term increase in cortisol was observed after weaning in both experimental groups. Enterobacteria decreased significantly after weaning in both groups, reaching values of weaning after 40 days. Lactobacilli counts decreased in both groups after weaning; however their counts were always higher than those obtained for enterobacteria. No differences were observed between 14W and 21W with regards to counts of anaerobes. The shortening of breast feeding time would favor an early synthesis of intestinal S-IgA after weaning. The changes observed in the microbiota could decrease postweaning enteric infections. However, early weaning induced negative effects on the cells of gut innate immunity and villi atrophy. This work provides knowledge about advantages and disadvantages at different weaning and long-lasting consequences on pig health. It is critical that swine producers become aware of the biological impacts of weaning age, so as to be able to decide the appropriate management strategies according to their facilities and rearing environment.

The American Pharmaceutical Association: a lens for viewing pharmacists (from compounders to therapeutic judges).

OBJECTIVE: (1) To document the changes that have occurred in pharmacy in the last century and (2) to investigate the role played by the American Pharmaceutical Association (APhA) during the changes. DATA SOURCES: Journal of the American Pharmaceutical Association (JAPhA). STUDY SELECTION: Sample articles published in JAPhA pertaining to practice and ethical issues. DATA EXTRACTION: Examples of articles at 10-year intervals from 1912 through 1997. DATA SYNTHESIS: Short reviews of the articles are included containing their purpose and topic. Authors' notes are included where appropriate. The research was performed using a qualitative/historical method. CONCLUSION: The changes that have occurred in pharmacy throughout the 20th century are seen through JAPhA. APhA has been a stabilizing social structure over the years, and continues to serve society in this manner.

Pharmacists' practice opportunities in women's health.

The article discusses the rising interest in women's health issues, including demographics, economic issues, and the unique health concerns of the postmenopausal woman. Practice opportunities abound regarding hormone therapy; heart disease; diabetes; osteoporosis; and psychosocial, health and diet, and lifestyle issues for this age group. Barriers to effective communication between the pharmacist and the postmenopausal woman are examined, and suggestions are made to improve communication skills. Patient assessment and the development and implementation of care plans and continued patient monitoring are reviewed. Resources for women's health care are suggested for both the practitioner and the patient.

Issues related to using a short-form of the Center for Epidemiological Studies-Depression Scale.

The study examined the reliability and validity, including the factor structure, of a 10-item abbreviated version of the Center for Epidemiological Studies-Depression (CES-Depression) scale when administered as part of a mail questionnaire. It also examined patterns of nonresponse to items and the effects of imputation of data for missing items on the factor structure of the inventory. A problem of missing data has been reported even with interview administration of the CES-Depression. Researchers have varied considerably in the amount of imputation used to replace missing datapoints. In this study, factor structures varied when items were imputed. In addition, those subjects with complete data were compared with those with up to two imputed datapoints. Those subjects with imputed data were more likely to be female, have lower functional status scores, lower self-reported health status, more advanced age, and a greater number of depressive symptoms than those with no missing data. While the estimate of coefficient alpha of .78 indicated the inventory was reliable, the effects of missing data on construct validity were problematic.

Role orientation and community pharmacists' participation in a project to improve patient care.

Community pharmacists are being assigned increased responsibility in assuring the appropriateness and effectiveness of drug therapy. This increased responsibility is reflected in recently passed legislation (OBRA '90) in the United States that requires pharmacists to counsel patients about prescriptions received and to engage in prospective drug use review for Medicaid recipients. The potential impact of this legislation is unclear due to a dearth of research evaluating the effects of community pharmacists' activities on medication use. In addition, there is little research on pharmacists' willingness to assume increased responsibility. Research that would demonstrate the effectiveness of community pharmacists in improving therapeutic outcomes is hampered by problems inherent in conducting experimentally designed research in field settings. This paper examines two issues of concern in such studies--namely, the extent to which those who agree to participate in a demonstration project differ from those who decline to participate and the extent to which differential dropout from treatment and control conditions compromise the comparability of the two groups. Specifically, this report examines pharmacist characteristics related to participation in a demonstration project to improve the care of elderly patients. Community pharmacists in Florida who had earlier been asked to participate in a demonstration project (N = 418) were sent mail questionnaires to assess their attitudinal, demographic and employment characteristics. In particular, researchers were interested in the role orientation of pharmacists in regard to patient counseling and physician consultation, satisfaction with current jobs and career choices, employment settings and treatment vs control group assignment as predictors of participation in the research project. Demographic characteristics were also examined as possible predictors of participation.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of an education program for community pharmacists on detecting drug-related problems in elderly patients.

Community pharmacists are in a position to assume increased responsibility for preventing and resolving drug-related problems in ambulatory patients. Such an expanded role is mandated under provisions of the Omnibus Budget Reconciliation Act of 1990. The need for pharmacist oversight of drug therapy may be most acute in elderly patients. This study reports on a program to teach community pharmacists a process of assessing drug therapy of elderly patients and intervening to correct problems. Community pharmacists (N = 102) were assigned to treatment and control conditions. Both groups targeted patients meeting criteria and enrolled them into the study. Treatment group pharmacists, who participated in a training program, also assessed the medication use of enrolled patients to identify and resolve medication-related problems. Patients (N = 762) were telephoned by researchers 1 month after enrollment for an interview. Comparisons between treatment and control group patients were made on reports of pharmacist activities, knowledge of regimens, compliance, and potential drug therapy problems, such as interactions and side effects. Treatment patients were more likely to report that pharmacists provided information and assessed for problems than were control patients. These differences were maintained on 3-month follow-up questionnaires. No differences were found on the odds that patients indicated misunderstanding of regimens, non-compliance, or potential therapeutic problems.

Quality of life across age and family stage.

It is clear that the quality of life of the individual is intertwined with that of his or her family. Therefore, health care professionals and other professionals who work with families facing terminal illness must (1) identify those factors that put the patient and the family at risk of suffering further disruption of psychosocial quality of life and (2) seek out whatever resources are necessary to help the patient and the family improve their quality of life. Families with young children are more dependent on external resources than are other families, and they place more strains on the spouse caregiver. If these resources are not available, parents are less able to handle crucial developmental family matters. Clinicians who are aware of this deficit are better able to recognize role performance problems and help families obtain the external resources. Secondly, families who have relied on ascribed roles before the parent fell ill are at greater risk of psychosocial dysfunction: they lack appropriate ways to deal with role reallocation in order to make the best use of their talents. Professionals who are sensitive to this can help families adapt to role changes. A third area that places families at risk is poor spousal communication. Good communication patterns appear to facilitate adjustment to both terminal illness and bereavement (4,6). Professionals trained in family and social therapy are equipped to help family members develop effective communication, which can in turn help them prioritize tasks, seek outside resources when needed, and negotiate role assignments.

On gold diggers: Status gain or loss in age heterogamous marriages.

Deviations from the age norms governing mate selection often provoke negative stereotypes regarding the participants. This article focuses on age heterogamous unions or so-called May-December marriages, involving an older person with a young spouse. The public often attributes pecuniary (gold digger) motives to the latter. Our research tests the widespread notion that the younger woman exchanges youth for status or money. Using data from the Panel on Income Dynamics, age homogamous and age heterogamous couples are compared in terms of each of the spouse's achieved and inherited status and the contribution these make to explained variance in family income. Analysis using hierarchical multiple regression revealed that, contrary to popular belief, the status of the older spouse does not make a more important contribution toward explained income. Indeed, in this study, the reverse was the case in that the wife's status contributed more toward explained income. The notion that age heterogamy in marriage represents a channel of upward mobility for young women married to older men needs systematic reexamination.