Impact of water troughs on cattle use of riparian zones in the Georgia Piedmont in the United States.

Cattle use of riparian areas may lead to stream water contamination with nutrients, pathogens, and sediments. Providing alternative water away from the stream may reduce the amount of time cattle spend near streams and therefore reduce contamination. We conducted this study to 1) evaluate the effect of providing water troughs outside of the riparian zones on the amount of time cattle spend in riparian zones, and 2) evaluate if environmental factors such as temperature and humidity affect the impact of water trough availability on the amount of time cattle spend within riparian and nonriparian locations. Global positioning system (GPS) collars were used to document cow locations every 5 min in 2 mixed tall fescue/common bermuda-grass pastures of the Georgia Piedmont in the United States. We found that when the temperature and humidity index (THI) ranged between 62 and 72, providing cattle with water troughs outside of riparian zones tended to decrease time cattle spent in riparian zones by 63% (52 min x d(-1); P = 0.11). When THI ranged between 72 and 84, nonriparian water availability did not have a significant impact on the amount of time cattle spent in the riparian zone or in riparian shade. These results suggest that water troughs placed away from unfenced streams may improve water quality by reducing the amount of time cattle spend in riparian zones when environmental conditions as evaluated by THI are not stressful.

Maternal understanding of diarrhoea-related dehydration and its influence on ORS use in Indonesia.

Dehydration resulting from diarrhoea remains a significant cause of death for young children in developing countries such as Indonesia. Although Oral Rehydration Solution (ORS) is effective in preventing and treating dehydration, its use in home treatment is not widespread. This study sought to assess whether mothers' understanding of diarrhoea-related dehydration influenced their use of ORS in home treatment. One hundred mothers of children under the age of five years in rural Indonesia were surveyed using a structured questionnaire, administered in an interview format in their homes. Only 38 (38%) of the mothers surveyed could identify two or more correct signs of dehydration. Significant relationship was found between maternal knowledge of correct signs of dehydration and the use of ORS in home treatment (OR 3.36, 95% CI 1.24, 10.63). Resulting recommendations include improved health education programming for mothers of young children, as well as future programme evaluation and intervention studies.

Phosphorus, sediment, and Escherichia coli loads in unfenced streams of the Georgia Piedmont, USA.

Contamination of unfenced streams with P, sediments, and pathogenic bacteria from cattle (Bos taurus) activity may be affected by the availability of shade and alternative water sources. The objectives of this study were to evaluate water quality in two streams draining tall fescue (Festuca arundinacea Schreb.)-common bermudagrass (Cynodon dactylon L.) pastures with different shade distribution, and to quantify the effects of alternative water sources on stream water quality. For 3 yr, loads of dissolved reactive phosphorus (DRP), total phosphorus (TP), and total suspended solids (TSS) were measured during storm flow, and loads of DRP, TP, TSS, and Escherichia coli were measured every 14 d during base flow. We also used GPS collars to determine amount of time cattle spent in riparian areas. Our results showed that cattle-grazed pastures with unfenced streams contributed significant loads of DRP, TP, TSS, and E. coli to surface waters (p < 0.01). Time spent by cattle in riparian areas as well as storm flow loads of DRP, TP, and TSS were larger (p < 0.08) in the pasture with the smaller amount of nonriparian shade. Water trough availability decreased base flow loads of TSS and E. coli in both streams, and decreased time cattle spent in riparian areas in the pasture with the smaller amount of nonriparian shade (p < 0.08). Our results indicate that possible BMPs to reduce contamination from cattle-grazed pastures would be to develop or encourage nonriparian shade and to provide cattle with alternative water sources away from the stream.

Neurobehaviour rounds and interdisciplinary education in neurology and psychiatry (698).

Increasing emphasis on interdisciplinary medical treatment and education suggests that something valuable has arisen from medical specialization beyond the further development of specialty knowledge: an integration of specialty knowledge that compliments and extends the integrating aspects of the primary care approach to medicine. Several educational models have been described which serve this function. In this paper the authors describe interdisciplinary clinical teaching, and research team linking neurology, neuroradiology, psychiatry and neuropsychology. The team provides neurobehavioural evaluations and sponsors monthly Neurobehaviour Rounds, an interdisciplinary patient conference that is the main formal teaching vehicle for the programme. After the model had been in place for 1 year, eight of nine neurology residents had Residency In-Service Training Examination scores in behavioural neurology that exceeded their overall average scores. This suggests that encouraging neurology residents to see patients through the eyes of different specialists may have contributed to improvement in their performance on a test of interdisciplinary knowledge. A neurobehavioural programme anchored to a formal neurobehaviour conference may encourage interdisciplinary learning within the related disciplines of neurology, neuropsychology and psychiatry.

Ensuring students' well-being as they learn to support victims of violence.

PIP: As medical schools in the US incorporate domestic violence into their curriculum, they must also create mechanisms to assist medical students who have personal histories of domestic violence. In addition, all students must receive the support they will need to confront the psychological difficulties of working with survivors of domestic violence. It is only within the past decade that the extent of domestic violence and its effects on health have been recognized. The few surveys that have examined the prevalence of a history of domestic violence among health care providers have revealed that figures for this population mirror those for the general population. One reason for this is that more women are becoming medical students, and significantly more women than men have violence in their histories. Because it is a caring profession, medicine also attracts those who were exposed to family violence. Some of these individuals become high achievers to alleviate their pain but find it impossible to maintain perfectionism in medical school. When survivors are ultimately unable to feel good about themselves, they are unable to deal with patients objectively. As patients begin to discuss experiences of violence with medical students, the students may react by withdrawal, denial, or "intrusive" actions such as rescue attempts or boundary violations. These situations may be particularly problematic for medical students who have survived violence. Medical schools, therefore, should offer self-care training as they address the presence of family violence experiences among their students.^ieng

A survey of family-violence curricula in Virginia medical schools and residencies at university medical centers.

PURPOSE: To examine the status (as of 1995) of family violence curricula at Virginia's three medical schools and their affiliated residencies. METHOD: Questionnaires were sent in the fall of 1995 to the deans of undergraduate medical education at the three schools and the directors of the 69 fully accredited residencies at the university medical center. The questionnaires inquired about the presence of particular family-violence topics in the curricula (battered women, child abuse, elder abuse) and whether teaching about family violence was required or elective. In addition, the medical schools' departments were asked to identify faculty who were experts in the area of family violence. RESULTS: All three schools responded about undergraduate education, showing considerable variability among departments concerning whether instruction was required or elective and what instructional methods were used. A total of 48 (70%) of the 69 residencies responded. Twenty-six (54%) indicated that they had at least some curriculum content related to particular family-violence topics: child abuse, 20 (42%); battered women, 13 (27%); and elder abuse, nine (19%). A total of 27 faculty with expertise in family violence were identified, and 16 were experts in identifying and treating injuries related to family violence. No expert was identified in such areas as mental health sequelae or violence prevention. CONCLUSION: The results allowed for the development of recommendations regarding medical education about family violence in Virginia, including the formal integration of family-violence curricula into medical school and internship and residency programs, and the coordination of disciplines within Virginia in family-violence prevention.

Training traditional birth attendants in Nigeria--the pictorial method.

High maternal mortality and morbidity rates are a challenge for all involved in the care of mothers and babies. One response takes the form of an educational programme led by professional midwives to teach traditional birth attendants to recognize risk conditions and improve their care of mothers and babies. Such a programme was organized as part of a Canadian-Nigerian safe motherhood initiative, and carried out in Akwa Ibom State, Nigeria.

Assessments and suggested interventions to assist newborn breastfeeding behavior.

Assessment of the newborn infant in the first few days after birth is important to ensure that the newborn and mother are beginning to establish lactation successfully. This article discusses breastfeeding assessment of the healthy neonate and includes a description of the Infant Breastfeeding Assessment Tool (IBFAT), a checklist on which neonatal breastfeeding behavior can be scored. Some interventions are suggested for those babies who may be having difficulties.

Neurobehavior rounds. Their role in promoting psychiatric liaison in a neurology inpatient unit.

A joint neurobehavior conference was established utilizing the models of Lipowski's Montreal conference and Geschwind's aphasia and neurobehavior rounds at the Boston VA Hospital in 1991. The authors report on the usefulness of this conference in promoting the goals of psychiatric consultation and liaison on a neurology inpatient unit, specifically on patient care, education, and collegiality. The value of the multidisciplinary approach in solving complex neuropsychiatric problems is also discussed.

Experiences of primiparous breast-feeding mothers in the first days following birth.

This study describes the breast-feeding patterns of 59 neonates and the experiences of their primiparous mothers during the early postpartum period. The results showed that most mothers and babies in this group had significant difficulties during the first 2 days after birth and that 33% of the mother-baby pairs were still having problems latching or sucking on discharge from hospital (fourth to fifth postpartum days). Of the mothers who were still having problems on leaving the hospital, 84% had given up breast-feeding by 8 weeks, most of them by 2 weeks following hospital discharge.

Survivors of abuse. Health care issues.

This article has discussed the most common sequelae of victimization with regard to incest, rape, and battering. Although legislators and law-enforcement officials have traditionally been viewed as having primary responsibility for the prevention and control of violence, it is now known that physicians must also act in this regard. Their action is especially required with regard to victim assessment and treatment. Physicians serve as the entry points not only to the health care system, but also to other resources for victims of violence. By identifying their victimized patients and by understanding the antecedents of their patients' symptoms, physicians can go much further in meeting their patients' needs for physical, mental, and social well-being. Given the scope and impact of violence, physicians have a moral and ethical obligation to inquire about the possibility of current violence, past violence, or both in their patients' lives.

Unmarried motherhood.

In the past, the children of unmarried women were stigmatized and treated as second-class citizens by both society and the law. As societal attitudes have become more tolerant, however, the laws have been changed to ensure equality for all children. Despite this, there is little evidence to show that the children of unmarried mothers receive the rights guaranteed them by law, or that the birth parents and caregivers are even aware of those rights.

Pseudocyesis in an adolescent incest survivor.

This case is an example of pseudocyesis in an incest survivor. Symptoms of pregnancy were unconsciously created by the patient to shield her from the memory of her incest and at the same time confront the reality of her abuse. Her symptoms allowed her entrance into the medical system. Once in the system, it was just a matter of time before she was referred for psychological evaluation. The authors recommend that family physicians consider incest when evaluating patients who present with pseudocyesis.