Coupling of plant and mycorrhizal fungal diversity: its occurrence, relevance, and possible implications under global change.

First principles predict that diversity at one trophic level often begets diversity at other levels, suggesting plant and mycorrhizal fungal diversity should be coupled. Local-scale studies have shown positive coupling between the two, but the association is less consistent when extended to larger spatial and temporal scales. These inconsistencies are likely due to divergent relationships of different mycorrhizal fungal guilds to plant diversity, scale dependency, and a lack of coordinated sampling efforts. Given that mycorrhizal fungi play a central role in plant productivity and nutrient cycling, as well as ecosystem responses to global change, an improved understanding of the coupling between plant and mycorrhizal fungal diversity across scales will reduce uncertainties in predicting the ecosystem consequences of species gains and losses.

Environmental predictors of dispersal traits across a species' geographic range.

Variation in habitat quality and quantity drive selection on dispersal traits in heterogeneous environments, but the extent to which environmental conditions predict geographic variation in dispersal is rarely evaluated. We assessed dispersal trait variation across the range of Cakile edentula var. lacustris, an annual herb that occupies beaches of the Great Lakes. Cakile edentula has dimorphic fruits that each contain one dispersive and one non-dispersive seed. Previous work showed that plant height, branching density, and dispersive fruit wing-loading can determine the distance that seeds disperse locally by wind, while pericarp thickness influences the distance they disperse by water. We tested if these traits vary predictably with latitude across the species' geographic range, and if variation in dispersal characteristics can be predicted by the quality and quantity of habitat available at a site. We observed that the dispersive fruits from northern and southern populations had thinner pericarps than those from the interior of the species' range, reflecting reduced long-distance dispersal by water at both range limits. Plants at the northern range limit were shorter with less dense branching and lower wing-loading than populations elsewhere in the range, suggesting that these populations have enhanced local wind dispersal. In contrast, southern populations exhibited traits with inconsistent effects on wind dispersal: plants tended to be short, which facilitates wind dispersal in C. edentula, but also had relatively higher branching density and distal segment wing-loading that reduce wind dispersal. Geographic variation in maternal plant height and branching density was partially explained by variation in habitat quality, which declined at the species' range limits. In addition, population differences in branching density, fruit wing-loading, and pericarp thickness were predicted by the abundance and distribution of beach habitat. Finally, a common garden analysis recovered latitudinal patterns for the dispersal traits associated with fruits, but not those associated with maternal architecture. Thus, the geographic patterns of dispersal trait variation that we observed likely reflect responses to past selection by the distribution, abundance, and quality of habitat, strong plasticity in dispersal traits, and the effects dispersal itself has in shaping local adaptation by driving gene flow among populations.

Spatial prediction of plant invasion using a hybrid of machine learning and geostatistical method.

Modeling ecological patterns and processes often involve large-scale and complex high-dimensional spatial data. Due to the nonlinearity and multicollinearity of ecological data, traditional geostatistical methods have faced great challenges in model accuracy. As machine learning has increased our ability to construct models on big data, the main focus of the study is to propose the use of statistical models that hybridize machine learning and spatial interpolation methods to cope with increasingly large-scale and complex ecological data. Here, two machine learning algorithms, boosted regression tree (BRT) and least absolute shrinkage and selection operator (LASSO), were combined with ordinary kriging (OK) to model plant invasions across the eastern United States. The accuracies of the hybrid models and conventional models were evaluated by 10-fold cross-validation. Based on an invasive plants dataset of 15 ecoregions across the eastern United States, the results showed that the hybrid algorithms were significantly better at predicting plant invasion when compared to commonly used algorithms in terms of RMSE and paired-samples t-test (with the p-value < .0001). Besides, the additional aspect of the combined algorithms is to have the ability to select influential variables associated with the establishment of invasive cover, which cannot be achieved by conventional geostatistics. Higher accuracy in the prediction of large-scale biological invasions improves our understanding of the ecological conditions that lead to the establishment and spread of plants into novel habitats across spatial scales. The results demonstrate the effectiveness and robustness of the hybrid BRTOK and LASOK that can be used to analyze large-scale and high-dimensional spatial datasets, and it has offered an optional source of models for spatial interpolation of ecology properties. It will also provide a better basis for management decisions in early-detection modeling of invasive species.

The influence of goal setting and SmartRoom patient education videos on readmission rate, length of stay, and patient satisfaction in the orthopedic spine population.

The SmartRoom technology, a system now owned by TeleTracking Technologies, aims to transform the delivery of patient care in the inpatient environment. The purpose of this project was to use goal setting and SmartRoom patient education videos to examine whether the videos more effectively engaged patients and their families in their discharge plan and encouraged them to take a more active role in their care while hospitalized. This study used a descriptive design to analyze the effect of goal setting and patient education videos on patient satisfaction at discharge, hospital average length of stay, and 30-day readmission rate in the orthopedic spine surgical care setting. Comparisons were made among three patient groups. No statistically significant difference was found for average length of stay and 30-day readmission across these three groups. However, patient satisfaction with discharge, as measured by the Hospital Consumer Assessment of Health Providers and Systems, revealed an increase in five items regarding discharge with statistically significant differences on two of the five items.

Third-year medical students' knowledge of privacy and security issues concerning mobile devices.

BACKGROUND: The use of mobile devices are ubiquitous in medical-care professional settings, but information on privacy and security concerns of mobile devices for medical students is scarce. AIMS: To gain baseline information about third-year medical students' mobile device use and knowledge of privacy and security issues concerning mobile devices. METHODS: We surveyed 67 third-year medical students at a Midwestern university on their use of mobile devices and knowledge of how to protect information available through mobile devices. Students were also presented with clinical scenarios to rate their level of concern in regards to privacy and security of information. RESULTS: The most used features of mobile devices were: voice-to-voice (100%), text messaging (SMS) (94%), Internet (76.9%), and email (69.3%). For locking of one's personal mobile phone, 54.1% never physically lock their phone, and 58% never electronically lock their personal PDA. Scenarios considering definitely privacy concerns include emailing patient information intact (66.7%), and posting de-identified information on YouTube (45.2%) or Facebook (42.2%). CONCLUSIONS: As the ease of sharing data increases with the use of mobile devices, students need more education and training on possible privacy and security risks posed with mobile devices.

Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach.

A gap in informatics expertise amongst nursing students, practising staff and faculty has been noted globally, which reduces the potential for nurses to utilise technology to enhance patient care. National nursing education strategies and recommendations from professional associations have identified digital health as an area that needs investment. This case study describes how health informatics is being integrated into a Bachelor of Nursing programme in the United Kingdom. An international collaboration with a US-UK Fulbright Specialist Scholar enabled individual learning units corresponding to key health informatics competencies to be designed and incorporated into a pedagogic framework grounded in the spiral learning approach. This approach is proposed as one way to integrate informatics into nursing education, so students can become competent clinicians that are able to deliver technology enabled care in the health service.

A description of a Web-based educational tool for understanding the PICO framework in evidence-based practice with a citation ranking system.

Asking a well-defined clinical question has revealed itself as a learned skill. Asking a "good" question is not an innate response to a clinical problem or clinical case but a task that requires insight, critical thinking, and evaluation, as well as grounding in subject-specific background information. To aid in the proficiency of asking an answerable clinical question, a Web-based tool named Accessing and Assessing the Evidence was developed to tutor students in asking such questions. The tool, consisting of two modules, presents the principles of evidence-based practice question formulation in the first module and permits users to compare their critical opinions of article citations and abstracts to those of their peers and experts in the second module. Initial findings suggest that the Accessing and Assessing the Evidence tool may be a valuable independent learning tool for undergraduate nursing students by providing question structure guidance with practical learning scenarios.

Linking the health data system in the U.S.: Challenges to the benefits.

In order to improve patient care in the United States there, the government made a mandate called HIE (Health Information Exchange). This order was created from the belief that sharing digital health information between, across, and within health communities will improve one's healthcare experience across their lifespan. Patient health information, i.e. the personal health record, should be shareable between healthcare providers; such as private practice physicians, home health agencies, hospitals and nursing care facilities. Most of the U.S. hospitals now have electronic health records, however, with a lack of standards for structuring health information and unified communication protocols to share health information across providers, only a small percentage of U.S. hospitals engage in computerized HIE. In order to understand barriers and facilitators in the U.S. of HIE adoption, we reviewed the published research literature between 2010 and 2015. Our search yielded 664 articles from Medline, PsychInfo, Global health, InSpec, Scopus and Business Source Complete databases. Thirty-nine articles met our inclusion criteria. This article presents the compiled organizational and end user barriers and facilitators along with suggested methods to achieve continuity of care through HIE.

Hybrid watermilfoil lineages are more invasive and less sensitive to a commonly used herbicide than their exotic parent (Eurasian watermilfoil).

Hybridization may stimulate the evolution of invasiveness in human-impacted habitats if unique hybrid genotypes have higher fitness than parental genotypes. Human efforts to control invasive taxa frequently involve the intentional alteration of habitats, but few studies have considered whether hybridization can result in decreased sensitivity to control measures. Here, we investigate whether interspecific hybrids between introduced Eurasian watermilfoil (Myriophyllum spicatum) and native northern watermilfoil (M. sibiricum) are more invasive than parental Eurasian watermilfoil, especially in regard to their relative responses to an herbicide commonly applied for their control (2,4-dichlorophenoxyacetic acid; 2,4-D). In two separate laboratory experiments, hybrids on average grew faster and were less sensitive to 2,4-D compared with parental Eurasian watermilfoil. These two invasive traits appear to be common in hybrid watermilfoils, as opposed to being restricted to a few unique lineages, because they were found in a diversity of hybrid genotypes from several independent hybridization events. In addition, we found that hybrids occurred more frequently than parental species in natural lakes previously treated with 2,4-D. Our results provide compelling empirical evidence that hybridization is associated with the evolution of increased invasiveness in watermilfoils, and have important implications for their management.

Hybridization, cryptic diversity, and invasiveness in introduced variable-leaf watermilfoil.

Hybridization may be important in the evolution of invasiveness, but few empirical studies compare introduced hybrid and parental lineages. Invasive 'variable-leaf watermilfoil' (Myriophyllum heterophyllum) in the northeastern United States consists of at least three distinct lineages: an interspecific hybrid (M. heterophyllum × Myriophyllum laxum) and two historically allopatric lineages of pure M. heterophyllum. Previous observations suggested that hybrid populations of variable-leaf watermilfoil may be comparatively more 'invasive' than pure lineages. However, no quantitative data comparing hybrid and parental lineages have been collected, nor has invasiveness been compared between parental lineages. Here, we demonstrate that these distinct lineages are also ecologically distinct. We find some support for the hypothesis that hybridization has played a role in the evolution of invasiveness: hybrids exhibited higher biomass, individual plant size, and greater branching than at least one parental lineage of M. heterophyllum. However, parental lineages did not differ from the hybrid for some traits, demonstrating that pure parental lineages can also be invasive. In addition, we found no evidence for a role of intraspecific hybridization in the evolution of invasiveness in these lineages of variable-leaf watermilfoil, even where they co-occurred locally. Our study suggests that distinguishing among cryptic lineages will help prioritize rapid response control efforts.

Transitioning from clinician to clinical research coordinator.

Use your nursing skills and personal qualities to move into this fast-growing, intellectually stimulating field.

Permanent Genetic Resources added to Molecular Ecology Resources Database 1 June 2010 - 31 July 2010.

This article documents the addition of 205 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Bagassa guianensis, Bulweria bulwerii, Camelus bactrianus, Chaenogobius annularis, Creontiades dilutus, Diachasmimorpha tryoni, Dioscorea alata, Euhrychiopsis lecontei, Gmelina arborea, Haliotis discus hannai, Hirtella physophora, Melanaphis sacchari, Munida isos, Thaumastocoris peregrinus and Tuberolachnus salignus. These loci were cross-tested on the following species: Halobaena caerulea, Procellaria aequinoctialis, Oceanodroma monteiroi, Camelus ferus, Creontiades pacificus, Dioscorea rotundata, Dioscorea praehensilis, Dioscorea abyssinica, Dioscorea nummularia, Dioscorea transversa, Dioscorea esculenta, Dioscorea pentaphylla, Dioscorea trifida, Hirtella bicornis, Hirtella glandulosa, Licania alba, Licania canescens, Licania membranaceae, Couepia guianensis and 7 undescribed Thaumastocoris species.

Patient first: a patient sensitivity tool for an electronic health record implementation.

Throughout the country, use of electronic health records continues to increase. For successful implementation of an electronic health record system in an acute care setting, it is vital to educate and address the patient's perceptions about the use of technology when caring for the patient. This article describes the development of an educational sensitivity tool designed to enhance clinicians' simultaneous interactions with patients and computers in a midsize community hospital. The Patient First tool brings attention to the thoughts and perceptions a patient may have in various situations, promoting alternative solutions for staff to properly address the patient's concerns. A committee was developed to address concerns regarding the impact a computer at the bedside would have on patient and clinician interactions. One primary educational tool developed was the Patient First sensitivity presentation that cautioned and guided clinicians to be aware of patient perceptions.

Using GIS to establish a public library consumer health collection.

BACKGROUND: Learning the exact demographic characteristics of a neighborhood in which a public library serves, assists the collection development librarian in building an appropriate collection. Gathering that demographic information can be a lengthy process, and then formatting the information for the neighborhood in question becomes arduous.As society ages and the methods for health care evolve, people may take charge of their own health. With this prospectus, public libraries should consider creating a consumer health collection to assist the public in their health care needs. Using neighborhood demographic information can inform the collection development librarians as to the dominant age groups, sex, and races within the neighborhood. With this information, appropriate consumer health materials may be assembled in the public library. METHODS: In order to visualize the demographics of a neighborhood, the computer program ArcView GIS (geographic information systems) was used to create maps for specified areas. The neighborhood data was taken from the U.S. Census Department's annual census and library addresses were accumulated through a free database. After downloading the census block information from http://www.census.gov/geo/www/tiger/ the data was manipulated with ArcView GIS and queried to produce maps displaying the requested neighborhood demographics to view in respect to libraries. RESULTS: ArcView GIS produced maps displaying public libraries and requested demographics. After viewing the maps the collection development librarian can see exactly what populations are served by the library and adjust the library's collection accordingly. CONCLUSIONS: ArcView GIS can be used to produce maps displaying the communities that libraries serve, spot boundaries, be it "man-made or natural," that exist prohibiting customer service, and assist collection development librarians in justifying their purchases for a dedicated consumer health collection or resources in general.