"She also had contact with the dog and also had more intensive contact with the patient when he got sick," said Dr Douglas.
Previous literature [ 13] suggests that more intensive contact may lead to a better recognition of needs.
Practitioners themselves can, of course, also titrate basal insulin, but this would involve more intensive contact with the patient than typically available in routine clinical practice.
Evidence of a possible Hawthorne effect may be supported by the finding that more intensive contact leads to lower reported quality of life.
Another possibility is that more intensive contact with study personnel led to greater awareness of the diagnosis and resultant disability, impairing perception of quality of life.
The calves are more likely because the boy's rabbits were housed in the calves' stable and therefore he had more intensive contact with the calves than with the pigs.
It is also possible that the skill levels or at least the students' confidence in their skills are in fact higher in the smaller schools, because of more opportunities to practice in hospitals and/or more intensive contact with teachers.
Also, children of 2-3 years old are likely to be in more intensive contact with the secretions of animals, which are associated with a greater possibility of BDV transmission in children than in adults [ 28].
CAU is provided by multidisciplinary MHC teams with assertive outreach elements for patients who need more intensive contact (Flexible ACT teams) and by Dutch regional institutes for Residential Care (RIRC, Dutch acronym RIBW), which support independent living in the community and offer supported housing facilities [ 29– 329.
However, manual stimulation of the udder and the teats before attachment of the milking clusters is accompanied by a more intensive contact of the potentially contaminated milkers' hands with the teat ends and may increase the risk of infection of the mammary gland.
