Virginia POST: Improving Patient- Physician Communication about End of Life Care

Educational Objectives 1. Examine the complexities of medical decision-making at the end of life and the inadequacy of advance directives alone to affect care at the end of life. 2. Demonstrate how effective communication can facilitate medical decision-making and improve congruency between care received and patient goals, priorities, and values. 3. Discuss the National POLST Paradigm and the current status of POST in Virginia

Funkcionālās agrobioloģiskās daudzveidības pasākumu novērtēšanas metodes ābeļu dārzos Latvijā

Overview about methods to evaluate functional agrobiodiversity in apple orchards in Latvia

Functional agrobiodiversity techniques to support beneficial organisms in apple orchards of Latvia

Overview about functional agrobiodiversity techniques that are used and can be used to support beneficial organisms in apple orchards of Latvia

Investigation of European shot-hole borer, Xyleborus dispar (Coleoptera, Scolytidae), in apple orchards of Latvia

European shot-hole borer is known to occur on a wide range of deciduous trees and frequently found on fruit trees in most of the Holarctic. During the last years increased activity of this beetle contributed necessity for investigation of it in apple orchards of Latvia. Because of the latent behavior it is difficult to control distribution of Xyleborus dispar. Often insecticides are not effective, especially if not used in an appropriate time and methods of integrated or biological plant protection are needed. In the current study, results of two year monitoring of X. dispar flying activity and effectiveness of two types of sticky traps, Rebell Rosso and Csalomon Palx, bitted with 50% alcohol are presented. Four traps of each type were placed in each orchard at the beginning of May in 2013 and at the middle of April in 2014. Differences among respective orchards were recorded: the highest number of beetles was found in the largest orchard surrounded by wide deciduous forests; the lowest number was recorded in the orchard surrounded by the agricultural lands. The first emerging X. dispar female was caught at the middle of April. During the vegetation season the highest flying activity of beetles was at the end of April - beginning of May (17th – 18th week). Afterwards number and flying activity of beetles decreased and at the middle of June (25th – 26th week) reached zero. In orchard with the highest number of European shot-hole borer, significantly higher number of beetles was recorded on Rebell Rosso traps; for the rest two orchards higher number of X. dispar was recorded on Csalomon Palx traps

EcoOrchard – collecting existing knowledge and generating new knowledge on functional biodiversity of organic orchards

Organic fruit growers often suffer economic losses due to insect damages. The available natural pest control products are not always effective; and most important: many organic fruit growers would prefer not to use any pesticide at all. EcoOrchard, a CORE Organic Plus project (2015-18) aims to collect existing knowledge and generate new knowledge in order to use Functional AgroBiodiversity (FAB) successfully in orchards. This includes experimental trials in seven countries on the potential of inter-row flower strips for control of key pests and natural enemy augmentation, the establishment of the EBIO-Network as a European-wide network of stakeholders for collecting, sharing and improving scientific and practical knowledge and experience in FAB management, the development and testing of simple FAB assessment tools for use on-farm by growers and advisors, and finally, using a participatory approach to learn about potential constraints that may hamper the adoption of innovative tools and how to solve these constraints by iterative reevaluation

Mycobacterium tuberculosis acquires limited genetic diversity in prolonged infections, reactivations and transmissions involving multiple hosts

Publisher Copyright: © 2018 Herranz, Pole, Ozere, Chiner-Oms, Martínez-Lirola, Pérez-García, Gijón, Serrano, Romero, Cuevas, Comas, Bouza, Pérez-Lago and García-de-Viedma.Background: Mycobacterium tuberculosis (MTB) has limited ability to acquire variability. Analysis of its microevolution might help us to evaluate the pathways followed to acquire greater infective success. Whole-genome sequencing (WGS) in the analysis of the transmission of MTB has elucidated the magnitude of variability in MTB. Analysis of transmission currently depends on the identification of clusters, according to the threshold of variability (<5 SNPs) between isolates. Objective: We evaluated whether the acquisition of variability in MTB, was more frequent in situations which could favor it, namely intrapatient, prolonged infections or reactivations and interpatient transmissions involving multiple sequential hosts. Methods: We used WGS to analyze the accumulation of variability in sequential isolates from prolonged infections or translations from latency to reactivation. We then measured microevolution in transmission clusters with prolonged transmission time, high number of involved cases, simultaneous involvement of latency and active transmission. Results: Intrapatient and interpatient acquisition of variability was limited, within the ranges expected according to the thresholds of variability proposed, even though bursts of variability were observed. Conclusions: The thresholds of variability proposed for MTB seem to be valid in most circumstances, including those theoretically favoring acquisition of variability. Our data point to multifactorial modulation of microevolution, although further studies are necessary to elucidate the factors underlying this modulation.publishersversionPeer reviewe

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population.Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay.Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity.Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes

Organic farmers’ reality to manage functional agrobiodiversity in European organic apple orchards

According to its principles and standards, organic farming particularly rely on natural processes and functional agro-biodiversity (FAB) to benefit from essential ecosystem services. However, these processes are mostly complex, hardly visible and site-specific, thereby making it difficult to assess and manage on-farm. A European survey has been carried out among organic farmers and emphasizes the variability among countries with a diversity of techniques targeting different functional groups according to farming contexts and farmers’ expectations. The different criteria used by farmers to evaluate FABtechniques efficiency and implementation potential clearly illustrate the difficulty to assess the agroecosystem as a whole

Functional agrobiodiversity (FAB) in apple pest management in Latvia: what do we know?

A short view on functional agrobiodiversity, what do we know about it in Latvia. What do Latvian apple orchard owners think about it, what are demands in national laws and regulations. What has been done in project ECOORCHARD in this context

Funkcionālā agrobioloģiskā daudzveidība un tās paaugstināšanas pasākumu novērtēšanas metodes: 2015.gada rezultāti

Stenda ziņojums par Funkcionālo agrobioloģisko daudzveidību un tās paaugstināšanas pasākumu novērtēšanas metodēm, rezultātiem 2015.gadā