Root Infections May Challenge Management of Invasive Phytophthora spp. in U.K. Woodlands.

Because sporulation of Phytophthora ramorum and P. kernoviae on Rhododendron ponticum, an invasive plant, serves as primary inoculum for trunk infections on trees, R. ponticum clearance from pathogen-infested woodlands is pivotal to inoculum management. The efficacy of clearance for long-term disease management is unknown, in part due to lack of knowledge of pathogen persistence in roots and emerging seedlings. The main objectives of this work were to (i) investigate whether both pathogens infect R. ponticum roots, (ii) determine the potential for residual inoculum of P. kernoviae to infect R. ponticum seedlings in cleared woodlands, and (iii) assess potential for R. ponticum roots to support survival and transmission of P. kernoviae. Roots of R. ponticum were collected from both unmanaged and cleared woodlands and assessed for pathogen recovery. Both P. ramorum and P. kernoviae were recovered from asymptomatic roots of R. ponticum in unmanaged woodlands, and P. kernoviae was recovered from asymptomatic roots from seedlings in cleared woodland. Oospore production of P. kernoviae was observed in naturally infected R. ponticum foliage and in inoculated roots. Roots also supported P. kernoviae sporangia production. The results of this study suggest that post-clearance management of R. ponticum regrowth is necessary for long-term inoculum management in invaded woodlands.

Phytophthora ramorum on Quercus ilex in the United Kingdom.

Phytophthora ramorum causes bleeding cankers of trunks of trees native to the west coast of the United States (i.e., Quercus kelloggii, Q. parvula var. shrevei, and Lithocarpus densiflorus). In the United Kingdom so far, bleeding cankers caused by inner bark infections have been found on Aesculus hippocastanum, Fagus sylvatica, Q. cerris, Q. falcata, and Q. petraea ( http://rapra.csl.gov.uk [2005]). Shoot tip dieback (ramorum dieback) and foliar necrosis (ramorum leaf blight) are other diseases caused by the pathogen on understory and ornamental plants (3). Inoculum is produced on infected shoots and leaves of foliar hosts but not on bole cankers (1). Foliar hosts are thus critical in initiating and maintaining epidemics of tree mortality resulting from lethal bark cankers. Ramorum dieback and blight occurs in Europe on genera Rhododendron, Camellia, Kalmia, Pieris, and Viburnum (http://rapra.csl.gov.uk [2005]), and now we report these diseases on foliage and shoots of holm oaks (Quercus ilex) in Cornwall (UK). First discovered in November 2003, infected young leaves had a water-soaked, dull gray appearance, and petioles were blackened. Lesions started at leaf margins, tips, or petioles, often progressing into the midrib veins. Initial infections also occurred on shoots and extended into the petioles. If shoots were infected, they were blackened at first, but later in the season clusters of dry, dead leaves and twigs characterized branch tips. Infected mature leaves bore dry, reddish-brown, restricted lesions. P. ramorum (A1 sexual compatibility type belonging to the European population) was isolated and confirmed by morphological studies, ITS sequence (GenBank Accession No. AY924253), and amplified fragment length polymorphism analyses. Lesions developed on detached leaves dipped for 10 sec in inoculum (4 × 105 zoospores per ml) and incubated in moist chambers at 20°C for 6 days (2). Two isolates were used (four leaves per isolate). The pathogen was reisolated, and the tests were repeated twice. Koch's postulates were also successfully completed once on foliage attached to saplings. To our knowledge, this is the first report of P. ramorum on holm oak. So far, at least 24 holm oaks are infected at various woodland and garden sites in the United Kingdom; infected rhododendrons have also been found at these sites. P. ramorum has also been recorded on saplings in nurseries. The high sporulation potential, the evergreen nature of leaves, and susceptible shoots indicate that holm oak could be a significant source of inoculum for other hosts. References: (1) J. M. Davidson et al. Phytopathology 95:587, 2005. (2) S. Denman et al. Plant Pathol. 54:512, 2005. (3) E. M. Hansen et al. Plant Dis. 89:63, 2005.

Pro-inflammatory and anti-inflammatory effects of the stable prostaglandin D2 analogue, ZK 118.182.

This study examined the pro- and anti-inflammatory effects of the stable prostaglandin (PG) D2 analogue, ZK 118.182 and the mechanism by which prostaglandins may exert their anti-inflammatory activity. Co-injected locally, ZK 118.182, like PGE2 and PGD2, dose-dependently increased plasma leakage induced by intradermal injection of bradykinin in rabbit skin. Infused i.v., ZK 118.182 (0.45 microgram/kg/min), a dose which did not affect systemic blood pressure, inhibited oedema formation in rabbit skin induced by the neutrophil-dependent agonists, formyl-methionyl-leucyl-phenylalanine (FMLP) and leukotriene B4 (LTB4). However, it did not modify plasma leakage induced by the neutrophil-independent mediators, bradykinin and platelet-activating factor (PAF). In contrast, neutrophil accumulation in response to LTB4 and FMLP was not affected in animals infused with ZK 118.182. In vitro, ZK 118.182, like PGE2 and PGD2 inhibited FMLP-induced superoxide anion (O2-) production by rabbit neutrophils. The compound, however, had minimal effects on O2- production induced by phorbol myristate acetate (PMA). ZK 118.182 inhibited to a small extent FMLP but not PMA-induced neutrophil adherence. These results show that depending on the route of administration, the PGD2 analogue, ZK 118.182, exhibits either pro- or anti-inflammatory effects. The anti-inflammatory effect may be related to the ability of the compound to inhibit increased microvascular permeability induced by neutrophil activation without interfering with neutrophil accumulation. This latter effect may be due to the analogue's capacity to suppress neutrophil secretion to a greater extent than neutrophil adherence.

Assessing the quality of care of multiple conditions in general practice: practical and methodological problems.

OBJECTIVE: To investigate practical and methodological problems in assessing the quality of care of multiple conditions in general practice. SETTING: Sixteen general practices from two socioeconomically diverse regions in the UK. METHOD: Quality of care was assessed in 100 randomly selected patient records in each practice using an established set of quality indicators covering 23 conditions commonly seen in primary care. Inter-rater reliability assessment was carried out for five of the conditions. RESULTS: Conducting simultaneous quality assessment across multiple conditions is highly resource intensive. Poor data quality and the low prevalence of some items of care defined by the indicators are significant problems. Scores for individual indicators require very large samples for reliable assessment. Quality scores are more reliable when reported at a higher unit of analysis. This is particularly true for indicators and conditions with low prevalence where data may need to be aggregated to the level of groups of conditions or organisational providers. There is no single ideal way of aggregating quality scores. CONCLUSION: The study identified some of the practical and methodological difficulties in assessing quality of care across multiple conditions. For improved quality assessment, advances in information technology and improvements in data quality are required for more efficient and reliable data extraction from medical records, together with the development of methods for combining scores across indicators, conditions, and practices. However, electronic data extraction methods will still be based on the assumption that the care recorded reflects the care provided.

Aftercare for alcoholics: services of community mental health centers.

Fewer than half of the patients hospitalized for alcoholism treatment received aftercare from a community mental health center, the variables significantly related to receipt of aftercare being number of previous hospitalizations and referral to the hospital by self or family rather than by a court.

Community mental health myths and the fate of former hospitalized patients.

This paper addresses one of these important emerging problems--the fate of former hospitalized patients--and the policy issues that the problem raises. The discussion is derived from observations of the experience of the mental health system in the State of Hawaii, but the issues raised are of relevance to other states as well.

The effect of characteristics of human service workers on subsequent morale and turnover.

The authors examine the relationship of sociopsychological characteristics of human services workers to their subsequent morale and continuance on the job. Eighty-two intensive case managers (half of them social workers) who had caseloads of clients with severe mental disorders were invited to participate in a four-wave panel study. Explored are the relationships between 16 predictors (general background, prior work experience and training, and social psychological variables) and worker outcomes (beliefs, attitudes, perceptions, and turnover). The major finding was that better personal well-being at the time of hiring was the most consistent and significant predictor of lower burnout, higher job satisfaction, and generally higher worker morale at later points in time. Those from higher social class backgrounds and those with lower starting salaries were more likely to leave the job. Those workers with more experience had a tendency to perceive greater client improvement.

Phytophthora taxa associated with cultivated Agathosma, with emphasis on the P. citricola complex and P. capensis sp. nov.

Agathosma species, which are indigenous to South Africa, are also cultivated for commercial use. Recently growers experienced severe plant loss, and symptoms shown by affected plants suggested that a soilborne disease could be the cause of death. A number of Phytophthora taxa were isolated from diseased plants, and this paper reports their identity, mating type, and pathogenicity to young Agathosma plants. Using morphological and sequence data seven Phytophthora taxa were identified: the A1 mating type of P. cinnamomi var. cinnamomi, P. cinnamomi var. parvispora and P. cryptogea, the A2 mating type of P. drechsleri and P. nicotianae, and two homothallic taxa from the P. citricola complex. The identity of isolates in the P. citricola complex was resolved using reference isolates of P. citricola CIT groups 1 to 5 sensu Oudemans et al. (1994) along with multi-locus phylogenies (three nuclear and two mitochondrial regions), isozyme analyses, morphological characteristics and temperature-growth studies. These analyses revealed the isolates from Agathosma to include P. multivora and a putative novel species, P. taxon emzansi. Furthermore, among the P. citricola reference isolates the presence of a new species was revealed, described here as P. capensis. Findings of our study, along with some recent other studies, have contributed to resolving some of the species complexity within the P. citricola complex, resulting in the identification of a number of phylogenetically distinct taxa. The pathogenicity of representative isolates of the taxa from Agathosma was tested on A. betulina seedlings. The putative novel species, P. taxon emzansi, and P. cinnamomi var. parvispora were non-pathogenic, whereas the other species were pathogenic to this host.

The psychiatric sick role and rejection.

One of the most generally accepted assumptions among mental health professionals is that if the mentally ill were accorded the rights and obligations of the sick role, they would be less rejected by the public. This is the first study that could be found in the literature which examines whether or not this assumption is valid. The data strongly suggest that conferring the sick role on the mentally ill does not lessen rejection, but may, in some instances, increase social rejection. A possible interpretation for this striking and unexpected finding is offered.

The sex offenses of blacks and whites.

Little is currently known about differences in the sex offenses of blacks and whites ii the 1nited states. Many major studies of sexual behavior and of sex offenders have purposely excluded data on blacks. This paper presents comparative data on 47 black and 47 white sex offenders in terms of the nature of the offense and victim characteristics. It was found that black offenders weremore likely than white offenders to engage invaginal intercourse with their victims, showed a trend to use force in their offenses, and were more likely to select adult female victims. These differences, however, appear to be due primarily to class rather than racial differences. Limitations of these dataare discussed.

Who gets aftercare? A study of patients discharged from state hospitals in Kentucky.

A cohort of 579 patients discharged from state mental hospitals in Kentucky during a one-year period was studied to determine the amount and nature of after-care services provided to them. A total of 319 received some form of attercare from community mental health centers during the two to three years after discharge. The majority received at least one service that could be classified as individual therapy or chemotherapy, about one-third received evaluation or rehabilitation services, and only a few had family interviews or group therapy. The majority of those receiving services had contact with psychiatrists, nurses, or other mental health professionals; less than half had contact with social workers or psychologists. In general the aftercare services tended to be medically oriented, brief, and limited in number. They were provided to a majority of the patients within their first month in the community.