First record of Anastrepha pseudoparallela Loew (Diptera: Tephritidae) infesting passion flowers in Peru / Primer registro de Anastrepha pseudoparallela Loew (Diptera: Tephritidae) infestando pasifloras en Perú

Abstract Several species of the genus Anastrepha Schiner are associated to different hosts and have a great economic importance in fruit crops of the Neotropical region. Ripe and unripe fruits of six passion flowers species were sampled in Oxapampa during 2016 and 2018. Larvae of Anastrepha pseudoparallela Loew (Diptera: Tephritidae) were detected infesting fruits of Passiflora ambigua Hemsl and Passiflora quadrangularis L. For the first time, this fruit fly species is recorded attacking fruits of passion flowers in Peru.

Resumen Diversas especies del género Anastrepha Schiner están asociadas a diferentes hospederos y tienen gran importancia económica en la fruticultura de la región Neotropical. Frutos maduros e inmaduros de seis especies de Passiflora L. fueron colectados en Oxapampa durante el 2016 y 2018. Larvas de Anastrepha pseudoparallela Loew (Diptera: Tephritidae) fueron encontradas infestando frutos de Passiflora ambigua Hemsl y Passiflora quadrangularis L. Por primera vez, esta especie de mosca es registrada atacando frutos de pasifloras en el Perú.

Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool.

OBJECTIVE: The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. DESIGN: Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. SETTING: Four residency training institutions in Washington state between February 2016 and March 2017. PARTICIPANTS: General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. RESULTS: The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. CONCLUSIONS: Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation.

Transforming Ward Rounds Through Rounding-in-Flow.

BACKGROUND: Traditional "batched" bedside clinical care rounds, where rounds for all patients precede clinical tasks, may delay clinical care and reduce resident work efficiency. INNOVATION: Using Lean concepts, we developed a novel "Rounding-in-Flow" approach, with the patient care team completing all tasks for a single patient before initiating any tasks for the next patient. Outcome measures included timely patient discharge and intern work hours. METHODS: We performed a retrospective cohort study with historic and contemporaneous control groups, with time series adjustment for underlying temporal trends at a single medical center. Primary outcomes were timely patient discharge orders and resident duty hours. Participants were 17 376 consecutive hospital inpatients between January 1, 2011, and June 30, 2012, and medical ward rounding teams of interns, residents, and attending hospitalists. RESULTS: Timely discharge orders, defined as written by 9:00 am, improved from 8.6% to 26.6% (OR, 1.55; 95% CI 1.17-2.06; P  =  .003). Time of actual patient discharge was unchanged. Resident duty hour violations, defined as less than 10 hours between clinical duties, decreased from 2.96 to 0.98 per intern per rotation (difference, 1.98; 95% CI 1.09-2.87; P < .001). Average daily intern work hours decreased from 12.3 to 11.9 hours (difference, 0.4 hours; 95% CI 0.16-0.69; P  =  .002). CONCLUSIONS: Compared with batched rounding, Lean Rounding-in-Flow using "1-piece flow" principles was associated with more discharge orders written before 9:00 am and fewer violations in the 10-hour break rule, with minimal changes to intern total work hours and actual patient discharge time.