Disease-related everyday communication of persons with rheumatic and musculoskeletal diseases-Results of a participatory research project.

OBJECTIVE: The aim of the present study is to describe and analyse significant factors of disease-related everyday communication of persons with RMDs in a nationwide project in Germany funded by the Deutsche Rheumaliga Bundesverband e.V. (German League against Rheumatism). METHODS: In this participatory research project four persons with RMDs are involved. An online questionnaire addressing context, difficulties, and burden of disease-related everyday communication was answered by 1.015 persons with RMDs. Social and communication skills were recorded by questionnaires to capture social insecurity and patient communication competence. RESULTS: More than half of the participants reported difficulties in disease-related conversations across various situations. The majority of these persons suffer from this experience particularly in conversations at the work environment or with staff members of authorities. They feel unconfident especially in situations which require saying "no". Furthermore, compared to the general population persons with RMDs have more anxiety about contact with others. CONCLUSION: Strengthening the social skills of persons with RMDs in conversations related to everyday situations can promote a self-determined life and contribute to the maintenance of social participation. PRATICE IMPLICATIONS: Based on the results, a communication skills training for persons with RMDs will be developed.

["Active in rehab": development and formative evaluation of a patient education program to increase health literacy of patients with chronic illness]. / "Aktiv in der Reha": Entwicklung und formative Evaluation einer Patientenschulung zur Förderung der Gesundheitskompetenz von chronisch Kranken.

OBJECTIVE: The aim of the article is to describe the development, the process of manualisation and results from the formative evaluation of a patient-oriented patient education program to increase health literacy of patients with chronic illness ("Active in rehab"). METHODS: Themes of the patient education program were extracted from 17 focus groups. An expert meeting was conducted to validate the content of the patient education program. The formative evaluation was based on a questionnaire (N(max) = 295 patients and N(max) = 39 trainers). RESULTS: The patient education program includes 4 modules with 3 themes (bio-psycho-social model, rehabilitation goals, communication competencies). The evaluation of the modules was good to very good. An analysis of free texts and a follow-up survey among trainers helped us to infer important improvements to the patient education program. CONCLUSION: RESULTS from the formative evaluation show that the patient education program meets patients and trainers needs and is accepted.

The oak processionary caterpillar as the cause of an epidemic airborne disease: survey and analysis.

BACKGROUND: Thaumetopoea processionea L. (order Lepidoptera), the oak processionary moth, is found in oak forests in most European countries. Its third to sixth larval instars are armed with poisonous hairs (setae) containing an urticating toxin (thaumetopoein) potentially harmful to humans. Because T. processionea infests trees at the edges of forests or standing alone people frequently come into contact with its setae. In the woodland bordering on the western suburbs of Vienna conditions favouring its increase have led to frequent outbreaks of lepidopterism. OBJECTIVES: To determine the incidence of lepidopterism in a suburban environment with three separate caterpillar-infested oak trees and to ascertain the frequency of the various symptoms of lepidopterism and the manner of contact with setae. METHODS: We conducted a telephone survey of all the households/institutions located within 500 m of the infested trees. To gain more information on patients' symptoms and on situations likely to lead to increased contact with setae we asked those who reported cutaneous reactions to complete a questionnaire. As part of the environmental study we described the outbreak site, examined patients and, with tape-strip samples taken from the surface of the soil, looked for setae persisting in the environment. RESULTS: Of 1025 people surveyed 57 (5.6%) reported one or more symptoms of lepidopterism: 55 (96%) reported pruritus, 54 (95%) dermatitis, eight (14%) conjunctivitis, eight (14%) pharyngitis and two (4%) respiratory distress. The questionnaire was returned by 37 (69%) of the individuals with dermatitis. Of those, 16% had reacted with weal formation, 49% with papular rash and 22% with toxic irritant dermatitis. In 13% of respondents it was not possible to define the reaction. The risk factor analysis showed that airborne contamination was the most important cause: 97% of people had frequently passed an infested tree, 57% lived near a tree (in a neighbouring garden) and 32% had a tree in their own garden. Direct contact with larvae was of minor importance (38%). In four of the tape-strip samples intact setae were identified 1 year after the infestation. CONCLUSIONS: Lepidopterism caused by T. processionea is a public health problem of increasing significance. In years with outbreaks of the pest it can reach epidemic proportions in communities located near infested trees. Contact with airborne setae was mainly responsible for the occurrence of the disease.

Effects of Glyptapanteles liparidis (Hym.: Braconidae) parasitism, polydnavirus, and venom on development of microsporidia-infected and uninfected Lymantria dispar (Lep.: Lymantriidae) larvae.

Effects of parasitism, polydnavirus, and venom of the endoparasitoid Glyptapanteles liparidis on Lymantria dispar larvae infected with the microsporidium Vairimorpha sp. and uninfected hosts were studied. We tested the impact on growth and development of hosts, as well as on microsporidian infection. Both parasitism and polydnavirus/venom treatment alone caused a slight increase in growth rate and relative growth rate in uninfected fourth instar hosts. This effect was more pronounced with the addition of Vairimorpha infection. With no parasitism, however, infection reduced host growth markedly. Microsporidiosis delayed larval molts of L. dispar, and additional polydnavirus/venom treatment or parasitization induced significantly earlier molting. Polydnavirus/venom treatment of uninfected L. dispar resulted in prolonged larval development due to supernumerary molts and in higher pupal mortality. Infected larvae treated with polydnavirus/venom died earlier than infected larvae that were not treated and produced more Vairimorpha spores per unit fresh mass of the host.

Isolation and characterization of juvenile hormone esterase from hemolymph of Lymantria dispar by affinity- and by anion-exchange chromatography.

Juvenile hormone esterase (JHE), which catalyzes the hydrolysis of juvenile hormone, was isolated from the hemolymph of 5(th) instars of Lymantria dispar by two different procedures. One procedure was based on affinity chromatography and the other on anion-exchange chromatography. The material from both purifications showed bands of approximately 50 kDa when analyzed by SDS-PAGE. Isoelectric focusing (IEF) gels in combination with enzyme activity assays indicated two isoelectric forms with the same pI values (pH 5.1. and 5.3) from affinity purification and from anion-exchange chromatography. Amino acid sequencing of several internal peptides from the 50 kDa band following affinity purification and alignment of these sequences with JHEs from previously purified lepidopteran species (Heliothis virescens, Manduca sexta) showed high homology of these enzymes. The isolated JHE, at least in the stage of insect used, was different from the enzyme reported earlier [Valaitis, A.P., 1991. Characterization of hemolymph juvenile hormone esterase from Lymantria dispar. Insect Biochemistry 21, 583-595] to hydrolyze JH in the hemolymph of gypsy moth, based on molecular weight and amino acid sequence.

Interactions between an entomopathogenic microsporidium and the endoparasitoid Glyptapanteles liparidis within their host, the gypsy moth larva.

Interactions in the host-parasitoid-pathogen system, Lymantria dispar L. (Lep., Lymantriidae)-Glyptapanteles liparidis (Bouché) (Hym., Braconidae)-Vairimorpha sp. (Protista, Microspora), were investigated. Host selection experiments revealed that G. liparidis females did not discriminate between infected and uninfected host larvae for oviposition. Transmission of the microsporidium from infected to uninfected hosts by stinging female wasps could not be ascertained. Females that developed in infected L. dispar larvae did not transmit the pathogen via oviposition. Vairimorpha infection of the host negatively affected the performance of the braconid, when inoculation took place either before or after parasitization. Microsporidiosis of the host caused delayed development, reduced pupation and adult eclosion, reduction in size and weight, and reduction of adult longevity of G. liparidis. Parasitoids themselves were not systemically infected by Vairimorpha sp., but braconid larvae did ingest microsporidian spores at the end of their endoparasitic development and accumulated the undigested and ungerminated spores in the blind midgut. Negative effects of host infection on parasitoid larvae were detectable from the beginning of parasitoid larval development. Lethal time was reduced when L. dispar larvae were infected and parasitized, often at the expense of the parasitoid when G. liparidis were unable to complete endoparasitic development before the host died. Intensity of infection, measured as number of spores produced per milligram fresh weight of L. dispar larva, was slightly higher in parasitized and infected hosts than in unparasitized and infected hosts.