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Pathogens transmitted by ticks are the leading cause of arthropod-associated human diseases in the United States and managing the risk of exposure to potentially infected ticks is of vital public health importance. A 3-year integrated tick management program to control blacklegged ticks, Ixodes scapularis, the primary vector for the pathogenic agents of Lyme disease, human anaplasmosis, and babesiosis, was implemented in the town of Redding in southwestern Connecticut beginning in 2013. Combinations of white-tailed deer, Odocoileus virginianus, reduction, area application of the entomopathogenic fungus Metarhizium anisopliae, and fipronil-based rodent bait boxes were evaluated for their ability to reduce nymphal I...

BACKGROUND: Mastery of laparoscopic skills is essential in surgical practice and requires considerable time and effort to achieve. The Virtual Basic Laparoscopic Skill Trainer (VBLaST-PC© ) is a virtual simulator that was developed as a computerized version of the pattern cutting (PC) task in the Fundamentals of Laparoscopic Surgery (FLS) system. To establish convergent validity for the VBLaST-PC© , we assessed trainees' learning curves using the cumulative summation (CUSUM) method and compared them with those on the FLS...

Japanese barberry (Berberis thunbergii de Candolle; Ranunculales: Berberidaceae) is an exotic invasive shrub that escaped cultivation in the United States and is now permanently established in many eastern and midwestern states. This study examined the long-term impacts of Japanese barberry management on blacklegged tick (Ixodes scapularis Say; Acari: Ixodidae) abundances and associated prevalence of Borrelia burgdorferi (Johnson, Schmid, Hyde, Steigerwalt, and Brenner; Spirochaetales: Spirochaetaceae), the etiologic agent of Lyme disease...

Atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and lobular carcinoma in situ (LCIS) are commonly seen on breast core needle biopsy (CNB). Many institutions recommend excision of these lesions to exclude malignancy. A retrospective chart review was performed on patients who had ADH, ALH, or LCIS on breast CNB from 1/1/08 to 12/31/10 who subsequently had surgical excision of the biopsy site. Study objectives included determining upgrade to malignancy at surgical excision, identification of predictors of upgrade, and validation of a recently published predictive model...

The Clinician Scholars Program at the Midwest AIDS Training and Education Center strengthens the workforce by increasing knowledge and skills related to HIV prevention and care. The 1-year individualized training program for minority-serving clinicians includes intensive mentoring and networking. Qualitative exit interviews (N = 50) conducted over 4 years demonstrate the effectiveness of the training, including changes at the individual and systems levels. Findings show that almost all graduates reported improvements in knowledge, two-thirds reported changes in empathic capacity and cultural competence, and nearly three-quarters reported changes in clinical practice...

Engaging new clinical providers in the HIV workforce is a critical need due to rapidly evolving treatment paradigms, aging out of existing providers, and special population needs. The 1-year competency-based Clinician Scholar Program for minority-serving providers with limited HIV care experience was individually tailored for each provider (n = 74), mostly nurse practitioners, physicians, and clinical pharmacists. Baseline and endpoint self-assessments of clinical knowledge and skills showed significant improvements in all 11 targeted competencies, particularly in managing antiretroviral medications, screening and testing methods, incorporating prevention into HIV care, understanding risk reduction methods, and describing current care standards...

Streptomycin is commonly used to control fire blight disease on apple trees. Although the practice has incited controversy, little is known about its nontarget effects in the environment. We investigated the impact of aerial application of streptomycin on nontarget bacterial communities in soil beneath streptomycin-treated and untreated trees in a commercial apple orchard. Soil samples were collected in two consecutive years at 4 or 10 days before spraying streptomycin and 8 or 9 days after the final spray...

No abstract text is available yet for this article.

The Midwest AIDS Training and Education Center (MATEC) implemented a Web-based survey method to measure impact on practitioners of HIV/AIDS skill-building workshops offered in seven midwestern states. Surveys were sent to 2,949 participants from 230 workshops 4-6 weeks after each workshop. Of those surveyed, 631 respondents provided usable data (22.4%). Self-reported narrative responses described practice changes attributed to training. Changes were categorized as (a) practitioner attitude/knowledge, (b) practitioner practice behavior, (c) planning system change, and (d) implemented adaptations to the clinical care system...

This study examined changes in service delivery patterns of health and mental health service providers one year after a training on the fundamentals of HIV/AIDS and mental health. Paired t-tests for 424 training recipients showed significant increases in delivery of HIV-related services, and these remained significant while controlling for additional training, job changes, region (urban, rural, suburban), and provider discipline. Multiple logistic regression analysis revealed a significantly greater likelihood of providing direct services to HIV+ individuals among male providers, those with more years of HIV experience, those in counseling disciplines, and those working in a new job since the training...

Both medical and community support services for people living with HIV and/or AIDS have been implemented on a widespread basis since the implementation of the 1990 Ryan White CARE Act. However, many services are provided without adequate evaluation or quality assurance, in spite of federal directions to both evaluate and ensure quality. This report details the development and implementation of a quality improvement project to evaluate Ryan White CARE services using a community stakeholder-based effort. The evaluation was consumer rather than administratively driven, including both consumers and providers to define, measure, and improve services...

Since 1990, the number of people in Minnesota living with HIV/AIDS has been steadily increasing. The demographics of who is infected with HIV have changed, with more women and people of color being diagnosed. In addition, with new therapies and continually updated treatment recommendations, the information needed to provide quality medical care to HIV-infected patients is constantly evolving. Thus, providers who care for patients with HIV/AIDS need ongoing education about the disease. The Midwest AIDS Training and Education Center (MATEC) is a federally funded program that helps health care providers stay abreast of HIV clinical care and management knowledge...

New treatment advances have radically altered the course of HIV illness and created new challenges for HIV-affected individuals, families, and communities. This article provides a conceptual framework for understanding HIV in the multiple contexts of the client's culture, strengths, life course, and biomedical progression. The article concludes with a discussion of HIV prevention and treatment adherence as key focal points for social workers and their clients.

This study investigated the needs of relative caregivers of children in the child welfare system whose parents had HIV. Families of children supported by the state child welfare agency were invited to participate in the study; 17 families reported that HIV affected them and 11 families did not identify HIV as an issue. The findings indicate that complex emotional and behavioral issues stressed the HIV-affected kin caregivers; these issues included the children's behavioral problems, HIV-related concerns, adolescent issues, emotional difficulties, and sexual abuse, HIV-affected caregivers had more concern about their health and multiple roles...

We surveyed pediatricians (PEDs), family physicians (FPs), otolaryngologists (ENTs), and emergency physicians (ERs) from across Michigan (100 each), as well as 30 nationally recognized experts about their clinical approach to acute otitis media (AOM). The overall response rate was 52%. There was substantial variation within each group with respect to diagnostic criteria and clinical decision-making, but no significant differences among groups. The 63% of respondents who considered symptoms among their diagnostic criteria for AOM were 3...

No abstract text is available yet for this article.

Epidemiological trends in HIV infection in the United States suggest existing primary and secondary prevention efforts are inadequate. Healthcare providers may be missing valuable opportunities to engage in necessary public health services, such as prevention education, risk assessment, and case finding. This study examined the HIV-related practice behaviors and training needs of physicians and nurses in the Midwest. A cross-sectional survey method was employed. A questionnaire was mailed to a probability sample of 1,500 physicians and registered nurses licensed as of August 1999 in one of six Midwestern states...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.