Public understanding of toxocariasis.
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Animals↗
Biomedical subjects
D L Wells
Publications and source records attributed to D L Wells.
Comparison of two treatments for preventing dogs eating their own faeces.
Twenty-eight domestic dogs with the behavioural problem of eating their own faeces were treated in two ways. Half of them were treated with a citronella spray collar, and the others were treated with sound therapy. To assess the relative efficacy of the treatments their owners rated the severity of their dog's faeces eating for a week before the study began, during each of three weeks of treatment, and at the end of a fourth week during which they had not been treated. The owners reported a significantly lower incidence of the behavioural problem during the first week of both treatments, but in the dogs treated by sound therapy its incidence subsequently increased. The behavioural problem was reduced most effectively in the dogs treated with the spray collar, and continued to decrease during the period of treatment.
Animals↗
Do resuscitation attempts in children who die, cause injury?
OBJECTIVE: To determine the incidence, type, and pattern of injury related to resuscitation attempts in children who die. DESIGN: Retrospective review of ambulance, hospital, and necropsy case records. METHOD: All children who died aged 0-14 years between 1994 and 1996, and underwent a full necropsy at the Victorian Institute of Forensic Medicine (Melbourne, Australia) were identified. Children who were subject to recognised trauma before resuscitation or died because of a congenital abnormality were excluded. The records of all remaining children were reviewed. Children were grouped according to whether resuscitation was attempted or not. RESULTS: From a total of 346 children who died, 204 (58.6%) were identified as meeting the inclusion criteria. Resuscitation was performed in 153 (75%) children and was started before ambulance arrival in 123 (60.3%) children. Injuries were detected at necropsy in 65 (42.5%) of children who had resuscitation compared with six (11.7%) of children who had no resuscitation (p<0.0001) chi(2) test. All but two of these injuries were of a minor nature consisting principally of bruises or abrasions. Two significant injuries were identified both occurring as a result of readily identifiable resuscitation procedures. The likelihood of injury increased with the length of resuscitation. In children resuscitated for less than 60 minutes the incidence of injury was 27% compared with 62% for children resuscitated for longer ( p<0.0001). CONCLUSION: This study has shown that cardiopulmonary resuscitation commonly causes minor injuries such as superficial bruises and abrasions and the likelihood of such injury increases with the duration of the cardiopulmonary resuscitation. This information should reassure parents and caregivers that basic life support may be instituted without fear of causing significant injury or adversely affecting outcome in the child with cardiorespiratory arrest. Caution must be exercised when attributing significant injuries to resuscitation attempts and alternative causes must be fully investigated.
Adolescent↗
Description of retained abilities in older persons with dementia.
There have been suggestions in the literature that the care of people with dementia must be focused on abilities as opposed to disabilities. However, this approach has not been carefully defined in terms of what constitutes remaining abilities. This article provides a description of the abilities in people with dementia, which is based on a descriptive analysis of data derived from a larger study regarding the psychometric evaluation of an abilities assessment instrument. The sample comprised 112 male veterans with dementia who were living in a long-term care facility. Their mean age was 75 years. Data were collected in the areas of self-care, social, interactional, and interpretive abilities. Abilities were retained in all four areas. Furthermore, abilities were differently affected and varied considerably across subjects, which is consistent with evidence pertaining to cognitive changes in dementia. Our results provide support for an individualized, abilities-focused approach to the care of people with dementia.
Activities of Daily Living↗
Epidemiological features of and public health response to a St. Louis encephalitis epidemic in Florida, 1990-1.
A St. Louis encephalitis (SLE) epidemic in Florida during 25 weeks in 1990-1, resulted in 222 laboratory-diagnosed cases, an attack rate in the 28 affected counties of 2.25/100,000. Disease risk rose with advanced age, to 17.14/100,000 in persons over 80 years, and all 14 fatal cases were in persons over 55 years (median, 70 years). Community serosurveys in Indian River County, the epicenter of the outbreak (attack rate 21/100,000), showed acute asymptomatic infections in 3.6% of the persons surveyed, with higher rates in persons with outdoor occupational exposure (7.4%) and in clients of a shelter for the indigent (13.3%). A matched case-control study found that evening outdoor exposure for more than 2 h was associated with an increased risk for acquiring illness (odds ratio [OR] 4.33, 95% CI 1.23-15.21) while a number of recommended personal protective measures were protective. Four SLE patients were dually infected with Highlands J virus, the first reported cases of acute infection with this alphavirus. The case-control study provided the first evidence that a public education campaign to reduce exposure had a protective effect against acquiring the disease.
Adolescent↗
The discrimination of dog odours by humans.
The domestic dog is able to identify both individual conspecifics, i.e. other dogs, and individual interspecifics, e.g. humans, by smell. Whilst humans can recognise individual members of their own species using olfactory information, it is unknown whether they can identify members of any other species in this manner. We examined the ability of humans to identify individual dogs by smell. Twenty-six dog owners were required to smell two blankets, one impregnated with the odour of their own dog, the other impregnated with the odour of an unfamiliar dog. Participants were required to indicate which of the odours smelt the strongest, which smelt the most pleasant, and which of the odours belonged to their own dog. Most of the participants (88.5%) were able to recognise the odour of their own dog. They showed no significant bias, however, in responding which of the odours they thought smelt the strongest or most pleasant. The results indicate that dogs produce odours that are individually distinctive to their owners, and highlight the fact that humans can recognise members of another species using olfactory cues--an ability presumably acquired without conscious effort.
Adult↗
Effects of an abilities-focused program of morning care on residents who have dementia and on caregivers.
OBJECTIVE: To conduct a controlled investigation to examine the effects of an abilities-focused program of morning care on the interaction behaviors and functioning of residents with dementia and on caregivers' interaction behaviors and perceptions of caregiving. DESIGN: A quasi-experimental, repeated measures design. SETTING: The study was conducted on four, nursing-home-level cognitive supports units in a geriatric care center. One of the units was randomly selected as the experimental unit; the other three served as controls. PARTICIPANTS: The final sample consisted of 40 residents (20 each in the experimental and three control groups) and 44 caregivers (16 on the experimental unit and 28 on the three control units). INTERVENTION: An educational program on delivering abilities-focused morning care, designed by the authors, was provided to caregivers on the experimental unit. MEASUREMENTS: Measures were taken at baseline and at 3 and 6 months postintervention with regard to residents' interaction behaviors, level of agitation, and level of function and to caregivers' interaction behaviors, perceived ease of caregiving, and level of stress. RESULTS: Repeated measures analysis of variance (RM-ANOVA) was used to compare the experimental and control groups in regard to changes in the outcomes over time. Results indicated that the abilities-focused program had statistically significant effects on (a) residents' personal attending and calm/functional behaviors, level of agitation, and levels of overall and social function, and (b) caregivers' verbal relevance and personal attending, relaxed, and social/flexible behaviors. CONCLUSIONS: The evidence suggests that both residents and caregivers benefit from morning care that is oriented toward the abilities of people with dementia.
Aged↗
Confidentiality and the courts.
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Australia↗
Prevalence of disease in dogs purchased from an animal rescue shelter.
The prevalence of diseases suffered by dogs within two weeks of their acquisition from a rescue shelter in Northern Ireland was investigated. A postal questionnaire was completed by 556 people who had purchased a dog from the Ulster Society for the Prevention of Cruelty to Animals (USPCA) to provide information on the diseases suffered by their dog. The majority of the dogs (53.7 per cent) had an ailment the most common being coughing and diarrhoea. Of the respondents who returned their dog to the USPCA, 92 per cent did so because the animal was unhealthy. Stray dogs were more likely to have an ailment than unwanted dogs, specifically coughing, and/or skin problems. More puppies suffered from parvovirus, vomiting, and/or diarrhoea than did juveniles or adults. Adult dogs were more likely to have a cough than juveniles or puppies. There was no association between the sex of the dogs and their ailments.
Animal Welfare↗
Bilateral cervicofacial, axillary, and anterior mediastinal emphysema: a rare complication of third molar extraction.
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Adolescent↗
The effect of blood in the oral cavity on breath alcohol analysis.
The theory that blood (containing alcohol) present in the oral cavity may falsely increase breath analysis recently led to a successful appeal against a drink driving conviction. Subjects who had previously consumed vodka (37.2% alc/vol), at 30 ml/10 kg and reached a BAC (blood alcohol concentration) of between 0.05 and 0.10% were then given four oral solutions consisting of a control (distilled water), and 0.05, 0.10 and 0.15% aqueous alcohol (ethanol) solutions, administered in coded form. A four-way cross-over, blind, randomized assay was conducted with the solutions, with breath analyses conducted in the presence or absence of solution in the mouth. The first trial group (n = 18) received 2 ml of solution, and we found that the simulated 0.15, 0.10 and 0.05% alcohol solutions in the mouth produced BAC reading increases of 0.0088 +/- 0.0014, 0.0062 +/- 0.0008 and 0.0055 +/- 0.0010% respectively (p < 0.001). The second trial group (n = 20) received 1 ml of solution and produced BAC reading increases of 0.0047 +/- 0.0011 (p < 0.001), 0.0023 +/- 0.0008 (p < 0.01) and 0.0020 +/- 0.0006% (p < 0.05) respectively. In conclusion, these studies indicate that small volumes of blood (containing alcohol) in the mouth would not have a practical effect on breath analysis readings.
Clinical Trial↗
Continuing education programme - Victorian Institute of Forensic Medicine and Department of Forensic Medicine, Monash University.
Given the increasing requirement of the courts for forensic experts to engage in ongoing education, a continuing education programme was developed in forensic medicine at the Victorian Institute of Forensic Medicine to cater for both clinicians and pathologists. The programme consists of a series of cases which are circulated several times per year. All are actual cases and are reflective of the types of presentations experienced in forensic medicine. Each case includes relevant and appropriate details/findings and may include photographs. A series of questions follow which are answered usually in short-answer format. The answers are returned and correlated by a review panel, and a commentary with the response outcome is distributed to all those involved. The cases presented here are selected from this programme.
Journal Article↗
The ability to comprehend affective communication in individuals with Huntington's disease.
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Affect↗
Expressive aphasia in glioblastoma multiforme patients: an application of content methodology.
Approximately one-third of patients with glioblastoma multiforme experience aphasia (Kraemer & Bullard, 1994). This loss of language abilities can be a major source of frustration for patients. Their quality of life is affected by the inability to interact with others. In this paper, an examination of the phenomenon of expressive aphasia will be conducted through the application of the content methodology process. Content methodology is a process for developing nursing knowledge, which strives to bridge the gap between theory, research and practice (Dawson & Wells, 1992). This process will guide in the development of substantive content for practice. An assessment tool and intervention plan will be presented.
Aphasia, Broca↗
An abilities assessment instrument for elderly persons with cognitive impairment: psychometric properties and clinical utility.
In this article the psychometric properties of an Abilities Assessment Instrument (AAI), developed to assess the self-care, social, interactional and interpretive abilities of older people with cognitive impairment (CI) related to dementia, are described. The sample consisted of 112 institutionalized older men with CI and 60 institutionalized older men without CI. The psychometric evaluation of the AAI indicated that: (a) it is reliable in terms of test-retest (Pearson's r range .93-.99), interrater (Pearson's r range .95- .99), and internal consistency evaluations (Cronbach's alpha .90-.98), as well as through confirmatory factor analysis; and (b) that it is valid with respect to content validity (CVI 87.3%), concurrent validity (Pearson's r correlations ranging from -.67-.80 on the London Psychogeriatric Rating Scale [LPRS], and from -.76-.85 on the Functional Assessment Stages Scale [FAST]), and construct validity with significant differences between subjects with and without CI (t values ranging from 5.13-9.30). The AAI is a reliable and valid instrument that can be used to provide assessment data.
Activities of Daily Living↗
The effects of language used by caregivers on agitation in residents with dementia.
In this study, We addressed the problem of whether residents with a diagnosis of dementia would become agitated if given verbal commands at a level of language complexity above their comprehension ability. The study used an A-B-A research design. The convenience sample of 15 subjects was comprised of 11 men and 4 women who resided in a long-term care institution. Their mean age was 86.6 years, and their average length of stay in the institution was 317.3 days. The results lent support to the hypothesis that exposing residents with dementia to language beyond their comprehension ability could result in agitated behavior. The predominant manifestations of agitation were general restlessness, strange noises, and negativism. An important implication for nursing practice is that the language used by caregivers should match the comprehension ability of residents. Caregiving can thereby facilitate communication and, potentially, prevent agitation.
Aged↗
Postcomatose unawareness/vegetative state following severe brain injury: a content methodology.
Postcomatose unawareness/vegetative state (PCU/VS) is an altered state of consciousness that may follow coma. It is characterized by wakefulness without awareness of self or the environment. While most frequently associated with trauma, it is also associated with anoxia, vascular injury or encephalitis. In this article, the clinical phenomenon of PCU/VS is explored using the content methodology process (CMP) in order to explicate content for nursing practice. There are five steps in the process: literature review, identification of the characteristic features and patient behaviors associated with PCU/VS, description of the specific abilities that are affected, formulation of nursing assessment and intervention approaches, and evaluation of these approaches in clinical practice and research. In this article, there is an extensive review and analysis of the literature related to PCU/VS. Substantive nursing knowledge was developed using the CMP. It was determined that the Freeman Questionnaire and the Sensory Stimulation Assessment Measure are appropriate tools to assess the interpretative abilities of patients with PCU/VS during the acute care period. Sensory regulation techniques that are appropriate for use during patient care to promote the recovery of cognitive abilities were identified. Both the recommended tools and the intervention approaches require further validation in empirical research.
Brain Injuries↗
Description of a self-care instrument for elders.
The psychometric properties of the self-care component of the Abilities Assessment Instrument were studied with elderly women. Thirty of the participants were cognitively impaired and 20 participants were not. Nonparametric statistics were used as the data were not normally distributed. Using the Spearman rank order correlation coefficient, test-retest reliability was rs = .79; p < .01 (n = 10) and interrater agreement was rs = .97; p < .01 (n = 9). Cronbach's alpha was .97. Between two content experts, the index of content validity was .89. Concurrent validity was assessed by comparing the self-care scores with the MMSE scores (rs = .91; p < .01). To establish construct validity, the self-care scores of those with dementia were shown to be statistically different from those who did not have dementia (Mann-Whitney U = 85). This study provided evidence for the reliability and validity of this self-care instrument.
Aged↗