Small spruce leaf wasp (Pristiphora abietina Christ. 1791) – contribution to the biology of pest in the view of newly damages

Utvrđivanje bionomije i utjecaja štetnika smrekine ose listarice, Pristiphora abietina na zdravstveno stanje šumskih kultura smreke provedeno je u sastojinama Šumskoprivrednog područja „Ključko“. Istraživanjem su procjenji­va­ni i mjereni sljedeći parametri: početak, tok i kraj rojenja male smrekine ose listarice, biologija i tok nastajanja simptoma na napadnutim stablima smreke. Za ulov jedinki P. abietina korištene su žute, ljepljive, ploče. Svaka od serija za ulov imala je 10 ploča sa 20 ljepljivih površina. Ukupno je u 180 ljepljivih ploča, ulovljeno 2640 jedinki P. abietina, od toga 1903 mužjaka ili 72,1 % i 737 ženki ili 27,9%. Utvrđene su značajne štete uzrokovane ovim štetnikom na istraživanom području.Determining the impact of pest P. abietina on the health of the forest of spruce plantations was conducted in the area of ​​the Forest area „Ključko“ within the department „27“ forest management unit „Ošljak-Golaja“. Within the object of research assessed and measured the following parameters: the start, the course and the end of swarming of small spruce leaf wasp; biology of species; flux emergence of symptoms in the attacked trees spruce. To capture – catch specimens P. abietina were used yellow sticky traps for insects. Each series (18 series) had 10 with 20 traps sticky surface. A total of 180 used sticky traps. Caught a total of 2,640 individuals of P. abietina, of which 1,903 or 72.1% of males and 737 females, or 27.9%. This pest caused significant damage in this locality

Relationship between expectation management and client retention in online cognitive behavioural therapy

Background: Engaging clients from the outset of psychotherapy is important for therapeutic success. However, there is little research evaluating therapists’ initial attempts to engage clients in the therapeutic process. This article reports retrospective analysis of data from a trial of online cognitive behavioural therapy (CBT) for depression. Qualitative and quantitative methods were used to evaluate how therapists manage clients’ expectations at the outset of therapy and its relationship with client retention in the therapeutic intervention. Aims: To develop a system to codify expectation management in initial sessions of online CBT and evaluate its relationship with retention. Method: Initial qualitative research using conversation analysis identified three communication practices used by therapists at the start of first sessions: no expectation management, some expectation management, and comprehensive expectation management. These findings were developed into a coding scheme that enabled substantial inter-rater agreement (weighted Kappa = 0.78; 95% CI: 0.52 to 0.94) and was applied to all trial data. Results: Adjusting for a range of client variables, primary analysis of data from 147 clients found comprehensive expectation management was associated with clients remaining in therapy for 1.4 sessions longer than those who received no expectation management (95% CI: -0.2 to 3.0). This finding was supported by a sensitivity analysis including an additional 21 clients (1.6 sessions, 95% CI: 0.2 to 3.1). Conclusions: Using a combination of qualitative and quantitative methods, this study suggests a relationship between expectation management and client retention in online CBT for depression, which has implications for professional practice. A larger prospective study would enable a more precise estimate of retention

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

An Evaluation of the You Matter Radicalisation Awareness Programme

The ‘You Matter Radicalisation Awareness Programme’ was developed by You & Co, Victim Support’s children and young people’s programme, in partnership with SLYNCS, utilising funding from the Department for Education. Thirty Youth Champions were recruited to help co-create a package of materials to raise awareness to help prevent radicalisation for delivery to young people and parents in a range of school and community based settings. This report is a summary of an evaluation completed by the University of Central Lancashire between July 2017 and March 2018. The evaluation comprised of two discrete but inter-linked components. The first concerned the journeys and outcomes for the thirty young people (the Youth Champions) who were recruited to help co-create the materials. The second concerned the outcomes achieved for the young people in a range of school and youth based settings who were recipients of the final package itself. Ethical approval for the study was granted by the PSYSOC ethics committee at the University of Central Lancashire. You & Co is Victim Support’s programme for supporting children and young people who are victims and witnesses of crime and abuse. SLYNCS are a youth empowerment charity, providing opportunities for young people to make positive changes in their own lives, their communities and society as a whole. In addition to providing an evaluation of the programme as a whole, the University of Central Lancashire was also involved in providing some briefing and training sessions to staff from both You & Co and SLYNCS. The thirty Youth Champions were also supported by the University of Central Lancashire to complete a Level Two Institute of Leadership and Management (ILM) Award, which was specifically designed to recognise the work of young people working as leaders in their local community

Evaluation of Retinal Nerve Fiber Layer in Strabismic and Anisometropic Amblyopia

Amaç: Tek taraflı strabismik ve anizometropik ambliyopisi olan çocuklarda peripapiller retina sinir lifi tabakası (RSLT) kalınlığının optikkoherans tomografi (OKT) ile değerlendirilmesi.Gereç ve Yöntem: Tek taraflı ambliyopisi olan 50 olgu (26 erkek, 24 kadın; ortalama yaş 9,02,0 yıl) ve 25 sağlıklı olgu (14 erkek, 11 kadın; ortalama yaş 8,91,9 yıl) çalışmaya dahil edildi. Ambliyopisi olan 50 olgunun 25'inde (%50,0) strabismik ambliyopi, 25'inde (%50,0) hipermetropik anizometropik ambliyopi mevcuttu. Her olguya detaylı oftalmolojik muayene, aksiyel uzunluk ölçümü ve Spectralis OKT(Heidelberg, Germany) kullanılarak RSLT kalınlığı ölçümü yapıldı. Ambliyopik gözlerden elde edilen ölçümler olguların diğer gözleri ile vekontrol grubu ile karşılaştırıldı. Yaş, cinsiyet, kırma kusuru ve en iyi düzeltilmiş görme keskinliği değerleri de kaydedildi.Bulgular: Ambliyopik gözlerde ortalama RSLT kalınlığı (105,312,0 µm) olguların diğer gözlerine göre (102,610,9 µm) anlamlı olarakartmış bulundu (p0,001). Anizometropik ambliyopisi olan olgularda ambliyopik göz ve diğer gözden elde edilen ortalama RSLT kalınlıklarıarasında anlamlı farklılık mevcuttu (p0,001), ancak strabismik ambliyopisi olan olgularda anlamlı fark izlenmedi (p0,925). Sağlıklı kontrololgularında ortalama RSLT kalınlığı (102,29,1 µm) ile ambliyop gözlerdeki ve ambliyop olguların diğer gözlerindeki RSLT kalınlığı arasında anlamlı fark yoktu (sırasıyla p0,499 ve p0,988). Ambliyop olguların her iki gözünde ortalama RSLT kalınlığı ile aksiyel uzunluk arasında negatif korelasyon saptanırken kontrol grubunda herhangi bir korelasyon izlenmedi.Sonuç: Anizometropik ambliyopisi olan olgularda ambliyopik gözlerdeki artmış RSLT kalınlığı ambliyopide organik değişikliklerin olabileceğini düşündürmektedir. Ancak, bu varsayımı desteklemek için daha fazla sayıda hasta içeren ileri çalışmalara gereksinim vardır.Objective: To evaluate peripapillary retinal nevre fiber layer (RNFL) thickness in children with unilateral strabismic and anisometropic amblyopia using optical coherence tomography (OCT). Material and Method: Fifty patients with unilateral amblyopia (26 male, 24 female; mean age 9.0±2.0 years) and 25 healthy control subjects (14 male, 11 female; mean age 8.9±1.9 years) were enrolled in the study. Of the 50 children with amblyopia, 25 (50.0%) had strabismic amblyopia and 25 (50.0%) had hyperopic anisometropic amblyopia. Each subject underwent a detailed ophthalmologic examination, axial length measurement and RNFL thickness measurement with Spectralis OCT® (Heidelberg, Germany). The results of the amblyopic eyes were compared with the fellow eyes of the subjects and control eyes. Age, sex, refractive error, and best-corrected visual acuity were also recorded. Results: The average RNFL thickness in amblyopic eyes (105.3±12.0 µm) was significantly greater than in fellow eyes (102.6±10.9 µm) (p>0.001). In subjects with anisometropic amblyopia, the difference in the average RNFL thickness between amblyopic eyes and fellow eyes was also statistically significant (p>0.001). However, no significant difference was observed between amblyopic eyes and fellow eyes in subjects with strabismic amblyopia (p0.925). The average RNFL thickness of the healthy control subjects (102.2±9.1 µm) did not differ significantly compared with amblyopic eyes (p0.499) and fellow eyes (p0.988). Axial length was negatively correlated with average RNFL thickness in amblyopic eyes and fellow eyes but not in control eyes. Conclusion: The increased RNFL thickness of the amblyopic eyes in patients with anisometropic amblyopia may suggest the existence of organic changes in amblyopia. However, further studies involving more subjects are warranted to support this hypothesis

A Prospective Observational Study to Assess the Impact of Pharmacogenetics on Outcomes in Vascular Surgery (PROSPER)

Introduction Patients with chronic limb threatening ischaemia (CLTI) are often prescribed clopidogrel in order to reduce their risk of major adverse limb and cardiovascular events. Clopidogrel is metabolised by the CYP2C19 enzyme, and genetics variations in CYP2C19 are common. These variants can influence an individual’s ability to metabolise clopidogrel to its active metabolite. This work aims to establish the relationship between patient genotype and outcomes after revascularisation in patients with CLTI who are prescribed clopidogrel. It will consider whether pharmacogenetics can be used to ensure patients are prescribed effective medications to optimise their outcomes.Methods and analysis This is a prospective observational cross-sectional study of patients undergoing lower limb surgical, endovascular or hybrid revascularisation for CLTI. Patients taking clopidogrel post-procedure, as well as those prescribed a non-clopidogrel based medication regimen, will be recruited prior to or shortly after revascularisation. Patients will undergo CYP2C19 genotyping and will be followed-up using online records

Can beta2-adrenoceptor agonists, anticholinergic drugs, and theophylline contribute to the control of pulmonary inflammation and emphysema in COPD?

Chronic obstructive pulmonary disease (COPD) has become a global epidemic disease with an increased morbidity and mortality in the world. Inflammatory process progresses and contributes to irreversible airflow limitation. However, there is no available therapy to better control the inflammatory progression and therefore to reduce the exacerbations and mortality. Thus, the development of efficient anti-inflammatory therapies is a priority for patients with COPD. beta(2) -Adrenoceptor agonists and anticholinergic agents are widely used as first line drugs in management of COPD because of their efficient bronchodilator properties. At present, many studies in vitro and some data obtained in laboratory animals reveal the potential anti-inflammatory effects of these bronchodilators but their protective role against chronic inflammation and the development of emphysema in patients with COPD remains to be investigated. The anti-inflammatory effects of theophylline at low doses have also been identified. Beneficial interactions between glucocorticoids and bronchodilators have been reported, and signaling pathways explaining these synergistic effects begin to be understood, especially for theophylline. Recent data demonstrating interactions between anticholinergics with beta(2) -adrenoceptor agonists aiming to better control the pulmonary inflammation and the development of emphysema in animal models of COPD justify the priority to investigate the interactive effects of a tritherapy associating corticoids with the two main categories of bronchodilators

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)