Disease Management Practices Research Articles

Changes in Production Practices Used for Disease Management in Blueberry Nurseries in Georgia, USA, Over a 15-year Period

Surveys of blueberry [rabbiteye blueberry (Vaccinium virgatum) and southern highbush blueberry (Vaccinium corymbosum interspecific hybrids)] nurseries in the State of Georgia, USA, were conducted in 2007 and 2022 to determine the prevalence of and associations among propagation practices, especially related to disease management. As indicated by the reduction in surveyed nurseries in 2022 (7) compared with 2007 (18), the Georgia blueberry nursery industry has consolidated. However, cultural disease management practices have generally improved in these remaining nurseries. In 2007, in nurseries where cuttings were grown in containers, 77.8% reused containers and 66.7% did not sterilize them before use. The growing medium [pine (Pinus sp.) bark] was reused for subsequent production cycles in 29.4% of nurseries, although such reuse of media tended to be associated with production in beds as opposed to containers (P = 0.08). Nurseries used well water in 88.2% and pond water in 11.8% of cases. Cuttings were grown on benches (vs. the ground) in slightly fewer than half of the nurseries. In contrast, all nurseries surveyed in 2022 grew their cuttings in containers, used well water, and had increased bench use, albeit only slightly. Although all nurseries reused containers, only 28.5% did not sterilize containers before use, and only 14.3% of nurseries reported reusing media. Most nurseries surveyed in 2007 (83.3%) were on a routine, calendar-based fungicide program using a.i. targeted primarily against aboveground diseases (blights and leaf spots) and secondarily against soil-borne water molds (Phytophthora and Pythium species of the Oomycetes class). In contrast, 42.8% of those surveyed in 2022 were on a 2- to 3-week spray schedule, 42.8% used fungicides on an as-needed basis, and 14.4% were on a monthly schedule, indicating that fungicide scheduling varied dramatically among the remaining nurseries.

Documenting Pharmacist Intervention: A Technology-Driven Solution to Overcome Challenges

Clinical pharmacist conducts multiple activities governed by the best evidence for disease management and safe medication practices. The ASHP highlighted the importance of documenting and recording clinical pharmacy interventions to prevent adverse drug events and reduce hospital length of stay. Our institution utilizes an in-house electronic documentation system (e-DS) to document clinical interventions. We aim to study the impact of enhancing the e-DS. This study is a retrospective single-center descriptive review post-implementation of in-house e-DS enhancements. Data were collected between September 2017 and December 2019 for documented interventions by clinical pharmacists for admitted patients. Fields for analysis include clinical interventions, expected outcomes of interventions, cycle time for documentation, and drug cost. Outcomes measures include several documented interventions, preventing medication errors/adverse drug events, time-saving and cost avoidance. Descriptive analysis will be performed for categorical variables. The study showed an increased number of documented interventions for preventing medication errors/adverse drug events, time-saving, and cost avoidance, with an average time-saving of 20 minutes per 10 interventions and estimated cost avoidance of 20 000 SAR per month. Study limitations include a lack of interface with EHR and non-feasibility to estimate indirect cost. Investment in documentation system optimization to reduce medication errors/adverse drug events, time-saving and cost avoidance.

Collaboration in the management of psoriasis and psoriatic arthritis: A survey of joint working in UK clinical practice

AbstractBackgroundTreatment guidelines for psoriasis and psoriatic arthritis consider all skin and joint domains and recommend collaborative multidisciplinary team (MDT) working. The uptake of joint working in clinical practice for psoriatic disease management has not been well studied.ObjectivesThis United Kingdom (UK) study aimed to provide a better understanding of current working patterns and collaborating specialities, as well as benefits and challenges of combined clinics.MethodsAn online survey was emailed to dermatology and rheumatology healthcare professionals (HCPs) using professional networks.ResultsResponses were received between October 2020 and April 2021 (N = 80); 60.0% of respondents worked in dermatology and 40.0% in rheumatology. Use of combined clinics with dermatology was reported by 40.6% of rheumatology HCPs, including joint (25.0%), parallel (3.1%) and virtual clinics (6.3%), and MDT meetings (6.2%). Similarly, 50.1% of dermatology HCPs reported use of joint (25.0%), parallel (4.2%) and virtual clinics (2.1%), single visits (2.1%), and MDT meetings (16.7%) with rheumatology. Around one‐quarter of respondents collaborated via email, which was also the main method of collaboration with other specialists. Overall, one‐quarter of respondents reported no collaboration in psoriatic disease management. Perceived benefits of combined clinics included shared knowledge, improved patient outcomes and increased patient satisfaction. Challenges included difficulties in aligning clinician time and geographical location, as well as limited ‘buy‐in’ from senior management. Most respondents felt that the COVID‐19 pandemic had partially or significantly impacted combined clinics.ConclusionsThis study is one of the first to survey collaborative working in psoriatic disease management and the first in the UK. These findings demonstrate the variety of approaches used and a lack of collaborative working by one‐quarter of respondents. Despite the benefits, numerous challenges in establishing formal arrangements exist. More evidence is needed to demonstrate improved patient outcomes with collaborative working and to standardise best practice.

Livestock producers' knowledge, attitude, and behavior (KAB) regarding antimicrobial use in Ethiopia.

Inappropriate antimicrobial use (AMU) in livestock production is an important aspect of the global burden of antimicrobial resistance (AMR). In Ethiopia, a low-income country with a large and increasing livestock population, AMU in food animals is not properly regulated. Hence, farmers are fully free to use antimicrobials to their (perceived) benefit. Therefore, understanding farmers' mindsets is important to improve antimicrobial stewardship in the livestock sector. This cross-sectional study was conducted to assess livestock disease management practices and knowledge, attitude, and behavior (KAB) among livestock producers regarding AMU, residues, and resistance, as well as factors potentially explaining differences in KAB. We determined the KAB of livestock owners of three selected districts of central and western Ethiopia (n = 457), using a pretested questionnaire administered through face-to-face interviews. Logistic regression was used to evaluate the association between potential explanatory variables and the KAB scores of the respondents. The results showed that 44% of the farmers used antimicrobials in the past few years, where antibiotics (21%) and trypanocides (11%) were most widely used to manage livestock diseases. Furthermore, most farmers showed poor knowledge about AMU, residues, and AMR (94%) and unfavorable attitudes (<50% correct answers) toward contributing factors for AMR (97%). On the contrary, 80% of the respondents had overall good behavior scores (≥50% correct answers) related to AMU. Multivariate analysis results showed that having good knowledge, keeping ≥2 animal species, and the occurrence of ≥4 livestock diseases on the farm in a year were strong predictors of bad behavior scores (p < 0.05). The findings of the current investigation also revealed that the incidence of livestock diseases on the farm and a higher level of formal education significantly contributed to better knowledge and desirable attitudes but bad AMU behavior. A low level of awareness about and undesirable attitudes toward AMU and AMR could potentially affect farmers' behavior toward judicious AMU, thus requiring awareness creation efforts on livestock disease management practices.

Early outcomes following integration of computed tomography (CT) coronary angiography service in an established cardiology practice in disease management

BackgroundComputed tomography coronary angiography (CTCA) is an established modality for the diagnosis and assessment of cardiovascular disease. However, price and space pressure have mostly necessitated outsourcing CTCA to external radiology providers. Advara HeartCare has recently integrated CT services within local clinical networks across Australia. This study examined the benefits of the presence (integrated) or absence (pre-integrated) of this “in-house” CTCA service in real-world clinical practice. MethodsDe-identified patient data from electronic medical records were used to create an Advara HeartCare CTCA database. Data analysis included clinical history, demographics, CTCA procedure, and 30-day outcomes post-CTCA from two age-matched cohorts: integrated (n ​= ​495) and pre-integrated (n ​= ​456). ResultsData capture was more comprehensive and standardised across the integrated cohort. There was a 21% increase in referrals for CTCA from cardiologists observed for the integration cohort vs. pre-integration [n ​= ​332 (72.8%) pre-integration vs. n ​= ​465 (93.9%) post-integration, p ​< ​0.0001] with a parallel increase in diagnostic assessments including blood tests [n ​= ​209 (45.8%) vs. n ​= ​387 (78.1%), respectively, p ​< ​0.0001]. The integrated cohort received lower total dose length product [Median 212 (interquartile range 136–418) mGy∗cm vs. 244 (141.5, 339.3) mGy∗cm, p ​= ​0.004] during the CTCA procedure. 30-days after CTCA scan, there was a significantly higher use of lipid-lowering therapies in the integrated cohort [n ​= ​133 (50.5%) vs. n ​= ​179 (60.6%), p ​= ​0.04], along with a significant decrease in the number of stress echocardiograms performed [n ​= ​14 (10.6%) vs. n ​= ​5 (11.6%), p ​= ​0.01]. ConclusionIntegrated CTCA has salient benefits in patient management, including increased pathology tests, statin usage, and decreased post-CTCA stress echocardiography utilisation. Our ongoing work will examine the effect of integration on cardiovascular outcomes.

Biological therapy in systemic lupus erythematosus, antiphospholipid syndrome, and Sjögren's syndrome: evidence- and practice-based guidance.

Systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), and Sjögren's syndrome (SS) are heterogeneous autoimmune diseases. Severe manifestations and refractory/intolerance to conventional immunosuppressants demand other options, namely biological drugs, and small molecules. We aimed to define evidence and practice-based guidance for the off-label use of biologics in SLE, APS, and SS. Recommendations were made by an independent expert panel, following a comprehensive literature review and two consensus rounds. The panel included 17 internal medicine experts with recognized practice in autoimmune disease management. The literature review was systematic from 2014 until 2019 and later updated by cross-reference checking and experts' input until 2021. Preliminary recommendations were drafted by working groups for each disease. A revision meeting with all experts anticipated the consensus meeting held in June 2021. All experts voted (agree, disagree, neither agree nor disagree) during two rounds, and recommendations with at least 75% agreement were approved. A total of 32 final recommendations (20 for SLE treatment, 5 for APS, and 7 for SS) were approved by the experts. These recommendations consider organ involvement, manifestations, severity, and response to previous treatments. In these three autoimmune diseases, most recommendations refer to rituximab, which aligns with the higher number of studies and clinical experience with this biological agent. Belimumab sequential treatment after rituximab may also be used in severe cases of SLE and SS. Second-line therapy with baricitinib, bortezomib, eculizumab, secukinumab, or tocilizumab can be considered in SLE-specific manifestations. These evidence and practice-based recommendations may support treatment decision and, ultimately, improve the outcome of patients living with SLE, APS, or SS.

Good methods for good farmers? Mapping the language of good farming with “diligent farmers” in Hong Kong

This paper explores two questions facing the use of the concept of the ‘good farmer’ in rural studies: what are the most appropriate methods to understand good farming; and what is the relevance of the concept in non-western countries? The paper explores these issues in the context of pig farmers' biosecurity decisions and daily disease management practices in the New Territories of Hong Kong. Specifically, we argue that to broaden the relevance of the good farming concept, we need to devise specific methodologies to capture the relational practices among farmers, non-human life forms and substances that construct the ‘good farmer’ meaning in different cultural contexts. Firstly, we consider the language of ‘good farming’, its possible translations, potential meanings and alternative phrases used amongst Chinese-speaking farmers. Secondly, we develop a farmer-oriented methodology to analyse how these locally specific translations of good farming are constructed and used in relation to the management of animal disease. Drawing on 12 farmers' mapping and their interview discussion, we develop a narrated mapping methodology in which the creation of farm maps acts as a device to illustrate and talk about biosecurity and good farming. This visual method triangulates the graphical data with subsequent interview data of farmers' maps. From this we show how the idea of the ‘diligent farmer’ has much stronger resonance in Hong Kong than good farming. Farm maps identify specific symbols of diligence, highlighting values of productivism, environmentalism and social relationships. The mapping methodology also reveals the performative work involved in becoming a diligent farmer. In conclusion, the paper considers the broader methodological implications for the concept of good farming, suggesting that cultural linguistic differences need to be recognised in the concept, and arguing for further methodological advancement.

Evaluating a Culturally Tailored Public Health Forum in Improving the Knowledge and Understanding of Chronic Disease Management in the Chinese Population: A Mixed-methods Study

Background:&#x0D; Chronic disease management is fraught with many challenges for ethnic minorities. Studies conducted in non-multicultural populations suggest that patient and community engaging initiatives can improve chronic disease management practices. However, literature on culturally specific community engaging programs is relatively sparse. The interCultural Online Health Network (iCON) is a culturally tailored, patient and community engaging health promotion program, which provides culturally specific health education to BC’s multicultural communities. We aimed to assess if the iCON 2020 Chinese Health Forum can improve the knowledge and understanding of chronic disease self-management in the Chinese community of Vancouver, BC.&#x0D; &#x0D; Methods:&#x0D; We conducted a sequential mixed-methods study by administering pre- and post- validated questionnaires, followed by semi-structured interviews conducted one-two months after the forum. We assessed our primary outcome of difference in self-efficacy scores post-forum using paired t-tests and further illuminated our research question through a thematic analysis of the semi-structured interviews.&#x0D; &#x0D; Results:&#x0D; From the 381 participants that attended the Health Forum, 131 consented to completing the pre- and/or post- surveys, and seven provided consent to participate in the follow-up interview. There was a statistically significant difference in self-efficacy scores pre- and post- forum participation (Mean difference = 0.58, S.D. = 1.42; [95% CI: 0.26 – 0.90], t(77) = 3.60; P = 0.001, d = 0.41). Participants attributed the effectiveness of the Health Forum to its accessible yet engaging programming and focus on culturally tailored health education.&#x0D; &#x0D; Conclusion:&#x0D; A culturally tailored, patient engagement and community outreach program effectively improved Chinese community members self-efficacy in managing their chronic diseases and was well received by participants. iCON’s 2020 Chinese Health Forum presents a model with associated principles of approach for similar culturally specific health education and community engagement programs that need to be developed to reduce the burden of chronic diseases in multicultural populations.

Real-world practice in Peyronie's disease management: Results from a national survey of urologists.

Despite many available treatments for Peyronie's disease (PD), practice patterns of available therapeutics are not well characterized. We conducted a national survey of urologists to characterize real-world practice patterns of PD management and to characterize the use of therapies discouraged by the American Urological Association guidelines on PD management. A 34-item survey was distributed via RedCap to urologists who treat patients with PD in all American Urological Association sections. Questions elicited demographic information as well as practices in the diagnosis and treatment of PD. Comparisons were made with Pearson's chi-squared test. The primary outcome was reported use of therapies discouraged by the American Urological Association guidelines on PD. A total of 145 respondents completed the survey, of whom 19% were fellowship trained in andrology/sexual medicine, 36% practiced in an academic setting, and 50% had at least 20 years in practice. Only 60% of respondents reporting performing in-office curvature assessment prior to commencing intralesional injection or surgical treatment, with higher prevalence in andrology/sexual medicine fellowship-trained versus non-fellowship-trained urologists (85%vs. 54%, p=0.003). The most popular treatment modalities were collagenase clostridium histolyticum (61% of respondents), phosphodiesterase-5 inhibitors (54%), and penile traction (53%). Twenty-one percent of respondents reported currently using a treatment that is explicitly discouraged by the American Urological Association guidelines (extracorporeal shockwave therapy for curvature, L-carnitine, omega-3 fatty acids, or vitamin E). Patients seeking PD treatment may be offered different therapies, some of which are not evidence-based, depending on the treating urologist. This study is limited by self-selection and response bias. Its strength is that it represents a cross-sectional overview of real-world practice patterns in PD management, which has not been previously described. A significant proportion of urologists reported PD management practices that are not evidence-based and not guideline-supported.

Biological Control Efficacy of Indigenous Antagonistic Bacteria Isolated from the Rhizosphere of Cabbage Grown in Biofumigated Soil against Pythium aphanidermatum Damping-Off of Cucumber

Soil biofumigation is a widely used farming practice for soil-borne disease management in vegetable crops. Soil biofumigation is the practice of the incorporation of fresh plant materials from the members of the Brassicaceae family into the soil which release antimicrobial volatile organic compounds (VOCs), namely glucosinolates and their hydrolysis products. However, the VOCs may affect non-target beneficial soil biota including microbial biocontrol agents (MBAs) due to their broad-spectrum toxicity. In this study, native antagonistic rhizobacteria were isolated from cabbage plants grown in biofumigated fields and their potential in the management of Pythium aphanidermatum cucumber damping-off was evaluated with and also without biofumigation using cabbage leaf residue. A total of 20 morphologically distinct, culturable bacterial strains were recovered from the rhizosphere soil of cabbage cultivated in a biofumigated field, with the largest fraction of the isolates belonging to the genus Bacillus. The other bacterial genera isolated were Pseudomonas, Serratia, Stenotrophomonas, Microbacterium and Priestia. Of the 20 bacterial isolates, Pseudomonas aeruginosa B1-SQU, Pseudomonas indica B2-SQU, Serratia marcescens B3-SQU and Pseudomonas brenneri B4-SQU exhibited inhibitory activity against P. aphanidermatum in a co-culture assay. The deformation and shrinkage of P. aphanidermatum hyphae due to diffusible antimicrobial compounds from these bacterial strains were witnessed through scanning electron microscopy. A biofilm was formed by these bacterial strains in vitro and they exhibited compatibility with each other; however, they had no significant plant growth promotion effect on cucumber. These bacterial strains significantly reduced damping-off in cucumber under greenhouse conditions when applied to soil singly, but failed to show a significant effect when combined with biofumigation treatment, though the bacterial population in the soil was maintained at higher levels. Soil biofumigation alone was also not effective in suppressing the damping-off of cucumber. Gas chromatography–mass spectrometry analysis revealed that 1-butanol, n-butyl butyrate and butyl acetate were the predominant VOCs in the soil amended with cabbage leaf residue. The results suggest that soil biofumigation with cabbage leaf residue has no significant effect on P. aphanidermatum under high inoculum levels; furthermore, it affects the efficiency of the bacterial antagonists in controlling damping-off in cucumber.

Basal Stem Rot of Oil Palm - The Pathogen, Disease Incidence, and Control Methods.

Basal stem rot of oil palm caused by Ganoderma boninense is the most serious disease of oil palm in Malaysia, Indonesia, and other oil palm producing countries. Economic losses caused by the disease can be up to USD500 million a year. For many years, basal stem rot was found to infect older palms of over 25 - 30 years. Only in the 1950s, the disease began to appear in much younger palms (10 to 15 years old) and in the last decade or so, palms as young as 1 year were infected by the disease. The highest incidence occurs in coastal areas of Southeast Asia but the disease has now infected oil palm in inland areas, mainly oil palm planted in peat soils. Disease incidence is also high in areas previously growing coconut or forest. Basal stem rot infection and spread occur through root-to-root contact, and basidiospores that colonize the roots also play a role. In the early stages of infection by G. boninense, the pathogen behaves as a biotroph and later as a necrotroph, secreting cell wall-degrading enzymes and triggering host defense responses. Genes, gene products and metabolic pathways involved in oil palm defense mechanisms against G. boninense have been identified, and these metabolites have the potential to be used as markers for early detection of the disease. Integrated disease management used to control basal stem rot includes cultural practices, chemical control, and application of biocontrol agents or fertilizers. Early detection tools have also been developed which could assist in management of basal stem rot infections. Development of resistant or tolerant oil palm is still at an early stage, so the existing integrated disease management practices remain the most appropriate methods for managing basal stem rot of oil palm.

A DESCRIPTIVE CROSS-SECTIONAL OBSERVATIONAL STUDY ON ASSESSMENT OF PATIENTS KNOWLEDGE, ATTITUDE AND PRACTICE ON HYPERTENSION AT A TERTIARY CARE HOSPITAL

Introduction: Hypertension is a strong independent risk factor for coronary and cerebrovascular diseases, as well as for heart failure, atrialfibrillation and chronic renal failure, thus substantially contributing to the global burden of disease. Moreover, it is well known that reducing blood pressure (BP) in hypertensive patientsis associated with a significant reduction in the rate of cardiovascular complications and adecline in renal function. Aim: To assess the patients knowledge, attitude and practice (KAP) and to create awareness about hypertension among hypertensive patients. Objectives: To evaluate the current situation and differences in knowledge, attitude and practices regarding hypertension and to create awareness of hypertension by giving verbal counseling to hypertensivepatients. Conclusion: Our study signifies that patients require support and guidance for practicing better disease management. Hence we conclude that aclinical pharmacist can play major role in improving patients knowledge and adherence bypatient education, developing maintenance of diet and exercise improved the patients practice activities. Clinical activities such as patient counseling, Home Medication Review, Pharmaceutical care program help to increase the patients practice in disease management.

Nanotechnological approaches for management of soil-borne plant pathogens.

Soil borne pathogens are significant contributor of plant yield loss globally. The constraints in early diagnosis, wide host range, longer persistence in soil makes their management cumbersome and difficult. Therefore, it is crucial to devise innovative and effective management strategy to combat the losses caused by soil borne diseases. The use of chemical pesticides is the mainstay of current plant disease management practices that potentially cause ecological imbalance. Nanotechnology presents a suitable alternative to overcome the challenges associated with diagnosis and management of soil-borne plant pathogens. This review explores the use of nanotechnology for the management of soil-borne diseases using a variety of strategies, such as nanoparticles acting as a protectant, as carriers of actives like pesticides, fertilizers, antimicrobials, and microbes or by promoting plant growth and development. Nanotechnology can also be used for precise and accurate detection of soil-borne pathogens for devising efficient management strategy. The unique physico-chemical properties of nanoparticles allow greater penetration and interaction with biological membrane thereby increasing its efficacy and releasability. However, the nanoscience specifically agricultural nanotechnology is still in its toddler stage and to realize its full potential, extensive field trials, utilization of pest crop host system and toxicological studies are essential to tackle the fundamental queries associated with development of commercial nano-formulations.

Enteric infections and management practices among communities in a rural setting of northwest Ethiopia

Infections with enteric pathogens have a high mortality and morbidity burden, as well as significant social and economic costs. Poor water, sanitation, and hygiene (WASH) conditions are the leading risk factors for enteric infections, and prevention in low-income countries is still primarily focused on initiatives to improve access to improved WASH facilities. Rural communities in developing countries, on the other hand, have limited access to improved WASH services, which may result in a high burden of enteric infections. Limited information also exists about the prevalence of enteric infections and management practices among rural communities. Accordingly, this study was conducted to assess enteric infections and management practices among communities in a rural setting of northwest Ethiopia. A community-based cross-sectional study was conducted among 1190 randomly selected households in a rural setting of northwest Ethiopia. Data were collected using structured and pretested interviewers-administered questionnaire and spot-check observations. We used self-reports and medication history audit to assess the occurrence of enteric infections among one or more of the family members in the rural households. Multivariable binary logistic regression model was used to identify factors associated with enteric infections. Statistically significant association was declared on the basis of adjusted odds ratio with 95% confidence interval and p value < 0.05. Out of a total of 1190 households, 17.4% (95% CI: 15.1, 19.7%) of the households reported that one or more of the family members acquired one or more enteric infections in 12 months period prior to the survey and 470 of 6089 (7.7%) surveyed individuals had one or more enteric infections. The common enteric infections reported at household-level were diarrhea (8.2%), amoebiasis (4.1%), and ascariasis (3.9%). Visiting healthcare facilities (71.7%), taking medications without prescriptions (21.1%), and herbal medicine (4.5%) are the common disease management practices among rural households in the studied region. The occurrence of one or more enteric infections among one or more of the family members in rural households in 12 months period prior to the survey was statistically associated with presence of livestock (AOR: 2.24, 95% CI:1.06, 4.75) and households headed by uneducated mothers (AOR: 1.62, 95% CI: (1.18, 2.23). About one-fifth of the rural households in the studied region reported that one or more of the family members had one or more enteric infections. Households in the study area might acquire enteric infections from different risk factors, mainly poor WASH conditions and insufficient separation of animals including their feces from human domestic environments. It is therefore important to implement community-level interventions such as utilization of improved latrine, protecting water sources from contamination, source-based water treatment, containment of domestic animals including their waste, community-driven sanitation, and community health champion.

Deposition aids, nozzle selection and carrier volume on canopy deposition and management of Cercospora leaf spot in sugarbeet (Beta vulgaris L.)

Cercospora leaf spot (CLS; Cercospora beticola Sacc.) is an economically devastating disease of sugarbeet (Beta vulgaris L.) in many regions worldwide. Field experiments evaluated the potential of InterLock deposition aid (MVO) and carrier volumes of 115, 235, 350, and 470 L ha−1 for improved CLS management with mancozeb (Manzate Pro-Stick) under moderate CLS intensity. Adding MVO to mancozeb did not reduce disease accumulation or improve yield or sugar quality more than mancozeb alone. Increased carrier volume did not affect disease progression but had a neutral effect on profit margin. Additional field experiments investigated the effect of MVO on spray deposition by analyzing Rhodamine WT recovery from leaves. Using MVO with mancozeb did not improve canopy deposition compared to mancozeb alone, regardless of the nozzle or carrier volume tested. Canopy deposition was improved using Hardi® ISO injet™ nozzles compared to Teejet® XR110 and Teejet® AI3070® nozzles. A quadratic relationship between dye recovery and carrier volume (R2 = 0.2871 p=<0.0001) was found; applications using a carrier volume of 350 L ha−1 improved deposition compared to 115 and 235 L ha−1. While MVO did not improve CLS management when mixed with Manzate Pro-Stick, nozzle selection did influence canopy deposition, and effects on CLS development require further investigation. In this study, increased carrier volume was not beneficial in limiting disease progress but incurred no economic penalty. Given the generally positive correlation between fungicide efficacy and the quality/degree of spray coverage, increased carrier volume should still be considered a best practice in disease management at the carrier volumes tested.

Evaluation of a nurse-led counselling intervention on selected outcome variables for parents of children with congenital adrenal hyperplasia.

Long-term care of children with congenital adrenal hyperplasia (CAH) has psycho-social implications for parents. Experts recommend a customized educational program for parents to facilitate their psychological adaptation and improve disease management. Such educational programs often provided by nurse counsellors are well evaluated in developed countries. There is a dearth of data on nurse-led counselling in the context of less developed countries. We aimed to evaluate the effect of a nurse-led counselling intervention on various psycho-social outcomes among parents of children with CAH. Fifty consecutive parents of children with CAH attending an outpatient clinic at a tertiary-care teaching hospital were enrolled. Parents' stress level, stigma, knowledge, practices, and treatment adherence were assessed by using Cohen's Perceived Stress Scale (PSS), DSD Stigma scale, and HILL-Bon Medication Adherence Scale (HB-MAS). Three educational counselling sessions were conducted within a month's gap, using PowerPoint presentations and a booklet. Assessment of outcomes was done at baseline and at the end of the third session. At baseline, the majority (90%) of the parents had moderate stress. Half of the parents had mild and the rest had moderate stigma. After the intervention, the majority (94%) of parents had shifted to mild levels of stress and stigma. At baseline, 86% of the parents had poor knowledge about the disease whereas post-intervention, 80% were having good knowledge. Disease management practices and treatment adherence also improved after the intervention. Nurse-led counselling was effective in reducing psycho-social problems, increasing knowledge, as well as improving practices and treatment adherence.

Practice Pattern Variability in the Management of Regional Lymph Node Metastasis in Extremity and Trunk Soft Tissue Sarcoma: A Survey of the Society of Surgical Oncology and Musculoskeletal Tumor Society Membership.

Regional lymph node metastasis in extremity and trunk soft tissue sarcoma (ETSTS) is rare with no standardized management. We sought to determine management patterns for regional lymph node metastasis in ETSTS. A survey regarding the management of ETSTS lymph node metastasis was distributed to the membership of the Musculoskeletal Tumor Society (MSTS) and the Society of Surgical Oncology (SSO) in January 2022. The survey queried the type of training (surgical oncology, orthopedic oncology), details of their practice setting, and management decisions of hypothetical ETSTS scenarios that involved potential or confirmed lymph node metastasis. The survey was distributed to 349 MSTS members (open rate of 63%, completion rate 21%) and 3026 SSO members (open rate of 55%, completion rate 4.7%) and was completed by 214 respondents, of whom 73 (34.1%) and 141 (65.9%) were orthopedic oncology and surgical oncology fellowship-trained, respectively. The majority of respondents practiced in an academic setting (n=171, 79.9%) and treat >10 extremity sarcoma cases annually (n=138, 62.2%). In scenarios with confirmed nodal disease for clear cell and epithelioid sarcoma, surgical oncologists were inclined to perform lymphadenectomy, while orthopedic oncologists were inclined to offer targeted lymph node excision with adjuvant radiation (p<0.001). There was heterogeneity of responses regarding the management of nodal disease regardless of training background. Self-reported management of nodal disease in ETSTS was variable among respondent groups with differences and similarities based on training background. These data highlight the variability of practice for nodal disease management and the need for consensus-based guidelines.

First Report of Tobacco Fusarium Root Rot Caused by Fusarium redolens in China

First Report of Tobacco Fusarium Root Rot Caused by <i>Fusarium redolens</i> in China

English

Xanthomonas wilt of enset is a major bacterial disease affecting the entire enset-growing belt in the southern Ethiopian highlands, impacting food security and livelihoods of small-holder subsistence farmers. Through extensive interviews and field validation visits with 354 households covering 19 communities (kebeles), we show 70% of the farms to present current and past enset Xanthomonas wilt infections, with a median of 18% cumulative plant loss across affected years since disease appearance. Training by extension services proved critical for building up farmers&rsquo; knowledge on disease management, the effective implementation of disease management, and farmers&rsquo; persistence to continue with enset production even when dealing with widespread infestations. After receiving training, farmers were ten times more likely to implement targeted hygienic practices and only half as likely to implement non-recommended cultural practices. Nevertheless, training in disease management did not guarantee consistent implementation by farmers. Farmers remained reluctant to dispose of infected plants, a critical part of Xanthomonas wilt management. Moreover, farmers mostly applied disease management practices once infected plants are observed on the farm, but were unaware of preventive approaches. Extension services had also not reached all communities, with 64% of the households not having received training at the time of the survey. Key words: Disease management, Ethiopian highlands, farmer training, household surveys, Xanthomonas campestris pv. musacearum

English

Xanthomonas wilt of enset is a major bacterial disease affecting the entire enset-growing belt in the southern Ethiopian highlands, impacting food security and livelihoods of small-holder subsistence farmers. Through extensive interviews and field validation visits with 354 households covering 19 communities (kebeles), we show 70% of the farms to present current and past enset Xanthomonas wilt infections, with a median of 18% cumulative plant loss across affected years since disease appearance. Training by extension services proved critical for building up farmers&rsquo; knowledge on disease management, the effective implementation of disease management, and farmers&rsquo; persistence to continue with enset production even when dealing with widespread infestations. After receiving training, farmers were ten times more likely to implement targeted hygienic practices and only half as likely to implement non-recommended cultural practices. Nevertheless, training in disease management did not guarantee consistent implementation by farmers. Farmers remained reluctant to dispose of infected plants, a critical part of Xanthomonas wilt management. Moreover, farmers mostly applied disease management practices once infected plants are observed on the farm, but were unaware of preventive approaches. Extension services had also not reached all communities, with 64% of the households not having received training at the time of the survey. Key words: Disease management, Ethiopian highlands, farmer training, household surveys, Xanthomonas campestris pv. musacearum