Are Physician Assistants Needed in Guatemala? A Survey of Potential Urban and Rural Users.

PURPOSE: The shortage of trained health care personnel has been increasing worldwide. With the physician assistant (PA) profession, created in the United States in the 1960s, expanding globally, this study sought to ascertain whether PAs can be an innovative solution to this crisis. METHODS: We conducted a convenience sample survey to assess the need for and acceptability of future PA professionals in Guatemala. Eighty-nine doctors, nurses, and community members from rural and urban areas of Guatemala participated in the survey. RESULTS: More urban (70%) than rural (58%) respondents found it difficult to access a doctor, with cost being the major reason (34%). Access in rural areas was reportedly limited by lack of doctors and inaccessible office hours. CONCLUSIONS: Most survey respondents considered PAs to be suitable and potentially helpful providers for Guatemala, with a preference for competencies in the diagnosis of serious illnesses, drug prescription, labor and delivery attendance, and care for injuries and fractures, especially in rural locations. Belonging to the community was deemed very important for a PA who would practice in the country.

N-P co-limitation of primary production and response of arthropods to N and P in early primary succession on Mount St. Helens volcano.

BACKGROUND: The effect of low nutrient availability on plant-consumer interactions during early succession is poorly understood. The low productivity and complexity of primary successional communities are expected to limit diversity and abundance of arthropods, but few studies have examined arthropod responses to enhanced nutrient supply in this context. We investigated the effects of nitrogen (N) and phosphorus (P) addition on plant productivity and arthropod abundance on 24-yr-old soils at Mount St. Helens volcano. METHODOLOGY/PRINCIPAL FINDINGS: We measured the relative abundance of eight arthropod orders and five families in plots that received N, P, or no nutrients for 3-5 years. We also measured plant % cover, leaf %N, and plant diversity. Vegetation responded rapidly to N addition but showed a lagged response to P that, combined with evidence of increased N fixation, suggested P-limitation to N availability. After 3 yrs of fertilization, orthopterans (primarily Anabrus simplex (Tettigoniidae) and Melanoplus spp (Acrididae)) showed a striking attraction to P addition plots, while no other taxa responded to fertilization. After 5 yrs of fertilization, orthopteran density in the same plots increased 80%-130% with P addition and 40% with N. Using structural equation modeling, we show that in year 3 orthopteran abundance was associated with a P-mediated increase in plant cover (or correlated increases in resource quality), whereas in year 5 orthopteran density was not related to cover, diversity or plant %N, but rather to unmeasured effects of P, such as its influence on other aspects of resource quality. CONCLUSIONS/SIGNIFICANCE: The marked surprising response to P by orthopterans, combined with a previous observation of P-limitation in lepidopteran herbivores at these sites, suggests that P-mediated effects of food quantity or quality are critical to insect herbivores in this N-P co-limited primary successional system. Our results also support a previous suggestion that the availability of N in these soils is P-limited.

Comparative genome scan detects host-related divergent selection in the grasshopper Hesperotettix viridis.

In this study, we used a comparative genome scan to examine patterns of population differentiation with respect to host plant use in Hesperotettix viridis, a Nearctic oligophagous grasshopper locally specialized on various Asteraceae including Solidago, Gutierrezia, and Ericameria. We identified amplified fragment length polymorphism (AFLP) loci with significantly elevated F(ST) (outlier loci) in multiple different-host and same-host comparisons of populations while controlling for geographic distance. By comparing the number and identities of outlier loci in different-host vs. same-host comparisons, we found evidence of host plant-related divergent selection for some population comparisons (Solidago- vs. Gutierrezia-feeders), while other comparisons (Ericameria- vs. Gutierrezia-feeders) failed to demonstrate a strong role for host association in population differentiation. In comparisons of Solidago- vs. Gutierrezia-feeding populations, a relatively high number of outlier loci observed repeatedly in different-host comparisons (35% of all outliers and 2.7% of all 625 AFLP loci) indicated a significant role for host-related selection in contributing to overall genomic differentiation in this grasshopper. Mitochondrial DNA sequence data revealed a star-shaped phylogeny with no host- or geography-related structure, low nucleotide diversity, and high haplotype diversity, suggesting a recent population expansion. mtDNA data do not suggest a long period of isolation in separate glacial refugia but are instead more compatible with a single glacial refugium and more recent divergence in host use. Our study adds to research documenting heterogeneity in differentiation across the genome as a consequence of divergent natural selection, a phenomenon that may occur as part of the process of ecological speciation.

Successional change in phosphorus stoichiometry explains the inverse relationship between herbivory and lupin density on Mount St. Helens.

BACKGROUND: The average nitrogen-to-phosphorus ratio (NratioP) of insect herbivores is less than that of leaves, suggesting that P may mediate plant-insect interactions more often than appreciated. We investigated whether succession-related heterogeneity in N and P stoichiometry influences herbivore performance on N-fixing lupin (Lupinus lepidus) colonizing primary successional volcanic surfaces, where the abundances of several specialist lepidopteran herbivores are inversely related to lupin density and are known to alter lupin colonization dynamics. We examined larval performance in response to leaf nutritional characteristics using gelechiid and pyralid leaf-tiers, and a noctuid leaf-cutter. METHODOLOGY/PRINCIPAL FINDINGS: We conducted four studies. First, growth of larvae raised on wild-collected leaves responded positively to leaf %P and negatively to leaf carbon (%C), but there was no effect of %N or quinolizidine alkaloids (QAs). Noctuid survival was also positively related to %P. Second, we raised gelechiid larvae on greenhouse-grown lupins with factorial manipulation of competitors and soil N and P. In the presence of competition, larval mass was highest at intermediate leaf NratioP and high %P. Third, survival of gelechiid larvae placed on lupins in high-density patches was greater when plant competitors were removed than on controls. Fourth, surveys of field-collected leaves in 2000, 2002, and 2003 indicated that both %P and %N were generally greater in plants from low-density areas. QAs in plants from low-density areas were equal to or higher than QAs in high-density areas. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that declines in lupin P content under competitive conditions are associated with decreased larval growth and survival sufficient to cause the observed negative relationship between herbivore abundance and host density. The results support the theoretical finding that declines in stoichiometric resource quality (caused here by succession) have the potential to cause a decrease in consumer abundance despite very dense quantities of the resource.

Linking community and ecosystem development on Mount St. Helens.

In the two decades following the 1980 eruption of Mount St. Helens in Washington State, the N2-fixing colonizer Lupinus lepidus is associated with striking heterogeneity in plant community and soil development. We report on differences in nutrient availability and plant tissue chemistry between older, dense patches (core) of L. lepidus and more recently established low density patches (edge). In addition, we conducted a factorial nitrogen and phosphorus fertilization experiment in core patches to examine the degree of N and P limitation in early primary succession. We found that there were no significant differences in N or P availability between core and edge L. lepidus patches during the dry summer months, although nutrient availability is very low across the landscape. In the high density patches we found lower tissue N content and higher fiber content in L. lepidus tissue than in the younger edge patches. The addition of nutrients substantially altered plant community composition, with N addition causing an increase in other forb biomass and a corresponding competition-induced decline in L. lepidus biomass. The majority of the positive biomass response came from Hypochaeris radicata. In the second year of the fertilization experiment, the addition of N significantly increased total community biomass while L. lepidus biomass declined by more than 50%. The response of every species other than L. lepidus to N additions suggests that N may be the macronutrient most limiting plant production on Mount St. Helens but that the gains in productivity were somewhat offset by a decline of the dominant species. By the third year of the experiment, L. lepidus began to increase in abundance with P addition. This result suggests co-limitation of the community by N and P.

When can herbivores slow or reverse the spread of an invading plant? A test case from Mount St. Helens.

Here we study the spatial dynamics of a coinvading consumer-resource pair. We present a theoretical treatment with extensive empirical data from a long-studied field system in which native herbivorous insects attack a population of lupine plants recolonizing a primary successional landscape created by the 1980 volcanic eruption of Mount St. Helens. Using detailed data on the life history and interaction strengths of the lupine and one of its herbivores, we develop a system of integrodifference equations to study plant-herbivore invasion dynamics. Our analyses yield several new insights into the spatial dynamics of coinvasions. In particular, we demonstrate that aspects of plant population growth and the intensity of herbivory under low-density conditions can determine whether the plant population spreads across a landscape or is prevented from doing so by the herbivore. In addition, we characterize the existence of threshold levels of spatial extent and/or temporal advantage for the plant that together define critical values of "invasion momentum," beyond which herbivores are unable to reverse a plant invasion. We conclude by discussing the implications of our findings for successional dynamics and the use of biological control agents to limit the spread of pest species.