Siberian sturgeon fry coming from three different ponds has been examined. 1. "Dgal" - fish culture conerete-terrestrial pond beloning to D.O.Z. Dgal Inland Fisheries Institute in Olsztyn supplied with fresh water from Great Dgal Lake; 2. "Grzmieca" - fish culture pond terrestrial, natural belonging to fishing farm Grzmieca near Brodnica; 3. "Konin" - fish culture pond near Konin supplied with water utilized by near heat and power generating plant. Total of 80 sturgeons fry with parameters: length 17.5 cm - 38.5 cm, weight 21 g - 134 g, age 0+1+ has been examined. The examinated group of sturgenos had metacercariae Diplostomum sp. in their lenses. Prevalence of infection of sturgeon with metacercariae Diplostomum sp. was high in all this three ponds. Intensity of infection was also high in ponds "Dgal" and "Grzmieca", but low in "Konin". In ponds "Dgal" and "Konin" we have obtained high positive correlation ("Dgal" - r = 0,606, p
Tuberculosis has continued to be a public health problem around the world. The urogenital tuberculosis clinic in the Russian Scientific Research Institute of Phthisiopulmonology was founded in 1950. The development of reconstruction operations for those with urogenital tuberculosis began in 1960. Since then 4298 patients with urogenital tuberculosis have been treated, and 2364 operations have been performed: 885 to remove an organ, 531 to preserve an organ, and 948 for reconstruction. The cases of extrapulmonary tuberculosis in recent years have increased to 6.0%. Surgery for urogenital tuberculosis is performed after specific medical therapy has been tried, but it is difficult, particularly if it is a reconstruction. The clinical features and results of various ureteral neoimplantation procedures using intestinal transplants (ileocystoplasty, sigmoidocystoplasty, cecocystoplasty) are discussed.
During the period 1990-1994 a total of 578 operations were performed in 502 patients with various forms of tuberculosis. Most of the patients (68%) were men aged 20 to 50 years (70%). Sputum cultures were positive in 55% of the patients. More than half of all patients were chronic smokers, and about 10% were alcoholics or drug addicts. There were no human immunodeficiency virus-infected patients, and none with acquired immunodeficiency syndrome. The most frequent surgical interventions were, according to the classification adopted in Russia, for cavernous or fibrocavernous tuberculosis (196 cases) and tuberculomas (161 cases). The main operative procedures used were pulmonary resection (n = 280) and pneumonectomy or pleuropneumonectomy (n = 80). Diseased intrathoracic lymph nodes were ablated in 62 patients. Thoracoplasty or thoracomyoplasty were performed in 46 cases, thoracostomy in 37, closure of a thoracic wall defect in 27, and reamputation of the main bronchial stump in 6. Postoperative complications arose in 20% of the patients. More than half occurred in the pleural cavity or bronchi and were associated with tuberculous infection. The postoperative hospital case-fatality rate was 2%. The overall clinical efficacy by the time of discharge was 82.7% (95% in tuberculomas). Reactivation of tuberculosis over the first 3 years after discharge occurred in 6.6% of the patients. Most patients with large or multiple caverns, tuberculomas, intrathoracic caseous lymphadenitis, or various complications of pulmonary tuberculosis cannot be cured (or are not amenable to care in principle) by means of antibacterial therapy because of irreversible morphologic changes in the lungs, bronchi, pleura, lymph nodes, or thoracic wall. For this reason, indications for surgical management of pulmonary tuberculosis should be generally expanded. Excessively long antibacterial therapy for tuberculosis is often inadvisable. Although the availability of standardized regimens of antibacterial therapy is strategically essential, each patient must be treated according to an individual plan. In certain cases thoracic surgeons should be enlisted to participate in the development of such plans.
Providing health information is an important aspect of public health nursing. This article describes how public health nurses (PHNs) give information to enhance client competence. The findings are part of a larger study that explored PHNs perspectives and experiences of their practice. The study employed an exploratory descriptive qualitative research design. Data were gathered through in-depth individual and focus group interviews with 28 PHNs in Alberta, Canada. Content analysis revealed that nurses work to enhance client competence by sharing professional knowledge and by building on the client's experiential knowledge. Nurses provide information to assist clients with immediate concerns and for future use, PHNs use three main strategies to deal with immediate concerns: being direct, providing options, and presenting a different view. Information for future use focused on enhancing development and forestalling future problems. Nurses build on clients' experiential knowledge by acknowledging their present situation, giving positive feedback, being there, and gently persuading. The authors suggest that the melding of professional and client knowledge is foundational to health promotion approaches that enhance client competence. There is a need for further research that explores the intricacies of developing partnerships between professionals and clients that embrace a sharing of professional and experiential knowledge.
Finland's active deinstitutionalization policy aims to reduce the number of elderly people in long-term residential care and to keep noninstitutionalized elderly people living at home as long as possible. As a contribution to the issue of the appropriateness of long-term institutional care, we compared the health and functional ability of elderly people living at home or in residential care to assess the theoretical possibility of discharging the least dependent elderly from residential homes. Findings from two separate data sets collected in 1992 were compared; one (n = 475) was obtained by computer-assisted telephone interview (elderly at home) and the other (n = 459) by postal survey (elderly in residential care). The direct method was used in age and gender standardization, and logistic regression analysis was applied. Elderly people living at home were found to be in better health and with better functional ability than those in residential care. However, a proportion of home-dwellers needing some help with Activities of Daily Living (ADLs) assessed their health as being even worse than those in care, and approximated that of institutionalized elderly judged by the personnel to be able to manage with home-based care. Compared with home-dwellers, those assessed as able to manage in-home care were mostly single and had less education and more restrictions in their Instrumental ADLs and medication. Our results indicate that one third of those assessed as able to manage in-home care could possibly be discharged if adequate servicers and housing were available.
Examination of nephrology practice variations in living donor renal grafts to determine their influence on organ supply, quality, and cost of chronic renal failure therapy.
Saskatchewan chronic dialysis, cadaveric, and living donor renal grafts in 1983-1994 inclusive.
Saskatchewan has three dialysis (I, II, III) and one transplant clinic. In the period the renal graft incidences/million population by these dialysis clinics by organ source were; Cadaveric: 23.1, 23.2, 21.1 (p = ns). Living: 5.4, 21.7, 8.3 (I or III vs II p
We aimed to assess the trends in prescribed defined daily doses (DDD) and drug expenses before and after the introduction of a computerized cost containment module into the computer record system of a defined group of GPs. The GPs' expectations for and experiences with the module were examined.
We performed a controlled follow-up study on antecedent data before and after intervention. A questionnaire was administered to the intervention group at the introduction and 1 year later. Data on prescribing were collected in the database of the Health Insurance Aarhus County, as a normal routine for accounting. The GPs were not aware of the ongoing cost supervision study. Additional cost information software was introduced on 1 January 1993 to 20 practices with 28 GPs. The software assisted the GPs in a semiautomatic way to identify and prescribe the cheapest drugs. The subjects comprised 158 practices including 231 GPs in Aarhus County, Denmark. Questionnaires were sent to the 20 intervention practices. The main outcome measures were prescribed DDD, reimbursement for prescribed drugs, and reimbursement per prescribed DDD quarterly during 1992 and 1993.
Compared with the controls there were no changes in prescribed DDD, reimbursement for prescribed drugs, and reimbursement per prescribed DDD in the intervention group after the introduction of the module.
Simply giving a random group of GPs computer assistance to choose less expensive drugs did not reduce expenditure per DDD. Cost containment procedures should be more intensive than just giving the doctors a computer-assisted decision aid.