Causes Of Abandonment Research Articles

Adherencia crónica al humidificador de traqueostoma en pacientes laringectomizados

Introduction and objectiveTotal laryngectomy leads to pulmonary problems such as excessive sputum production, forced expectoration and increased coughing. The use of a heat and moisture exchanger (Provox® HME) reduces these symptoms. The aim of this study was to quantify chronic adherence to HME use in laryngectomized patients. MethodsA prospective study of 115 patients laryngectomized at our centre during 2005-2011 was performed. ResultsOf the 115 patients, 90 (78.2%) used the HME consistently and 25 (21.8%) abandoned its use. The most common causes of desertion were adhesion problems due to mucus and skin irritation. Of the 30 patients with voice prostheses, 90% of them used the HME system regularly. Voice prosthesis use (P=.05) and early indication in postoperative laryngectomy (P=.001) were factors significantly associated with chronic HME use. ConclusionsThere is high adherence (78.2%) to heat and moisture exchanger (Provox® HME) use in laryngectomized patients. Chronic HME use was higher in patients with voice prosthesis and the ones with early indication in postoperative period. The major causes of abandonment were related to problems with the adhesive.

Causes, outcome and prevention of abandonment in retinoblastoma in India

The high-cure rates of 90% in retinoblastoma are not replicated in developing countries due to late presentation and poor compliance to treatment. The present study takes a closer look at causes of abandonment of therapy and effectiveness of counselling in reducing abandonment. A retrospective study of children with retinoblastoma registered at our centre from March 2008 through August 2011. Fifty (49.50%) of 101 children registered for treatment abandoned therapy. Abandonment rates were significantly higher in rural as compared to urban children (P = 0.02). There was no significant difference in rate of abandonment between stages or laterality of disease and other socio-demographic factors. Telephone calls were more effective than letters in tracing patients (31.2% vs. 2.4%). Major reasons cited behind abandonment were financial problems (30%) and unwillingness to enucleate (20%). Of the 12 children who returned and were retreated 6 (50%) died of progressive disease. Nineteen (73%) of those who did not return died at home. Abandonment rates steadily declined from 71.42% in 2008 to 16.66% in 2011 (P = 0.01) due to effective pre-abandonment counselling by a support team under the National Retinoblastoma Registry of India from 2009. Abandonment rates for children with retinoblastoma continue to be unacceptably high. Rural background, financial constraints and hesitancy to enucleate were important causes behind abandonment. Outcome of patients who abandoned treatment was uniformly dismal. Inclusion of support team and intensified initial counselling helped in improving compliance.

SÍNDROME DA ANSIEDADE DE SEPARAÇÃO (SAS) EM CÃES ATENDIDOS NO HOSPITAL VETERINÁRIO DA UNICASTELO, FERNANDÓPOLIS, SP

The separation anxiety syndrome (SAS) is defined by a group of altered behaviors showed by dogs when they are left alone, contributing for the most common behavior problems in this specie. The basic clinical signs of SAS are the following: distress vocalization (whining, barking, howling), destructiveness and house soiling. SAS reduce the animal’s life quality and is a frequent cause of abandonment and euthanasia of these dogs. The goal of this research was to verify the occurrence of SAS in dogs from Fernandopolis, SP, referred to the veterinary hospital of Unicastelo, in the period lying between december/2007 and december/2008. Seventy five animals were studied, comprising 30 (40%) adult males, 9 (12%) young males, 30 (40%) adult females and 6 (8%) young females. The dogs were evaluated through data given by the owners, according to a behavior questionnaire. From the general studied population, 35 dogs (47%) showed distress vocalization, 29 (39%) dogs showed micturition at inappropriate places, 17 (23%) dogs showed defecation at inappropriate places and 22 (29%) showed destructiveness during the periods of the owner’s absence. From the obtained results we may conclude the occurrence of SAS in 68% of the studied dogs. KEY WORDS: Dogs, animal behavior, behavior disturbances, SAS.

Pediatric Lymphoma: A 10-year Experience at a Tertiary Care Hospital in Pakistan

Lymphoma is the third most common childhood malignancy. Less information is available on this disease and its outcome from our country. We present here a single institute experience. A retrospective study was carried out at Aga Khan University Hospital, Karachi on children (<15 y) diagnosed with lymphoma from 1998 to 2007. Sixty-eight patients were identified. Fifty-one children were diagnosed as non-Hodgkin lymphoma (NHL). Mean age of presentation was 8.4 years with male-to-female ratio of 5.8 : 1. Most common histopathologic subtype of NHL was Burkitt lymphoma (55%). Abdominal mass was the main presenting feature of Burkitt and diffuse large B cell lymphoma. T-lymphoblastic lymphoma presented mainly as mediastinal mass. Ten children died, 4 secondary to tumor lysis syndrome, 5 because of disease progression, and 1 with chemotherapy-induced toxicity. One-third of the patients left without treatment. Seventeen children were diagnosed as Hodgkin lymphoma with mixed cellularity as the commonest subtype (65%). Overall survival of children with NHL and Hodgkin lymphoma was 62% and 94%, respectively. A greater proportion of NHL, advanced stage, and profound male preponderance were observed. Improvement in survival can only be achieved with increasing awareness, identifying and tackling causes of abandonment, early referral, and better supportive care.

A INFLUÊNCIA DA ANTICONCEPÇÃO HORMONAL NA SEXUALIDADE FEMININA

Os autores revisam os artigos publicados cujo objetivo principal fosse avaliar a influência da anticoncepção hormonal (AH) na sexualidade feminina. Há uma variabilidade muito grande na resposta das mulheres aos AH e ainda não há como se prever quais mulheres irão apresentar efeitos colaterais sexuais. Estes efeitos, entretanto, podem ser causa de abandono do método e, portanto, devem ser valorizados. Os AH ocasionam uma diminuição dos níveis de androgênios endógenos e, ao mesmo tempo, causam um aumento da SHBG. Essas alterações aparentemente são reversíveis após a suspensão destes medicamentos. Os AH orais contendo baixa dose de EE, 15 mcg, parecem ter um impacto negativo sobre a sexualidade, relacionado a um pior controle de ciclo e menor lubrificação vaginal. Os AH orais contendo EE 20 ou 30 mcg parecem ter boa aceitabilidade no que concerne a sexualidade. A minipílula não interfere na sexualidade feminina e o anel vaginal parece ter os melhores efeitos, aumentando as fantasias e o interesse sexual do casal. Casais com bom grau de ajustamento conjugal parecem ter maior chance de sofrer um eventual impacto negativo relacionado ao uso dos AH.

"It is me who endures but my family that suffers": social isolation as a consequence of the household cost burden of Buruli ulcer free of charge hospital treatment.

Despite free of charge biomedical treatment, the cost burden of Buruli ulcer disease (Bu) hospitalisation in Central Cameroon accounts for 25% of households' yearly earnings, surpassing the threshold of 10%, which is generally considered catastrophic for the household economy, and calling into question the sustainability of current Bu programmes. The high non-medical costs and productivity loss for Bu patients and their households make household involvement in the healing process unsustainable. 63% of households cease providing social and financial support for patients as a coping strategy, resulting in the patient's isolation at the hospital. Social isolation itself was cited by in-patients as the principal cause for abandonment of biomedical treatment. These findings demonstrate that further research and investment in Bu are urgently needed to evaluate new intervention strategies that are socially acceptable and appropriate in the local context.

The guardians' perspective on paediatric cancer treatment in Malawi and factors affecting adherence

Abandonment of paediatric cancer treatment is a common problem in developing countries. Little is known about the guardians' perspective on cancer treatment in these countries, especially the factors that affect adherence. Following a pilot study enquiring into the possible causes of abandonment, a problem analysis diagram was drawn which helped to develop the questionnaires. Semi-structured interviews (n = 83) and focus group discussions (n = 8) were held with the guardians of 25 Burkitt lymphoma patients and 7 Wilms tumour patients at different phases of therapy in Malawi. Parents in Malawi are very motivated to continue treatment if they think that it will cure their child. Financial costs are important concerns. Not all tasks at home are assumed by other household members. The diagnosis of cancer was unknown before being told about it in hospital and caused fear of recurrence and death. Guardians are reluctant to ask the health personnel questions. They worry that taking frequent blood samples will weaken their child. The side effects of the chemotherapy are seen as a proof of efficacy. It is important to appreciate the guardians' concerns when offering treatment that requires their sustained commitment. It is necessary to provide not only medical treatment, but also travel allowances and adequate nutritional support during long hospital stays to impoverished families. Information should be given proactively.

Soil penetrability as a key factor affecting the nesting of burrowing birds

AbstractSoil penetrability resistance was found to be crucial for nest site selection of all three Central European burrowing bird species—Sand Martins (Riparia riparia), European Bee‐eaters (Merops apiaster), and Eurasian Kingfishers (Alcedo atthis). Soil penetrability resistance measurements were used to find out whether increased hardness of unexcavated banks is the key factor affecting the presence of burrowing birds. All three species avoided banks composed of too compact or too loose soils. Birds discriminated not only between high‐ and low‐quality breeding banks, but also between different soil strata within banks. In banks with generally low penetrability resistance, Sand Martins preferred soil strata with the highest available penetrability resistance and compactness to avoid hole collapses. There was a preference for hard soil below holes to serve as a resistant platform when birds begin to dig their holes. In Sand Martins, the penetrability resistance level affected physical characteristics of holes such as tunnel length and dimensions of the orifices. Excessive compactness—and probably not high talus presence—was a major cause of abandonment of Sand Martin localities. A high penetrability resistance is the crucial factor for site selection in Sand Martins.

Free-roaming dogs and cats in central Italy: Public perceptions of the problem

A cross-sectional telephone survey of randomly selected households examined the extent and types of problems associated with free-roaming dogs and cats in the Teramo province of Italy. The households were sampled randomly within each municipality; municipalities were combined into coastal, central hills and mountain regions for analysis. The survey was conducted in May and June of 2004 with a response rate of 74% (397/536). Ninety percent of respondents ( N = 356) believed that free-roaming dogs and cats were a problem. They were most commonly concerned about personal safety, followed by animal welfare, public health and environmental sanitation. Sixty-nine percent of respondents (274) actually saw free-roaming dogs or cats where they live. While dogs were most commonly seen, cats were seen in greater numbers. Overall, 10% (39/297) and 5% (21/397) of respondents cared for free-roaming cats and dogs, respectively. Two-thirds of the respondents (251/397) believed that animals were abandoned because the owners lost interest. About 2/3 of respondents (251/397) reported that the community government should have the responsibility for dealing with free-roaming dogs and cats. The respondents supported the idea of building more shelters and controlling the birth rate as control measures rather than euthanizing dogs and cats. The results suggest that free-roaming dogs and cats are a very common sight in this part of Italy with substantial concerns by the residents. However, concerns about the animals’ welfare were clearly raised, supporting the laws that make it illegal to euthanize a healthy dog or cat in Italy. Using the information from this study, research on the underlying causes of abandonment of dogs and cats or failing to sterilize them should be undertaken to begin to address this problem. Further, national and regional funding must be provided to support existing laws which should help protect and eventually decrease the numbers of free-roaming and homeless dogs and cats.

Improving outcomes for children with cancer in low‐income countries in Latin America: A report on the recent meetings of the Monza International School of Pediatric Hematology/Oncology (MISPHO)‐Part I

The difference in survival for children diagnosed with cancer between high- and low-income countries (LIC) continues to widen as curative therapies are developed in the former but not implemented in the latter. In 1996, the Monza International School of Pediatric Hematology/Oncology (MISPHO) was founded in an attempt to narrow this survival gap. During its sixth and seventh meetings, members recognized the problem of lack of affordability of essential drugs to treat childhood cancer in many LIC, and initiated an advocacy program. In 1998, MISPHO spawned a collaboration of Central American pediatric oncology centers: the Asociación de Hemato-Oncología Pediátrica Centroamericana (AHOPCA). AHOPCA members reported preliminary findings from several of the 10 cooperative protocols that are currently in progress. In 2003, a second regional collaborative group was formed that includes seven centers in South America. Twinning programs between MISPHO centers and centers in high-income countries (HIC) have proven invaluable to harness the resources of these centers to improve pediatric oncology care in LIC. MISPHO educational efforts include oncology nursing, supportive care, cancer-specific updates, epidemiology, and clinical research methods. Educational efforts are facilitated by educational content and online conferencing via www.cure4kids.org. Identifying preventable causes of abandonment of therapy and documenting the nutritional status of patients treated at MISPHO centers are areas of active research.

Floodplain construction in an anastomosed river

Fluvial environments and sedimentary facies involved in the floodplain (C2a type) construction of an anastomosed river system (Upper Paraná River, Brazil) were studied. Sediment volume of floodplain deposits and sedimentation rate of each environment were obtained: channel (51.56%; 8.5 mm/yr), splay (33.85%; 1.27 mm/yr), pond (8.60%; 1.0 mm/yr), abandonment (3.64%; 3.87 mm/yr) and natural levee (3.41%; 2.34 mm/yr), reaching a total sedimentation rate average of 5.07 mm/yr. The causes of abandonment are also discussed.

Économie et société de l’Égypte romano-byzantine (IVe-VIIe siècles). À propos de quelques publications récentes

The author presents a critical overview of recent publications which bring forward both new documents and new discussions on the economic and social development of Roman and Byzantine Egypt. The agricultural accounts from Kellis modify our view of the Egyptian rural economy, and the dominant role traditionally attributed to the 'great estates'. They raise the issue of the abandonment of agricultural activity in the southern quarter of the Great Oasis, which is also the subject of an archaeo-ecological study by Bernard Bousquet at the site of Douch. Even in areas so close in place and time, the causes of abandonment may yet have been different. The reconsideration of the role of money in the late antique economy, and the reaction against the 19th century models of a 'natural economy' are reinforced, with regard to salaries, by the study by Francesco Morelli, of allocations of oil. On the question of professional 'corporations', as well as the issue of curiales, several historians have tackled the contradiction between the impressions given by the legal sources and by the papyrus documents, even when they are describing the same situation; this invites us to reconsider the ways in which these different kinds of source should be used, with more attention to their particular nature, and a more cautious approach to establishing their relationship to one another. [Author, translated by Charlotte Roueché]

Housing Abandonment in Inner Cities-The Politics of Low Demand for Housing

Abandonment of property in all housing tenures is a problem in some British inner cities, especially in the north of England. The paper outlines the causes of this phenomenon and describes some of the social problems that arise in areas containing significant quantities of abandoned property. A principal underlying cause of abandonment is low demand creating, initially, voids and vacancies in the dwelling stock and ultimately housing abandonment. The paper considers the relationship between empty stock and abandonment particularly in the social housing sector. It reviews the US and UK literature and concludes that the UK literature and research agenda is deficient in its analysis of the problem of abandonment. The paper then explores evidence of the source of the abandonment problem in the low demand for housing in some parts of the country, particularly those affected by industrial collapse. Abandonment is also explained as a case of policy failure particularly due to the housing subsidy system and the conflicting interests of central and local government. Finally, the social consequences for communities afflicted by low demand and abandonment are explored and evidence is presented of the severe impact on neighbourhood stability.

The Abandonment of the ZH‐Mozartstrasse Early Bronze Age Lake‐settlement. GIS Computer Simulation of the Lake‐level Fluctuation Hypothesis

Although ‘lake‐dwellings’ existed from the middle of the fifth millennium to the eighth century BC, the entire phenomenon was not a continuous one. There are several periods when the lake shores were abandoned and subsequently reoccupied. The pattern of occupation depends on cultural as well as environmental factors, amongst them the topography and the climate.Unlike the southern part of the Alps, which seems to have had a more regular occupational pattern throughout the Neolithic and the Bronze Age, the northern Alpine region shows a marked discontinuity along most of the lake shores. Two relevant breaks in lake‐shore occupation are known within the northern Alpine region Bronze Age. The first occurred between the 24th and the 20th centuries BC, and the second from the 15th to the middle of the 12th century BC.The Early Bronze Age site of ZH‐Mozartstrasse, situated on the western extreme of Lake Zurich (Switzerland), was abandoned immediately before the beginning of the second major occupational gap in 1503 BC. Two other Early Bronze Age sites namely Bodman‐Schachen 1 on Lake Constance, and Arbon‐Bleiche 2 on the Swiss part (the southern shore) of the same lake, follow a similar chronology in occupation; and they were both abandoned in the last decade of the 16th century BC.A possible cause of abandonment is discussed in this paper using an environmental approach related to an abrupt change of climatic conditions which resulted in an increase of the lake levels which forced those prehistoric populations to leave the proximity of the lake shores. Following the implications of pollen and sedimental analyses, the transformation of the Bronze Age landscape caused by the lake water invasion will be simulated with the help of CAD and GIS computer programs.

The Use of Continuous Peritoneal Dialysis in Europe for the Treatment of Children with End-Stage Renal Failure: Data from the EDTA Registry

The demographic data on the use of continuous peritoneal dialysis in Europe for children starting renal replacement therapy under the age of 15 years was obtained from data collected by the Registry of the European Dialysis and Transplant Association--European Renal Association (EDTA Registry) on individual patient questionnaires 1980-1986. Continuous ambulatory peritoneal dialysis (CAPD) and its variants appeared to be increasingly utilised as treatment for children with end-stage renal failure (ESRF) and accounted for approximately 25% of all renal replacement therapy (RRT). Important differences in its use in various European countries are demonstrated. The proportional contribution of CAPD to treatment was higher during the first year of RRT and gradually decreased thereafter. No significant sex differences existed in the use of this treatment. Approximately 70% of all patients on CAPD were older than 6 years of age, but it is in those under 6 years that the highest proportion are put on CAPD as first method of treatment for end-stage renal failure. The most common cause of abandonment of this treatment was peritonitis, which contributed 50% of the drop-out rate.

Child abandonment: The abandoned expression of abuse and neglect

Professional concerned with early child development and care have focused their attention on the physical maltreatment of children while excluding abandonment from the definitional sphere of abuse and neglect. At the same time there has been little cross-cultural research on child abandonment, particularly in Third World countries. The short- and long-term effects of abandonment of the child, however, may be more crippling and difficult to reverse than those resulting from physical battering or emotional neglect. Our knowledge of abandonment to date is restricted to retrospective clinical descriptions of abandoned children and their families as well as anthropological records of abandonment. Close inspection of the few existing reports in certain Non-Western cultures reveals that the abandonment of children is not limited to Western (Euro-Americanl societies. Moreover, the incidence, expression, and probable causes of abandonment show extreme variance both within and between these cultural entities. Factors contributing to abandonment may include aspects of pre- and post-natal risk, child temperament characteristics, a low quality of attachment between mother and infant, lack of caregiving skills, personality attributes of the mother and father, marital dynamics, family stress and economic difficulty. We have much to learn about how to prevent abandonment by careful examination of those cultures in which the incidence of abandonment appears to be exceptionally low. Effective intervention and prevention may also be augmented by research oriented toward the detection of high-risk abandonmentprone families, areas, and sociocultural groups.

Pollen and Archaeology at Wetherill Mesa

AbstractNine profiles of prehistoric cultural deposits at Wetherill Mesa, Mesa Verde National Park, Colorado, were analyzed for fossil pollen content. Relatively large numbers of corn (Zea) pollen occur in certain deposits of Mug House. In the alluvium retained behind low walls of two check-dams, the frequency of Zea is relatively low (.07%) but approximates the frequency of Zea pollen in soil of a garden on Chapin Mesa planted in Indian corn since 1919. Evidently, soil behind the prehistoric checkdams served as corn plots. The abundance of pollen resembling bee-weed (Cleome serrulata) suggests a more important role for the caper family in prehistoric time than would be inferred from its macrofossil record alone. The Cieome-type is common in prehistoric refuse and in human coprolite in the Four Corners area.Pollen content of matrix within a single archaeological site may vary, depending on the nature of the deposit. Although parts of their deposits overlap in time, the pollen content of (1) a trash slope, (2) a kiva, and (3) a work area within Mug House pueblo varies greatly, especially in economic pollen. Variation between profiles is reduced considerably when they are taken from the same type of deposit, that is, adjacent kivas or trash profiles.The hope that the fossil record would shed new light on the cause of abandonment of Mesa Verde was largely unrealized. The main stratigraphic event in the pollen sequence of the last 1000 years is a relative increase in juniper and pine pollen following abandonment 700 years ago. Ecologically, this rise can be explained as the result of secondary plant succession with first juniper and then pinyon invading fields when human disturbance ended. It may or may not reflect climatic change.