bluuebunny/crossref_metadata_2025 huggingface dataset:
Achieving Equity in Medicare Disproportionate Share Payments to Rural Hospitals: An Assessment of the Financial Impact of Recent and Proposed Changes to the Disproportionate Share Hospital Payment Formula
Authors: Sutton Janet P. , Stensland Jeffrey , Zhao Lan , Cheng Michael
Published: April 2008

Historically, the Medicare Disproportionate Share Hospital (DSH) payment program has been less favorable to rural hospitals: eligibility thresholds were higher and the payment adjustment was smaller for rural than for urban hospitals. Although the Medicare, Medicaid, and SCHIP Benefit Improvement and Protection Act (BIPA) of 2000 established a uniform low‐income threshold and increased the magnitude of the adjustment for certain small and rural hospitals as a means to promote payment equity, the DSH distribution formula continues to vary by location. This study examines how the DSH revisions mandated under BIPA are likely to affect rural hospitals' financial performance and simulates the financial impact of implementing a uniform DSH payment adjustment. Using data from the 1998 Medicare cost report and impact files, this study found that two‐thirds of both rural and urban hospitals would have qualified for DSH payments following BIPA compared with only one‐fifth of rural hospitals' and one‐half of urban hospitals prior to BIPA. Although the impact of BIPA revisions on rural hospitals' total margins were found to be modest, the financial impact of a uniform payment adjustment would be somewhat greater: rural hospitals' average total margins would have increased by 1.6 percentage points. Importantly, 20% of rural hospitals with negative total margins would have been “in the black” if rural and urban hospitals were reimbursed using the same DSH formula. These findings suggest that elimination of rural and urban disparities in DSH payment could strengthen the rural health care safety net.
Chronic Disease and Injury in an Agricultural County: The Keokuk County Rural Health Cohort Study
Authors: Merchant James A. , Stromquist Ann M. , Kelly Kevin M. , Zwerling Craig , Reynolds Stephen J. , Burmeister Leon E.
Published: April 2008

The Kevkuk County Rural Health Study (KCRHS) was designed as a 20‐year, prospective cohort study focusing on chronic disease and injury in an agricultural southeastern Iowa county. The goals of the KCRHS are to prospectively describe, measure, and analyze prevalent rural and agriculturally related adverse health outcomes and their respective risk factors and to provide the basis for future community‐based intervention programs to reduce disease and injury incidence. Methods of data collection included in‐person interviews, medical screenings, and environmental assessments of homes and farms. All households studied were rural; comparisons were made among farm, rural nonfarm, and town households, between men and women, and between smokers and nonsmokers. The present paper reports selected adult baseline data from Round 2 of this study. Residents of farm households were somewhat younger and better educated than residents of rural nonfarm and town households; smoked less; were more likely to have ridden an all‐terrain vehicle; and were more likely to report firearms in the home. Eighty‐nine percent of the men and 66% of the women engaged in farming or did so in the past. Men more often reported hearing loss, were more often overweight and obese, more often reported an injury, less often reported asthma, and less often saw a medical practitioner. Women reported poorer emotional health and higher rates of depression symptoms. The KCRHS has identified several modifiable health outcomes and risk factors as candidates for further analysis and targets for community‐based prevention and intervention programs.
Smoking, Exercise and Dietary Behaviors Among Mothers of Elementary School‐aged Children in a Rural North Carolina County
Authors: C.Tilson Elizabeth , McBride Colleen M. , B.Albright Jennifer , D.Sargent James
Published: April 2008

Tobacco use, poor diet, and physical inactivity are risk behaviors established during childhood and influenced by parents. Improving health habits of rural families poses particular challenges because resources may be limited in number and reach. To characterize the kinds of prevention programs needed by rural families, 501 surveys were mailed to caregivers of elementary school children living in a rural North Carolina county. Health behaviors, related atfitudes, and demographic characteristics were assessed. Risk behaviors were defined as eating less than 5 fruits and vegetables a day, exercising less than 20 minutes 3 times a week, and being a smoker. Two hundred and sixty‐one adults (55%) completed the surveys. Two hundred and forty‐four (93%) were female, with a mean age of 37 years, 55% had a high school or less education, 89% reported at least one risk behavior, and 57% reported 2 or more risk behaviors. Female caregivers with multiple risk behaviors had lower educational levels (p > 0.007) and placed less importance on childrens health behaviors (p > 0.009) than other caregivers. Female caregivers with multiple risk behaviors were no less confident they could change their behavior than those with only one risk behavior. The majority of female caregivers of elementary school children in this rural population engaged in and modeled multiple health risk behaviors for their children. Health promotion activities that address multiple risk factors and inmfve children are needed by young families in rural communities.
Effect of Medicare Payment on Rural Health Care Systems
Authors: McBride Timothy D. , Mueller Keith J.
Published: April 2008

Medicare payments constitute a significant share of patient‐generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in for‐service payment policy, prospects for change because of the payment to Medicare +Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment‐to‐cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare +Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.
Medicaid and Rural Health Care
Authors: Hurley Robert E. , Crawford Hershel , Praeger Sandy
Published: April 2008

The impact of Medicaid policies on systems of rural health care has typically been understood in terms of payment methods and rates. But Medicaid agencies have multifaceted influences, including service funding, promotion of access and quality, and infrastructure. We present in this article a general framework to explore these facets and examine literature that has attempted to identify and measure the impacts of the Medicaid program on rural health cure systems. While the literature is relatively sparse, there is evidence that rural health systems have been both bolstered and challenged by Medicaid policies in several areas. Several contemporary developments in Medicaid, including increased state flexibility, uneven coverage expansion, and aggressive Medicaid purchasing strategies, suggest that tensions between Medicaid policy and rural health care needs could grow in the future. These tensions provide focus for developing a research agenda that explores the intersection of Medicaid and rural concerns; a number of research questions that would be a part of this agenda are presented.
Rural Hospitals: Trends, Challenges, and. a Future Research and Policy Analysis Agenda
Authors: Moscovice Ira , Stensland Jeffrey
Published: April 2008

Previous reviews of the status of rural hospitals conclude that rural hospitals play a major role in ensuring the provision of health services in rural areas, are an essential part of the social and economic identity of rural communities, have had mixed success in their ability to respond to environmental threats, and are very sensitive to public policies due, in part, to their small size. The evolving hospital paradigm in the United States and a turbulent economic and health care environment have created an uncertain future for the rural hospital. Hospitals are being forced to shift their emphasis from filling acute inpatient care beds to providing a more diversified set of services through linkages with other institutions and provider groups. This presents challenges for rural hospitals, which often serve as the foundation for health care delivery in rural communities yet struggle to Overcome the effects of troubled local economies, shortages of health professionals, and public policy inequities. This article reviews key trends and challenges facing rural hospitals from the perspective of their structure and organization, financial sustainability, quality of care provided, and strategic linkages with other entities. It concludes with the presentation of a research and policy analysis agenda that addresses the feasibility of the role of the rural hospital as the hub or coordinator of the rural health care delivery system, the fiscal viability of the rural hospital in the post‐Balanced Budget Act period, strategies for measuring and improving the qualify of care provided by rural hospitals, and the structure and value of horizontal and vertical linkages of rural hospitals.
Developing Policies Responsive to Barriers to Health Care Among Rural Residents: WhatDo We Need to Know?
Authors: T.Slifkin Rebecca
Published: April 2008

A substantial body of research has been devoted to the subject of access to health care services for rural residents, much with the intention of shaping government policies to remove barriers or equalize the distribution of health care services. A number of programs and policies hove grown out of or been affected by access research, yet despite identifiable successes of the policy research process, barriers to health care services still exist in rural areas. This article attempts to stimulate discussion about ways that rural health researchers can build on past research on access to care. A framework for posing access questions is proposed, suggesting that access research focus on the following areas: factors that drive differences in utilization, availability, and acceptability; consumer satisfaction and an understanding of why rural consumer satisfaction has been found to be high; factors that impede access that are mutable; and services that can be shown to improve outcomes.
Behavioral Health: Setting the Rural Health Research Agenda
Authors: Hartley David , Britain Catherine , Sulzbacher Stephen
Published: April 2008

This article seeks to identify current research priorities in the area of rural behavioral health. The method for accomplishing this task begins by identifying several domains where policy has a potential to effect improvements in access or quality but has been hampered by lack of empirical knowledge. In each domain a synthesis of current research summarizes what is known and draws attention to knowledge gaps. Research questions in each domain are proposed. The policy domains are theoretically based, using a conceptual model of access to health care, with a focus on illness level (prevalence), enabling factors (the delivery system, organization and financing, the promise of telemedicine), and predisposing factors (special populations, beliefs, values, stigma).
Brief Report Trends in Childhood Drowning on U. S. Farms, 1986–1997
Authors: Adekoya Nelson
Published: April 2008

Abstract: Computerized mortality data files from the National Center for Health Statistics were analyzed to describe childhood farm drowning from 1986 through 1997. Farm drowning rates were compared to the U. S. unintentional youth drowning rates for the same period. The denominator for the calculation of rates was derived from a series of farm youth estimates published by the Bureau of Census. There were 378 childhood farm drowning cases during the study period, for an average annual rate of 2.3 deaths per 100,000 farm youth resident years. This rate is comparable to unintentional drowning rates for U. S. youth (2.2/100,000 population). Fatality rates declined 28% from 1986 through 1997 (p = 0.0024) for farm youth and 41% for U. S. youth (p = 0.0001). An average 32 farm drowning incidents occur to youth annually, making drowning a legitimate concern for farm residents and visitors.
The Effect of Undergraduate GPA Selectivity Adjustment on Pre‐interview Ranking of Rural Medical School Applicants
Authors: Gilbert Gregory Eastham , Blue Amy Victoria , Jr William Thomas Basco
Published: April 2008

Abstract: Context: The ongoing need to attract more physicians into rural practice is well documented, and medical school admission practices are a critical component of a multistep effort to produce rural practitioners. Purpose: This study was completed to evaluate whether the practice of adjusting for the selectivity of the undergraduate school attended by medical school applicants has a detrimental effect on the pre‐interview rankings of rural applicants. Methods: Applicants to the Medical University of South Carolina from 1996 through 1999 were the subjects. Applicant preinterview scores were calculated with and without the adjustment to grade point average (GPA) for selectivity. Findings: There were 2033 in‐state applicants in 1996 through 1999, and 8.5% to 9.7% were from rural areas. The selectivity adjustment resulted in 1 less rural applicant gaining an admission interview in 2 cohorts, 1 additional rural applicant gaining an admission interview in 1 cohort, and no difference in the other cohort. Conclusion: Adjusting undergraduate GPAs of medical school applicants based on undergraduate selectivity did not adversely affect the number of rural applicants offered admission interviews.
Small Town Health Care Safety Nets: Report on a Pilot Study
Authors: Taylor Pat , Blewett Lynn , Brasure Michelle , Call Kathleen Thiede , Larson Eric , Gale John , Hagogian Amy , Hart L. Gary , Hartley David , House Peter , James Mary Katherine , Ricketts Thomas
Published: April 2008

Abstract: Context: Very little is known about the health care safety net in small towns, especially in towns where there is no publicly subsidized safety‐net health care. Purpose: This pilot study of the primary care safety net in 7 such communities was conducted to start building knowledge about the rural safety net. Methods: Interviews were conducted and secondary data collected to assess the community need for safety‐net care, the health care safety‐net role of public officials, and the availability of safety‐net care at private primary care practices and its financial impact on these practices. Findings; An estimated 20% to 40% of the people in these communities were inadequately insured and needed access to affordable health care, and private primary care practices in most towns played an important role in making primary care available to them. Most of the physician practices were owned or subsidized by a hospital or regional network, though not explicitly to provide charity care. It is likely this ownership or support enabled the practices to sustain a higher level of charity care than would have been possible otherwise. In the majority of communities studied, the leading public officials played no role in ensuring access to safety‐net care. Conclusions: State and national government policy makers should consider subsidy programs for private primary care practices that attempt to meet the needs of the inadequately insured in the many rural communities where no publicly subsidized primary safety‐net care is available. Subsidies should be directed to physicians in primary care shortage areas who provide safety‐net care; this will improve safety‐net access and, at the same time, improve physician retention by bolstering physician incomes. Options include enhanced Medicare physician bonuses and grants or tax credits to support income‐related sliding fee scales.
Brief Report:Participant Satisfaction in an Adult Telehealth Education Program Using Interactive Compressed Video Delivery Methods in Rural Arkansas
Authors: Bynum Ann B. , Cranford Charles O. , Irwin Cathy A. , Denny George S.
Published: April 2008

Abstract: Context: Rural Americans have less access than their urban counterparts to health promotion information

Purpose: To assess differences in program satisfaction associated with age, gender, ethnicity, community size, and education among participants in an Arkansas adult telehealth education program that utilized interactive video technology

Methods: A program evaluation instrument was administered to a convenience sample of 2567 people who participated in the program from 1996 through 1999

Findings: The evaluation instrument demonstrated adequate internal consistency reliability (Cronbach's alpha = 0.85) and construct validity. Older adults, blacks, American Indians, and participants from smaller rural communities and with a high school degree or less had significantly greater satisfaction (P<0.001 to P = 0.03)

Conclusions: The findings suggest that socioeconomic and demographic factors can affect satisfaction with telehealth education programs
Using the Theory of Reasoned Action to Model Retention in Rural Primary Care Physicians
Authors: Feeley Thomas Hugh
Published: April 2008

Abstract: Context: Much research attention has focused on medical students', residents', and physicians' decisions to join a rural practice, but far fewer studies have examined retention of rural primary care physicians

Purpose: The current review uses Fishbein and Ajzen's Theory of Reasoned Action (TRA) to organize the literature on the predictors and correlates of retention of rural practicing physicians. TRA suggests turnover behavior is directly predicted by one's turnover intentions, which are, in turn, predicted by one's attitudes about rural practice and perceptions of salient others' (eg, spouse's) attitudes about rural practice and rural living. Methods:Narrative literature review of scholarship in predicting and understanding predictors and correlates of rural physician retention.

Findings: The TRA model provides a useful conceptual model to organize the literature on rural physician retention. Physicians' subjective norms regarding rural practice are an important source of influence in the decision to remain or leave one's position, and this relation should be more fully examined in future research
Children's Agricultural Health: Traumatic Injuries and Hazardous Inorganic Exposures
Authors: Perry Melissa J.
Published: April 2008

Abstract: Context: Farming is one of the most hazardous occupational industries in the USA, and farms pose numerous health risks for youth visiting, living in, or working in the farm environment

Purpose: This review discusses both potential traumatic injuries and hazardous inorganic exposures that are common in agricultural settings

Findings: An estimated 2 million youth under the age of 20 currently live or work on US farms. Approximately 103 farm fatalities occur in this age group each year; over 32 000 nonfatal youth injuries occurred on farms in 1998. Children working in US agriculture make up only 8% of the population of working minors overall, yet they account for 40% of work‐related fatalities among minors. Farm children and youth are also exposed to potentially harmful chemicals, such as pesticides and solvents, and many of these exposures go undetected. The long‐term health effects of exposure to pesticides or solvents are not known, but the developmental vulnerabilities of children and youth are of particular concern.

Conclusions: Clinical and epidemiologic research in pediatric populations is needed to expand the empirical data, particularly for inorganic and organic exposures, musculoskeletal trauma, skin disorders, occupation‐induced hearing loss, and psychosocial stress. Rural health professionals can work to reduce these risks to farm youth by becoming more aware of the problem, by conducting clinical and epidemiologic research, and by engaging in advocacy at state and local levels
Use of and Attitudes Toward Complementary and Alternative Medicine Among Family Practice Patients in Small Rural Illinois Communities
Authors: Herron Michael , Glasser Michael
Published: April 2008

Abstract: Context: Complementary and alternative medicine (CAM) use continues to increase in the United States. Data on rural patients' use and extent of integration of CAM with conventional medicine are lacking, although this is a population often associated with use of “folk remedies” and self‐care strategies

Purpose: To examine rural primary care patients' attitudes toward and use of CAM

Methods: A total of 176 surveys (70% response rate) were returned by patients at 5 geographically dispersed, rural Illinois family practice clinics to examine rural patients' use of, attitudes toward, and experiences with alternative medicine and providers.

Findings: Nearly two thirds of patients reported use of alternative medicine. Therapies most often used were vitamins/megavitamins, chiropractic, relaxation, and prayer/faith healing. Rural patients with more medical problems and a higher level of education were more likely to use alternative techniques. Three fifths of the patients felt that their doctor should discuss alternative medicine and therapies with them

Conclusions: Physician understanding and communication regarding CAM may be especially important in rural areas, where access to care is more limited and where there is greater reliance on the primary care physician as a “gatekeeper” for patient health
Rural‐Urban Differences in Health Care Benefits of a Community‐Based Sample of At‐Risk Drinkers
Authors: Fortney John C. , Booth Brenda M. , Kirchner JoAnn E. , Han Xiaotong
Published: April 2008

Abstract: Context: Different types of health plan costcontainment strategies (eg, gatekeeping, selective contracting, and cost‐sharing) may affect the utilization of behavioral health services differently in urban and rural areas

Purpose: This research compares the cost‐containment strategies used by the health plans of insured at‐risk drinkers residing in rural and urban areas

Methods: A screening instrument for at‐risk drinking was administered by phone to approximately 12 000 residents of 6 southern states; 442 at‐risk drinkers completed 4 interviews over a 2‐year period and consented to release insurance and medical records. Two thirds of the sample (n=294) were insured during the last 6 months of the study. In 1998, health plan characteristics were successfully collected for 217 (72.3%) of the insured at‐risk drinkers, representing 113 different health plans and 206 different policies.

Findings: Compared with urban at‐risk drinkers, rural at‐risk drinkers were significantly less likely to be enrolled in a health plan with gatekeeping policies for both behavioral health (P = 0.001), and physical health (P = 0.031). Compared with urban enrollees, rural enrollees were significantly more likely to pay deductibles (P = 0.042), to pay coinsurance for physical health services (P = 0.002), and to have limits placed on physical health services use (P = 0.067), but they were less likely to pay copayments for physical health (P = 0.046). Rural enrollees were less likely to face higher copayments (P = 0.007) and higher coinsurance (P = 0.076) for mental health than for physical health, compared to urban enrollees

Conclusions: Because rural residents were more likely to be enrolled in indemnity plans and less likely to be enrolled in health maintenance organizations, rural at‐risk drinkers were enrolled in plans that relied less on supply‐side cost‐containment strategies and more on demand‐side cost‐containment strategies targeting physical health service use, compared with their urban counterparts. Rural at‐risk drinkers were less likely to be enrolled in health plans with greater cost‐sharing for mental health than for physical health compared to urban at‐risk drinkers
Attitudes of Family Physicians in Washington State Toward Physician‐Assisted Suicide
Authors: Hart L. Gary , Norris Thomas E. , Lishner Denise M.
Published: April 2008

Abstract: Context: The topic of physician‐assisted suicide is difficult and controversial. With recent laws allowing physicians to assist in a terminally ill patient's suicide under certain circumstances, the debate concerning the appropriate and ethical role for physicians has intensified. Purpose: This paper utilizes data from a 1997 survey of family physicians (FPs) in Washington State to test two hypotheses: (1) older respondents will indicate greater opposition to physician‐assisted suicide than their younger colleagues, and (2) male and rural physicians will have more negative attitudes toward physician‐assisted suicide than their female and urban counterparts. Methods: A questionnaire administered to all active FPs obtained a 68% response rate, with 1074 respondents found to be eligible in this study. A ZIP code system based on generalist Health Service Areas was used to designate those practicing in rural versus urban areas. Findings: One‐fourth of the respondents overall indicated support for physician‐assisted suicide. When asked whether this practice should be legalized, 39% said yes, 44% said no, and 18% indicated that they did not know. Fifty‐eight percent of the study sample reported that they would not include physician‐assisted suicide in their practices even if it were legal. Responses disaggregated by age‐groups closely paralleled the group overall. There was a significant pattern of opposition on the part of rural male respondents compared to urban female respondents. Even among those reporting support for physician‐assisted suicide, many expressed reluctance about including it in their practices. Conclusions: These findings highlight the systematic differences in FP attitudes toward one aspect of health care by gender, rural‐urban practice location, and other factors.
Rural and Small‐Town Attitudes About Alcohol Use During Pregnancy: A Community and Provider Sample
Authors: Logan TK , Walker Robert , Nagle Laura , Lewis Jimmie , Wiesenhahn Donna
Published: April 2008

Abstract: Context: While there has been considerable research on prenatal alcohol use, there have been limited studies focused on women in rural and small‐town environments. Purpose: This 2‐part study examines gender differences in attitudes and perceived barriers to intervention in a large community sample of persons living in rural and small‐town environments in Kentucky (n = 3,346). The study also examines rural/small‐town prenatal service providers' perceptions of barriers to assessment and intervention with pregnant substance abusers (n = 138). Methods: Surveys were administered to a convenience sample of employees and customers from 16 rural and small‐town community outlets. There were 1503 males (45%) and 1843 females (55%) ranging in age from under 18 years old to over 66 years old. Surveys also were mailed to prenatal providers in county health departments of the 13‐county study area, with 138 of 149 responding. Findings: Overall results of the community sample suggest that neither males nor females were knowledgeable about the harmful effects of alcohol use during pregnancy. Results also indicate substantial gender differences in alcohol attitudes, knowledge, and perceived barriers. Further, prenatal care providers identified several barriers in assessment and treatment of pregnant women with alcohol use problems in rural and small‐town communities, including lack of knowledge and comfort with assessment as well as a lack of available and accessible treatment for referrals
Portosystemic encephalopathy in two young dogs: some additional diagnostic and therapeutic considerations
Authors: MADDISON JILL E.
Published: April 2008

Congenital portosystemic encephalopathy was diagnosed in two young dogs. A venous ammonia tolerance test was found to have limitations as a diagnostic aid in certain circumstances. Therapy with a synthetic disaccharide, lactulose, resulted in a period of clinical improvement in one dog.
Osteochondritis dissecans of the lateral ridge of the trochlea of the tibial tarsal bone in the dog
Authors: ROBINS G. M. , READ R. A. , CARLISLE C. H. , WEBB S. M.
Published: April 2008

The diagnosis and treatment of two cases of osteochondritis dissecans affecting the lateral ridge of the trochlea of the tibial tarsal bone is described. Radiographs taken in medio‐lateral and oblique projections proved to be the most valuable for diagnosis. The lesions were treated surgically via a limited cranio‐lateral approach. The lameness improved following surgery.
Laryngeal leiomyoma in a dog
Authors: LIGHTFOOT R. M. , BEDFORD P. G. C. , HAYWARD A. H. S.
Published: April 2008

Laryngoscopy and radiography demonstrated that the cause of severe dyspnoea in a middle‐aged Old English Sheepdog was obstruction of the laryngeal vestibule and glottis by a large intralaryngeal tumour. The post mortem histological examination demonstrated that the tumour was a leiomyoma, but its smooth muscle origin could not be defined with any certainty.
Primary aldosteronism (Conn's syndrome) in a cat; a case report and review of comparative aspects
Authors: EGER CLIVE E. , ROBINSON WAYNE F. , HUXTABLE CLIVE R. R.
Published: April 2008

An aged cat was presented with a history of chronic relapsing weakness and depression. Profound hypokalaemia was detected in association with increased serum aldosterone levels and marginally subnormal plasma renin activity. A diagnosis of primary aldosteronism (Conn's syndrome) was made and the cat was successfully treated for 2 ½ months with spironolactone. When renal failure developed, the cat was destroyed and at autopsy a large adrenal cortical adenocarcinoma was found.
Bacteriology of the horizontal ear canal of dogs
Authors: DICKSON D. B. , LOVE DARIA N.
Published: April 2008

Of 57 dogs included in a survey of the bacteriology of the horizontal ear canal, 31 showed clinical signs consistent with ear irritation. Twenty‐six dogs were presented for other reasons and were asymptomatic for ear irritation.

All dogs sampled were anaesthetized and sterile moistened swabs used to sample the horizontal ear canal. Swabs were introduced through a sterilized (121°C for 15 min) polypropylene otoscope cone and care was taken to prevent contamination of the cone with material from elsewhere in the ear canal. Swabs were processed within 20 min of sampling and cultures were incubated aerobically and anaerobically. Swabs from the ears of asymptomatic dogs were mixed in broth prior to plating to ensure optimal elution of small numbers of organisms from the swabs.

Very small numbers of bacteria and yeasts were isolated from asymptomatic dogs while Pseudomonas spp. and Proteus spp. were frequent isolates from symptomatic dogs with chronic irritation.

The significance of these findings is discussed in relation to the sampling and culturing techniques used in this and other surveys.
Haemophilia A in the cocker spaniel: a case report
Authors: D.Pearce R. , Cooper M. L.
Published: April 2008

A four‐year‐old entire male cocker spaniel was presented with a history of dyspnoea due to tracheal stenosis.

As part of the clinical approach, a coagulation screening profile revealed moderately reduced levels of Factor VIII procoagulant activity (VIII: C), but elevated factor VHI‐related antigen levels (VIIIR: Ag). A diagnosis of haemophilia A (classic haemophilia) was made and the tracheal stenosis attributed to a mediastinal haematoma.

The dyspnoea was alleviated by the surgical insertion of a tracheostomy tube and the dog was treated with citrated whole blood and fresh‐frozen canine plasma.

Response to treatment was excellent and follow‐up radiography three months later revealed resolution of the tracheal stenosis.
The normal endoscopic appearance of the caudal reproductive tract of the cyclic and non‐cyclic bitch: post‐uterine endoscopy
Authors: LINDSAY F. E. F.
Published: April 2008

Endoscopy of the caudal reproductive tract, or post‐uterine endoscopy, is a method of examining the mucosal aspect of the vagina and vestibule/vulva of the live bitch. In this study the post‐uterine, or caudal, reproductive tracts of forty‐five bitches of pedigree and mixed ancestry were examined endoscopically. The instrumentation and method of endoscopic examination are described. The endoscopic appearance of the mucosal aspect of the vagina, vestibule and vulva was observed during anoestrus and several phases of the sexual cycle, and in the spayed bitch. Visual records made during endoscopy were compared with the exfoliative vaginal cytology and behavioural responses. The results obtained indicate that post‐uterine endoscopy is a relatively rapid and accurate method of detecting the sexual status of the bitch, and compared well with the other methods used in this study. It is suggested post‐uterine endoscopy also has a value in allied investigative procedures or reproductive processes.
Endoscopic management of a cystic naso‐lacrimal obstruction in a dog
Authors: WHITE R. A. S. , HERRTAGE M. E. , WATKINS S. B.
Published: April 2008

A young adult Dachshund was presented with a cystic obstruction of the nasolacrimal duct causing maxillo‐turbinate destruction but no epiphora. The lesion was demonstrated by dacryocystorhinography and identified on nasal endoscopy which also permitted the successful creation of a permanent fistula without resort to invasive surgery. Histological examination of the cystic wall of the duct showed normal turbinate structures replaced by chronic inflammatory tissue.
Spinal cord degeneration in hound ataxia
Authors: PALMER A. C. , MEDD R. K. , WILKINSON G. T.
Published: April 2008

An ataxia is described in seven Foxhounds, seven Harrier hounds and two Beagle hounds, aged from 2 to 7 years. Weakness and incoordination occurred in the hind‐legs; there was no loss of deep reflexes or of conscious pain sensation. The panniculus reflex was abnormal in 75 per cent of animals examined. Pathologically, Wallerian degeneration was present in the spinal cord, especially in the cervical and thoracic levels, but the dorsal and lateral columns were largely spared. Secondary degeneration occurred in ascending tracts in the brainstem. All the animals were kept under hunt conditions and were usually fed a diet of paunch and occasional knacker meat. The cause of the condition was not established but it may be related to nutritional deficiency or to neurotoxicity.
The natural history of the major feline viral diseases
Authors: GASKELL ROSALIND M.
Published: April 2008

This paper discusses factors that are important in the natural history of five major feline viral diseases, namely, feline panleucopenia, feline viral rhinotracheitis, feline caliciviral disease, feline leukaemia virus infection, and feline infectious peritonitis. Each disease is considered in terms of the properties and infectivity of the infecting agent, the sources of infectious virus, the mode of transmission of the disease, and the methods by which the agent persists in the cat population. Finally, each disease is discussed in terms of immunity and the role of vaccination. All these factors affect the balance of the virus‐host relationship and are thus directly relevant to the epizootiology of these diseases and their control.
Feline dysautonomia (the Key‐Gaskell syndrome): a clinical and pathological study of forty cases
Authors: SHARP N. J. H. , NASH A. S. , GRIFFITHS I. R.
Published: April 2008

Feline dysautonomia is a dysfunction of the autonomic nervous system, the main features of which are dilated pupils, dry mucous membranes, mega‐oesophagus and constipation. The clinical and pathological features, treatment and follow‐up details of 40 cases seen at the University of Glasgow Veterinary School are described. The pathology was demonstrated to be mainly restricted to the autonomic ganglia and neurons in selected cranial nerve nuclei. Less marked changes were also found in neurons of the spinal cord and dorsal root ganglia. Nine cases recovered but this required up to one year and, in some, mild clinical signs persisted. Viral, toxicological and epidemiological studies were unrewarding and the aetiology is presently unknown. The similarities between this condition, grass sickness of horses and dysautonomia in the dog and man are discussed.
Clinical laboratory evaluation of deep mycotic diseases in dogs
Authors: CARAKOSTAS MICHAEL C. , MILLER RICHARD I. , GOSSETT KENT A.
Published: April 2008

A retrospective study of 27 dogs with deep mycoses was conducted to evaluate the usefulness of initial laboratory results in determining a diagnosis. Fifteen cases of disseminated blastomycosis, five cases of disseminated histoplasmosis and seven cases of gastrointestinal phycomycosis were studied. Haematologic results consistent with a chronic inflammatory disease (mild to moderate anaemia and moderate to marked monocytosis) were common findings in blastomycosis and phycomycosis. Cases of histoplasmosis were characterized by a more severe anaemia with a neutrophilia and left shift. The severe anaemia present in three out of five (3/5) dogs with histoplasmosis was apparently due to myelophthisis and intravascular erythrocyte fragmentation. Coagulation function tests and/or the haemograms suggested the presence of microangiopathic haemolysis in four dogs with histoplasmosis. Clinical chemistry results in blastomycosis and phycomycosis were usually unremarkable. Hepatic lesions in histoplasmosis were suggested by increases in serum alkaline phosphatase and decreases in serum albumin. Cytology was frequently diagnostic for blastomycosis (11/13 cases) and histoplasmosis (3/4 cases) but was inconsistent in phycomycosis (1/3 cases).
Osteochondrosis of the shoulder and elbow joints in dogs
Authors: HOULTON J. E. F.
Published: April 2008

Osteochondrosis, a failure of normal endochondral ossification, represents a significant cause of forelimb lameness in medium to large dogs. This paper describes a series of 58 cases of osteochondrosis of the shoulder and elbow diagnosed at a referral centre over a 30‐month period. Affected joints which were persistently painful were treated surgically while the non‐painful joints were treated conservatively. Details of the radiographic findings are recorded and a grading system is described to enable comparison between the surgically and conservatively treated joints. The progress of the cases was followed over a minimum period of 6 months and the majority of the dogs were re‐examined clinically and radiographically.
Clinical observations on the use of the muscle relaxant atracurium in the dog
Authors: JONES R. S. , CLUTTON R. E.
Published: April 2008

The use of the new neuromuscular blocking agent, atracurium besylate, is described in 22 dogs undergoing a variety of surgical procedures under general anaesthesia. An initial dose of 0.5 mg/kg proved effective and produced a block of 40 min duration. Incremental doses of 0.2 mg/kg were used. Reversal of the neuromuscular block by neostigmine preceded by atropine was rapid and effective. No untoward side‐effects were observed with this drug.
Splenosis in a dog
Authors: PATNAIK AMIYA K. , LIEBERMAN PHILIP H. , MACEWEN E. GREGORY
Published: April 2008

A 6‐year‐old male Rhodesian Ridgeback dog developed splenosis following splenectomy for a rupture of the spleen. The dog did well for 4 years following splenectomy but then developed progressive hepatomegaly, leading to the death of the animal. Grossly the abdomen was filled with masses of tissue arising from the liver. Multiple nodules of various sizes were seen in the remainder of the liver and attached to the mesentery, diaphragm and peritoneal wall. Histologically, the lesions contained splenic tissue consisting of both red and white pulp, and were characterized by all the normal cell elements of the spleen, including erythropoietic tissue. The proportion of red to white pulp was, however, abnormal, and the fibromuscular septae and sheath arteries were not obvious. In the smaller lesions, and in the margins of the large lesions, splenic tissue replaced the hepatic tissue except for the bile ducts. The multiple, intrahepatic nodules indicated splenic vein embolism.
Kinking of the intrathoracic caudal vena cava in five dogs
Authors: CORNELIUS LARRY , MAHAFFEY MARY
Published: April 2008

Five dogs with kinking of the intrathoracic caudal vena cava (CVC) were studied. One dog had neither clinical nor laboratory abnormalities associated with the kinked CVC, and the cause was unknown. The other four dogs had evidence of post‐sinusoidal obstruction of venous flow characterized by high protein ascites (modified transudate). Causes of the kinked CVC were automobile trauma (two dogs), cardiomegaly with ascites, and a large neoplastic lung mass. Surgical removal of the kinked caval segment was successful in the two dogs injured by automobiles. Medical therapy with a diuretic was associated with a decrease in ascites, straightening of the CVC, and improvement in clinical condition of the dog with cardiomegaly and ascites. Surgical removal of the neoplastic lung mass in one dog resulted in straightening of the CVC, but it later died of respiratory failure associated with pulmonary neoplasia.
A contrast radiographic study of the vagina and uterus of the normal bitch
Authors: ALLEN W. EDWARD , FRANCE CAROL
Published: April 2008

A method is described for investigating radiographically the shape of the bitch's vagina. The intra‐pelvic vagina is readily dilated whereas the intra‐abdominal vagina is narrow and tortuous, and cranially is typically ‘spoon‐shaped’.

Contrast medium entered the uterus during pro‐oestrus, oestrus and the post‐partum period, indicating patency of the cervix at these times. No cervical relaxation was evident at the end of the luteal phase, i.e. during anoestrus. The possible relevance of these findings to the aetiology of pyometra is discussed.
Successful removal of a heart‐base tumour in a dog with pericardial haemorrhagic effusion
Authors: BROWNLIE SERENA E. , JONES D. G. CLAYTON
Published: April 2008

This paper describes a case of pericardial haemorrhagic effusion in an eight‐year‐old Labrador Retriever bitch which presented with ascites, muffled heart sounds, a weak femoral pulse and weight loss. The successful removal of a heart‐base tumour is described.
The treatment of canine cervical disc disease by acupuncture: a review of thirty‐two cases
Authors: JANSSENS L. A. A.
Published: April 2008

The results of acupuncture treatment in 32 cases of canine cervical disc disease are reported with special reference to the outcome, follow up and recurrence. Acupuncture was an effective therapeutic method of treatment in about 70 per cent of the cervical intervertebral disc protrusions. It had no prophylactic effect on the recurrence of the symptoms.
Hydronephrosis, hydroureter and hydrometra associated with ectopic ureter in a bitch
Authors: LAPISH J. P.
Published: April 2008

A case of ectopic ureter opening into the uterus of a five‐month‐old black Labrador Retriever bitch is described. The possible embryological implications of the case are discussed.
Observations on breed and sex in relation to canine heart valve incompetence
Authors: THRUSFIELD M. V. , AITKEN C. G. G. , DARKER P. G. G.
Published: April 2008

The association between breed, sex and canine heart valve incompetence was investigated by means of an observational study of a veterinary clinic population. Odds ratio estimations revealed statistically significant positive associations between some small and medium‐sized breeds and heart valve incompetence, and significant negative associations between some large breeds and heart valve incompetence. The log odds, determined for each breed and sex, indicated that males were more susceptible than females.
Diagnosis of canine trypanosomiasis: three sites of blood collection compared
Authors: UCHE U. E.
Published: April 2008

Haematological studies on 100 dogs that were weak, anorectous and had rectal temperatures of not less than 103d̀F (39‐4d̀C) showed that 7 (7 per cent) had trypanosomes present in blood smears.

Blood collected from the tip of the tail and edge of the pinna yielded more trypanosomes than those collected via a saphenous venepuncture.

The use of a pin‐puncture on the edge of the pinna has proved the best source of blood for studies involving only the haematological demonstration of trypanosomes.
Evaluation of some drug combinations for sedation in the dog
Authors: TAYLOR POLLY M. , HERRTAGE MICHAEL E.
Published: April 2008

A double blind trial was performed in order to investigate the effects of some sedatives in the dog. One hundred and forty‐two dogs undergoing radiography for the BVA/KC hip dysplasia scheme were sedated with combinations of acepromazine with pethidine or buprenorphine, or with acepromazine alone. The degree of sedation, resistance to manipulation, sensitivity to noise and response to pain were assessed, and arterial blood samples taken for blood gas analysis. In all respects the combinations of acepromazine with buprenorphine or pethidine produced significantly better sedation than acepromazine alone. Pa02 and pH were lower and PaCO2 higher in dogs receiving the combinations compared with those receiving acepromazine alone, but all values were within normal limits. It was concluded that combinations of pethidine or buprenorphine with acpromazine provide extremely effective and safe sedation in the dog.
Pemphigus foliaceus: a report of two cases in the dog
Authors: McEWAN N. A. , McNEIL P. E. , KIRKHAM D.
Published: April 2008

The clinical and diagnostic features of two cases of pemphigus foliaceus in the dog are described. Dermatohistopathology and direct immunofluorescence examination of skin biopsies were diagnostic for pemphigus foliaceus. Both dogs required immunosuppressive dosages of prednisolone to achieve control of the condition.
Radiographic anatomy of the canine liver: simple measurements determined from the lateral radiograph
Authors: COCKETT P. A.
Published: April 2008

The literature on plain film evaluation of the canine liver is reviewed and the problems associated with radiographic hepatometry in this species and in man are outlined. Methods used to determine liver size in man are briefly described. Liver measurements obtained from lateral recumbent radiographs of 20 German Shepherd Dogs were examined statistically. The ratio of a measurement of liver length to second lumbar vertebra body length was found to be of statistical value, as was the relative position of the junction separating left medial, right medial and quadrate lobes from a further part of the right medial and left lateral lobes. The extrapolation of these results to other breeds is discussed.