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1.
N Z Vet J ; 72(5): 288-299, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38946044

RESUMO

AIMS: To compare the recovery of lambs, goats, and calves from head-only (HO) or high-frequency head-to-body stunning and evaluate the complementary use of behaviour and electroencephalography (EEG) to assess return to consciousness after electrical stunning in these species. METHODS: Six-month-old lambs, adult goats and calves (< 7 days old) were subjected to reversible head-only stunning (50 Hz, 1 A, 2 seconds) or reversible high-frequency head-to-body stunning (RHTB: HO followed by 2,000 Hz, 2 A, 4-second stun to body). Following stunning, behavioural recovery was assessed in 21 lambs, 22 goats, and 20 calves. Latencies to first perform behaviours (end of convulsions, head lift, attempt to right, successful righting, attempt to stand, successful standing) after stunning were scored from video recordings. Recovery of electrical brain activity indicative of consciousness was assessed using EEG in a separate cohort of minimally-anaesthetised lambs, goats and calves (n = 20 per species). EEG traces collected before and after stunning were classified as normal, epileptiform, isoelectric, or transitional activity. Following stunning, the duration of epileptiform and isoelectric activity combined (states of brain activity incompatible with conscious awareness) was calculated, as was latency to return of normal (pre-stun) EEG. RESULTS: The RHTB stun was reversible in all three species, although one sheep failed to recover and was euthanised. Both methods caused tonic and clonic convulsions in all species. Behavioural recovery of sheep and calves was similar for both methods while goats took longer to recover from RHTB than HO stunning. There was no evidence of differences between methods in the duration of EEG incompatible with consciousness or the latency to recovery of normal EEG. CONCLUSIONS: Head-to-body stunning as applied here produced a reversible electrical stun in lambs, adult goats and young calves, although the benefits in terms of meat quality and operator safety are uncertain. Goats took longer to recover behaviourally from head-to-body stunning, possibly due to disrupted motor function, but there was no indication that post-stun unconsciousness lasted longer than following head-only stunning in any species. The normal behaviour for the animals' developmental age should be considered when deciding on behavioural indicators of recovery. The minimal anaesthesia model provided excellent quality EEG data that was valuable for interpretation of the behavioural responses. CLINICAL RELEVANCE: For the purposes of pre-slaughter stunning of sheep, goats and young calves, recovery appears comparable between the two methods, with all but 1/63 animals in the behaviour study recovering normal function.


Assuntos
Matadouros , Eletroencefalografia , Cabras , Animais , Cabras/fisiologia , Ovinos/fisiologia , Bovinos/fisiologia , Eletroencefalografia/veterinária , Carne , Eletrochoque/veterinária , Masculino , Bem-Estar do Animal , Comportamento Animal/fisiologia , Feminino
2.
Tech Coloproctol ; 27(9): 769-774, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37133736

RESUMO

PURPOSE: Invasive surgical management of cryptoglandular perianal fistulas (PF) is challenging because of high recurrence rates and the potential for injury to the sphincter complex. In the present technical note, we introduce a minimally invasive treatment for PF using a perianal fistula implant (PAFI) comprising ovine forestomach matrix (OFM). METHODS: This retrospective observational case series highlights 14 patients who had undergone a PAFI procedure at a single center between 2020 and 2023. During the procedure, previously deployed setons were removed and tracts were de-epithelialized with curettage. OFM was rehydrated, rolled, passed through the debrided tract, and secured in place at both openings with absorbable suture. Primary outcome was fistula healing at 8 weeks, and secondary outcomes included recurrence or postoperative adverse events. RESULTS: Fourteen patients underwent PAFI using OFM with a mean follow-up period of 37.6 ± 20.1 weeks. In follow-up, 64% (n = 9/14) had complete healing at 8 weeks and all remained healed, except one at last follow-up visit. Two patients underwent a second PAFI procedure and were healed with no recurrence at the last follow-up visit. Of all patients that healed during the study period (n = 11), the median time to healing was 3.6 (IQR 2.9-6.0) weeks. No postprocedural infections nor adverse events were noted. CONCLUSIONS: The minimally invasive OFM-based PAFI technique for PF treatment was demonstrated to be a safe and feasible option for patients with trans-sphincteric PF of cryptoglandular origin.


Assuntos
Próteses e Implantes , Fístula Retal , Animais , Humanos , Canal Anal/cirurgia , Fístula Retal/cirurgia , Fístula Retal/complicações , Estudos Retrospectivos , Ovinos , Resultado do Tratamento , Cicatrização
3.
Educ Prim Care ; 30(3): 145-151, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30747043

RESUMO

The World Health Organisation policy of improving retention of rural health care practitioners recommended that continuing medical education (CME) programmes addressing their needs should be accessible and delivered where they live and work. This cross-sectional study involved a self-administered anonymous questionnaire completed by GPs attending CME small groups (CME-SGL) in Ireland. All GPs attending CME-SGL in a one-month period were invited to complete the questionnaire which examined demographic details, distance to travel to educational meetings/nearest regional hospital, barriers to accessing continuing education, whether CME-SGL met their educational needs, morale and professional isolation. A total of 1,686 responses were collected, of which 332 (19.6%) were from rural GPs. Of these, 289 (87%) reported that their educational needs were fully or mostly met by attending CME-SGL. Compared to urban doctors, rural GPs had further to travel to CME-SGL meetings, were further from the nearest regional hospital, and reported increased barriers to accessing continuing education. Rural GPs reported lower morale and greater levels of professional isolation. Despite considerable barriers to accessing continuing education, rural GPs reported that CME-SGL meets their educational needs. Future research should focus on the potential positive impact this may have on professional isolation and morale.


Assuntos
Educação Médica Continuada/métodos , Clínicos Gerais/educação , Adulto , Estudos Transversais , Feminino , Clínicos Gerais/psicologia , Humanos , Irlanda , Masculino , Pessoa de Meia-Idade , Moral , População Rural , Inquéritos e Questionários , Viagem
4.
J Dairy Sci ; 102(3): 2492-2506, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30638993

RESUMO

Anesthesia of the horn bud for calf disbudding commonly is attained by injection of local anesthetic over branches of the cornual nerve, with anesthesia achieved in 3 to 20 min. With experienced and trained staff, this method is effective in 88 to 100% of calves. Variability in response and time of onset can compromise calf welfare if calves are disbudded before anesthesia is attained. Proposed legislative reliance on effective local anesthetic as the minimal method of pain relief for calves at disbudding means that administration of local anesthetic must achieve a repeatable level and rapid onset of analgesia. We describe an alternative method of local anesthesia administration that uses local site infiltration of anesthetic over the horn bud. However, this method has not yet been scientifically validated. This study assessed differences between disbudding using the cornual nerve block and disbudding with local anesthesia administered by local site infiltration. Efficacy of local anesthesia was assessed at 30-s intervals after administration by absence of reaction to 3 consecutive needle pricks over the horn buds. Behavior indicating pain was assessed during disbudding and scored from 0 to 3. Calf behavior was also recorded for 3 h after disbudding. Accelerometer data loggers were fitted to each calf for 24 h before and after disbudding to assess lying and standing times. Median time to cutaneous desensitization for local infiltration was 60 s compared with 225 s for cornual nerve block, and the variance in time to desensitization was less with local infiltration. Calves disbudded under cornual block had a larger behavioral response (indicated by a graded aversive body reaction) than calves disbudded under local infiltration. A multivariable model predicted that the mean body reaction score would be 0.6 for calves disbudded under local infiltration and 1.2 for calves disbudded under cornual block. There was no difference in any behaviors between the treatment groups in the 3 h after disbudding. Method of analgesia had no effect on lying time over the 24 h after disbudding. In this study, local infiltration was at least as effective in providing analgesia for disbudding as the cornual nerve block. Our results suggest that a more consistent, effective level of analgesia during disbudding was achieved using local infiltration and that there was no difference in postoperative expressions of pain.


Assuntos
Anestésicos Locais/administração & dosagem , Bovinos/cirurgia , Cornos/cirurgia , Manejo da Dor/veterinária , Dor Pós-Operatória/veterinária , Analgesia/veterinária , Anestesia Local/veterinária , Animais , Bloqueio Nervoso/métodos , Nova Zelândia , Dor Pós-Operatória/prevenção & controle
5.
J Small Anim Pract ; 57(2): 105-109, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25988822

RESUMO

Glucocorticoids are the standard of care for the treatment of immune-mediated disorders, and ciclosporin is increasingly being used off-label as an adjunct immunosuppressive drug in dogs. However, opportunistic infections can develop during combination immunosuppressive regimens. This case series describes atypical fungal infections in eight dogs treated with immunosuppressive dosages of glucocorticoids and ciclosporin. The median duration of combined treatment prior to the identification of fungal infection was 31 (range, 13 to 201) days, although two dogs received glucocorticoids for prolonged periods prior to the addition of ciclosporin. The estimated prevalence of serious fungal infections with this drug combination appears to be low (approximately 1 · 67%), but these infections led directly or indirectly to death or euthanasia in five of eight (63%) dogs. These cases highlight the need for frequent clinical monitoring of dogs receiving immunosuppressive dosages of glucocorticoids and ciclosporin.

6.
Child Care Health Dev ; 42(2): 188-94, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26686096

RESUMO

BACKGROUND: A reliable and valid screening tool for detecting children at risk for Developmental Coordination Disorder (DCD) is needed. The purpose of this study was to evaluate the ability of the Ages and Stages Questionnaire-Third Edition (ASQ-3) motor scales to detect children at risk for DCD in a community-based sample of children aged 3.5-5.5 years. METHODS: One hundred and sixty parent-child pairs were recruited from community-based organizations. Children were eligible if they spoke English and had no known physical impairments. Eligible parents were asked to fill out the ASQ-3, following which their child's fine motor and gross motor proficiency was assessed using the Movement Assessment Battery for Children-Second Edition (MABC-2). DCD risk was defined as those children scoring at or below the 16th percentile on the MABC-2. Sensitivity and specificity of the fine and gross motor areas of the ASQ-3 were examined and referenced against the DCD risk classification. RESULTS: The ASQ-3 total motor score correlated moderately with overall standard score on the MABC-2 (r = 0.41; p < 0.001). Regardless of the ASQ-3 cut-off used, sensitivities of the ASQ-3 fine motor or gross motor scale to detect DCD risk were low at 21-47%, whereas specificities were high at 89-96%. CONCLUSION: Early identification of motor skill delays is important in order to intervene and hopefully prevent the associated negative health consequences. However, because of the low sensitivity of the ASQ-3 motor scales, these results suggest that the ASQ-3 is not an appropriate screening tool to identify children at risk for DCD in the preschool population.


Assuntos
Deficiências do Desenvolvimento/diagnóstico , Programas de Rastreamento/métodos , Transtornos das Habilidades Motoras/diagnóstico , Pré-Escolar , Diagnóstico Precoce , Feminino , Humanos , Masculino , Equilíbrio Postural , Reprodutibilidade dos Testes , Medição de Risco , Inquéritos e Questionários
7.
J Crit Care ; 30(5): 901-7, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26004031

RESUMO

PURPOSE: Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. MATERIALS AND METHODS: Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months. RESULTS: A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009). CONCLUSION: Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.


Assuntos
Assistência Ambulatorial/métodos , Aminoácidos Essenciais/administração & dosagem , Estado Terminal/reabilitação , Modalidades de Fisioterapia , Análise de Variância , Ansiedade/prevenção & controle , Cuidados Críticos/métodos , Depressão/prevenção & controle , Suplementos Nutricionais , Método Duplo-Cego , Terapia por Exercício/métodos , Feminino , Glutamina/administração & dosagem , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Caminhada/fisiologia
8.
Ir Med J ; 108(4): 109-11, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26016300

RESUMO

In Ireland, Continuing Medical Education (CME) for GPs is delivered by a national network of 37 tutors who coordinate learning sessions for between 2 and 5 small groups of physicians (SGL). Each group meets up to 8 times per year; 1100 to 1700 doctors attend CME-SGL nationally each month, with numbers increased since the Irish Medical Practitioners Act. This study investigated whether CME-SGL improves clinical knowledge of doctors. A questionnaire was administered by 35 CME tutors at their scheduled meetings in November/December 2012; 1366 (96%) attendees responded. In total 1312 (97%) doctors reported that they want to improve their clinical practice, and 1143 (86.3%) agreed that CME had helped them to do so. Of these, 1041 (91.1%) doctors gave specific examples. This survey provides evidence of how CME-SGL has impacted on the knowledge, skills, attitudes, prescribing, use of investigations, and application of guidelines and audit of these Irish GPs.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Educação Médica Continuada/métodos , Clínicos Gerais/educação , Adulto , Idoso , Humanos , Irlanda , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
9.
J Intellect Disabil Res ; 57(10): 923-35, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22672339

RESUMO

BACKGROUND: Although the promotion of social inclusion through sports has received increased attention with other disadvantaged groups, this is not the case for children and adults with intellectual disability who experience marked social isolation. The study evaluated the outcomes from one sports programme with particular reference to the processes that were perceived to enhance social inclusion. METHOD: The Youth Unified Sports programme of Special Olympics combines players with intellectual disabilities (called athletes) and those without intellectual disabilities (called partners) of similar skill level in the same sports teams for training and competition. Alongside the development of sporting skills, the programme offers athletes a platform to socialise with peers and to take part in the life of their community. Unified football and basketball teams from five countries--Germany, Hungary, Poland, Serbia and Ukraine--participated. Individual and group interviews were held with athletes, partners, coaches, parents and community leaders: totalling around 40 informants per country. RESULTS: Qualitative data analysis identified four thematic processes that were perceived by informants across all countries and the two sports to facilitate social inclusion of athletes. These were: (1) the personal development of athletes and partners; (2) the creation of inclusive and equal bonds; (3) the promotion of positive perceptions of athletes; and (4) building alliances within local communities. CONCLUSIONS: Unified Sports does provide a vehicle for promoting the social inclusion of people with intellectual disabilities that is theoretically credible in terms of social capital scholarship and which contains lessons for advancing social inclusion in other contexts. Nonetheless, certain limitations are identified that require further consideration to enhance athletes' social inclusion in the wider community.


Assuntos
Promoção da Saúde/organização & administração , Deficiência Intelectual/psicologia , Deficiência Intelectual/reabilitação , Comportamento Social , Esportes , Adolescente , Adulto , Atletas/psicologia , Atitude Frente a Saúde , Criança , Feminino , Amigos/psicologia , Humanos , Cooperação Internacional , Masculino , Motivação , Satisfação do Paciente , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Adulto Jovem
10.
Ir Med J ; 105(4): 114-5, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22708225

RESUMO

The Irish Medical Practitioners Act 2007 places a statutory obligation on all registered Medical Practitioners to maintain their professional competence by participating in a recognised Professional Competence Scheme. A questionnaire survey was conducted among 48 GPs attending educational meetings to see if doctors had concerns about the Professional Competence Scheme and to ask if they felt they had the necessary time, skills and knowledge to carry out an audit. Twenty-eight GPs (58%) had concerns regarding their participation in the Professional Competence Scheme; 75% were concerned about the time required, and 67% felt they needed further education about the scheme. Although 73% of doctors reported that they understand how to undertake a clinical audit and 50% reported they have carried out an audit in practice, 60% have never had any teaching on audit and 85% would like teaching in this area. Only 48% of the group surveyed felt that audit was practical in their current practice. Doctors have some concerns about the new Professional Competence Scheme, including the audit component. In particular, they report a requirement for more teaching in this area, and are concerned about the time involved.


Assuntos
Atitude do Pessoal de Saúde , Medicina Geral/normas , Auditoria Médica/legislação & jurisprudência , Medicina Geral/legislação & jurisprudência , Humanos , Irlanda , Atenção Primária à Saúde/normas
11.
J Vet Intern Med ; 25(2): 206-14, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21281353

RESUMO

BACKGROUND: Nephrotic syndrome (NS) develops most commonly in people with glomerular diseases associated with marked albuminuria. Hypernatremia, hypertension, and progressive renal failure are more prevalent in nephrotic than nonnephrotic human patients. HYPOTHESIS/OBJECTIVES: Dogs with NS have higher serum cholesterol, triglyceride, and sodium concentrations, higher urine protein:creatinine ratios (UPC) and systolic blood pressure, and lower serum albumin concentrations than dogs with nonnephrotic glomerular disease (NNGD). NS is associated with membranous glomerulopathy and amyloidosis. Affected dogs are more likely to be azotemic and have shorter survival times. ANIMALS: Two hundred and thirty-four pet dogs (78 NS dogs, 156 NNGD dogs). METHODS: Multicenter retrospective case-control study comparing time-matched NS and NNGD dogs. NS was defined as the concurrent presence of hypoalbuminemia, hypercholesterolemia, proteinuria, and extravascular fluid accumulation. Signalment, clinicopathologic variables, histopathologic diagnoses, and survival time were compared between groups. RESULTS: Age, serum albumin, chloride, calcium, phosphate, creatinine, and cholesterol concentrations, and UPC differed significantly between NS and NNGD dogs. Both groups were equally likely to be azotemic at time of diagnosis, and NS was not associated with histologic diagnosis. Median survival was significantly shorter for NS (12.5 days) versus NNGD dogs (104.5 days). When subgrouped based on serum creatinine (< or ≥1.5 mg/dL), survival of NS versus NNGD dogs was only significantly different in nonazotemic dogs (51 versus 605 days, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Presence of NS is associated with poorer prognosis in dogs with nonazotemic glomerular disease. Preventing development of NS is warranted; however, specific interventions were not evaluated in this study.


Assuntos
Doenças do Cão/patologia , Nefropatias/veterinária , Glomérulos Renais/patologia , Síndrome Nefrótica/veterinária , Albuminúria/etiologia , Albuminúria/veterinária , Animais , Azotemia/etiologia , Azotemia/veterinária , Estudos de Casos e Controles , Creatinina/sangue , Creatinina/metabolismo , Doenças do Cão/mortalidade , Cães , Feminino , Glomerulonefrite Membranosa , Nefropatias/complicações , Nefropatias/mortalidade , Nefropatias/patologia , Masculino , Síndrome Nefrótica/complicações , Síndrome Nefrótica/mortalidade , Síndrome Nefrótica/patologia , Prognóstico , Proteinúria/etiologia , Proteinúria/veterinária , Estudos Retrospectivos
12.
J Dairy Sci ; 92(4): 1512-9, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19307632

RESUMO

This study examined the effects of a nonsteroidal antiinflammatory agent (NSAID) on physiological responses of calves immediately after hot-iron dehorning (DH) and during the time that local anesthetic (LA) wears off (2 to 3 h) after this procedure. Forty-six calves (33 +/- 0.3 d of age) were randomly assigned to 6 treatments: hot-iron DH versus sham DH with either no pain mitigation, LA alone, or LA with NSAID (i.v. Meloxicam). Eye temperature (measured using infrared thermography) was recorded every 5 min for 3 h after treatments. Heart rate (HR) and heart rate variability (HRV) were recorded continuously; for analysis of HRV, short segments of 512 interbeat intervals were examined. After DH without LA or NSAID, HR increased by 35 +/- 3.0 beats/min in the first 5 min and remained elevated above baseline for 3 h. The HRV around the time of DH did not differ between treatments; however, the root mean square of successive differences decreased from 68 to 41 +/- 12.6 ms immediately following DH without pain relief, suggesting a decrease in vagal tone at this time. Between 2 and 3 h following DH with LA, there was a decrease in eye temperature (-0.6 +/- 0.1 degrees C), an increase in HR (8 +/- 3.0 beats per min) and changes in HRV. Changes in HRV at this time included a decreased high-frequency power and an increase in the low-frequency power and low-frequency/high-frequency ratio, indicating a change in sympatho-vagal balance. The changes in eye temperature, HR, and HRV between 2 and 3 h following DH with LA indicated the onset of pain coinciding with the time that the LA effects wear off. In addition, this study demonstrated that the combination of LA and NSAID mitigated the onset of pain responses when the LA wanes.


Assuntos
Anestésicos Locais/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Indústria de Laticínios/métodos , Cornos/cirurgia , Temperatura Alta , Dor/veterinária , Animais , Temperatura Corporal , Bovinos , Feminino , Frequência Cardíaca , Lidocaína/uso terapêutico , Masculino , Meloxicam , Fenômenos Fisiológicos Oculares , Dor/tratamento farmacológico , Dor/prevenção & controle , Distribuição Aleatória , Tiazinas/uso terapêutico , Tiazóis/uso terapêutico , Fatores de Tempo
13.
Physiol Behav ; 93(4-5): 789-97, 2008 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-18177678

RESUMO

The possibility that pain can be detected from changes in eye temperature and heart rate variability (HRV) during disbudding was examined in thirty calves, randomly assigned to four treatments: 1) sham handling (control), 2) local anaesthetic (LA, cornual nerve injection) and sham disbudded, 3) sham LA and disbudded, 4) LA and disbudded. During a 40 min sampling period, maximum eye temperature, behavior and HRV parameters were recorded continuously. One week later, twelve disbudded calves were injected with adrenocorticotrophic hormone (ACTH) or saline and maximum eye temperature was recorded. There was a rapid drop in eye temperature during the 5 min following disbudding without LA (P<0.05). Eye temperature then increased and was higher than baseline over the remaining sampling period following both disbudding procedures (P<0.001), a response which could not be explained by increased physical activity LA increased eye temperature prior to disbudding (P<0.001). Heart rate increased (P<0.001) during the 5 min following disbudding with and without LA, however, LF/HF ratio only increased during this time (P<0.01) following disbudding without LA. Eye temperature did not change following ACTH, suggesting that hypothalamus-pituitary-adrenal axis (HPA) activity is not responsible for the changes in eye temperature following disbudding. The increase in LF/HF ratio following disbudding without LA suggests an acute sympathetic response to pain, which could be responsible for the drop in eye temperature via vasoconstriction. HRV and eye temperature together may be a useful non-invasive and more immediate index of pain than HPA activity alone.


Assuntos
Anestesia Local/métodos , Temperatura Corporal/fisiologia , Olho , Frequência Cardíaca/fisiologia , Hormônio Adrenocorticotrópico/administração & dosagem , Análise de Variância , Animais , Temperatura Corporal/efeitos dos fármacos , Bovinos , Olho/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Hidrocortisona/metabolismo , Termografia/métodos
14.
Public Health ; 121(11): 869-79, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17606280

RESUMO

BACKGROUND: Early interventions targeting health inequalities, and changing policies for mothers and pre-school children, have focused attention on existing interventions. OBJECTIVES: To collect baseline data about current roles and activities undertaken by health visitors; and to understand the relationship between existing services and recommended practice shown in research about preventive programmes. METHODS: A national postal survey was used to collect data about current roles and activities undertaken by health visitors across the UK (n=1459, 46% response rate). RESULTS: A description is provided of activities undertaken and the types of needs addressed by health-visiting services. The established health-visiting purpose of using a caseload of infants and pre-school children as a base from which to reach out to a wider community seems to be still in place, with difficulty. The major focus of their work was on primary and secondary prevention, but included provision for identified problems. Two main patterns of service provision were identified; one 'comprehensive' and one that was more restricted. The 'restricted service,' available in most places, was mainly reactive, with child protection and social factors predominant. Even the 'comprehensive services' were far lower in intensity than programmes shown, through research, to improve family wellness. In addition, less than half of respondents thought that it was always feasible to deliver services as planned. CONCLUSIONS: The results question the premise, upon which universal provision rests, that all families receive a service offering proactive health promotion and the timely identification of additional health needs.


Assuntos
Enfermagem em Saúde Comunitária/estatística & dados numéricos , Atenção à Saúde/organização & administração , Visita Domiciliar/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pré-Escolar , Serviços de Saúde Comunitária/organização & administração , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários , Reino Unido
15.
J Intellect Disabil Res ; 50(Pt 4): 277-87, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16507032

RESUMO

BACKGROUND: Bereaved adults with intellectual disabilities are known to experience prolonged and atypical grief which is often unrecognized. The aim of this project was to find an effective way to improve mental health and behavioural outcomes. METHODS: Subjects were randomized to two different therapeutic interventions: traditional counselling by volunteer bereavement counsellors, and an integrated intervention delivered by carers which offered bereavement specific support. Qualitative and quantitative methods were used to determine their effectiveness and efficacy. RESULTS: The counselling intervention resulted in measurable gains both clinically and in terms of quality of life; the second intervention proved impracticable in most settings and no improvement in mental health or behaviour resulted. CONCLUSIONS: Despite small numbers, the quantitative findings were highly significant, were supported by the qualitative data, and were of practical relevance to primary care practitioners and specialist mental health and intellectual disability staff.


Assuntos
Luto , Serviços Comunitários de Saúde Mental , Pesar , Deficiência Intelectual/psicologia , Adulto , Cuidadores , Aconselhamento , Feminino , Humanos , Londres , Masculino , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Determinação da Personalidade , Qualidade de Vida , Apoio Social , Voluntários
16.
J Intellect Disabil Res ; 49(Pt 7): 537-43, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15966961

RESUMO

BACKGROUND: Our knowledge and understanding of grief and its consequences have grown rapidly in recent years. There is a growing understanding that bereavement and loss represent a very significant event in the lives of people with intellectual disabilities (IDs). To date, there is no systematic review of the literature on the emotional, psychiatric and behavioural responses to bereavement in people with IDs. METHOD: This comprehensive literature review firstly examines the current opinion regarding the phenomenology of pathological grief in the general population. Research examining the ability of people with IDs to understand the concept of death is explored. In addition, a systematic review of the literature looking at the emotional, behavioural and psychiatric responses to bereavement is carried out. RESULTS: Bereavement and loss have distinct effects on the mental health, behaviour and emotional lives of people with IDs. Following a bereavement, symptoms of depression and anxiety increase, and general behaviour is altered. Traumatic grief symptoms have not yet been specifically studied and quantified. CONCLUSIONS: Particular difficulties are associated with researching the effects of bereavement on people with IDs. Further work needs to be done to more accurately describe the nature, time-scale, severity and frequency of the symptoms of traumatic grief in people with IDs, in order to improve assessment and treatment of affected individuals.


Assuntos
Afeto , Luto , Deficiência Intelectual/epidemiologia , Transtornos Mentais/epidemiologia , Humanos
17.
Ir Med J ; 95(7): 215-6, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12227529

RESUMO

Palliative Care is an important and emerging medical speciality, formally recognised by the Irish Medical Council in June 1995. Three years previously, in 1992, the Association of Palliative Medicine for Great Britain and Ireland published an official curriculum for undergraduate medical education in palliative care. The European Association of Palliative Care held a workshop the following year and reported that, with the exception of the UK, education for medical students is incomplete. This review examines the evidence that European undergraduate medical education in palliative care is underdeveloped. Key elements of effective undergraduate teaching programmes in this discipline are identified. Finally, it is noted that little has been written about undergraduate palliative care education in Irish medical schools; the situation in this country is thus unknown. A study to determine current education in palliative care in Irish medical schools is required.


Assuntos
Currículo , Educação de Graduação em Medicina , Cuidados Paliativos , Europa (Continente) , Humanos , Irlanda , Reino Unido
19.
J Anim Sci ; 80(1): 68-78, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11831530

RESUMO

Two experiments, one involving 29 commercial farms and the other involving 94 commercial farms, were conducted to examine the effects of a training program targeting a number of attitudinal and behavioral variables in stockpeople. These stockperson variables had been previously shown to be related to fear of humans and productivity of commercial cows. In both experiments, two treatments were imposed: an Intervention treatment, consisting of a cognitive-behavioral intervention procedure designed to improve the attitude and behavior of stockpeople toward cows, and a Control treatment, in which no intervention was attempted. In Exp. 1, an analysis of covariance, using previous lactation variables as the covariate, revealed effects of the Intervention treatment on the attitude and behavior of the stockpeople and the behavior of cows. Stockpeople at Intervention farms showed more (P < 0.01) positive beliefs about handling cows and used a lower (P < 0.05) number and percentage of negative tactile interactions in handling cows than stockpeople at the Control farms. Cows at the Intervention farms showed a shorter (P < 0.05) flight distance to humans, indicating a lower level of fear of humans by these cows. However, 36% of the Intervention farms failed to show a reduction in average flight distance over the two lactations. Although there was no significant treatment effect on milk yield, the Intervention farms in which fear levels declined following the intervention had a higher (P < 0.05) milk yield than the other farms. In Exp. 2, a significant (P < 0.05) increase was found in the milk yield of cows following the Intervention treatment. Similar treatment effects were observed on both milk protein and milk fat. These results indicate that cognitive-behavioral interventions that successfully target the key attitudes and behavior of stockpeople that regulate the cow's fear of humans offer the industry good opportunities to improve the productivity of cows.


Assuntos
Comportamento Animal , Bovinos/fisiologia , Terapia Cognitivo-Comportamental , Indústria de Laticínios/métodos , Medo/fisiologia , Leite/metabolismo , Criação de Animais Domésticos/métodos , Animais , Atitude , Bovinos/psicologia , Medo/psicologia , Feminino , Manobra Psicológica , Humanos , Hidrocortisona/análise , Lactação , Masculino , Leite/química , Inquéritos e Questionários
20.
Mol Biochem Parasitol ; 105(1): 1-12, 2000 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-10613694

RESUMO

Using monoclonal antibody (mAb) 70/52.9, generated from a Babesia bovis fraction enriched for spherical body organelles, we have identified a 135-kDa protein containing an epitope conserved in B. bovis strains from Texas, Mexico, and Australia. The protein was localized to the spherical bodies of the babesial apical complex and was designated spherical body protein 3 (SBP3), according to the established nomenclature. Immunofluorescence studies showed binding of the 70/52.9 mAb to the infected-erythrocyte membrane region but not to their uninfected counterparts, demonstrating a host-cell association shared with the previously isolated B. bovis spherical body proteins, SBP1 and SBP2. Using mAb 70/52.9, the full-length cDNA encoding SBP3 was isolated from an expression library, sequenced, and oligonucleotide primers synthesized to amplify the genomic copy by polymerase chain reaction. The genomic copy contained no introns and was identical to the cDNA sequence with each containing a single, large open reading frame encoding a protein of 1089 residues. Analysis of the SBP3 amino acid sequence revealed no significant amino acid identity to SBP1 and SBP2 and a lack of repeated epitopes, a notable feature of the other two spherical body proteins. Labeled probes derived from the coding region of SBP3 hybridized to single fragments on Southern blots containing B. bovis genomic DNA indicating a single copy gene. With the identification of this third spherical body protein, which associates with the cytoplasmic face of the infected-erythrocyte membrane, a complement of distinct B. bovis proteins have been identified that are likely to contribute to intracellular survival, growth, and development for this parasite. The encoded protein should be valuable for functional investigations and evaluation of potential targets for host immunity.


Assuntos
Babesia bovis/fisiologia , Membrana Eritrocítica/metabolismo , Eritrócitos/parasitologia , Organelas/metabolismo , Proteínas de Protozoários/metabolismo , Sequência de Aminoácidos , Animais , Anticorpos Monoclonais/biossíntese , Anticorpos Monoclonais/imunologia , Babesia bovis/genética , Babesia bovis/imunologia , Babesia bovis/metabolismo , Sequência de Bases , Células Cultivadas , Clonagem Molecular , Immunoblotting , Camundongos , Camundongos Endogâmicos BALB C , Dados de Sequência Molecular , Organelas/imunologia , Testes de Precipitina , Proteínas de Protozoários/química , Proteínas de Protozoários/genética , Proteínas de Protozoários/imunologia , Análise de Sequência de DNA
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