First Report of Plumed Cockscomb (Celosia argentea var. plumosa) Stem Blight Caused by Phytophthora nicotianae in Taiwan.

Celosia spp. is a widely cultivated ornamental plant in gardens or parks in Taiwan. In September 2021, withering leaves and grayish-brown lesions were observed on the lower stem of plumed cockscombs (C. argentea var. plumosa) in Taichung City, with an incidence of about 22% in 136 plants after continuous precipitation, impacting the aesthetic value of the landscape. Symptomatic plants were collected, surface disinfected with 70% EtOH for ~20 sec., blotted dried, and excised diseased tissues (~ 3×3 mm2) were placed on 2% water agar. Four representative isolates were obtained after purification and the colonies were white with aerial and non-septated hyphae on V8 agar for 7 days. Sporangia were ovoid, ellipsoid or obpyriform, papillate, (26.3-55.9) 38.0 × 29.0 (20.1-40.6) µm (n = 200) (Ahonsi et al. 2007). Chlamydospores were spherical, terminal or intercalary, 26.0 (15.1-40.4) µm (n = 200). All isolates belong to A2 mating type with amphigynous antheridia and plerotic oospores, 21.0 (17.7-25.7) µm (n = 200), resembling the descriptions of Phytophthora (Erwin & Ribeiro 1996). For molecular identification, sequences of the ITS, ß-tubulin (ß-tub), and EF-1α regions of all isolates were amplified using ITS1/ITS4, TUBUF2/TUBUR1, and ELONGF1/ELONGR1 primers, respectively (White et al. 1990; Kroon et al. 2004). BLAST analyses of isolates cap1-2 (ITS: OQ581785; ß-tub: OQ590022; EF-1α: OQ590026), cap1-3 (ITS: OQ581786; ß-tub: OQ590023; EF-1α: OQ590027), cap2-1 (ITS: OQ581787; ß-tub: OQ590024; EF-1α: OQ590028), and cap2-2 (ITS: OQ581788; ß-tub: OQ590025; EF-1α: OQ590029) showed 100% of ITS identity, 99.5 to 99.9% of ß-tub identity, and 99.4 to 99.6% of EF-1α identity with Phytophthora nicotianae (ITS: MG865551; ß-tub: MH493987; EF-1α: MH359043). Phylogenetic trees were constructed using concatenated ITS, ß-tub, and EF-1α sequences based on maximum likelihood with a GTR+G model in MEGA X and Bayesian inference method in Geneious Prime 2022.2. All isolates were clustered in P. nicotianae with similar topology, thereby were identified as P. nicotianae. To confirm pathogenicity, 7 to 10-day-old seedlings and 6-week-old plumed cockscomb plants were inoculated in separate trials and each experiment was conducted twice. For each seedling, the lower stem was inoculated with 50 µl of zoospore suspension (104 zoospores/ml), 3 plants per isolate, and then incubated at 30±2℃ with 12 h light. For adult plants, each was inoculated with mycelial plugs from one V8 plate of 10-day-old P. nicotianae, 5 plants per isolate, and incubated at 25±2℃ in a greenhouse. Control plants were inoculated with sterile water and V8 agar plugs, respectively. Stem and root rot were observed on seedlings 4 days after inoculation while wilting and lower stem browning were observed on adult plants 2 months after inoculation. All control plants remained healthy at the end of repeated trials and identical pathogens were re-isolated only from symptomatic plants, thus fulfilling Koch's rules. P. nicotianae has been reported causing root rot and stem necrosis not only on cockscomb (C. plumosa Hort. ex Burvenich) in Argentina (Frezzi 1950), but also infecting several ornamental plants recently in Taiwan (Ann et al. 2018). To our knowledge, this is the first report of stem blight caused by P. nicotianae on plumed cockscombs in Taiwan. This finding suggests limited options for landscaping and the host preference of the isolates obtained in this study should warrant further studies.

Impact of Type D Personality, Role Strain, and Diabetes Distress on Depression in Women With Type 2 Diabetes: A Cross-Sectional Study.

BACKGROUND: Women with diabetes face a significantly elevated risk of developing depression. Clarifying the factors associated with depression is critical to designing more timely interventions for this vulnerable population. PURPOSE: This study was developed to examine the impact of Type D personality, diabetes-care-related role strain, and diabetes-related distress on depression in women with Type 2 diabetes. METHODS: A cross-sectional design was used. Convenience sampling was used to recruit 298 women aged 20-64 years who had been diagnosed with Type 2 diabetes for over 6 months from three outpatient endocrine clinics in Taiwan. Demographic and disease characteristics and Type D personality (negative affectivity and social inhibition), diabetes-care-related role strain, and diabetes-related distress and depression status information were collected using self-reported questionnaires and medical records. The important factors of influence on depression were examined using hierarchical multiple regression. RESULTS: On the basis of the results of the hierarchical multiple regression analysis, age, negative affectivity, diabetes-care-related role strain, and diabetes-related distress were identified as significantly associated with depression, with negative affectivity explaining most (43.4%) of the variance in depression, followed by diabetes-care-related role strain and diabetes-related distress, which respectively explained 3% and 2.5% of the variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The negative affectivity associated with the Type D personality was shown to be more significantly associated with depression than diabetes-related psychosocial factors such as diabetes-related distress and diabetes-care-related role strain. Timely assessment of negative affectivity and the provision of brief mindfulness intervention to reduce negative affectivity may be useful in preventing depression in women with Type 2 diabetes, whereas addressing diabetes-related distress and diabetes-care-related role strain should not be neglected when providing comprehensive depression-preventing interventions to young women with diabetes.

The Impact of Self-Stigma, Role Strain, and Diabetes Distress on Quality of Life and Glycemic Control in Women With Diabetes: A 6-Month Prospective Study.

PURPOSES: Women with diabetes (WD) are more severely impacted by the consequence of suboptimal diabetes control. This study aims to examine the impact of demographic and disease characteristics, baseline self-stigma, role strain, diabetes distress on Hemoglobin A1C (A1C) levels, quality of life (D-QoL) and 6-month A1C levels in younger WD. METHODS: This study was a 6-month prospective study. In total, 193 WD aged 20-64 years were selected by convenience sampling from three outpatient clinics in Taiwan. Demographic and disease characteristics, self-stigma, role strain, diabetes distress, A1C levels, and D-QoL were collected at baseline. A1C levels were further collected 6 months later. Structural equation modeling was conducted to test the hypothesized model. RESULTS: The final model supported that higher baseline D-QoL directly associated with lower concurrent A1C levels and indirectly associated with lower 6-month A1C levels through baseline A1C levels. Higher baseline self-stigma, role strain, and diabetes distress directly associated with lower baseline D-QoL, and indirectly associated with higher 6-month A1C levels through D-QoL. CONCLUSION: Improving self-stigma, role strain, and diabetes distress should be considered as promising strategies to improve D-QoL in young WD. D-QoL plays a mediation role between baseline self-stigma, role strain, diabetes distress and subsequent glycemic control in younger WD. Enhancing baseline D-QoL is fundamental to improve subsequent glycemic control.

Scale for Measuring Role Strain in Women With Diabetes: Development and Psychometric Testing of the Chinese Version.

BACKGROUND: Women with diabetes (type 1 and type 2) have excessive risk of developing cardiovascular disease compared with men with diabetes, so optimizing diabetes control is crucial for women to reduce this risk. Women with diabetes experience role strain, and a scale to measure role strain in the context of diabetes control could help healthcare providers improve diabetes control in women with diabetes. OBJECTIVE: The aims of the study were to develop a short-form scale for measuring role strain in Taiwanese women with diabetes and test its psychometric properties. METHODS: This study was conducted from October 2018 to May 2019 and used a cross-sectional design. Based on literature reviews and results of focus groups, a 28-item role strain scale was developed and administered to 519 women with diabetes in Taiwan. Item analysis, exploratory factor analysis, confirmatory factor analysis, concurrent validity, and reliability testing were used to examine the psychometric characteristics of the scale. RESULTS: A 9-item role strain scale including subscales for role guilt and role conflict, supported by exploratory factor analysis and confirmatory factor analysis, was produced. High role strain significantly correlated with high depression (r = 0.399, P < .001) and high hemoglobin A1c levels (r = 0.169, P < .001). The overall and subscale Cronbach's α ranged between 0.78 and 0.86, with test-retest reliability ranging between 0.64 and 0.81. CONCLUSIONS: The role strain scale for women with diabetes is reliable and valid and can be used to evaluate role strain in women with diabetes.

Efficacy of five-element gymnastics in glucose and lipid control in Taiwanese patients with type 2 diabetes.

The purpose of this quasi-experimental study was to determine the efficacy of Five-Element Gymnastics (FEG) in controlling glycosylated hemoglobin (HbA1C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) at the 8th and the 16th weeks of intervention for patients with type 2 diabetes in Taiwan. FEG consolidates several traditional Chinese exercises including Qigong, Xiang Gong, and martial arts with gymnastics. The experimental group (n = 31) practiced FEG at home for 16 weeks. The control group (n = 35) maintained usual activities. FEG was associated with decrease of HbA1C, TG, and LDL-C levels at the 8th week and continuous decrease of HbA1C through the 16th week. FEG could be an exercise choice for patients with type 2 diabetes.

[The effects of economic crises on health care].

In September 2008, financial turmoil on Wall Street led to severe losses in that country's financial derivatives market and plunged the United States into the most severe financial crisis in over a decade. The backlash of this "financial tsunami" has affected countries around the world. The world economy, facing the most critical financial crisis since the 1930s, must deal with recession, severe unemployment and general fears of worse to come, which have, in turn, spawned a range of physical, psychological and spiritual problems. In this article we study the effects of the economic crisis on healthcare from several angles, including: decreasing incomes causing changing attitudes toward seeking healthcare; decreasing numbers of people covered by medical insurance; increasing impact on the job market of untreated illnesses; changing national healthcare policies in response to economic pressures; increasing physical, psychological and social problems resulting from economic problems; and the need for the nursing profession to respond to these and other rapid changes in the healthcare landscape. Nursing staff are sometimes unaware of social problems outside their profession. This article may, therefore, provide a general reference to medical and nursing staff on the effects of the economic crisis on healthcare.

[Implementation and evaluation of a proper dietary behavior program in diabetes support groups].

BACKGROUND: Active promotion in recent years of the Diabetes Share Care Program by the national Department of Health and the medical profession has gradually established a diabetes support system as well as patient support groups in Taiwan. The program concept holds that, by participating in a patient support group, diabetes patients and people in high risk categories will learn to adopt a healthier lifestyle in order to delay / avoid diabetes onset and complications. PURPOSE: Within the diabetes support group framework, we implemented correct dietary behavior programs and evaluated their efficacy. METHOD: A study using a quasi-experimental, single-group pretest and posttest design was carried out from December 2007 to May 2008. Participants included 48 registered patient members of a diabetes patient group located at a regional teaching hospital in Kaohsiung. Researchers used the Donabedian framework to evaluate program efficacy. RESULTS: Results indicated that the program could effectively promote proper dietary behavior in patients. CONCLUSION: Providing instant data during program execution and evaluation can enhance program efficacy. We hope that this experience can serve as a reference for medical staff when executing such programs.