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Medium 9781937554637

5 Working With Institutional Review Boards (Ethics Committees)

R. Jennifer Cavalieri Sigma Theta Tau International ePub

Research professionals and their institutional review board (IRB) are partners working with the common goal of protecting human research subjects. Learning about the IRB resources and navigating its processes can be a challenge for those new to research. This chapter provides a basic explanation of IRB processes from the research professional’s perspective and focuses on examples and tips for working more effectively and efficiently with this important committee.

The investigator is responsible for research compliance, which includes obtaining and maintaining IRB approval for their trials. The investigator’s research staff, coordinators, assistants, or regulatory specialists, draft documents and maintain study regulatory files for the investigator.

An institutional review board (IRB) is an independent board composed of representatives from a variety of scientific and professional disciplines and the community. The IRB follows the U.S. Department of Health and Human Services (DHHS) Regulations for Protection of Human Subjects 45 CFR 46 and conducts comprehensive reviews of all research protocols involving human subjects (U.S. Department of Health and Human Services, n.d., b).

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Medium 9781591202042

CHAPTER 4 - Human Error in Thyroid Testing

James K. Rone Basic Health Publications, Inc. ePub


ouve got a number of symptoms that could suggest hypothyroidism and decide to visit Dr. Whitecoat, bringing along a meticulously prepared list of complaints, perhaps bolstered by a book like this one, and plead for a thyroid check. He kindly complies and a few days later you get a call from the nurse: Your thyroid levels are fine. The doctor will see you again next year.

But, but . . .

What is the multi-symptomatic patient to do? First, you should consider the possibility that Dr. Whitecoat is correct. Your thyroid system might be normal. In that case, your doctor should explore other explanations for your symptoms. For every medical complaint, there is a list of possible causes called its differential diagnosis. Hypothyroidism is in the differential diagnosis of fatigue, as are many other things, which may or may not be medical in nature. I see patientsoften womenwhose lives are quite obviously exhausting: kids, their activities, job, housework, and invalid elderly relatives all vying for their time and energy. And some people I see are saddled with still more stressful ordeals on top of the routine ones: divorce, domestic abuse, death, suicide, layoffs, even livestock plagues. Yet it seems a shock to themabsurd, eventhat life might cause their fatigue. My point is, be frank with yourself. There is not always a disease to explain physical symptoms or always a pill to fix them.

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Medium 9781786394040

3 Parasites of the Respiratory System

Elsheikha, H.M.; Wright, I.; McGarry, J. CABI PDF


Parasites of the

Respiratory System

Angiostrongylosis (Angiostrongylus vasorum)

What is canine angiostrongylosis?

This parasitic worm infects dogs and the infective L3 larvae are carried by slugs and snails. Referring to Angiostrongylus vasorum as a lungworm is something of a misnomer. Although the larval and egg stages of the parasite do affect the lungs and coughing associated with bronchitis is the most common presenting sign, the adult worms actually live in the heart and pulmonary artery. A. vasorum is also known as the French heartworm but the term heartworm should really be for Dirofilaria immitis, covered in the next chapter.

Infections in dogs may be subclinical or lead to clinical pathology and signs

(angiostrongylosis) including bronchitis, clotting defects, neurological deficits associated with blood clots and aberrant larval migration and heart disease. Secondary coagulopathies (disseminated intravascular coagulation, immune-mediated thrombocytopenia) can result in subcutaneous haematomas or occasionally in fatal cerebral, spinal or abdominal haemorrhage.

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Medium 9781786394583

Association Between Puppy Classes and Adult Behaviour of the Dog

Denenberg, S. CABI PDF

Association Between Puppy

Classes and Adult Behaviour of the Dog

Ángela González-Martínez1*, María Fuencisla

Martínez1, Maruska Suárez2, Germán Santamarina2,

Belén Rosado3, Isabel Luño3, Sylvia García-Belenguer3,

Jorge Palacio3, Ainara Villegas3, Luis Felipe de la

Cruz4 and Francisco Javier Diéguez Casalta2

Hospital Veterinario Universitario Rof Codina, Universidad de Santiago de

Compostela, Lugo, Spain; 2Departamento de Anatomía, Producción Animal y Ciencias Clínicas Veterinarias, Universidad de Santiago de Compostela,

Lugo, Spain; 3Departamento de Patología Animal, Facultad de Veterinaria,

Universidad de Zaragoza, Zaragoza, Spain; 4Departamento de Fisiología,

Universidad de Santiago de Compostela, Lugo, Spain


Conflict of interest: The authors declare no conflict of interest.

Keywords: dogs, puppy class, behaviour problems, behaviour


A puppy’s early environment may have a profound effect on its future behaviour, making appropriate socialization and habituation during the early weeks of life essential for lifelong well-being (Sforzini et al., 2009). Nevertheless, the literature shows opposite effects between puppy classes and adulthood behaviour (Seksel et al., 1999; Batt et al., 2008; Blackwell et al., 2013; Kutsumi et al., 2013; Howell et al., 2015). The aim of this study was to assess the effect of puppies’ attendance at dog-training programmes on their behaviour later in adulthood.

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Medium 9781609945176

One Best Care Anywhere

Longman, Phillip Berrett-Koehler Publishers ePub

When you read “veterans hospital,” what comes to mind? Maybe you recall the headlines about the three decomposed bodies found near a veterans medical center in Salem, Virginia, in the early 1990s. Two turned out to be the remains of patients who had wandered off months before. The other patient had been resting in place for more than fifteen years. The Department of Veterans Affairs admitted that its search for the missing patients had been “cursory.”1

Or maybe you recall images from movies like Born on the Fourth of July, in which Tom Cruise plays an injured Vietnam vet who becomes radicalized by his shabby treatment in a crumbling, rat-infested veterans hospital in the Bronx. Sample dialogue: “This place is a fuckin’ slum!”

By the mid-1990s, the reputation of veterans hospitals had sunk so low that conservatives routinely used their example as a kind of reductio ad absurdum critique of any move toward “socialized medicine.” Here, for instance, is Jarret B. Wolistein, a right-wing activist and author, railing against the Clinton health-care plan in 1994: “To see the future of health care in America for you and your children under Clinton’s plan,” Wolistein warned, “just visit any Veterans Administration hospital. You’ll find filthy conditions, shortages of everything, and treatment bordering on barbarism.”2

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Medium 9781786394583

Compulsive Self-licking and Self-biting in Dogs with Paraesthesia: Two Cases

Denenberg, S. CABI PDF

�Compulsive Self-licking and

Self-biting in Dogs with

Paraesthesia: Two Cases

Carlo Siracusa*, Lena Provoost, M. Leanne Lilly, Lili

Duda, Leontine Benedicenti and Ludovica Chiavaccini

Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Conflict of interest: The authors declare no conflict of interest.

Keywords: compulsive behavior, dog, paraesthesia

Case One

History and presenting signs

A 10.5-year-old castrated male Coonhound/Great Dane cross presented with a

1-year history of anxious behaviour and repetitive licking of the left carpus, which started following a 3-week absence of the owners. They noted a small button-like tumour on the left carpus, which had grown to 8×8 cm size at presentation.


The repetitive licking was thought to be initiated by separation anxiety and perpetuated by discomfort/pain.


Treatment included behaviour modification, amitriptyline, gabapentin and amantadine. Histopathology revealed a fibroadnexal hamartoma. Palliative

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Medium 9781786392077

7 Lyme Borreliosis: The European Perspective

Halperin, J.J. CABI PDF


Lyme Borreliosis: The European


Franc Strle,1 Gerold Stanek2 and Klemen Strle3

Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana,

Slovenia; 2Medical University of Vienna, Institute for Hygiene and Applied

Immunology, Vienna, Austria; 3Division of Rheumatology, Allergy and Immunology,

Center for Immunology and Inflammatory Diseases, Massachusetts General

Hospital, Boston, Massachusetts, USA


7.1  History of Lyme Borreliosis

Lyme borreliosis (LB) encompasses several clinical manifestations that may affect multiple organ systems, most commonly the skin, heart, nervous system or joints. Although this constellation of rather diverse manifestations now falls under a common term (Lyme borreliosis/Lyme disease), most individual manifestations were described in Europe several decades before the discovery of the etiological agent, Borrelia burgdorferi (as discussed in Chapter 2, the genus has now been renamed Borrelia) (Adeolu and Gupta, 2014;

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Medium 9781937554385

4 Getting Excited About Computers

Brittney Wilson Sigma Theta Tau International ePub

Computers are modern marvels and incredible pieces of machinery. We often forget to acknowledge how amazing all their masterful capabilities truly are. Rather, we get bogged down on their current complications and inconveniences, because our attention is always on the latest and greatest design that is lighter and thinner than the current model. What we have to remember is how far computers have come. The general rule is that the longer we have a certain technology, the more user-friendly it becomes. Like all technology, computers are forever changing, and one area of life they continue to improve is delivery of nursing care.

Computers are so ubiquitous in our lives today that we probably couldn’t imagine life without them—from grocery store checkout lanes to the smartphone (or even not-so-smartphones) you use every day. Do you have a GPS in your car? Have you programmed your DVR lately? Have you documented patient medical records at work? Just take a moment to think of anything electronic you use—chances are these items probably contain computers.

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Medium 9978193883527

Chapter 13: Caring Economics: A Key to Health Care Reform

Riane Eisler and Teddie M. Potter Sigma Theta Tau International ePub

“We have to change our present economic systems if we, our children, and future generations are to survive and thrive.”

–Riane Eisler, The Real Wealth of Nations, 2007, p. 1

We are not used to thinking of caring and economics together. But what if we did? Would we see so much degradation and despoliation of people and nature, so much poverty and injustice, so much suffering and environmental destruction? Would the work of care continue to be devalued? These questions are especially relevant for the future of health care and the advancement of nursing to its rightful place in both preventing illness and healing. For this reason, even though economics has not traditionally been part of nursing education, we are proposing that it should be.

Learning about economics will help nurses understand health care finance so they can advocate for economic support of effective care models by pointing to how these can also be more cost-effective. We want all nurses to be equipped to understand the shortcomings of conventional economic thinking and become active participants in building a new economic system that recognizes the enormous value of the work of care.

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Medium 9781786391520

4 The Epidemiology of Mycobacterium bovis Infection in Cattle

Chambers, M.; Gordon, S.; Olea-Popelka, F. CABI PDF


The Epidemiology of Mycobacterium bovis Infection in Cattle

Andrew J.K. Conlan* and James L.N. Wood

Disease Dynamics Unit, Department of Veterinary Medicine, University of

Cambridge, Cambridge, UK

The epidemiology of bovine tuberculosis is, by its very nature, inconsistent. Mycobacterium bovis is poorly transmissible between cattle, but has a high potential for spread due to the chronic nature of infection. The risk of infection, susceptibility and progression of disease in individual animals is highly variable but it does vary systematically with age (Brooks-Pollock et al.,

2013; Downs et al., 2016), breed (Ameni et al.,

2007), host genetics (Allen et al., 2010;

­Bermingham et al., 2014) and production type

(Broughan et al., 2016), which in themselves will vary in different epidemiological contexts.

Resolving the impact of these biological factors on transmission is difficult as transmission rates, the duration of latency and the immunological response of infected animals to diagnostic tests all compete on timescales comparable to the life expectancy of the host. As a consequence, despite rich detailed surveillance data and a

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Medium 9781780644554

13: Mass Casualty Incidents

Wapling, A. CABI PDF


Mass Casualty Incidents

M. Shanahan

Head of Special Operations, Yorkshire Ambulance Service NHS Trust, UK

Key Questions 

• What is a mass casualty incident?

• Why is it different from a major incident?

• What are the challenges for the NHS in managing this type of incident?

13.1  Introduction

This chapter largely considers the preparedness for and response to mass casualty incidents (MCIs) in the UK; however, principles can be extrapolated to other settings. The emergency services are well versed in planning and preparing for large-scale incidents. It is commonplace for events hosting in excess of 100,000 people to be planned for and safely managed. In the UK this is achieved through coordinated planning and management of the events using guidance such as the Purple Guide to Health, Safety and Welfare at Music and Other Events or The Guide to Safety at Sports Grounds (see Further Reading).

Apart from the planned events, the day-to-day business of the emergency services is to respond to the unplanned, no-notice incidents. In 2015 the police and ambulance services across England responded to over 22,000 emergency calls in any 24-hour period, with the fire and rescue services responding to approximately 1700 calls in the same period. A number of the calls related to multiple casualty incidents, arising from events such as road traffic collisions or relocating people who became displaced from their homes because of

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Medium 9781609945176

Eleven VA Care for Everyone

Longman, Phillip Berrett-Koehler Publishers ePub

After reading previous editions of this book, many people have asked me why the United States does not simply create a civilian VA? If we know the VA offers a model of care that uniquely combines high quality, cost effectiveness, and patient satisfaction, why not just have the government nationalize hospitals and run them using the VA’s protocols of care?

Aside from the obvious political obstacles, one good answer, it seems to me, is that such a plan of action misses one of the key and often overlooked lessons of the VA’s turnaround, which is the role of competition in the public sector. Recall that the VA for most of its history was a moribund organization. Its transformation under Ken Kizer came only after its sinking reputation and other political circumstances conspired to make it seem quite likely that the Veterans Health Administration would be “zeroed out” and replaced by a system of vouchers. It was only at that point that the VA stopped behaving like a monopoly and embraced wholesale reform. As is often said in other contexts, nothing concentrates the mind like the imminent prospect of being hanged.

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Medium 9781608682065

Chapter 6. Healthy Habits

MD Heather Tick New World Library ePub

Nothing so needs reforming as other people’s habits.


I can think of many good reasons to adopt healthy habits in your daily life. Above all, they will improve your health and your body’s ability to heal and will reduce the impact of pain in your life. If you incorporate even a few of these habits, you’ll be able to do more of the things you want to do.

Habits are not necessarily voluntary. They can be hardwired into your brain, and when bad habits cause pain, that pain, too, can be hardwired into your brain. Fortunately, making good habits can change the wiring of your brain, which can relieve the pain brought on by bad habits. This is called neuroplasticity, and in chapter 3 I mentioned its potential for treating chronic conditions. Our brains get better at whatever we focus on, just as our bodies get better at sports when we practice. We can train our brains to sharpen our focus on pain or to lessen that focus. Good habits can reduce pain and improve our ability to do the activities that are meaningful to us.

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Medium 9781626569072

3. Myth #3 Health care institutions, not to mention the whole system, can be fixed with more heroic leadership

Mintzberg, Henry Berrett-Koehler Publishers ePub

Health care institutions, not to mention the whole system, can be fixed with more heroic leadership.

Leadership is all the rage today, especially in business, but well beyond it, too, and the field of health care is hardly immune. Count the thousands of books about leadership on Amazon, and then try to find the few on followership. Are we so obsessed with leadership because we get so little of it? Or, do we get so little of it because we are so obsessed with it?

Of course leadership matters. The problem is the elevation of leadership to heroic status, as if leaders ontopare superior tohuman resourcesbelow. Such leaders are supposed to drive others to participate, for example by “empowering” them. Go tell that to professionals in hospitals, even to bees in a hive. They know what they have to do and just get on with doing it—unless, of course, they have long been disempowered by their leadership.

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Medium 9781780647876

1: Principles of Equine Thermography

Soroko, M.; Davies Morel, M.C.G. CABI PDF


Principles of Equine


1.1  Thermography

Thermography is a non-invasive diagnostic method, based on body surface temperature detection. The infrared radiation emitted from the body surface is recorded and visualized in the form of a temperature distribution map. The resulting ‘thermogram’ can be used to determine physiological changes to, and reflect blood flow patterns and the speed of metabolism in, the body of a horse (Turner, 1991). It also reflects the impact of environmental factors during examination.

In order to obtain reliable thermographic measurements of the horse’s body surface temperature, the examination should be carried out on a carefully p

­ repared animal and in an appropriate examination room.

Constant body temperature is a characteristic feature among warm-blooded animals. During exercise, working muscles produce substantial quantities of heat, which must be eliminated from the body in order to prevent the animal from overheating. This loss of heat is achieved through sweating (evaporation), heat conduction, air flow (convection) and infrared radiation. In cold weather conditions, the animal starts thermogenesis (heat production) in order to maintain a constant body temperature (Ivanov, 2006). The skin and hair coat play an important role in the process of heat exchange between the body and the environment. Skin also acts as a thermal perception organ, informing the animal about environmental conditions, including changes in temperature and humidity. Hence, the body surface temperature of a horse as measured by thermography is the combined result of the heat produced by the body and the impact of environmental factors.

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