The impact of infrared beak treatment on turkey tom and hen beak length and performance to 12 weeks of age.

Controlling injurious pecking in commercial turkeys remains a significant challenge to producers and the industry. Infrared beak treatment is an effective method of controlling injurious pecking in chickens; however, the effects of infrared beak treatment on turkey performance are still largely unknown. Two experiments were conducted to determine the impact of infrared beak treatment on the beak length and performance of turkeys raised to 12 wk of age.

The effect of infrared beak treatment on the welfare of turkeys reared to 12 weeks of age.

This study aimed to determine the effects of infrared beak treatment on the behavior and welfare of male and female turkeys reared to 12 wk of age. To do this, poults (236 males and 324 females) were assigned to one of 2 beak treatments: infrared beak treated on day of hatch (IR) or sham untreated control (C). Data collected included heterophil/lymphocyte (H/L) ratio, pecking force, feather cover, behavioral expression, and beak histology.

Development of a Coccidiosis Disease Challenge Model Using a Commercially Available Live Oocyst Vaccine.

With growing cross-disciplinary collaboration among researchers, it is increasingly important to record detailed methodology to prevent the repetition of preliminary experiments. The purpose of this paper is to explain the development of a coccidiosis challenge model for the investigation of dietary interventions to coccidiosis in broiler chickens. The objectives are to select a dose of mixed species coccidial vaccine and evaluate the suitability (ability to produce a consistent, marked change) of selected response variables important to nutritional studies at different times postinfection (PI).

The influence of hospitalisation on the initiation, continuation and discontinuation of benzodiazepines and Z-drugs - an observational study.

Background And Objectives: Hospitalisation influences drug therapy in ambulatory care and this influence is generally negatively perceived. The few studies that have explored changes in benzodiazepine or sleep medication use as a function of hospitalisation failed to precisely determine the hospital's role in initiating, continuing and discontinuing these drugs on a valid basis. The aim of the study was to ascertain the overall influence of hospitalisation on the prescription of benzodiazepines and Z-drugs in outpatient care with a special focus on the role of different hospital departments and drug classes.

Medication management for people with dementia in primary care: description of implementation in the DelpHi study.

Background: As the population ages, the relative and absolute number of age-associated diseases such as dementia will increase. Evaluation of the suitability and intake of medication and pharmacological treatment is an important aspect of care for people with dementia, especially if they live at home. Regular medication reviews and systematic cooperation between physicians and pharmacists are not common in routine care.

Dementia care management: going new ways in ambulant dementia care within a GP-based randomized controlled intervention trial.

Background: Increasing prevalence of dementia is a major challenge for the German healthcare system. The study DelpHi-MV ("Dementia: life- and person-centered help in Mecklenburg-Western Pomerania") aims to implement and evaluate an innovative subsidiary support system for persons with dementia (PwDs) living at home and their caregivers.

Methods: DelpHi-MV is a GP-based cluster randomized controlled intervention trial.

Effects of a three party healthcare network on the incidence levels of drug related problems.

Background: Drug related problems (DRPs) are impairing patients' health and cause high costs. Neither delegation of home medication review nor regular pharmaceutical care are common in Germany.

Objective: We aimed to reduce several DRP by the implementation of a three party healthcare team [AGnES-practice assistant, pharmacist, general practitioner (GP)] and adherence supporting strategies (using a medication reminder chart, medication compliance aid).

Prevalence and determinants of controlled hypertension in a German population cohort.

Background: Data of the German population-based cohort SHIP (Study of Health in Pomerania) were analysed to examine treatment rates, antihypertensive substances prescribed, and the proportion of hypertensive study participants reaching target values for blood pressure as well as determinants.

Methods: The study population was defined using baseline data of the cohort (collected between 1997 and 2001). Participants with blood pressure values ≥140/90 mmHg and/or antihypertensive medication with known hypertension and participants with risk-comorbidity (diabetes, stroke, angina pectoris, and/or myocardial infarction) and blood pressure values ≥130/80 mmHg were included.

Changes in blood pressure in patients with hypertension in the context of delegated GP-home visits: a prospective implementation study.

Background: The AGnES-concept (GP-supporting, community-based, e-health-assisted, systemic intervention) includes the delegation of general practitioner (GP)-home visits to qualified practice assistants, especially in underserved areas. Most visited patients were elderly, multimorbid patients with limited mobility. We analyzed a subgroup of hypertension patients to assess the proportion of patients with controlled hypertension, the number of patients that changed between different categories of blood pressure during the project, and to identify possible determinants for these changes.

Life- and person-centred help in Mecklenburg-Western Pomerania, Germany (DelpHi): study protocol for a randomised controlled trial.

Background: The provision of appropriate medical and nursing care for people with dementia is a major challenge for the healthcare system in Germany. New models of healthcare provision need to be developed, tested and implemented on the population level. Trials in which collaborative care for dementia in the primary care setting were studied have demonstrated its effectiveness.

Cognitive impairment in primary ambulatory health care: pharmacotherapy and the use of potentially inappropriate medicine.

Objective: Drug intake is associated with a risk of drug-related problems, for example, the intake of potentially inappropriate medication (PIM), especially for cognitively impaired individuals. The proportion of PIM taken by immobile individuals, especially patients with suspicion of dementia in the AGnES studies (German: Arzt-entlastende Gemeinde-nahe E-Health-gestützte Systemische Intervention), and possible determinants were analyzed.

Methods: In a community-based, prospective cohort study in the ambulatory healthcare sector, a sample of 342 patients aged ≥65 years were screened for dementia and received a home medication review.

[Medication review for dementia patients].

Due to demographic changes we are faced with several challenges as an increasing prevalence of dementia patients. We report on a medication review of a patient with Alzheimer's disease as well as Lewy body dementia. The intake of risperidone was interrupted instead of a dose reduction which was recommended by the psychiatrist to improve mobility.

Frequency and determinants of potential drug-drug interactions in an elderly population receiving regular home visits by GPs--results of the home medication review in the AGnES-studies.

Purpose: There is limited knowledge about prevalence and determinants of potential drug-drug-interactions (pDDI) in the ambulatory health care setting. In this manuscript we analysed the prevalence and determinants of pDDI in the AGnES home visit population (GP-supporting, community-based, e-health-assisted, systemic intervention).

Methods: 779 Home-dwelling patients received an IT-supported home medication review (HMR).

[Time required and associated costs for implementation of home medication review with associated pharmaceutical and medical evaluation in the ambulatory health care sector].

Introduction: We aimed to estimate the time which is needed to conduct a home medication review (HMR) in the context of the AGnES implementation studies (AGnES=GP-supporting, community-based, e-health-assisted, systemic intervention). In a subsequent step associated costs were calculated.

Methods: IT-supported HMR were conducted by specially qualified AGnES-practice assistants to detect selected drug-related problems (DRP).

Frequency of inappropriate drugs in primary care: analysis of a sample of immobile patients who received periodic home visits.

Background: drug intake is associated with the risk of drug-related problems (DRPs), e.g. the intake of PIM.

Detection of drug related problems in an interdisciplinary health care model for rural areas in Germany.

Objective: The disparity between an increasing complexity of patients' treatment and the declining number of general practitioners (GP) require action. The AGnES-concept (general practitioner-relieving, community-based, e-health assisted, systemic intervention) is based on the delegation of original physician-activities to qualified AGnES-practice assistants. Purposes of AGnES part 1 were to determine the feasibility of community-based home medication reviews (HMR) and the establishment of a health professional network to identify drug related problems (DRP) in the domicile of elderly patients.

AGnES: supporting general practitioners with qualified medical practice personnel: model project evaluation regarding quality and acceptance.

Background: The German AGnES (community-based, e-health-assisted systemic support for primary care) project allows general practitioners (GPs) to delegate certain elements of medical care, including house calls, to qualified AGnES employees and thereby provide primary care to a larger number of patients. AGnES projects of various types have been carried out in a number of German federal states from 2005 onward. In this article, an evaluation of the AGnES projects to date is presented.

GP-support by means of AGnES-practice assistants and the use of telecare devices in a sparsely populated region in Northern Germany--proof of concept.

Background: In many rural regions in Germany, the proportion of the elderly population increases rapidly. Simultaneously, about one-third of the presently active GPs will retire until 2010. Often it is difficult to find successors for vacant GP-practices.

Pharmaceutical care for migraine and headache patients: a community-based, randomized intervention.

Background: Despite the high prevalence of headache and migraine in the general population, many people do not receive adequate medical attention and treatment.

Objective: To evaluate the effects of pharmaceutical care (defined as intensified structured counseling between patient and pharmacist, including the use of drug databases), for patients with headache or migraine, on both clinical and psychological endpoints.

Methods: A prospective, randomized, controlled intervention study was conducted using pharmacies in Northern Germany.

Mesenteric mast cell degranulation is not essential for conditioned taste aversion.

The possible role of mesenteric mast cell degranulation as the mediator of the initial UCS effects in the complex sequences leading to conditioned taste aversion (CTA) was studied. Both LiCl and Compound 48/80, a potent mast cell degranulator, produced CTA to 10% sucrose. Whereas the Compound 48/80 groups displayed massive mast cell degranulation, neither the LiCl treated nor saline control groups demonstrated any histologically determinable alterations.

Perforated viscus presenting with gas in the soft tissues (subcutaneous emphysema).

We have reviewed the spectrum of gaseous densities in the soft tissues secondary to a perforated viscus. All patients presented late and most were elderly. The most common surgical procedure was diversion of the fecal stream proximal to the perforation.