A typology of drought decision making: Synthesizing across cases to understand drought preparedness and response actions

Drought is an inescapable reality in many regions, including much of the western United States. With climate change, droughts are predicted to intensify and occur more frequently, making the imperative for drought management even greater. Many diverse actors – including private landowners, business owners, scientists, non-governmental organizations (NGOs), and managers and policymakers within tribal, local, state, and federal government agencies – play multiple, often overlapping roles in preparing for and responding to drought. Managing water is, of course, one of the most important roles that humans play in both mitigating and responding to droughts; but, focusing only on “water managers” or “water management” fails to capture key elements related to the broader category of drought management. The respective roles played by those managing drought (as distinct from water managers), the interactions among them, and the consequences in particular contexts, are not well understood. Our team synthesized insights from 10 in-depth case studies to understand key facets of decision making about drought preparedness and response. We present a typology with four elements that collectively describe how decisions about drought preparedness and response are made (context and objective for a decision; actors responsible; choice being made or action taken; and how decisions interact with and influence other decisions). The typology provides a framework for system-level understanding of how and by whom complex decisions about drought management are made. Greater system-level understanding helps decision makers, program and research funders, and scientists to identify constraints to and opportunities for action, to learn from the past, and to integrate ecological impacts, thereby facilitating social learning among diverse participants in drought preparedness and response

Silence as an element of care:A meta-ethnographic review of professional caregivers’ experience in clinical and pastoral settings

Background: In interactions between professional caregivers, patients and family members at the end of life, silence often becomes more prevalent. Silence is acknowledged as integral to interpersonal communication and compassionate care but is also noted as a complex and ambiguous phenomenon. This review seeks interdisciplinary experience to deepen understanding of qualities of silence as an element of care. Aim: To search for published papers which describe professional caregivers’ experience of silence as an element of care, in palliative and other clinical, spiritual and pastoral care settings and to synthesise their findings. Design: Meta-ethnography: employing a systematic search strategy and line-of-argument synthesis. Data sources: PsycINFO and seven other cross-disciplinary databases, supplemented by hand-search, review of reference lists and citation tracking. No date range was imposed. Inclusion criteria focused on reported experience of silence in professional caregiving. Selected papers (n = 18) were appraised; none were rejected on grounds of quality. Results: International, interdisciplinary research and opinion endorses the value of silence in clinical care. As a multi-functional element of interpersonal relationships, silence operates in partnership with speech to support therapeutic communication. As a caregiving practice, silence is perceived as particularly relevant in spiritual and existential dimensions of care when words may fail. Conclusion: Experience of silence as an element of care was found in palliative and spiritual care, psychotherapy and counselling supporting existing recognition of the value of silence as a skill and practice. Because silence can present challenges for caregivers, greater understanding may offer benefits for clinical practice

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Medication Error Reporting Systems: A Survey of Canadian Intensive Care Units

ABSTRACTBackground: Patients in the intensive care unit (ICU) have complex problems and experience many medical errors. Currently, little is known about the measurement of medication errors and adverse drug events in Canadian ICUs.Objective: To investigate methods of measuring medication errors and adverse drug events in ICUs in Canada.Methods: A questionnaire was constructed and uploaded to an online survey tool, SurveyMonkey. Through the mailing list software of the Critical Care Pharmacy Specialty Network of the Canadian Society of Hospital Pharmacists, the survey was sent by e-mail to 146 pharmacists working in 79 ICUs across Canada; 2 reminder e-mails followed. The survey was open from July 18 to September 18, 2007.Results: A total of 34 individual responses were received from 31 (39%) of the 79 ICUs. Responses were from academic hospitals (11/31 [35%]), community teaching hospitals (9/31 [29%]), and community nonteaching hospitals (11/31 [35%]). Twenty-six (84%) of the 31 responding ICUs had a process for tracking medication errors and adverse drug events: non-anonymous voluntary reporting (19 or 73%), direct observation (14 or 54%), anonymous voluntary reporting (12 or 46%), chart review (6 or 23%), computerized system (3 or 12%), trigger tools (2 or 8%), pharmacist intervention (2 or 8%), and weekly ICU “safety huddles” (1 or 4%). Fourteen (54%) of the 26 ICUs that had a method of measuring medication errors and adverse drug events had implemented changes to address identified problems.Conclusions: Most respondents were measuring the frequency of medication errors and adverse drug events, but a wide variety of methods were in use. Only about half of the ICUs had implemented changes as a result of these measurements. There is an opportunity to improve standardization of the measurement of medication errors and adverse drug events in Canadian ICUs.RÉSUMÉContexte : Les patients à l’unité de soins intensifs (USI) ont des problèmes complexes et sont victimes de nombreuses erreurs médicales. On connaît actuellement peu de choses sur la mesure des erreurs de médication et des événements indésirables liés aux médicaments dans les USI au Canada.Objectif : Étudier les méthodes de mesure des erreurs de médication et des événements indésirables liés aux médicaments dans les USI au Canada.Méthodes : Un questionnaire a été élaboré et téléchargé dans l’outil de sondage en ligne, SurveyMonkey. Le sondage a été envoyé à 146 pharmaciens d’hôpitaux de 79 USI du Canada à partir du gestionnaire de liste de diffusion du Réseau de spécialistes en pharmacie des soins intensifs de la Société canadienne des pharmaciens d’hôpitaux, et ceci suivi de deux courriels de rappel. Le sondage était ouvert du 18 juillet au 18 septembre 2007.Résultats : Trente-quatre pharmaciens de 31 (39 %) des 79 USI ont répondu au sondage. Les réponses provenaient d’hôpitaux d’enseignement universitaire (11/31 ou 35 %), d’hôpitaux d’enseignement communautaires (9/31 ou 29 %) et d’hôpitaux communautaires sans vocation d’enseignement (11/31 ou 35 %). Vingt-six (84 %) des 31 USI disposaient d’un processus pour faire le suivi de erreurs de médication et des événements indésirables liés aux médicaments : les déclarations volontaires non anonymes (19 ou 73 %), les observations directes (14 ou 54 %), les déclarations volontaires anonymes (12 ou 46 %), l’examen des dossiers médicaux (6 ou 23 %), un système informatisé (3 ou 12 %), des outils d’alerte (2 ou 8 %), les interventions des pharmaciens (2 ou 8 %) et les « caucus de sécurité » hebdomadaires de l’USI (1 ou 4 %). Quatorze (54 %) des 26 USI qui disposaient d’une méthode pour mesurer les erreurs de médication et les événements indésirables liés aux médicaments avaient mis en oeuvre des changements pour rectifier les problèmes décelés.Conclusions : La plupart des répondants mesuraient la fréquence des erreurs de médication et des événements indésirables liés aux médicaments, mais utilisaient diverses méthodes. Seulement près de la moitié des USI avaient mis en oeuvre des changements par suite de ces mesures. Il y a une occasion d’améliorer la standardisation des mesures des erreurs de médication et des événements indésirables liés aux médicaments dans les USI du Canada

Producción y comercialización del queso en el municipio de Ariguaní (departamento del Magdalena)

El municipio de Ariguaní, se encuentra ubicado al sur-este del departamento del Magdalena, el cual se encuentra circundado a su vez por el norte con el municipio de Pivijay y Fundación, por el sur con el municipio de Santa Ana, por el este con el departamento del Cesar y por el oeste con los municipios de Plato y Chivolo. El objetivo básico de la investigación presente, fue descubrir y conocer los factores que en una u otra forma inciden en la disminución o aumento de la producción y comercialización del queso. Así como también las condiciones existentes por la explotación, hacer análisis que nos permitan detectar en parte, algunos de los problemas que ellos afrontan. Se analizaron algunas de las funciones de mercadeo del queso en la zona de estudio, Ariguaní; clasificadas como funciones físicas tales como almacenamiento y transporte. Se detectó que los sistemas de transporte más utilizados son: camión, tractor, burro y mulos. Se logró determinar que el 23.8% de las fincas encuestadas obtienen una producción de 800 lt diario de leche. También se determinó en este estudio, que hay fincas que producen 100 Kl de queso, que representan el 23.8% de la producción total. La existencia de ganado en la zona de Ariguaní es de 3.610 cabezas, que representan -el 100% de la zona encuestada. La variedad de pasto predominante en la región es el Angleton con el 82% del área total, siendo los pastos de menor porcentaje el Faragua y el Estrella. Se trató por consiguiente de establecer los posibles canales de comer cialización del queso en la zona de Ariguaní, el cuál detectó que quién comercializa el queso es el intermediario. El aumento y disminución de los precios se deben a la topografía de la región, ya que el municipio de Ariguaní, presenta muchos accidentes geográficos lo cual inciden en el desmejoramiento en las vías de penetración

Symbiotic and endophytic fungi as biocontrols against cocoa (Theobroma cacao L.) phytopathogens

<div><p>ABSTRACT Cocoa (Theobroma cacao L.) is a tropical tree, seriously affected by fungal diseases. To control several pathogens, biological methods are prescribed since they are friendly to the environment and easy to use. The main objective of this study was to assess the biocontrol effect of two native strains, Trichoderma viride and Botryosphaeria quercum, on phytopathogens such as Phytophthora palmivora and Moniliophtora roreri, causal agents of black pod and frosty pod rot diseases, respectively. In addition, biocontrolers were faced on potential mycotoxigenic fungi such as Aspergills flavus and Fusarium solani, which are very common on cocoa. The Bio-Control Index (BCI) was calculated to determine the in vitro biocontrol effect against the four phytopathogens. Results indicated that the best biocontrol agent of phytopathogens was B. quercum, showing BCI of 82.3%, 80.7%, 63.3% and 59.7% for each tested phytopathogen, respectively. Competition for substrate was the dominant biocontrol strategy. As to the origin of strains, those coming from the Department Norte de Santander and Santander showed the highest average inhibition percentage. This study provides an initial screening to the endophytic and antagonistic potential of fungi, specifically those capable of colonizing cocoa pods and soils. Thus, these strains can be used as an efficient biological control alternative against several known phytopathogens of cocoa in the field.</p></div

Introduction to Diagnostic Tests in NANOS NOTE

An introduction to Diagnostic Test

Development and Validation of a Pneumocystis jirovecii Real-time Polymerase Chain Reaction Assay for Diagnosis of Pneumocystis Pneumonia

BACKGROUND: Pneumocystis jirovecii (PJ), a pathogenic fungus, causes severe interstitial Pneumocystis pneumonia (PCP) among immunocompromised patients. A laboratory-developed real-time polyermase chain reaction (PCR) assay was validated for PJ detection to improve diagnosis of PCP.METHODS: Forty stored bronchoalveolar lavage (BAL) samples (20 known PJ positive [PJ+] and 20 known PJ negative [PJ−]) were initially tested using the molecular assay. Ninety-two sequentially collected BAL samples were then analyzed using an immunofluorescence assay (IFA) and secondarily tested using the PJ real-time PCR assay. Discrepant results were resolved by retesting BAL samples using another real-time PCR assay with a different target. PJ real-time PCR assay performance was compared with the existing gold standard (ie, IFA) and a modified gold standard, in which a true positive was defined as a sample that tested positive in two of three methods in a patient suspected to have PCP.RESULTS: Ninety of 132 (68%) BAL fluid samples were collected from immunocompromised patients. Thirteen of 92 (14%) BALs collected were PJ+ when tested using IFA. A total of 40 BAL samples were PJ+ in the present study including: all IFA positive samples (n=13); all referred PJ+ BAL samples (n=20); and seven additional BAL samples that were IFA negative, but positive using the modified gold standard. Compared with IFA, the PJ real-time PCR had sensitivity, specificity, and positive and negative predictive values of 100%, 91%, 65% and 100%, respectively. Compared with the modified gold standard, PJ real-time PCR had a sensitivity, specificity, and positive and negative predictive values of 100%.CONCLUSION: PJ real-time PCR improved detection of PJ in immunocompromised patients.Peer Reviewe