Aspen, Important Pests of Ornamental Spen

Aspens are one of the more popular forest trees in the Intermountain West. They add a brilliant yellow glow to the collage of fall colors. In an attempt to enjoy these beautiful trees around the home environment, many well-intentioned homeowners purchase or otherwise acquire aspens and transplant them into their landscapes. Unfortunately, aspens are not adapted to the environmental conditions of the valleys, and many problems develop

Patients' perceptions of a NHS Health Check in the primary care setting

The NHS Health Checks is a cardiovascular disease (CVD) risk assessment and management programme for individuals in England aged between 40 and 74 with the aim of identifying previously unassessed individuals that are at high risk of CVD. Little research to date has explored patient perceptions and opinions of Health Checks. This paper aims to investigate the perceptions and opinions of patients who had attended a Health Check appointment within a cohort of 83 General Practices in Gloucestershire. A cross sectional survey of patients who had completed a Health Check appointment during the period May to June 2012 within a single county in England. Quantitative and qualitative data were acquired from 1,011 standardised and anonymised patient surveys sent out by a Health Check Commissioner and GPs. Data gathered included perceptions concerning all aspects of the Health Checks process and actual appointment. Descriptive analysis was used to interrogate the quantitative data. Inductive content analysis was used to analyse qualitative data. Concerns about health were a principal driver of attendance. Reassurance, access to health information and guidance, and the identification of CVD risk and CVD diagnosis were perceived as key benefits of attending the appointment. Principal disadvantages included inconsistencies in the Health Check process, administration of appointments and a lack of appropriate follow up advice. Health Checks are popular with patients and provide useful outcomes but greater consistency is needed in engaging patients and describing its purpose

The relationship of oral health literacy with oral health-related quality of life in a multi-racial sample of low-income female caregivers

<p>Abstract</p> <p>Background</p> <p>To investigate the association between oral health literacy (OHL) and oral health-related quality of life (OHRQoL) and explore the racial differences therein among a low-income community-based group of female WIC participants.</p> <p>Methods</p> <p>Participants (N = 1,405) enrolled in the Carolina Oral Health Literacy (COHL) study completed the short form of the Oral Health Impact Profile Index (OHIP-14, a measure of OHRQoL) and REALD-30 (a word recognition literacy test). Socio-demographic and self-reported dental attendance data were collected via structured interviews. Severity (cumulative OHIP-14 score) and extent of impact (number of items reported fairly/very often) scores were calculated as measures of OHRQoL. OHL was assessed by the cumulative REALD-30 score. The association of OHL with OHRQoL was examined using descriptive and visual methods, and was quantified using Spearman's <it>rho </it>and zero-inflated negative binomial modeling.</p> <p>Results</p> <p>The study group included a substantial number of African Americans (AA = 41%) and American Indians (AI = 20%). The sample majority had a high school education or less and a mean age of 26.6 years. One-third of the participants reported at least one oral health impact. The OHIP-14 mean severity and extent scores were 10.6 [95% confidence limits (CL) = 10.0, 11.2] and 1.35 (95% CL = 1.21, 1.50), respectively. OHL scores were distributed normally with mean (standard deviation, SD) REALD-30 of 15.8 (5.3). OHL was weakly associated with OHRQoL: prevalence <it>rho </it>= -0.14 (95% CL = -0.20, -0.08); extent <it>rho </it>= -0.14 (95% CL = -0.19, -0.09); severity <it>rho </it>= -0.10 (95% CL = -0.16, -0.05). "Low" OHL (defined as < 13 REALD-30 score) was associated with worse OHRQoL, with increases in the prevalence of OHIP-14 impacts ranging from 11% for severity to 34% for extent. The inverse association of OHL with OHIP-14 impacts persisted in multivariate analysis: Problem Rate Ratio (PRR) = 0.91 (95% CL = 0.86, 0.98) for one SD change in OHL. Stratification by race revealed effect-measure modification: Whites--PRR = 1.01 (95% CL = 0.91, 1.11); AA--PRR = 0.86 (95% CL = 0.77, 0.96).</p> <p>Conclusions</p> <p>Although the inverse association between OHL and OHRQoL across the entire sample was weak, subjects in the "low" OHL group reported significantly more OHRQoL impacts versus those with higher literacy. Our findings indicate that the association between OHL and OHRQoL may be modified by race.</p

The Lion, the Witch and the Wardrobe

C.S. Lewis’ heroic tale of love, faith, courage, and giving; the life and death struggle for control of Narnia; and the grandeur of the triumph of good over evil has been faithfully captured for the stage by acclaimed playwright Joseph Robinette. Robinette is one of the most produced playwrights for family audiences in the world. He has dramatized the exciting story of three children who join the fight against the White Witch, with the Lion Aslan as their leader and protector. This production will delight audiences of all ages, true to the original Chronicles of Narnia books. Fans of Lewis’ work will find added insight into the author’s views of God, faith, and the promise of heaven to come.https://digitalcommons.cedarville.edu/theatre_productions/1039/thumbnail.jp

Intimate Attachment of Escherichia coli O157:H7 to Urinary Bladder Epithelium in the Gnotobiotic Piglet Model

Enterohemorrhagic Escherichia coli (EHEC), a pathogenic subset of Shiga toxin-producing E. coli (STEC), is an important cause of hemorrhagic colitis and hemolytic–uremic syndrome (HUS), and a rare cause of urinary tract infections (UTIs) with associated HUS. EHEC strains attach intimately to intestinal epithelium with formation of actin pedestals (attaching-effacing (A/E) lesions); however, the mechanism of EHEC attachment to the uroepithelium is unknown. We conducted a retrospective study on archived urinary bladder specimens from gnotobiotic piglets that naturally developed cystitis associated with EHEC O157:H7 infection following oral inoculation and fecal shedding. Paraffin-embedded bladder tissues from three piglets with cystitis and immunohistochemical evidence of EHEC O157:H7 adherence to the uroepithelium were processed for and examined by transmission electron microscopy. EHEC O157:H7 bacteria were found in one of three piglets, intimately attached to pedestals on the apical surfaces of the superficial urothelium (umbrella cells). Cystitis was significantly associated with the length of survival of the piglets post-inoculation (p = 0.0339; estimated odds ratio = 2.6652). This is the first report of E. coli causing A/E-like lesions in the uroepithelium, and also evidence of the utility of the gnotobiotic piglet as a model for studies of the pathogenesis of EHEC UTIs

Patients' perceptions of a NHS Health Check in the primary care setting

The NHS Health Checks is a cardiovascular disease (CVD) risk assessment and management programme for individuals in England aged between 40 and 74 with the aim of identifying previously unassessed individuals that are at high risk of CVD. Little research to date has explored patient perceptions and opinions of Health Checks. This paper aims to investigate the perceptions and opinions of patients who had attended a Health Check appointment within a cohort of 83 General Practices in Gloucestershire. A cross sectional survey of patients who had completed a Health Check appointment during the period May to June 2012 within a single county in England. Quantitative and qualitative data were acquired from 1,011 standardised and anonymised patient surveys sent out by a Health Check Commissioner and GPs. Data gathered included perceptions concerning all aspects of the Health Checks process and actual appointment. Descriptive analysis was used to interrogate the quantitative data. Inductive content analysis was used to analyse qualitative data. Concerns about health were a principal driver of attendance. Reassurance, access to health information and guidance, and the identification of CVD risk and CVD diagnosis were perceived as key benefits of attending the appointment. Principal disadvantages included inconsistencies in the Health Check process, administration of appointments and a lack of appropriate follow up advice. Health Checks are popular with patients and provide useful outcomes but greater consistency is needed in engaging patients and describing its purpose

Multicompartment Ecosystem Mass Balances as a Tool for Understanding and Managing the Biogeochemical Cycles of Human Ecosystems

Nitrogen remains a ubiquitous pollutant in surface and groundwater throughout the United States, despite 30 years of pollution control efforts. A detailed multicompartment N balance for the Central Arizona-Phoenix ecosystem is used to illustrate how an ecosystem-level approach can be used to develop improved N management strategies. The N balance is used to demonstrate how nitrate in pumped groundwater used for crop irrigation could be used to reduce inputs of commercial fertilizer and decrease N leaching to aquifers. Effectively managing N pollution also will require an understanding of the complex factors that control the N balance, including targeted regulations, individual human behavior, land-use conversion, and other ecosystem management practices that affect the N balance. These sometimes countervailing factors are illustrated with several scenarios of wastewater treatment technology and population growth in the Phoenix area. Management of N eventually must be coupled to management of other elements, notably carbon, phosphorus, and salts. We postulate that an ecosystem framework for pollution management will result in strategies that are more effective, fairer, and less expensive than current approaches

Perceptions of health professionals involved in the implementation of a NHS Health Check care pathway in the primary care setting

Background: The national NHS Health Check programme in England aims to help people stay well for longer and is designed to support individuals aged between 40 and 74 to manage their risk of developing vascular diseases by offering a cardiovascular risk assessment every five years. Aim: To investigate health professionals’ experiences and perspectives concerning the implementation of a local HC programme and challenges to delivery. Methods: Surveys including standardised quantitative questions and qualitative questions were administered to GP practice staff (n = 25) directly involved in the implementation of Health Checks within a single county in the South West of England. Results: There was a lack of clarity concerning the expectations for Health Checks and barriers to consistently implementing the pathway. Practitioners were not always confident in communicating risk or supporting change in patient health behaviours. Conclusions: There is a need for on-going training and support in respect of Health Checks for those engaged in its implementation

Practice-based competencies for accreditation of and training in graduate programs in genetic counseling

In January 1996, the American Board of Genetic Counseling (ABGC) adopted 27 practice-based competencies as a standard for assessing the training of graduate students in genetic counseling. These competencies were identified and refined through a collective, narrative process that took place from January through November 1994, and included directors of graduate programs in genetic counseling, ABGC board members and expert consultants. These competencies now form the basis of the document “Requirements for Graduate Programs in Genetic Counseling Seeking Accreditation by the American Board of Genetic Counseling” (American Board of Genetic Counseling, 1996). The competencies are organized into four domains and are presented and discussed in this article.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44929/1/10897_2005_Article_BF01408656.pd

Preliminary Analysis of in Utero Low-Level Arsenic Exposure and Fetal Growth Using Biometric Measurements Extracted from Fetal Ultrasound Reports

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. Results: In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value \u3c 0.05). Although, associations were attenuated in adjusted analyses — among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: −0.151, 0.007) decrease in biparietal head diameter Z-score. Conclusions: Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation