Agrobiodiversity and smallholder resilience: A scoping review.

Agrobiodiversity is often touted as a crucial adaptation strategy to mitigate risks linked to climate change by increasing the response capability of a system to external shocks and, consequently, the smallholder's resilience. This scoping review, conducted following the PRISMA protocol, aims to elucidate how agrobiodiversity's effect on resilience has been conceptualized, analyzed, and reported in the literature and to identify knowledge gaps. We systematically examined 193 articles, with 63 selected for full review based on predefined criteria. Notably, only 16 studies featured actual measurements of the effect of agrobiodiversity on resilience. Our findings indicate that articles often operationalize these complex theoretical concepts using limited variables. Agrobiodiversity is typically measured by crop count, while resilience is assessed through economic, ecological, and/or social dimensions. We identified key attributes expected in resilient systems and found that agrobiodiversity's impact on resilience was positive in 10 cases, negative in 9, and contingent on production types and system shocks in others. This review emphasizes the context-dependent agrobiodiversity-resilience relationship and the need for tailored agricultural diversification strategies. We discuss how inconsistencies between theoretical concepts and practical measures may compromise study validity and comparability and how smallholder context can influence resilience conceptualization. Based on our findings, we propose guidelines for future research and emphasize the need for improved metrics, empirical evidence generation, and mixed-method approaches. Our findings prompt further exploration of key questions to advance our understanding of agrobiodiversity's role in fostering agricultural resilience.

A single dose of prophylactic antibiotic may be sufficient to prevent postprocedural infection in upper endosonography guided fiducial marker placement.

AIM: Prophylactic antibiotic after endosonographic ultrasound (EUS) guided fiducial marker placement is common practice to prevent infection. Duration of using prophylaxis antibiotic is unknown. The aim of this paper was to assess whether one time intraprocedural administration of a prophylactic antibiotic is sufficient to prevent infection after EUS guided fiducial marker placement. METHODS: Retrospective study was performed included all adult patients who underwent EUS guided fiducial markers over 18 month period. Procedure related infection was defined as any infection not directly attributable to any other cause within 30 days of the procedure. The patients followed up with the Gastroenterology clinic in one week and with Radiation Oncology clinic weekly after undergoing EUS guided fiducial marker placement. RESULTS: A total of 35 upper EUS-guided fiducial markers were placed during 20 procedures on 18 patients. The average age of patients was 59 years. There were 10 females and 8 males.. All patients received one dose of cephalosporin, amoxicillin, clindamycin or levoflocaxin. The fiducial markers were deployed in different organs. None of the patients developed any infections due to the procedure. CONCLUSION: This study suggests that one dose of intravenous antibiotic administered intraprocedurally is sufficient to prevent infection related to upper EUS guided fiducial marker placement.

Validation of food-grade salts of organic acids as ingredients to control Listeria monocytogenes on pork scrapple during extended refrigerated storage.

This study was conducted to investigate control of Listeria monocytogenes on pork scrapple during storage at 4°C. In phase I, scrapple was formulated, with or without citrate-diacetate (0.64%), by a commercial processor to contain various solutions or blends of the following antimicrobials: (i) lactate-diacetate (3.0 or 4.0%), (ii) lactate-diacetate-propionate (2.0 or 2.5%), and (iii) levulinate (2.0 or 2.5%). Regardless of whether citrate-diacetate was included in the formulation, without the subsequent addition of the targeted antimicrobials pathogen levels increased ca. 6.4 log CFU/g within the 50-day storage period. In the absence of citrate-diacetate but when the targeted antimicrobials were included in the formulation, pathogen numbers increased by ca. 1.3 to 5.2 log CFU/g, whereas when citrate-diacetate was included with these antimicrobials, pathogen numbers increased only by ca. 0.7 to 2.3 log CFU/g. In phase II, in the absence of citrate-diacetate, when the pH of the lactate-diacetate-propionate blend (2.5%) was adjusted to pH 5.0 or 5.5 pathogen numbers remained unchanged (≤0.5 log CFU/g increase) over 50 days, whereas when citrate-diacetate was included with the lactate-diacetate-propionate blend adjusted to pH 5.0 or 5.5, pathogen numbers decreased by 0.3 to 0.8 log CFU/g. In phase III, when lower concentrations of the lactate-diacetate-propionate blend (1.5 or 1.94%) were adjusted to pH 5.5, pathogen numbers increased by ca. 6.0 and 4.7 log CFU/g, respectively, whereas when the mixture was adjusted to pH 5.0, pathogen numbers increased by ≤0.62 log CFU/g. Thus, scrapple formulated with lactate-diacetate-propionate (1.5 and 1.94% at pH 5.0) is an unfavorable environment for outgrowth of L. monocytogenes.

Leprosy acquired by inoculation from a knee injury.

This case study reports on the development of clinical leprosy in a young Caucasian female from a non-endemic country who contracted the disease while living in a leprosy endemic country. In the presentation and discussion, some relevant factors will be reviewed and discussed that may play a role in the transmission, susceptibility and clinical development of the disease.

Viability of Listeria monocytogenes on commercially-prepared hams surface treated with acidic calcium sulfate and lauric arginate and stored at 4°C.

We demonstrated the effectiveness of delivering an antimicrobial purge/fluid into shrink-wrap bags immediately prior to introducing the product and vacuum sealing, namely the "Sprayed Lethality In Container" (SLIC™) intervention delivery method. The pathogen was Listeria monocytogenes, the antimicrobials were acidic calcium sulfate (ACS; calcium sulfate plus lactic acid; 1:1 or 1:2 in dH(2)O) and lauric arginate (LAE; Ethyl-N-dodecanoyl-l-arginate hydrochloride; 5% or 10% in dH(2)O), and the product was commercially prepared "table brown" ham (ca. 3 pounds each). Hams were surface inoculated with a five-strain cocktail of L. monocytogenes (ca. 7.0 log(10) CFU per ham), added to shrink-wrap bags that already contained ACS or LAE, vacuum-sealed, and stored at 4°C for 24h. Pathogen levels decreased by 1.2, 1.6, 2.4, and 3.1 log(10) CFU/ham and 0.7, 1.6, 2.2, and 2.6 log(10) CFU/ham in samples treated with 2, 4, 6, and 8mL of a 1:1 and 1:2 solution of ACS, respectively. In samples treated with 2, 4, 6, and 8mL of a 5% solution of LAE, pathogen levels decreased by 3.3, 6.5, 5.6, and 6.5 log(10) CFU/ham, whereas when treated with a 10% solution of LAE pathogen levels decreased ca. 6.5 log(10) CFU/ham for all application volumes tested. The efficacy of ACS and LAE were further evaluated in shelf-life studies wherein hams were surface inoculated with either ca. 3.0 or 7.0 log(10) CFU of L. monocytogenes, added to shrink-wrap bags that contained 0, 4, 6, or 8mL of either a 1:2 solution of ACS or a 5% solution of LAE, vacuum-sealed, and stored at 4°C for 60 days. For hams inoculated with 7.0 log(10) CFU, L. monocytogenes levels decreased by ca.1.2, 1.5, and 2.0 log(10) CFU/ham and 5.1, 5.4, and 5.5 log(10) CFU/ham within 24h at 4°C in samples treated with 4, 6, and 8mL of a 1:2 solution of ACS and a 5% solution of LAE, respectively, compared to control hams that were not treated with either antimicrobial. Thereafter, pathogen levels remained relatively unchanged (±1.0 log(10) CFU/ham ) after 60 days at 4°C in hams treated with 4, 6, and 8mL of a 1:2 solution of ACS and increased by ca. 2.0-5.0 log(10) CFU/ham in samples treated with 4, 6, and 8mL of a 5% solution of LAE. For hams inoculated with 3.0 log(10) CFU, L. monocytogenes levels decreased by 1.3, 1.9, and 1.8 log(10) CFU/ham within 24h at 4°C in samples treated with 4, 6, and 8mL of a 1:2 solution of ACS, respectively, compared to control hams that were not treated. Likewise, levels of the pathogen were reduced to below the limit of detection (i.e., 1.48 log(10) CFU/ham) in the presence of 4, 6, and 8mL of a 5% solution of LAE within 24h at 4°C. After 60 days at 4°C, pathogen levels remained relatively unchanged (±0.3 log(10) CFU/ham) in hams treated with 4, 6, and 8mL of a 1:2 solution of ACS. However, levels of L. monocytogenes increased by ca. 2.0 log(10) CFU/ham in samples treated with 4 and 6mL of a 5% LAE solution within 60 days but remained below the detection limit on samples treated with 8mL of this antimicrobial. These data confirmed that application via SLIC™ of both ACS and LAE, at the concentrations and volumes used in this study, appreciably reduced levels of L. monocytogenes on the surface of hams within 24h at 4°C and showed potential for controlling outgrowth of the pathogen over 60 days of refrigerated storage.

Prevalence of Campylobacter within a swine slaughter and processing facility.

In this work, the occurrence of Campylobacter in a swine slaughter and processing facility was studied. Thirty composite carcass samples, representing 360 swine carcasses, were taken immediately after exsanguination, immediately after polishing, after the final wash, and after overnight chilling at 2 degrees C. Thirty matching composite rectal samples were also taken immediately after exsanguination, and 60 nonmatching individual colon samples were collected from the same lot of swine during evisceration. Also, 72 environmental samples were collected from equipment used in the slaughter operation (42 samples) and the processing operation (30 samples). Campylobacter was isolated by direct plating on Campy-Line agar (CLA) or Campy-Cefex agar (CCA), as well as by Bolton broth enrichment and subsequent inoculation onto CLA or CCA. For all four recovery methods combined, Campylobacter was detected on 33% (10 of 30) of the composite carcasses immediately after exsanguination, 0% (0 of 30) after polishing, 7% (2 of 30) immediately before chilling, and 0% (0 of 30) after overnight chilling. The pathogen was recovered from 100% (30 of 30) of the composite rectal samples and 80% (48 of 60) of the individual colon samples. Campylobacter was detected in 4.8% (2 of 42) and 3.3% (1 of 30) of the slaughter and processing equipment samples, respectively. The recovery rate achieved with direct plating on CLA was significantly higher (P < 0.05) than those achieved with the other three recovery methods. For the 202 isolates recovered from all of the various samples tested, Campylobacter coli was the predominant species (75%) and was followed by Campylobacter spp. (24%) and Campylobacter jejuni (1%). These results indicate that although Campylobacter is highly prevalent in the intestinal tracts of swine arriving at the slaughter facility, this microorganism does not progress through the slaughtering operation and is not detectable on carcasses after overnight chilling.

Salmonella spp. and Escherichia coli biotype I on swine carcasses processed under the hazard analysis and critical control point-based inspection models project.

The present study examined the prevalence of Salmonella spp. and the prevalence and quantity of generic (biotype I) Escherichia coli on carcasses or in pig feces at a pork processing plant operating under the hazard analysis and critical control point-based inspection models project (HIMP) program. The surfaces of carcasses were sponged on 10 separate days over a 30-day period at two processing steps: (i) immediately following exsanguination (100 carcasses), and (ii) after the carcasses were washed, eviscerated, and chilled overnight (122 carcasses). Feces were also collected from 60 of the 100 sponged, postexsanguinated pigs. Salmonella spp. were detected on 73.0% of the 100 postexsanguinated pigs, in 33.3% of the 60 fecal samples, and on 0.7% of the 122 chilled carcasses. E. coli was found on 100.0% of the postexsanguinated pigs and on 30.1% of chilled carcasses tested. The mean concentration of E. coli on carcasses was 1,700 CFU/cm2 immediately after the exsanguination step and 1.1 CFU/cm2 at the chilled carcass stage. Previous studies at this processing plant showed that the pre-HIMP baseline level of Salmonella spp. on the chilled carcasses was 0.8%, indicating that the present HIMP inspection system produced an equivalent level of bacteriological performance.

Variations in feminine hygiene practices of military women in deployed and noncombat environments.

There is limited information on how military women manage feminine hygiene practices in combat and noncombat environments. The purpose of this study was to describe feminine hygiene practices of military women in deployed and noncombat (normal) environments. A nonexperimental descriptive research design was used. The study used a survey questionnaire, the Deployed Female Health Practice Questionnaire, which was developed specifically for military women to report their experiences with hygiene issues. Significant differences between deployed and normal environments were found in the areas of types of menses management products used and in douching and handwashing practices. Continuing education about safe feminine hygiene practices will help military women cope better in deployed (field) environments. Recommendations suggest further study on intervention strategies for hygiene management practices.

Improving qualitative proposals: common problem areas.

Advanced practice nurses conducting clinical research may decide to use qualitative methods. These types of studies also are now receiving more positive consideration for funding than they have in the past. When writing a proposal for research projects, investigators new to qualitative research frequently have misconceptions about this type of research and the assumptions on which the research is based. These misconceptions lead to problems within the proposals that make it difficult for reviewers to evaluate adequately the research plan. In this article, the authors outline problems frequently observed in qualitative proposals, offer advice on how to correct the problems, and provide some examples from their own funded proposals.

The relationship of burnout, stress, and hardiness in nurses in a military medical center: a replicated descriptive study.

The purpose of this descriptive study was to determine whether the personality trait of hardiness is a predictor of burnout and whether it can buffer the effect of stress on burnout. Forty-nine registered nurses working in 7 special care units completed the Tedium Burnout Scale, the Nursing Stress Scale, and the Hardiness Test. Results indicate that burnout, stress, and hardiness had a significant relationship (P < .001). Hierarchical multiple regression analysis indicated that hardiness alone accounted for 35% of burnout variance (P < .05) and that the addition of stress had no effect. A previous study reported that burn unit nurses had the least burnout and greatest hardiness. However, in this study, nurses from the Burn Intensive Care Unit had the highest burnout and stress scores and the lowest hardiness scores of nurses from the 7 units. This study confirms findings by a previous study that hardiness is a predictor of burnout but is not a buffer in the stress-burnout relationship. To further understand burnout and hardiness, longitudinal and multisite studies that include burn units are recommended.

Development of a decision tree for support surfaces: a tool for nursing.

The use of specialty support surfaces can be clinically beneficial for at-risk patients, but can prove costly if their use is not closely monitored. A decision tree can guide health care providers in selecting the most appropriate support surface based on the patient's condition. The process used by one medical center to develop and test a decision tree for specialty support surfaces selection is described.

Costs and outcomes of a military bone marrow transplant program.

There is a lack of published cost and outcome data concerning bone marrow transplant (BMT) patients treated in a military health care setting. The objectives of this prospective investigation were to collect demographic data concerning the characteristics of patients using the service, to track outcomes of length of stay, relapse, and mortality, and to analyze cost data based on a specific cost accounting system that was created to accurately capture individual versus aggregate costs. The sample consisted of 106 patients, 71 adults and 35 children. The mean cost of an adult autologous BMT was $45,600, the mean cost for a pediatric autologous BMT was $60,725, and the mean cost of a pediatric allogeneic BMT was $68,930. Previously, $100,000 to $500,000 per transplant was paid for military beneficiaries receiving BMTs in the civilian sector. Expenditures related to treating adult patients were reduced by $50,000 to $100,000 per patient. Savings associated with each pediatric transplant ranged from $100,000 to $200,000.

Diseases treated with blood cell transplants.

OBJECTIVES: To provide an overview of the vast amount of clinical and research data concerning the diseases treated with blood cell transplants. DATA SOURCES: Research studies, abstracts, book chapters, and articles pertaining to diseases treated with blood cell transplantation (BCT). CONCLUSIONS: The potential for the expanded use of BCT in cancer and other diseases appears unlimited. This type of transplantation is gaining widespread use and the number of centers offering this treatment for hematologic and solid tumors is increasing. IMPLICATIONS FOR NURSING PRACTICE: Nurses working in acute care, outpatient, and home care settings need to familiarize themselves with the rapidly expanding role of this treatment to provide the most state-of-the-art care to their patients.

Expectations and experiences of patients with cancer participating in phase I clinical trials.

PURPOSE/OBJECTIVES: To describe the expectations and experiences of patients entering phase I clinical trials. DESIGN: Descriptive, exploratory, prospective. SETTING: A large military medical teaching center. SAMPLE: Thirty-seven adult patients completed the entry and exit interviews. Subjects had a good performance status, were middle aged, and had common tumor types. METHODS: Interviews using structured entry and exit questionnaires. MAIN RESEARCH VARIABLES: Expectations and experiences of patients in phase I clinical trials. FINDINGS: Patients expected slightly increased support from family members and received more support than expected. Patients' expectations for tumor response and increased communication with their physician were not met. Patients expected symptoms such as fatigue, nausea and vomiting, and weight loss to improve during therapy, yet their expectations were not met. CONCLUSIONS: One theme that emerged from the data was hope/optimism. An issue that needs further exploration is the extent to which patients accurately understand information in the consent form. Findings also support the importance of communication between the patient and family members and the healthcare team. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses can mediate the flow of information between physicians and patients. Oncology nurses can and should assess the patient's level of understanding of the clinical trial, the consent form, and potential side effects at the time of entry into the trial and intermittently during the course of therapy. Nurses must allow patients with cancer who are undergoing investigational therapy to maintain a level of hope, while realistically counseling them about their progress during phase I trial participation.

Practice environment for nurse practitioners in California. Identifying barriers.

Barriers exist that prevent nurse practitioners from using their primary health care knowledge and skills. We present the incidence of and specific barriers experienced by nurse practitioner respondents in California, the state with the largest number of nurse practitioners in the nation. A January 1995 survey was sent to all nurse practitioners certified in California to elicit their experiences regarding legal or social barriers in their practice, with space for an open-ended response. Of an estimated 3,895 nurse practitioners in California, 2,741 (70%) returned surveys. Most nurse practitioner (65%) respondents in California are providing primary care. Perceived barriers to practice are lack of prescriptive authority, lack of support from physicians, reimbursement difficulties, and lack of public awareness. Current barriers to nurse practitioner practice in California are similar to national barriers discovered in 1992 data. The development of interprofessional dialogue and the recognition of the contributions of all primary care professionals are some of the steps that can be taken to reduce these barriers and increase the use and effectiveness of nurse practitioners in primary care.