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3%)). Among perinatal factors, NRI was related to diabetes mellitus (p = .008; odds ratio = 3.290; 95% CI 1.371-7.895), twin pregnancy (p = .032; odds ratio = 2.061; 95% CI 1.062-3.998), and cesarean section (p = .036; odds ratio = 1.537; 95% CI 1.027-2.299) using multiple logistic regression analysis. Almost all infants with RIAC and RIGER, even those with severe cases, recovered until discharge. However, 93 (41.0%) infants with feeding hypoxemia needed additional feeding control after being discharged. Despite the provision of nursing guidance in feeding control, 143 (63.0%) infants experienced feeding hypoxemia continuously. The more frequently the infants experienced feeding hypoxemia, the more severe the degree of feeding hypoxemia became. Breastfeeding reduced the frequency and degree of feeding hypoxemia compared to bottle-feeding.Conclusions NRI was often observed in healthy infants. Breastfeeding and careful feeding control should be recommended to mothers of infants with repeated feeding hypoxemia.Purpose The purpose of this study was to describe the experiences of sexual relationship after a nurse-led psychosexual intervention for Indonesian cervical cancer survivors and their husbands.Design A qualitative descriptive study was conducted.Participants and methods Sixteen cervical cancer survivors and their husbands who had participated in the nurse-led psychosocial intervention were invited for semi-structured in-depth interviews. Data were analyzed using thematic analysis.Findings Four themes were identified (1) lessening suffering; (2) supporting each other to regain sexual life (2a) finding reasons to do or undo sexual intercourse, (2 b) "How can I bring back my wife's sexual desire?," (2c) "Finally, I get to a climax;" (3) getting more intimate and caring about each other, and (4) "Now I'm getting more confident." Cervical cancer survivors and their husbands experienced overall positive outcomes in their sexual and intimate relationship after a psychosexual intervention.Conclusions The psychosexual intervention helped the survivors and their husbands adapt and manage sexual dysfunction following cancer treatment. Nurses and other healthcare professionals should initiate psychosexual care by assessing the concerns and needs of women diagnosed with cervical cancer, as an integral part of their care plan.PRACTICAL RELEVANCE Skull trauma in cats, which includes fractures of the mandible and maxilla, as well as temporomandibular joint (TMJ) conditions, is frequently encountered in general practice. CLINICAL APPROACH Head trauma requires immediate attention and the initial approach should be focused on stabilisation of the patient and evaluation of the major body systems, including respiratory and cardiovascular assessment, and neurological and ophthalmic examination. The head, oral occlusion and the patient's ability to open and close the mouth should be carefully evaluated. Once the cat is stable enough for anaesthesia, diagnostic imaging is essential to assess for skull injuries. Radiography may be helpful, although some conditions may be difficult to visualise due to soft tissue and bony structure superimposition. CT is a more sensitive technique for detecting skull injuries. TREATMENT GOALS AND TECHNIQUES A variety of stabilisation techniques have been described in the feline patient, and repair goals focus on restoration of the animal's oral function, while ensuring adequate dental occlusion, minimal invasiveness and morbidity, and pain relief. Surgical repair of mandibular and maxillary fractures may variously involve interdental wiring, interarcade wiring or suture, use of interfragmentary wires, plate and screw fixation, external skeletal fixation and use of dental acrylic. Decision-making with regard to treatment options depends on dental occlusion, type and location of the fracture, fracture stability and pain. AIM This review, directed at general practitioners working with cats, describes the relevant anatomy of the feline skull, the most common mandibular, maxillary and TMJ conditions, and their recommended management.GLOBAL IMPORTANCE Leptospirosis is the most widespread zoonosis worldwide. Mammals (eg, rats, horses, cows, pigs, dogs, cats and aquatic species, such as sea lions and northern elephant seals) can all be infected by leptospires. Infection in animals occurs through contact with urine or water contaminated with the bacteria. In people, the disease is acquired mainly from animal sources or through recreational activities in contaminated water. PRACTICAL RELEVANCE Literature on the clinical presentation of leptospirosis in cats is scarce, although it has been demonstrated that cats are susceptible to infection and are capable of developing antibodies. The prevalence of antileptospiral antibodies in cats varies from 4% to 33.3% depending on the geographical location. Urinary shedding of leptospires in naturally infected cats has been reported, with a prevalence of up to 68%. Infection in cats has been associated with the consumption of infected prey, especially rodents. Thus, outdoor cats have a higher risk of becoming infected. CLINICAL CHALLENGES Clinical presentation of this disease in cats is rare and it is not known what role cats have in the transmission of leptospirosis. Ongoing work is needed to characterise feline leptospirosis. selleck AUDIENCE This review is aimed at all veterinarians, both general practitioners who deal with cats on a daily basis in private practice, as well as feline practitioners, since both groups face the challenge of diagnosing and treating infectious and zoonotic diseases. EVIDENCE BASE The current literature on leptospirosis in cats is reviewed. To date, few case reports have been published in the field, and information has mostly been extrapolated from infections in people and dogs. This review is expected to serve as a guide for the diagnosis and management of the disease in cats.IMPACT Low-cost spay-neuter clinics were first established nearly 50 years ago in response to the numbers of dogs and cats euthanized in animal shelters. Since then, high-quality, high-volume spay-neuter (HQHVSN) clinics have been established throughout the USA and have contributed to a significant reduction in animal euthanasia in shelters. These clinics, specializing in efficient systems and surgical techniques, provide an avenue for clients who cannot afford surgery to sterilize their pets. These clinics have also helped animal shelters with limited financial resources implement spay-neuter prior to adoption policies. RESPONSE The veterinary profession's reaction to HQHVSN clinics has been mixed; some practitioners question the quality of care provided or fear the loss of clientele, while others recognize the need for such clinics and support their development. CHALLENGES As veterinary education has become more expensive and veterinary care more sophisticated, the cost of veterinary care, including spay-neuter surgery, has risen.
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