Effect of Wheat Cultivars and Blends on the Oviposition and Larval Mortality of Cephus cinctus (Hymenoptera: Cephidae) and Parasitism by Bracon cephi (Hymenoptera: Braconidae).

The wheat stem sawfly (Cephus cinctus Norton) is a major historical pest of wheat in the northern Great Plains of North America. The insect spends most of its life as a larva protected inside grass stems so that its management has relied on strategies other than insecticides. We conducted a study in southern Alberta from 2006-2009 to assess the effects of wheat species, cultivar, seeding rate, and blending a resistant and a vulnerable cultivar, on oviposition, larval infestation, and cutting damage. The mortality caused by its primary parasitoid, Bracon cephi (Gahan), was also assessed to investigate the potential benefit of cultivar blends to enhance sawfly biological control. Sawfly laid fewer eggs on plants of the durum cultivar 'AC Avonlea' and on those of the solid-stemmed cultivar 'Lillian' compared to plants of the hollow-stemmed cultivar 'CDC Go.' Larval establishments (infestation) followed a similar pattern to that of oviposition. At these locations there was low cutting damage in most years and to a large extent this was due to mortality inflicted by the parasitoid Bracon cephi (40-60%). However, the remaining mortality was attributed to other factors and host, particularly the inclusion of the solid-stemmed cultivar. Direct and indirect factors likely affected the success of the parasitoid in the crop monocultures and blends, and these mechanisms require further research.

Investigation of Mannheimia haemolytica bacteriophages relative to host diversity.

AIMS: This study aimed to characterize the impact of lytic and temperate bacteriophages on the genetic and phenotypic diversity of Mannheimia haemolytica from feedlot cattle. METHODS AND RESULTS: Strictly lytic phages were not detected from bovine nasopharyngeal (n = 689) or water trough (n = 30) samples, but Myoviridae- or Siphoviridae-like phages were induced from 54 of 72 M. haemolytica strains by mitomycin C, occasionally from the same strain. Phages with similar restriction fragment length polymorphism profiles (RFLP ≥70% relatedness) shared common host serotypes 1 or 2 (P < 0·0001). Likewise, phages with similar RFLP tended to occur in genetically related host bacteria (70-79% similarity). Host range assays showed that seven phages from host serotypes 1, 2 and 6 lysed representative strains of serotypes 1, 2 or 8. The genome of vB_MhM_1152AP from serotype 6 was found to be collinear with P2-like phage φMhaA1-PHL101. CONCLUSIONS: Prophages are a significant component of the genome of M. haemolytica and contribute significantly to host diversity. Further characterization of the role of prophage in virulence and persistence of M. haemolytica in cattle could provide insight into approaches to control this potential respiratory pathogen. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrated that prophages are widespread within the genome of M. haemolytica isolates and emphasized the challenge of isolating lytic phage as a therapeutic against this pathogen.

Genetic characterization and antimicrobial susceptibility of Mannheimia haemolytica isolated from the nasopharynx of feedlot cattle.

A surveillance study was undertaken to examine the population dynamics and antimicrobial resistance of Mannheimia haemolytica isolated from feedlot cattle. A total of 416 isolates were collected from the nasopharynx either upon entry or exit from two feedlots in southern Alberta, Canada. Isolates were serotyped, characterized by pulsed-field gel electrophoresis and tested for susceptibility to ten antimicrobial agents via disk diffusion. Resistant isolates were screened by PCR for select antimicrobial-resistance gene determinants. Isolates were highly diverse, with 335 unique pulsed-field profiles identified among 147 strongly related clusters (similarity ≥ 85%). Clonal spread of isolates throughout the feedlots was limited and no clear association was found between genetic relatedness of M. haemolytica and sampling event (entry or exit). Pulsed-field profiles sharing a common serotype and resistance phenotype tended to cluster together. The majority of isolates were identified as serotype 2 (74.5%) although both serotype 1 (11.9%) and 6 (12.7%) were detected. Only 9.54% of isolates exhibited antimicrobial resistance. Resistance to oxytetracycline was most prevalent (n=16), followed by ampicillin (n=10), and amoxicillin/clavulanic acid (n=7). Multi-drug resistance was observed in five isolates. The tetH gene was detected in all but two oxytetracycline resistant isolates. Other detectable resistance determinates included ermX and bla(ROB-1). In the two feedlots examined, M. haemolytica exhibited considerable genetic diversity and limited resistance to common veterinary antibiotics. Garnering further information on the linkage between genotype and phenotype should contribute toward a better understanding of the pathogenesis and dissemination of M. haemolytica in feedlots.

Comparison of repetitive PCR and pulsed-field gel electrophoresis for the genotyping of Mannheimia haemolytica.

Mannheimia haemolytica is an opportunistic pathogen that can cause fibrinonecrotic pneumonia in cattle and is the main bacterial agent implicated in bovine respiratory disease-complex (BRD). Despite its economic importance to the cattle industry, few studies have characterized the genetic nature of M. haemolytica and none have genotyped isolates from feedlots. Identifying and monitoring genetic variants of M. haemolytica is important to understanding the etiology of BRD in cattle. We investigated the capacity of three genotyping techniques (BOX-PCR, (GTG)(5)-PCR and PFGE analysis of SalI-restricted DNA) to discriminate among 24 reference strains from the family Pasteurellaceae and 40 M. haemolytica isolates collected from feedlot cattle. From cluster analysis of the M. haemolytica isolates, PFGE was revealed as most discriminating, followed by BOX-PCR and then (GTG)(5)-PCR (Simpson's diversity index >0.98, 0.82, and 0.72, respectively). Of these methods, PFGE also had the greatest mean repeatability (0.96). The PFGE and BOX-PCR assays grouped all M. haemolytica in a single cluster but only BOX-PCR and (GTG)(5)-PCR grouped the Mannheimia glucosida and Mannheimia ruminalis strains together. Refinement of genotyping procedures for M. haemolytica could offer new insight into the etiology of this pathogen in BRD.

Prognostic value of the ECG on admission in patients with acute major pulmonary embolism.

A number of ECG abnormalities can be observed in the acute phase of pulmonary embolism (PE). Their prognostic value has not yet been systematically studied in large patient populations. In 508 patients with acute major PE derived from a large prospective registry, the current authors assessed, on admission, the impact of specific pathological ECG findings on early (30-day) mortality. Atrial arrhythmias, complete right bundle branch block, peripheral low voltage, pseudoinfarction pattern (Q waves) in leads III and aVF, and ST segment changes (elevation or depression) over the left precordial leads, were all significantly more frequent in patients with a fatal outcome. Overall, 29% of the patients who exhibited at least one of these abnormalities on admission did not survive to hospital discharge, as opposed to only 11% of the patients without a pathological 12-lead ECG. Multivariate analysis revealed that the presence of at least one of the above ECG findings was, besides haemodynamic instability, syncope and pre-existing chronic pulmonary disease, a significant independent predictor of outcome. In conclusion, ECG may be a useful, simple, non-costly tool for initial risk stratification of patients with acute major pulmonary embolism.

Women's health care: a new paradigm for the 21st century.

Oppression based on gender exists in all aspects of women's lives and transcends contemporary cultures, economic systems, and even health care services. Radical feminism provides an alternative philosophic framework of health care that is based on a women-centered viewpoint, with the experiences of women as its unifying philosophy. Midwifery is a means to apply this new philosophic approach to the health care of women. A partnership between midwifery and feminist philosophy will allow women's voices to be heard, while guiding research in women's health care in new directions, and illuminating new approaches to current health problems. The new millennium provides an opportunity to explore an alternative framework and philosophy that will change the current paradigm of women's health care.

Midwifery in Northern Belize.

During several volunteer experiences in the Corozal District in Northern Belize, the authors worked with and interviewed traditional midwives, midwife educators, administrators, and professional midwives, who practice in public health clinics, rural health outposts, and a government hospital. One interview with a traditional midwife from a rural Mayan village, garnered interesting information about her 63-year practice, which is compared with the practice of professional midwives. Issues important to midwifery and health care in Belize are discussed. The interviews and the authors' own experiences reveal changing birthing practices, as well as the continued importance of midwives in the care of childbearing women in Northern Belize.

Emergency contraception for midwifery practice.

Every year in the United States, there are an estimated 3.5 million unplanned pregnancies with nearly one third of these attributed to contraceptive failures. Despite the availability of effective contraceptive methods, far too many women still experience unwanted pregnancies. It has been estimated that emergency contraception, also referred to as postcoital contraception or "the morning after pill," can reduce the risk of pregnancy after unprotected intercourse by as much as 75%. When administered within 72 hours of unprotected intercourse, emergency contraception, inhibits implantation of a fertilized ovum. The most common method of emergency contraception, the administration of ethinyl estradiol and dL-norgestrel, was initially described by Yuzpe in 1977. In the past 20 years, multiple studies have demonstrated the effectiveness of commonly prescribed combination oral contraceptives containing ethinyl estradiol and levonorgestrel. For those women in whom estrogen is contraindicated, progestin-only pills or the synthetic androgen Danazol have been used with comparable effectiveness rates. For appropriately selected women, an intrauterine device such as the Paraguard T380A (Ortho Pharmaceuticals, Raritan, NJ) also may be inserted within 5-7 days after unprotected intercourse to reduce the risk of unintended pregnancy. Despite its success and safety, emergency contraception is underused by women and their health care providers. As providers of comprehensive health care, midwives should provide patients with accurate information concerning pregnancy prevention. For many women, obtaining emergency contraception is an entry into the health care system and provides them an opportunity to be educated about safer sex practices, contraception, and the importance of regular health screening. Regularly discussing emergency contraception with patients at routine health visits will enable them to participate fully in their health care decisions and diminish the physical, psychological, and societal stressors associated with unplanned pregnancy.

PIP: Midwives have substantial contact with women who are at risk of unintended pregnancy and are thus ideally placed to promote use of emergency contraception. Emergency contraception has the potential to reduce the risk of pregnancy after unprotected intercourse by as much as 75%. Potential candidates for this method are women who have missed multiple contraceptive pills, incorrectly used barrier methods, unsuccessfully relied on withdrawal, were exposed to a possible teratogen, or were sexually assaulted. Multiple studies have confirmed the effectiveness of postcoital regimens such as oral contraceptives containing ethinyl estradiol and levonorgestrel, progestin-only pills, the synthetic androgen Danazol, or IUD insertion. Nonetheless, emergency contraception remains underutilized in the US and other countries. There is a need for health care providers to begin to integrate this method into the routine education offered to women during comprehensive health care visits. Women who use barrier methods or spermicide alone as their primary birth control method may benefit from having emergency contraception readily available. Printed materials about emergency contraception should be placed in waiting rooms, and office staff should be prompted to schedule patients requesting the method immediately. Visits for emergency contraception offer a valuable opportunity to provide education about sexually transmitted diseases, safer sex practices, and the importance of consistent use of reliable contraception.

Unintended pregnancy. Consequences and solutions for a worldwide problem.

Unintended pregnancy is a worldwide problem that affects women, their families, and society. Unintended pregnancy can result from contraceptive failure, non-use of contraceptive services, and, less commonly, rape. Abortion is a frequent consequence of unintended pregnancy and, in the developing world, can result in serious, long-term negative health effects including infertility and maternal death. In many developing countries, poverty, malnutrition, and lack of sanitation and education contribute to serious health consequences for women and their families experiencing an unintended pregnancy. Regardless of the cause, unintended pregnancy and its negative consequences can be prevented by access to contraceptive services including emergency contraception, safe and legal abortion services, and a society that allows women to determine their own reproductive choices. Addressing unintended pregnancy and its substantial human and dollar costs should be a priority in every country. The availability of reliable contraception for all, regardless of age or ability to pay, is an essential first step. Women and adolescents require access to age-appropriate and culturally sensitive reproductive health care services, including emergency contraception. Access to safe, legal abortion services is necessary to impact the staggering maternal mortality rates worldwide. Midwives throughout the world provide the majority of care for women of reproductive age. It is essential to identify those at risk for unintended pregnancy, provide the services they require, and remain diligent to ensure that those women and their families have safe options to consider when faced with an unintended pregnancy. In 1920, Magaret Sanger said, "No women can call herself free who does not control her own body." Although great strides have been made to improve the health and status of women since Ms. Sanger spoke those words, there remains much work to be done.

PIP: Unintended pregnancies (UPs) are a global problem with substantial negative consequences for women, their families, and society. In developing country settings, women who seek to abort UPs face the risk of serious long-term health effects, including infertility and maternal death. Access to contraceptive services (including emergency contraception), safe and legal abortion services, and societal norms that empower women to make their own reproductive choices are prerequisites to solving this problem. An essential first step is universal access to safe, reliable contraception regardless of age or ability to pay. Those at risk for UPs, especially adolescents, should be identified and targeted for special intervention.