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In central Europe, including Germany, Telekia speciosa (heart-leaved oxeye) is a synanthropic, non-native plant species commonly grown as an ornamental plant. A powdery mildew has recently been introduced on this host in Germany. This powdery mildew has previously been assigned to Golovinomyces cichoracearum (≡ Erysiphe cichoracearum) sensu lato. Two German specimens of powdery mildew on Telekia have been sequenced and phylogenetically analysed. The analyses revealed that the German sequences obtained from the Telekia powdery mildew are identical with a sequence retrieved from Golovinomyces inulae on Pentanema salicinum (≡ Inula salicina) collected in Switzerland. Furthermore, holotype material of G. inulae, described from Korea, has been sequenced, which confirmed G. inulae as causative agent of the Telekia powdery mildew. The current distribution of G. inulae in Germany is briefly discussed including a first report of this pathogen from Austria. [ABSTRACT FROM AUTHOR]

Purpose: To determine the relationships between delivery agents'physical activity characteristics and subsequent adoption of a physical activity promotion program for community implementation.Methods: Agents responsible for county health promotion in Kansas (n = 91; 94.5% women; mean age = 43.0 +/- 11) completed interviews that assessed physical activity self-efficacy, value, and participation. Subsequent implementation of a physical activity program was monitored. The response rate was 100%.Results: Fifty-five percent of the agents met Centers for Disease Control and Prevention (CDC) recommendations for physical activity, 35% were active but did not meet CDC recommendations, and 10% were inactive. On the basis of logistic regression analysis (Wald statistic = 7.63; p < .05), agents who met recommendations were more likely to adopt the program for their county (69%) than were agents who were less active (41%) and inactive (11%).Discussion: The data suggest that increasing the proportion of delivery agents who meet the CDC recommendations for physical activity could be related with a higher proportion of communities implementing physical activity programs. [ABSTRACT FROM AUTHOR]

These are exciting times for geographers, with stimulating possibilities being offered to the discipline by various bodies of poststructural, especially deleuzian, theory. There is, however, a dearth of empirical studies utilising these opportunities, particularly in Australian geography. King Island, located in Bass Strait, is used in this article to broach some theoretical potentials. First, we introduce deleuzian theory. Second, we view King Island through three geographic representations and respective mappings. Third, we discuss the implications of lived practices, which constitute various (major and minor) geographies on and of King Island, for existing perspectives on spatial relations and linear flows between local and global scales. Lastly, we explore some recent treatments of space inflected through the work of Deleuze and Guattari, consolidating some spatial concepts and relations gleaned from King Island's cartographic moments and movements. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to assess the impact of a simulation workshop on self‐efficacy towards teaching for nurse educators in India. Additionally, we sought to revise and validate a tool to measure self‐efficacy in teaching for use with a global audience. Background: Simulation is an evidence‐based teaching and learning method and is increasingly used in nursing education globally. Introduction: As new technology and teaching methods such as simulation continue to evolve, it is important for new as well as experienced nurse educators globally to have confidence in their teaching skills and abilities. Methods: The study included (1) instrument revision, and measures of reliability and validation, (2) an 8‐h faculty development workshop intervention on simulation, (3) pre‐ and post‐survey of self‐efficacy among nurse educators, and (4) investigation of relationship between faculty socio‐demographics and degree of self‐efficacy. Results: The modified tool showed internal consistency (r = 0.98) and was validated by international faculty experts. There were significant improvements in total self‐efficacy (P < 0.001) and subscale scores among nurse educators after the simulation workshop intervention when compared to pre‐survey results. No significant relationships were found between socio‐demographic variables and degree of self‐efficacy. Discussion: Strong self‐efficacy in teaching among nurse educators is crucial for effective learning to occur. Conclusions and implications for nursing: Results indicated the simulation workshop was effective in significantly improving self‐efficacy towards teaching for nurse educators using an internationally validated tool. Implications for nursing policy: The Minister of Health in India recently called for improvements in nursing education. Introducing nursing education on simulation as a teaching method in India and globally to improve self‐efficacy among teachers is an example of a strategy towards meeting this call. [ABSTRACT FROM AUTHOR]

BACKGROUND: Twenty-three million Americans have limited English proficiency. Language barriers can have major adverse consequences in health care, but little is known about whether pharmacies provide adequate care to patients with limited English proficiency. OBJECTIVES: We sought to evaluate pharmacies' ability to provide non-English-language prescription labels, information packets, and verbal communication, and assess pharmacies' satisfaction with communication with patients who have limited English proficiency. METHODS: We used a cross-sectional, mixed-methods survey of Milwaukee County, Wisconsin, pharmacies. Survey questions addressed sociodemographic and language-service characteristics of pharmacies. A pharmacist or technician at each pharmacy was asked 45 questions by telephone, fax, or mail. The main outcome measures were the ability of pharmacies to provide non-English-language prescription labels, information packets, and verbal communication; and pharmacy satisfaction with communication with patients who have limited English proficiency. RESULTS: Of 175 pharmacies, 73% responded. Forty-seven percent of the pharmacies never/only sometimes can print non-English-language prescription labels, 54% never/only sometimes can prepare non-English-language information packets, and 64% never/only sometimes can verbally communicate in non-English languages. Eleven percent use patients' family members/friends to interpret. Only 55% were satisfied with their communication with patients who have limited English proficiency. In multivariate analyses, community pharmacies had significantly lower odds of being able to verbally communicate in non-English languages, whereas pharmacies using telephone interpreting services had significantly higher odds. Pharmacies' suggestions for improving patient communication included continuing education, producing a chain-wide list of resources, hiring bilingual staff, using telephone interpreters, analyzing translation quality/accuracy of labels and information packets, and adding more languages to pharmacy software. CONCLUSIONS: Approximately half of Milwaukee pharmacies never/only sometimes can provide non-English-language prescription labels or information packets, and approximately two thirds never/only sometimes can verbally communicate in non-English languages. One in 9 pharmacies that verbally communicate in non-English languages use patients' family members/friends to interpret. Almost half of the pharmacies are dissatisfied with their communication with patients who have limited English proficiency. Community pharmacies are less likely and pharmacies using telephone interpreting services are more likely to be able to verbally communicate in non-English languages. Study findings indicate that improvements in pharmacies' communication with patients who have limited English proficiency may result by increasing the quality and number of non-English languages in existing computer programs, hiring bilingual staff, and using telephone interpreting services when in-person interpreters are unavailable. [ABSTRACT FROM AUTHOR]

The perception of natural scenes relies on the integration of pre-existing knowledge with the immediate results of attentional processing, and what can be remembered from a scene depends in turn on how that scene is perceived and understood. However, there are conflicting results in the literature as to whether people are more likely to remember those objects that are consistent with the scene or those that are not. Moreover, whether any discrepancy between the likelihood of remembering schema-consistent or schema-inconsistent objects should be attributed to the schematic effects on attention or on memory remains unclear. To address this issue, the current study attempted to directly manipulate attention allocation by requiring participants to look at (i) schema-consistent objects, (ii) schema-inconsistent objects, or (iii) to share attention equally across both. Regardless of the differential allocation of attention or object fixation, schema-consistent objects were better recalled whereas recognition was independent of schema-consistency, but depended on task instruction. These results suggest that attention is important both for remembering low-level object properties, and information whose retrieval is not supported by the currently active schema. Specific knowledge of the scenes being viewed can result in the recall of non-fixated objects, but without such knowledge attention is required to encode sufficient detail for subsequent recognition. Our results demonstrate therefore that attention is not critical for the retrieval of objects that are consistent with a scene's schematic content. [ABSTRACT FROM AUTHOR]

The concept of family-centred care is familiar to children's nurses but needs further clarity if child and family participation is to become a reality, as Valerie Coleman and colleagues explain. [ABSTRACT FROM AUTHOR]

The partially edentulous adult offers a unique and problem-rich resource as a basis for a case-based learning scenario in clinical dentistry in the field of planning oral rehabilitation. However, there is little resource material available to help students negotiate the territory between diagnosis and treatment options of discrete conditions and treatment sequencing once decisions have been made. To address the educational void surrounding the teaching and learning of oral rehabilitation strategies, the authors have developed a CD-ROM 'Interactive Learning in Dentistry: Decision making in the oral rehabilitation of the partially edentulous adult'. The disc emphasises the distinction between 'doing' and 'planning to do' in the decision-making process. After using the disc the students should be able to apply a generic framework to formulate a custom oral rehabilitation plan for their own patient. The disc was evaluated by final-year students from the Faculty of Dentistry, University of Sydney. Response to the program was essentially positive and comments from students have impacted on further development. [ABSTRACT FROM AUTHOR]

Introduction Hip fractures are devastating injuries which incur high healthcare costs. Despite national standards and guidelines, there is substantial variation in hospital delivery of hip fracture care and in patient outcomes. This study aimed to understand organisational processes that facilitate successful delivery of hip fracture services. Method Forty qualitative interviews were conducted with healthcare professionals involved in delivering hip fracture care at four English hospitals. Interview data were supplemented with documentary analysis of 23 anonymised British Orthopaedic Association hospital-initiated peer-review reports of services. Data were analysed thematically, with themes transposed onto key components of the care pathway. Results We identified multiple aspects of service organisation that facilitated good care delivery. At admission, standardisation of training in nerve block administration impacted care delivery. During hospital stays, service delivery was improved by integrated, shared-care between orthopaedics and orthogeriatrics, and by strategies to improve trauma list efficiency. Adequately staffed orthogeriatric services and the 'right' skills and seniority mix were important to holistic care provision. Placing patients on designated hip fracture wards concentrated staff expertise. Collaborative working was achieved through multi-disciplinary team (MDT) meetings between key staff, protocols and care pathways that defined roles and responsibilities, MDT documentation, 'joined-up' IT systems within hospitals and with primary care, and shared working spaces such as shared offices and onwards. Trauma and hip fracture coordinators organised care processes and provided a valuable central point of contact within teams. Nominated leads, representing diverse specialties, worked together in MDT planning meetings to develop joint protocols, establish audit priorities, and agree shared goals. Routine, comprehensive monitoring and evaluation of service delivery, with findings shared throughout the MDT, was beneficial. Conclusion Our study has characterised potentially modifiable elements of successful hip fracture service delivery. Findings are intended to help services overcome organisational barriers towards delivery of high-quality hip fracture services. [ABSTRACT FROM AUTHOR]

Introduction Older adults who sustain a hip fracture require complex multidisciplinary care, which can challenge organisational structures within hospitals. Despite standards and guidelines, substantial variation remains in hip fracture care delivery across the UK. We aimed to determine which hospital-level organisational factors predict adverse patient outcomes in the post injury period. Method A cohort of 178,757 patients aged 60+ years in England and Wales (2016–19) who sustained a hip fracture was examined. Patient-level Hospital Episodes Statistics, National Hip Fracture Database, and mortality data were linked to metrics from 18 hospital-level organisational audits/reports/series. Multilevel models determined the organisational factors, independent of patient case-mix, associated with three patient outcomes: length of hospital stay (LOS), 30-day all-cause mortality, and emergency 30-day readmission. Results Overall LOS was mean 21 days (standard deviation, 20); 13,126 (7.3%) died within 30-days; and 25,239 (15.3%) were readmitted. 25 organisational factors independently predicted LOS: for example, a hospital's ability to promptly mobilise ≥90% of patients was associated with a 2-day (95%CI:1.3–2.7) shorter LOS, and hospitals where all patients received orthogeriatric assessment within 72 hours of admission had mean 1.5-day (95%CI:0.6–2.3) shorter LOS. Ten organisational factors independently predicted 30-day mortality: providing prompt surgery (≤36 hours from admission) to >80% patients was associated with the same 10% reduction in mortality (95%CI:4–15%), as was discussion of 'patient experience' feedback at clinical governance meetings (95%CI:5–15%). Nine organisational factors independently predicted readmission: knowledge of time from discharge to start of community therapy was associated with 17% (95%CI:9–24%) lower readmission rates. Organisational delivery of clinical governance, surgery, and physiotherapy were associated with all outcomes. Conclusion Multiple, potentially modifiable, organisational factors are associated with important patient outcomes post-hip fracture. These factors, if causal, indicate auditable components of hospital care where interventions can be targeted to reduce variability in hip fracture care delivery, to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment secondary to frontal lobe atrophy exists in 40–60% of Amyotrophic Lateral Sclerosis (ALS) cases. We aimed to determine the prevalence of frontal-lobe mediated behavioral impairment in (ALS) and to ascertain its relationship to cognitive impairment. Methods: Two-hundred and twenty five patients diagnosed with sporadic ALS were evaluated for behavioral dysfunction using the Frontal Systems Behavior Scale (FrSBe), a validated measure used to examine frontal-lobe mediated behaviors, specifically apathy, executive dysfunction and disinhibition; a total behavior score is also provided. Additionally, a subset of patients also underwent a comprehensive neuropsychological evaluation. Results: Changes in the total FrSBe scores were observed in 24.4% of the patients and 39.6% of the patients had impairment in at least one behavioral domain with symptoms of Apathy being the most common (31.1%). Cognitively impaired ALS patients had worse total ( P = 0.05) and apathy scores ( P < 0.01); however, behavioral dysfunction was also present in 16% of the cognitively intact patients. Half of the behaviorally intact patients exhibited cognitive impairment. Significant correlations were observed for performance on certain neuropsychological tests (Animal fluency, Block Design, Logical Memory I and Verbal Series Attention Test) and severity of behavioral dysfunction on certain FrSBe sub scores. Conclusions: Frontal-lobe mediated behavioral dysfunction appears to be common in ALS. Cognitively impaired ALS patients had greater behavioral dysfunction. Recognition of behavioral and cognitive dysfunction may assist health-care providers and care-givers recognize changes in decision-making capacity and treatment compliance of patients with ALS. [ABSTRACT FROM AUTHOR]

AIM: The purpose of this study was to determine if a 9-month regimen of sub-antimicrobial doxycycline (20 mg, bid) had an effect on either the intestinal or the vaginal microflora. MATERIAL AND METHODS: A total of 69 periodontally diseased subjects were randomized to receive drug or placebo control for a 9-month period. Stool specimens and vaginal swabs were collected at baseline and after 3 and 9 months of therapy. Samples were examined for total anaerobic counts, opportunistic pathogens, and doxycycline-resistant (>or=4 microg/ml) bacteria. All isolates that survived sub-culture were identified and their susceptibilities determined to six antibiotics. Analyses were performed to determine if treatment differences were present. RESULTS: The only statistically significant differences (p<0.05) between the two treatment groups occurred in the doxycycline-resistant counts at the baseline sample period for the faecal samples. This imbalance was before treatment initiation and the administration of the study drug. No between-treatment differences were detected at either the 3- or 9-month sample period either in the predominant bacterial taxa present or in their antibiotic susceptibilities. CONCLUSIONS: There was no evidence that sub-antimicrobial doxycycline treatment exerted an effect on the composition or doxycycline resistance level of either the faecal or the vaginal microflora. Copyright (c) Blackwell Munksgaard, 2005. [ABSTRACT FROM AUTHOR]

Rationale: Lesions of the orbital prefrontal cortex (OPFC) can cause pathologically impulsive behaviour in humans. Inter-temporal choice behaviour (choice between reinforcers differing in size and delay) has been proposed as a model of "impulsive choice" in animals. Objective: A quantitative method was used to analyse inter-temporal choice in rats with lesions of the OPFC and sham-lesioned control rats. Methods: Under halothane anaesthesia, rats received injections of the excitotoxin quinolinate into the OPFC (0.1 M, 0.5 µl; two injections in each hemisphere), or sham lesions (injections of the vehicle). They were trained to press two levers (A and B) for sucrose reinforcement (0.6 M) in discrete-trials schedules. In free-choice trials, a press on A resulted in delivery of 50 µl of the sucrose solution after a delay d[sub A]; a press on B resulted in delivery of 100 µl of the same solution after a delay d[sub B]. d[sub B] was increased progressively across successive blocks of six trials in each session, while d[sub A] was manipulated systematically across phases of the experiment. The indifference delay, d[sub B](50) (value of d[sub B] corresponding to 50% choice of B) was estimated for each rat in each phase. Linear functions of d[sub B](50) versus d[sub A] were derived, and the parameters of the function compared between the groups. The locations of the lesions were verified histologically at the end of the experiment. Results: In both groups, d[sub B](50) increased linearly with d[sub A] (r²>0.98 in each case). The slope of the function was significantly steeper in the lesioned group than the sham-lesioned group, whereas the intercept did not differ significantly between the groups. The brains of the lesioned rats showed extensive atrophy/gliosis of the OPFC, with sparing of the dorsolateral prefrontal cortex. Conclusions: The results indicate that lesions of the OPFC can alter inter-temporal choice, either promoting or suppressing... [ABSTRACT FROM AUTHOR]

Rationale: Lesions of the orbital prefrontal cortex (OPFC) can cause pathologically impulsive behaviour in humans. Inter-temporal choice behaviour (choice between reinforcers differing in size, delay and/or probability) has been proposed as a model of "impu>Abstract. Rationale: Lesions of the orbital prefrontal cortex (OPFC) can cause pathologically impulsive behaviour in humans. Inter-temporal choice behaviour (choice between reinforcers differing in size, delay and/or probability) has been proposed as a model of "impulsive choice" in animals. Objective: The effect of lesions of the OPFC on rats' inter-temporal choice behaviour was examined in two experiments: (1) rats chose between a smaller immediate reinforcer and a larger delayed reinforcer; (2) rats chose between a smaller certain reinforcer and a larger probabilistic reinforcer. Methods: Under halothane anaesthesia, rats received injections of the excitotoxin quinolinate into the OPFC (0.1 M, 0.5 µl, two injections in each hemisphere), or sham lesions (injections of vehicle). They were trained to press two levers (A and B) for food-pellet reinforcers in discrete-trials schedules. In free-choice trials, a press oexperiment 2, both groups showed declining choice of lever B as a function of the odds against delivery of the two-pellet reinforcer, θ (θ=[1/p]–1). The lesioned rats showed lower indifference odds (θ[sub 50] : the value of θ corresponding to 50% choice of lever B) than the sham-lesioned rats. In both experiments, the lesioned rats showed extensive atrophy of the OPFC, with sparing of the dorsolateral prefrontal cortex. Conclusions: The results show that lesions of the OPFC can promote preference for the smaller and more immediate, and the smaller and more certain of two reinforcers. The results are consistent with two interpretations: the lesion may have altered (i) the rates of delay and odds discounting, and/or (ii) sensitivity to the ratio of the sizes of... [ABSTRACT FROM AUTHOR]

Rationale: The 5-hydroxytryptamine (5-HT)[sub 1A] receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) alters temporal differentiation of behaviour on the free-operant psychophysical procedure, displacing the psychophysical curve to the left, thereby reducing the indifference point T[sub 50] . However, it is not known whether this effect of 8-OH-DPAT is mediated by an action of the drug at somatodendritic autoreceptors or at postsynaptic receptors. Objective: To compare the effects of 8-OH-DPAT on performance on the free-operant psychophysical procedure in normal (sham-lesioned) rats and in rats whose 5-HTergic pathways had been lesioned by means of intra-raphe injections of the selective neurotoxin 5,7-dihydroxytryptamine (5,7-DHT). Methods: Twelve rats received 5,7-DHT-induced lesions of the median and dorsal raphe nuclei, and twelve received sham lesions. They were trained under the free-operant psychophysical procedure to press two levers (A and B) in 50-s trials, during which reinforcement was provided intermittently for responding on A in the first half and B in the second half of the trial. Percentage responding on B (%B) was recorded in successive 5-s epochs of the trials; logistic psychophysical curves were fitted to the data from each rat for the derivation of timing indices [T[sub 50] (time corresponding to %B=50%) and Weber fraction] following treatment with acute doses of 8-OH-DPAT (25, 50, 100, 200 µg kg[sup –1] , s.c.) and saline (vehicle-alone treatment). Levels of 5-HT, 5-hydroxyindoleacetic acid (5-HIAA), noradrenaline and dopamine were measured in forebrain regions after the completion of the experiment. Results: Under the vehicle-alone condition, the lesioned group displayed a greater propensity for switching between the levers, but T[sub 50] and the Weber fraction did not differ between the groups. In both groups, 8-OH-DPAT shifted the psychophysical curve to the left, significantly reducing T[sub 50] at the ... [ABSTRACT FROM AUTHOR]

Abstract Background/objective: Subantimicrobial dose doxycycline (SDD 20 mg bid) plus scaling and root planing (SRP) significantly improved clinical attachment level (CAL) and reduced probing depth (PD) compared with placebo plus SRP in a double-blind, placebo-controlled, multicenter study of patients with adult periodontitis (AP). In a study conducted as a follow-up, the post-treatment effects of SDD were assessed in patients who completed the SRP study. Methods: The SRP study was a 9-month, active-treatment study and the follow-up was a 3-month, no-treatment study. In the SRP study, tooth sites in qualifying quadrants were scaled and root planed and patients were randomized to receive twice daily SDD 20 mg or placebo. In the follow-up, patients received no study drug; investigators and patients remained blinded to the previous treatment group assignments. Efficacy measures included the change in CAL and PD from baseline values determined at the start of the SRP study in tooth sites stratified by baseline PD (i.e., 0–3 mm, 4–6 mm, ≥7 mm). Safety was evaluated using adverse event data and the results of clinical laboratory tests, oral pathology examinations, and microbiological assessments. Results: Within each disease stratum, the incremental improvements in PD and CAL demonstrated in the SDD group over 9 months of active treatment were maintained through 3 additional months of no treatment. Treatment cessation did not result in an accelerated regression of periodontal health. No differences in the incidence of adverse events (including those related to infection) or laboratory or microbiological parameters were noted between the SDD group and the placebo group. Conclusions: The administration of SDD 20 mg bid for a period of up to 9 months is not associated with rebound effects or delayed or negative after-effects for a 3-month period after cessation of therapy. [ABSTRACT FROM AUTHOR]