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Self-directed care (SDC) models allow Home and Community Based Services (HCBS) consumers to direct their own care, thus supporting flexible, person-centered care. There are many benefits to the SDC model but access to resources is essential to successful outcomes. Considering the autonomy and flexibility associated with SDC, it is important to understand how SDC responded to the COVID-19 pandemic and the resources available to help manage this situation. We conducted 54 in-depth interviews with HCBS consumers, direct support workers, family caregivers, and providers to examine the impact of COVID-19 on HCBS services in Kansas. Findings illuminate how self-directed consumers carried a lot of employer responsibility, with limited resources and systemic barriers constraining self-determination and contributing to unmet care needs, stress, and burden. Policy flexibilities expanding the hiring of family members were beneficial but insufficient to address under-resourced working conditions and labor shortages that were exacerbated by the pandemic.

OBJECTIVE: To illustrate Black youth’s perceptions of police violence in West Louisville, Kentucky, how they make sense of it, and their responses to it. METHOD: The study used qualitative interviews with youth ages 10 to 24 residing in West Louisville. The interviews did not specifically inquire about experiences with police, but the theme emerged so strongly from the overall analysis that the current study was warranted. The research team employed a constructivist analytic approach. RESULTS: The analysis yielded two overarching themes, each with several subthemes. The first theme was Black youth experience profiling and harassment by police, with subthemes focused on youth feeling targeted, youth recognizing policing as a tactic to remove them from their community, and youth being acutely aware of police-involved violence. The second theme was Black youth’s experiences with the police cultivates mistrust and unsafety, with subthemes including police seen as more likely to harm than help, police not resolving injustices against Black people, and police presence escalating conflict in Black communities. CONCLUSIONS: Youth’s narratives regarding their experiences with police highlight the physical and psychological violence enacted by police who come into their community, supported by the law enforcement and criminal justice systems. Youth recognize systemic racism in these systems and how it affects officers’ perceptions of them. The long-term implications of persistent structural violence these youth endure has implications on their physical and mental health and wellbeing. Solutions must focus on transforming structures and systems.

Objectives. To characterize health and health-related resources in the new qualified opportunity zones (QOZs) relative to tracts not selected or not eligible for this federal investment incentive. Methods. We used tract-level data from the 498 largest cities in the contiguous United States (n = 24 409), categorized using designations from the Department of Treasury. We compiled data on population characteristics, health-related resources, and health from the American Community Survey, the National Establishment Time Series, the National Land Cover Dataset, and the US Small-Area Life Expectancy Estimates Project and the 500 Cities projects. We calculated means and SDs for ineligible, eligible (but not designated), and designated QOZ tracts. Results. In general, designated QOZ tracts had lower access to health care facilities, physical activity resources, and healthy food. They had a higher prevalence of unhealthy behaviors and worse health outcomes across most measures. Conclusions. By benchmarking conditions, we facilitate tracking and assessment of QOZ impacts. Public Health Implications. QOZ could spur unprecedented neighborhood change with substantial influence on health resources and outcomes. Public health collaboration and strategic local governance of QOZ will be crucial for yielding health benefits for existing residents.

Although community capacity has been prominent in the public health literature for nearly 20 years, the field has only operationalized a few dimensions. An intriguing dimension of capacity is a community’s ability to critically reflect. On the basis of previous research as well as theoretical and practical insights from management and organizational learning literature, we offer a process framework for critical reflexivity practice in community. The framework draws on ideas regarding cognition and agency, praxis, as well as the transformative learning model to conceptualize how reflexivity happens as an emergent community process. The implication is that reflexivity is a community-level process of making meaning of experiences that drive a common narrative. Inclusivity and establishing consensus are paramount, and can be difficult in light of power dynamics and consideration of dissenting voices and different experiences; enlightened self-interest and creating conducive spaces for dialogue are key in this process. Strengthening communities’ ability to gain and employ collective wisdom from their experience will also build their overall capacity for population health improvement.

Objectives. To measure changes in body mass index (BMI) percentiles among third- and fourth-grade students in stand-biased classrooms and traditional seated classrooms in 3 Texas elementary schools. Methods. Research staff recorded the height and weight of 380 students in 24 classrooms across the 3 schools at the beginning (2011–2012) and end (2012–2013) of the 2-year study. Results. After adjustment for grade, race/ethnicity, and gender, there was a statistically significant decrease in BMI percentile in the group that used stand-biased desks for 2 consecutive years relative to the group that used standard desks during both years. Mean BMI increased by 0.1 and 0.4 kilograms per meter squared in the treatment and control groups, respectively. The between-group difference in BMI percentile change was 5.24 (SE = 2.50; P = .037). No other covariates had a statistically significant impact on BMI percentile changes. Conclusions. Changing a classroom to a stand-biased environment had a significant effect on students’ BMI percentile, indicating the need to redesign traditional classroom environments.

• The current study is a longitudinal cohort study following stand-capable workstation intervention usage patterns in an in-situ environment.

Recently, public health has acknowledged racism as a social determinant of health. Much evidence exists on the impact of individual-level racism and discrimination, with little to no examination of racism from the standpoint of systems and structures. The purpose of this systematic literature review is to analyze the extent to which public health currently addresses systemic racism in the published literature. Utilizing the PRISMA guidelines, this review examines three widely used databases to examine published literature covering the topic as well as implications for future research and practice. A total of 85 articles were included in the review analysis after meeting study criteria. Across numerous articles, the terms racism and systemic racism are largely absent. A critical need exists for an examination of the historical impact of systemic racism on the social determinants of health and health of marginalized populations.

Objective The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework. Design The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. Setting Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities. Participants Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville. Main outcome measure(s) The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development. Results The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results. Conclusion The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to improve their community as well as their practical approaches towards leadership and equity.

Due to the increasing prevalence of childhood obesity, the association between classroom furniture and energy expenditure as well as physical activity was examined using a standing-desk intervention in three central-Texas elementary schools. Of the 480 students in the 24 classrooms randomly assigned to either a seated or stand-biased desk equipped classroom, 374 agreed to participate in a week-long data collection during the fall and spring semesters. Each participant’s data was collected using Sensewear® armbands and was comprised of measures of energy expenditure (EE) and step count. A hierarchical linear mixed effects model showed that children in seated desk classrooms had significantly lower (EE) and fewer steps during the standardized lecture time than children in stand-biased classrooms after adjusting for grade, race, and gender. The use of a standing desk showed a significant higher mean energy expenditure by 0.16 kcal/min (p < 0.0001) in the fall semester, and a higher EE by 0.08 kcal/min (p = 0.0092) in the spring semester.

Walleye (Sander vitreus) populations in Wisconsin are near the center of their geographical range and support valuable fisheries. The role of seasonal temperature and precipitation in Walleye recruitment was examined using regression tree analysis. Climatological variables were estimated at the 8 km2 scale and Walleye recruitment was estimated based on 298 individual electrofishing surveys. Estimated changes in Walleye recruitment between 1950 and 2006 were examined based on changes in explanatory climatological variables. Spring precipitation and summer maximum temperature were significant predictors of age-0 Walleye density and mean estimated changes in these variables between 1950 and 2006 were used to estimate changes in Walleye recruitment. The model predicted a small overall increase in Walleye recruitment and provides insight into the direct role of climatological variables in Walleye recruitment. However, given the low explanatory power (R2 = 0.103), it is likely that historic climatological changes have had a limited effect on recruitment levels.

We examined traditional knowledge of fire use by the Ichishikin (Sahaptin), Kitsht Wasco (Wasco), and Numu (Northern Paiute) peoples (now Confederated Tribes of Warm Springs, CTWS) in the eastside Cascades of Oregon to generate insights for restoring conifer forest landscapes and enhancing culturally-valued resources. We examined qualitative and geospatial data derived from oral history interviews, participatory GIS focus groups, archival records, and historical forest surveys to characterize cultural fire regimes (CFRs) –an element of historical fire regimes– of moist mixed conifer (MMC), dry mixed conifer (DMC), and shrub-grassland (SG) zones. Our ethnohistorical evidence indicated a pronounced cultural fire regime in the MMC zone, but not in the two drier zones. The CFR of the MMC zone was characterized by frequent (few-year recurrence), low-severity burns distributed in a shifting pattern. This regime helped to maintain forest openings created by previous ignitions, resulting from lightning or possibly human-set, that had burned large areas. The CFR was influenced by the CTWS traditional knowledge system, which consisted of four elements: fire use and associated resource tending practices, tribal ecological principles, the seasonal round (the migratory pattern to fulfill resource needs), and culture. Thinleaf huckleberry (Vaccinium membranaceum), a cultural keystone species, occurs primarily in the MMC zone and was a principle focus of traditional fire use of the CTWS peoples. Fire was deployed to maintain shrub productivity and site access for harvesting. Cessation of fire use by ∼1940 has caused a decline in huckleberry productivity throughout much of the historical harvest zone. Our findings about CFR scale show how a nested, multi-level framework (patch- and landscape-levels) may be employed to reintroduce fire and thereby promote forest restoration and enhance culturally-valued resources. Our findings also highlight the utility of engaging the communities that hold traditional knowledge in the forest management and planning process.

Background : Following a community health assessment the Brazos Valley Health Partnership (BVHP) organized to address fragmentation of services and local health needs. This regional partnership employs the fundamental principles of community-based participatory research, fostering an equitable partnership with the aim of building community capacity to address local health issues. Objectives : This article describes changes in relationships as a result of capacity building efforts in a community-academic partnership. Growth in network structure among organizations is hypothesized to be indicative of less fragmentation of services for residents and increased capacity of the BVHP to collectively address local health issues. Methods : Each of the participant organizations responded to a series of questions regarding its relationships with other organizations. Each organization was asked about information sharing, joint planning, resource sharing, and formal agreements with other organizations. The network survey has been administered 3 times between 2004 and 2009. Results : Network density increased for sharing information and jointly planning events. Growth in the complexity of relationships was reported for sharing tangible resources and formal agreements. The average number of ties between organizations as well as the strength of relationships increased. Conclusion : This study provides evidence that the community capacity building efforts within these communities have contributed to beneficial changes in interorganizational relationships. Results from this analysis are useful for understanding how a community partnership’s efforts to address access to care can strengthen a community’s capacity for future action. Increased collaboration also leads to new assets, resources, and the transfer of knowledge and skills.

This study examines associations between social capital and health outcomes with data from the 2010 Brazos Valley Health Survey (Texas) (N = 3,176). Multivariate adjusted logistic regression analysis demonstrated that poor and fair health status was inversely predicted by both high trust (adjusted OR = .67 [CI = .50–.92]) and high informal social ties (adjusted OR = .68 [CI = .49–.94]), as well as being predicted by the interaction of urban-rural and community participation (adjusted OR = 1.20 [CI = 1.02–1.40]). Mental distress was inversely predicted by high trust (adjusted OR = .51 [CI = .29–.89]) and the interaction of urban/rural and informal social ties (adjusted OR = .77 [CI = .61–.97]). Thus, whereas social capital poses general benefits in regard to improving health status and mental distress, the former benefits are greater for rural respondents, while the latter benefits are greater for urban respondents.

BACKGROUND Since July 1st, 2009 in accord with the statuary order based on the German law for infectious diseases (Infektionsschutzgesetz), MRSA in blood and liquor have to be notified to the public health authorities. The aim of this extension of the notification to report is to improve the surveillance of nosocomial infections and the prevention of nosocomial MRSA infections. In this paper data of the notifications in the year 2011 within the MDRO-Net Rhine-Main, an association of 7 public health authorities in the region, are reported in order to investigate whether the aims of the obligation for notification could be achieved. RESULTS In 2011, 138 MRSA bloodstream infections, including 1 MRSA in liquor culture, were notified to the 7 health protection authorities, resulting in an incidence rate of 5.6/100,000 inhabitants. In urban regions with more hospitals available, the incidence rate was higher than in rural districts with less medical facilities (6.9 vs. 4.4/100,000 inhabitants). Only 46 (35%) of the patients with MRSA cultured in their blood had been detected via anamnesis as patients on risk for MRSA, and 59 (45%) had been screened for MRSA on admission. The incidence rate in the different hospitals was 0.041 ± 0.031/1,000 patient days (range 0-0.145/1,000 patient days). CONCLUSIONS For the first time, data on notification of MRSA cultures in blood specimen are published from a whole MRE Network in Germany encompassing >2.1 million inhabitants. Incidence rates per 100,000 inhabitants alone do not seem adequate to cope with the aims of the obligation for notification. Instead, reference to patient days in the respective clinic enables an external comparison to other medical institutions in the region and is a better base for discussion with these institutions on improvements of surveillance, screening and hygiene.

Compared with their urban counterparts, rural populations face substantial disparities in terms of health care and health outcomes, particularly with regard to access to health services. To address ongoing inequities, community perspectives are increasingly important in identifying health issues and developing local solutions that are effective and sustainable. This article has been developed by both academic and community representatives and presents a brief case study of the evolution of a regional community of solution (COS) servicing a 7-county region called the Brazos Valley, Texas. The regional COS gave rise to multiple, more localized COSs that implemented similar strategies designed to address access to care within rural communities. The regional COS, known as the Brazos Valley Health Partnership, was a result of a 2002 health status assessment that revealed that rural residents face poorer access to health services and their care is often fragmented. Their localized strategy, called a health resource center, was created as a "one-stop shop" where multiple health and social service providers could be housed to deliver services to rural residents. Initially piloted in Madison County, the resource center model was expanded into Burleson, Grimes, and Leon Counties because of community buy-in at each of these sites. The resource center concept allowed service providers, who previously were able to offer services only in more populous areas, to expand into the rural communities because of reduced overhead costs. The services provided at the health resource centers include transportation, information and referral, and case management along with others, depending on the location. To ensure successful ongoing operations and future planning of the resource centers, local oversight bodies known as health resource commissions were organized within each of the rural communities to represent local COSs. Through collaboration with local entities, these partnerships have been successful in continuing to expand services and initiating health improvements within their rural communities.

Objectives Examined the severity of depressive symptoms and the rates of probable depression assessed by different instruments that were included in two separate surveys of residents in a predominately rural region of the United States. Method Surveys of the Brazos Valley region in south central Texas were conducted and responses to the short form of the Center for Epidemiological Studies-Depression scale (in the 2006 survey) and the Patient Health Questionnaire-9 (in the 2010 survey) were analyzed. Results Regardless of instrument used, results indicate that women and African Americans are at greater risk for depression in this underserved region, but no unique effects were found for rural residency. Implications Implications for research, assessment, program planning, and policy are discussed. Language: en

The Physical Activity and Community Engagement Project utilized a comparative case study to understand how a theoretical framework called community health development (CHD) influences community capacity. Three rural communities (cases) developed interventions using a CHD framework. Researchers collected qualitative evidence measuring capacity and the CHD process for more than 3 years. Patterns identified seven capacity constructs relevant to CHD, including community history, civic participation, leadership, skills, resources, social and interorganizational networks, and critical reflection. Community health development focuses on population health improvement and strengthening community capacity. As such, it helps communities address local priorities and equips them to address future issues.

Schools have been suggested as a viable avenue to combat childhood obesity. School administrators are sometimes faced with the conflicting demands of improving the health of their students and maintaining academic performance. Dynamic furniture such as stand-biased desks may be one way to address both academic and health demands placed on schools to prevent childhood obesity. Classrooms with stand-biased desks were compared with classrooms using traditional seated desks in 2nd, 3rd, and 4th grades. The academic engagement of 282 participants was observed in the fall and spring during one academic year. The engagement of the treatment classrooms was compared with the engagement of the control classrooms. Both groups showed general increases in their academic engagement over time. Stand-biased desks do not seem to result in adverse effects on academic engagement when used in elementary classrooms. The data suggest promising results for the use of stand-biased desks in elementary school classrooms. The resul...

In order to assist staff in recognizing patients prone to violence and guide their clinical decision-making, this study summarizes mental health inpatient unit incidents over a one-year period. Results describe demographic and clinical information for patients, and evaluate risk assessment tools currently used to predict risk. A retrospective analysis included data on patients involved in incidents and frequency matched controls. There were a total of 44 incidents, caused by 38 unique patients. A constructed model to estimate patient characteristics and risk of violent incidents included involuntary admittance (OR 2.07, 95% CI 1.05-6.11, p = 0.039), more than one admission at the facility (OR 4.18, 95% CI 1.71-10.22, p = 0.002) and Global Subjective Irritability on day one (OR 4.24, 95% CI 1.77-10.16, p = 0.001). Violent incidents on the mental inpatient unit threaten safety and disrupt the therapeutic environment. The findings may be useful in aiding clinicians to quickly recognize patients that are prone to violence.

Childhood obesity has grown into a national epidemic since the 1980s. Many school-based intervention efforts that target childhood obesity involve curriculum and programming that demands instructional time, which disincentivizes school participation. Stand-biased classrooms are an environmental intervention that promotes standing rather than sitting by utilizing standing height desks that allow students to stand during normal classroom activities. The quasi-experimental pilot study was conducted in 5 first-grade classrooms in a Texas elementary school, with 2 control classrooms, 2 treatment classrooms, and 1 classroom that was a control in the fall and treatment in the spring (to allow for within-group comparisons). This intervention has been shown effective in significantly increasing caloric expenditure. In addition, the present study reveals potential behavioral effects from standing. This article presents lessons learned from the pilot study that may prove useful for others implementing similar interventions and calls for additional research on the academic benefits of standing for students.

How can psychologists aid in addressing current disparities in accessibility to meet the mental health needs of rural areas? In this paper, we discuss an innovative partnership created between community leaders in a rural county and an APA-accredited doctoral training program and its mental health clinic at a regional Federally Qualified Health Center (FQHC) to provide mentalhealth services. We describe the efforts to build community capacity to develop the partnership and provide sustainable mental health services via teleconferencing to a remote site in a rural county. Also, to presentinitial evidence of the services’ effectiveness in alleviatingclientdistress,aswellasmeetingtheexpectationsofreferralsourcesandcommunitystakeholders, we used the Patient Health Questionnaire (PHQ), the SF-12v.2, and a qualitative community survey. We examined data from a maximum of 68 clients ( M age 5 40.5, SD 5 14.1; 48 females and 20 males); the number of available client data varied by analysis. We found that clients showed significant decreases in depressive symptoms ( M decrease 5 5.88, SD 5 7.16, p , .001) and significant increases Mental Health Composite Scores (MCS; Mincrease 511.39, SD 57.94, p ,.005). Results from the community survey revealed encouraging results as well as areas for improvement. Implications of developing community capacity for sustainable psychological services in rural areas are discussed.

Childhood obesity is a public health concern with significant health and economic impacts. We conducted a prospective experimental study in 4 classrooms in central Texas to determine the effect of desks that encourage standing rather than sitting on caloric expenditure in children. Students were monitored with calorie expenditure–measuring arm-bands worn for 10 days in the fall and spring. The treatment group experienced significant increases in calorie expenditure over the control group, a finding that has implications for policy and practice.

The Leon County Health Resource Commission sought to increase access to mental health services for their rural community. The commission formed a network of partners who collaborated to increase free transportation to mental health services outside the community and developed a telehealth-based counseling program through a counseling psychology training program. Learning opportunities emerged during the development and implementation of these activities for both the students and the community in how to successfully utilize and sustain this service. This article describes the telehealth counseling model, presents lessons learned in the process, and presents recommendations for others interested in utilizing similar strategies.

Residents’ experiences provide rich insight into the factors that drive widening social and health disparities, and those experiences are not homogeneous. Only through attending to people’s lived experiences will society begin to see these as issues of the entire community, and only by engaging residents in the process of community change can the kinds of change that are needed ever be achieved. Photovoice is a participatory qualitative research method that gives voice to participants’ experiences and perspectives while simultaneously facilitating critical consciousness-raising for social action and social change. This study employed a Photovoice process to explore experiences and perspectives of residents and people working in organizations that serve West Louisville, and to facilitate dialogue and action leading to social change. Forty-three individuals across eight groups completed the Photovoice project, representing youth, older adults, LGBTQ people, faith leaders, educators, activists, and two groups of Black men. Analysis of photos and group dialogue within and across the eight groups identified several common themes that pointed at the historical and present structural racism in the community, the city’s lack of concern for the Black community, the importance of Black history, and the need for collective community action. The public Photovoice exhibit helped inform the subsequent agenda for the city’s Center for Health Equity.

Exergames are an innovative type of physical activity that engages participants through interactive gameplay. One exergame growing in popularity is geocaching. Geocaching is a high-tech treasure hunt that uses GPS-enabled technology to locate hidden caches. Caches are hidden all over the world, and their coordinates are listed in an online forum ( Geocaching.com ). Exergames like geocaching are widely endorsed; however, there is a lot of information that still needs to be learned about why people participate in these activities.Thirty-four current geocachers were recruited from a larger geocaching study to learn about their motivations for engaging in the game. Individuals were asked to respond to a 30-minute phone interview, and 12 both consented and participated the interviews. Interviews assessed how individuals became involved in geocaching, how frequently they participated, who they went geocaching with, and their motivations behind geocaching. Interviews were recorded and then thematically coded.The majority of participants had geocached for more than 5 years and had learned about the activity through media. All 12 participants geocached at least once a week. The primary motivations behind geocaching were being outdoors, social interaction, physical activity, and relaxation. Individuals described geocaching as being part of a community. They typically made friends while geocaching or when they were on Geocaching.com and felt connected to other geocachers through their mutual interest.Geocaching and other exergames that use game-like properties to engage users, specifically though technology, have the potential to impact individual health through nontraditional methods of activity and socialization.

The authors present the results of a media documentary, Weight of the Nation, disseminated in rural communities in the Brazos Valley region of east central Texas. Researchers relied on a community-based participatory research strategy to assure community participation in the implementation and evaluation of the media documentary in rural communities. To measure the short-term effects of the documentary, the research team used a mixed-methods approach of quantitative panel data from a pre/post survey, qualitative meeting notes, and observations from facilitated discussion groups. Results showed short-term increases in behavioral intention, as well as an increase in self and collective efficacy of participants to make healthy changes at individual and community levels to reduce obesity. The findings suggest that Weight of the Nation is a catalyst for increasing awareness about obesity and initiating changes in intention and efficacy perceptions.

Comparisons of habitat use to availability suggested that cover and low velocity refugia were preferentially selected by channel catfish (Ictalurus punctatus) in the Red River of the North. We did not find greater depth to be selected as has been suggested in other studies; however, we examined only summer, daytime habitat use. We defined habitat variables as being selected when used by radio-tagged channel catfish in greater proportion than available in the environment. Channel catfish selected habitat with greater cover density and percent cover (two-six cover structures and 10–40% cover by area) and lesser velocity (< 0.6 m/s) and distance to cover (often < 10 m). It appeared that cover, primarily in the form of large woody debris, was important habitat for channel catfish and is necessary for conservation. It is likely that lower velocities associated with cover result in substantial reduction in the energetic cost of holding position in lotic systems.

Both Altfeld (1984) and Morrow (1991) offer theoretical foundations that explain why alliances form. Security concerns and autonomy desires are the driving force for the pursuit of allies. While this response explains why states become allies, it does not address which do. To explain with which potential allies states choose to share alliance membership, I construct a three‐dimensional space in which security, autonomy, and political system structure are each represented as one of the three dimensions of ally choice. Every state that shared alliance membership with any other given state from 1946–1992, on a yearly basis, is assigned a unique, tri‐component point in the three‐dimensional space. The distances in the space between each state and all other states’ tri‐component points are calculated, and this distance is then incorporated into a probit estimation of ally choice. By examining the role that security and autonomy trade‐offs and level of political system structure similarity play in determining a...

The population dynamics of the silverleaf whitefly (SLWF), Bemisia argentifolii Bellows and Perring (=sweetpotato whitefly, B. tabaci Biotype “B”, [Gennadius]), and its endemic parasitoids (mostly Encarsia spp. [Aphelinidae]) were monitored in a heterogeneous cropping area, consisting of cotton, cantaloupe and kenaf (tall fiber crop). To assess the suitability of the whitefly for areawide pest management, we compared estimates of population densities using different sampling methods and determined the effects of agronomic practices on the whitefly and parasitoid populations. There was no correlation between adult SLWF estimates using sticky traps and those counted directly on the leaves. However, counts of immatures using disk subsamples were found to be good predictors of whole leaf counts. SLWF counts were low in cotton, until the harvest period of cantaloupes, which may have triggered migration from cantaloupe to cotton. The determinants of emigration from cotton were less clear. High numbers of adults were migrating well before harvest or the application of a defoliant. One likely contributing factor in triggering whitefly migration was leaf senescence. Despite rather high adult densities sampled in kenaf, populations of immature SLWF were low, suggesting that it is not a preferred host. Parasitoid populations were high in the kenaf fields, causing 20 to 80% parasitism and suggesting that kenaf could serve as a reservoir of natural enemies within a larger cropping system. Parasitism in cotton was less than that in kenaf, usually at ~10 to 15%. Encarsia spp. sampled on sticky traps indicated significant activity of the adults in the cotton and kenaf fields, and much lower numbers in the cantaloupe. Because it is a dispersive and polyphagous pest, areawide suppression of SLWF must include the consequences of farming practices and cropping patterns in heterogeneous fields, especially when they are under different management.

Since July 1st, 2009 in accord with the statuary order based on the German law for infectious diseases (Infektionsschutzgesetz), MRSA in blood and liquor have to be notified to the public health authorities. The aim of this extension of the notification to report is to improve the surveillance of nosocomial infections and the prevention of nosocomial MRSA infections. In this paper data of the notifications in the year 2011 within the MDRO-Net Rhine-Main, an association of 7 public health authorities in the region, are reported in order to investigate whether the aims of the obligation for notification could be achieved.In 2011, 138 MRSA bloodstream infections, including 1 MRSA in liquor culture, were notified to the 7 health protection authorities, resulting in an incidence rate of 5.6/100,000 inhabitants. In urban regions with more hospitals available, the incidence rate was higher than in rural districts with less medical facilities (6.9 vs. 4.4/100,000 inhabitants). Only 46 (35%) of the patients with MRSA cultured in their blood had been detected via anamnesis as patients on risk for MRSA, and 59 (45%) had been screened for MRSA on admission. The incidence rate in the different hospitals was 0.041 ± 0.031/1,000 patient days (range 0-0.145/1,000 patient days).For the first time, data on notification of MRSA cultures in blood specimen are published from a whole MRE Network in Germany encompassing2.1 million inhabitants. Incidence rates per 100,000 inhabitants alone do not seem adequate to cope with the aims of the obligation for notification. Instead, reference to patient days in the respective clinic enables an external comparison to other medical institutions in the region and is a better base for discussion with these institutions on improvements of surveillance, screening and hygiene.