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Linda Ryan, a Veterinary Technician Specialist in Behaviour, and in Oncology, and a Certified Clinical Animal Behaviourist, offers advice on making your clinic ‘dog-friendly’, highlighting in-clinic considerations to help reduce the stress canine patients experience when visiting your practice.

Despite the benefits of utilising community-based care services (CBS) for people with dementia and their caregiver being well established, people with dementia and caregivers use fewer services in comparison to other people in need of care. While societal, cultural and logistical factors effecting caregiver use of CBS are frequently studied, research of internal emotional barriers, mental limitations created by one's own self that prevents open communication of thoughts and feelings, and their effect on CBS use is limited. This paper explores internal emotional barriers on caregivers' use of CBS within the Irish Healthcare System. Professional Healthcare Providers were also interviewed as a preliminary indicator of their awareness of these internal emotional barriers and their impact on caregivers' use of CBS. Using interpretive description methodology, interviews with 20 caregivers and fourteen dementia professional healthcare providers were transcribed and a thematic analysis methodology applied to illuminate themes/ patterns within participants’ subjective perceptions of caregivers emotional barriers to using CBS. Four themes emerge: reluctance to question general practitioner (GP) authority; embarrassment during level of care requirement reviews; sense of obligation to provide all care; and fear of stigma. Caregivers interviewed were reluctant to communicate concerns with professional healthcare providers (PHPs), thereby reducing the PHP’s awareness of these barriers and delaying/preventing use of CBS. As key gatekeepers within the care pathway, GPs should address the uneven power dynamic with the caregiver through user-centred models of care, which actively encourage open dialogue, and receive training to identify the indicative behaviours of internal emotional barriers and empower the caregiver to communicate their feelings/concerns directly.

This article visits the subject of nasal lymphoma in cats, its incidence, presenting signs, treatment options and nursing care. Lymphosarcoma, or lymphoma, is a systemic, round cell cancer, which arises from lymphoid tissues. Whilst multicentric lymphoma is more commonly diagnosed in dogs, it is more usual for cats to present with a specific anatomical site affected. Lymphoma is the most commonly diagnosed cancer in the nasal cavity, although nasal lymphoma is a relatively uncommon tumour. Nasal lymphoma is termed an extranodal lymphoma, commonly affecting older cats, and representing 5 – 10% of anatomic-specific lymphoma cases. Presenting signs are a consequence of the anatomical location of the tumour and its local effects. Diagnostics for nasal lymphoma follow a stepwise approach to initially establish a general health profile of the individual patient, as well as more specific modalities, including advanced imaging. A variety of treatment options may be employed and will depend on the grade a...

Nurses in all settings care for patients who have underlying alcohol dependencies. Approximately 18-20% of patients in ambulatory settings have alcohol abuse or dependency problems, and 30-50% of all hospital admissions are related to the effects of alcohol abuse. Yet clinicians practicing in hospitals frequently have minimal training in the field of chemical dependency. Nurses practicing in general acute care facilities must assess for and intervene with the withdrawal process when alcohol-dependent patients are hospitalized for medical or surgical treatment. This study hypothesized that, if an alcohol withdrawal program were instituted in a medical surgical setting, patient outcomes might be improved. An alcohol program was developed and instituted at a large urban, teaching, community hospital. Variables were compared between the alcohol abusive/dependent populations preprogram and post-program implementation. The results demonstrated a 78% reduction in the occurrence of delirium tremens, a 67% reducti...

The liver is structurally and functionally complex and has been considered second only to brain in its complexity. Many mysteries still exist in this heterogeneous tissue whose functional unit of the lobule has continued to stump morphologists for over 300 years. The primary lobule, proposed by Matsumoto in 1979, has been gaining acceptance as the functional unit of the liver over other conceptual views because it’s based on vessel architecture and includes the classic lobule as a secondary feature. Although hepatocytes comprise almost 80% of the liver, there are at least another dozen cell types, many of which provide “cross-talk” and play important functional roles in the normal and diseased liver. The distribution and functional roles of all cells in the liver must be carefully considered in both the analysis and interpretation of research data, particularly data in the area of genomics and “phenotypic anchoring” of gene expression results. Discoveries regarding the functional heterogeneity of the various liver cell types, including hepatocytes, hepatic stellate cells, sinusoidal endothelia, and Kupffer cells, are providing new insights into our understanding of the development, prevention and treatment of liver disease. For example, functional differences along zonal patterns (centrilobular or periportal) have been demonstrated for sinusoidal endothelium, Kupffer cells, and hepatocytes and can explain the gradients and manifestations of disease observed within lobules. Intralobular gradients of bile uptake, glycogen depletion, glutamine synthetase, and carboxylesterase by hepatocytes; widened fenestrations in centrilobular sinusoidal lining cells; and differences in the components of centrilobular extracellular matrix or function of Kupffer cells have been demonstrated. Awareness of the complexities and heterogeneity of the liver will add to a greater understanding of liver function and disease processes that lead to toxicity, cancer, and other diseases.