Healing the Professional Culture of Medicine.

The past decade has been a time of great change for US physicians. Many physicians feel that the care delivery system has become a barrier to providing high-quality care rather than facilitating it. Although physician distress and some of the contributing factors are now widely recognized, much of the distress physicians are experiencing is related to insidious issues affecting the cultures of our profession, our health care organizations, and the health care delivery system.

Whistle Blowing: A Message to Leaders and Managers Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organizations".

This comment argues that instead of worrying about the pros and cons of whistleblowing one should focus on the more general problem of the failure of upward communication around safety and quality problems and consider what leaders and managers must do to stimulate subordinates to communicate and reward such communication. The article analyzes why safety failures occur and introduces the concept of practical drift and adaptive moves as necessary for systemic safety to be understood and better handled. It emphasizes the key role of senior leadership in creating a climate in which critical upward communication will become more likely.

Tick infestation and prophylaxis of dogs in northeastern Germany: a prospective study.

Ticks transmit various important pathogens to humans and animals, and dogs are frequently exposed to tick infestation. The objective of this study was to examine tick infestation and the characteristics of tick prophylaxis of dogs in the Berlin/Brandenburg area. A total of 441 dogs (392 owners) was examined from March 2010 to April 2011.

A novel high-resolution melt PCR assay discriminates Anaplasma phagocytophilum and "Candidatus Neoehrlichia mikurensis".

"Candidatus Neoehrlichia mikurensis" (Anaplasmataceae) is an emerging pathogen transmitted by Ixodes ticks. Conventional PCR and the newly developed high-resolution melt PCR were used to detect and discriminate "Candidatus Neoehrlichia mikurensis" and Anaplasma phagocytophilum. Both bacterial species were frequently found in Ixodes ricinus and Ixodes hexagonus but virtually absent from Dermacentor reticulatus.

[Tick infestation and tick prophylaxis in dogs in the area of Berlin/Brandenburg--results of a questionnaire study].

Ticks can transmit different pathogens to humans and animals. Dogs are frequently exposed to tick infestation, which underscores the importance of tick control measures. The objective of this study was to examine the awareness of dog owners regarding tick infestation and tick prophylaxis by a questionnaire survey.

Advances in laboratory diagnosis of parasitic infections of sheep.

Parasitic infections constitute an important group of diseases in sheep concerning the health status, welfare and productivity. On a global scale, there are considerable differences concerning the epidemiological situation with respect of the various parasite species. However, there are also numerous species, which occur on all continents and, potentially, in every country.

Molecular biological comparison of different Besnoitia species and stages from different countries.

Besnoitia besnoiti tissue cysts from a recent outbreak in cattle in Germany were characterized with respect to their internal transcribed spacer regions 1, 2, and 18S rDNA gene sequences. These results were compared with own sequences of an Israelian isolate of B. besnoiti and of Besnoitia jellisoni cystozoites stored for years in liquid nitrogen.

An appraisal of current and new techniques intended to protect bulls against Culicoides and other haematophagous nematocera: the case of Schmergow, Brandenburg, Germany.

The outbreak of bluetongue (BTV-8) in many parts of north-western Europe led to efforts to curb the spread of the disease, particularly in farms with valuable livestock, as on a stud bull farm in Schmergow, Brandenburg, Germany. In the abundance of the putative BT vectors, Palaearctic Culicoides species, several vector control methods were applied in the hope for a reduction of the target insect populations. Insecticide-impregnated ear tags and regular treatments at 6-week intervals of all bulls with deltamethrin pour on were expected to achieve the desired control of the biting midges.

Seasonal dynamics of biting midges (Diptera: Ceratopogonidae, Culicoides spp.) on dairy farms of Central Germany during the 2007/2008 epidemic of bluetongue.

The unforeseen outbreak of bluetongue in north-western Europe in August 2006 raised the question, which Culicoides spp. were involved in the transmission of bluetongue virus (BTV). Based on the decision 2007/20/EU of December 2006, a large-scale entomological surveillance programme was initiated in the five affected EU member states including Germany.

Another African disease in Central Europa: Besnoitiosis of cattle. I. Light and electron microscopical study.

The paper reports the first detection of besnoitiosis of cattle in Germany. Just 2 years after the first appearance of the African Bluetongue disease (BTD) of cattle in Central Europe, another African agent of disease has arrived in Germany. While it was proven that the BTD virus was transmitted (after its first appearance) by endemic midges of the genus Culicoides (C.

[Dermacentor reticulatus (Fabricius, 1794)--distribution, biology and vector for Babesia canis in Germany].

This work deals with occurrence, distribution as well as biology and vectorial capacity of the ornate dog tick (Dermacentor (D.) reticulatus). Until 30 years ago this tick has only been described in a few natural foci in southern Germany.

[Pilot study to evaluate the efficiency of insecticide-treated mosquito net fences for the protection of horses against nuisance insects in northern Brandenburg].

A fence of black mosquito netting of 100 cm height, pre-treated with 80 mg/m2 of deltamethrin and UV-protected, was used to shelter horses from nuisance and biting insects on pasture in northern Brandenburg. The netting material was attached to the surrounding poles of the existing fences at a height of 15 cm above ground. Three trial groups were selected grazing in spatially separated areas with comparable densities of insect populations.

Evaluation of the efficacy of emodepside+praziquantel topical solution against cestode (Dipylidium caninum, Taenia taeniaeformis, and Echinococcus multilocularis) infections in cats.

Emodepside+praziquantel topical solution was developed to provide broad-spectrum anthelmintic activity against gastrointestinal parasites in cats. Eight controlled studies were conducted to evaluate the efficacy of a topical solution of emodepside (3 mg/kg) and praziquantel (12 mg/kg) (Profender, BayerAG, Leverkusen, Germany) against feline infections with three species of cestodes. Studies featured naturally acquired infections of Dipylidium caninum or Taenia taeniaeformis, or experimental infections with Echinococcus multilocularis that were placebo-controlled, randomized and blinded.

Crossreacting IgG antibodies against fox mite antigens in human scabies.

Scabies continues to be an important parasitic disease of mammals. There remain, however, major gaps in the understanding of the human host immune response, and a simple diagnostic test is lacking. In contrast to human mites, red fox mites (Sarcoptes scabiei var.

A field study to estimate the prevalence of Trypanosoma equiperdum in Mongolian horses.

From May to July 2000, a cross-sectional study was conducted to estimate the prevalence of Trypanosoma equiperdum in the horse population of the central province (Tuv aimag) of Mongolia. On average, four herds were selected from each of the 29 aimag subdivisions (119 herds). From each herd, 10 horses were sampled in proportion to sex and age categories in the respective herds (1190 horses).

Detection of antibodies in sera of weaned pigs after contact infection with Sarcoptes scabiei var. suis and after treatment with an antiparasitic agent by three different indirect ELISAs.

Three commercial enzyme-linked immunosorbent assays (ELISAs) were compared for the detection of antibodies to Sarcoptes scabiei var. suis using experimental sera of six 8-week-old pigs after contact infection with Sarcoptes scabiei var. suis.

The anxiety of learning. Interview by Diane L. Coutu.

Despite all the time, money, and energy that executives pour into corporate change programs, the stark reality is that few companies ever succeed in genuinely reinventing themselves. That's because the people at those companies rarely master the art of transformational learning--that is, eagerly challenging deeply held assumptions about a company's processes and, in response, altering their thoughts and actions. Instead, most people just end up doing the same old things in superficially tweaked ways.

Electron microscopic investigations on stages of dog piroplasms cultured in vitro: Asian isolates of Babesia gibsoni and strains of B. canis from France and Hungary.

Stages obtained from two Asian Babesia gibsoni-isolates cultured in vitro were studied by means of transmission electron microscopy and compared to strains of B. canis cultured in vitro. While the developmental stages of the latter preserved their shape in culture, many of the initially small stages of the B.

[Liver fluke infection and sarcoptic mange in red foxes in Berlin].

396 red foxes originating from the city of Berlin were examined for opisthorchiid liver flukes and clinical sarcoptic mange between January 1997 and March 1998. Out of 232 (= 58.6%) foxes positive for opisthorchiid flukes 221 animals harboured Metorchis bilis and 70 were infected with Opisthorchis felineus.

Generation of cytotoxic T lymphocytes and cytostatic acting cells in T. annulata-immune cattle.

Cattle immunized against Theileria annulata with schizont containing autologous cell lines are immune to challenge with a homologous parasite strain. Two cell types have been detected in the peripheral blood of the immunized animals: cytotoxic T lymphocytes (CTL) and cytostatic acting cells (CAC). Killing the target cells by CTL is infection associated and is MHC class I restricted.

Lymphocyte stimulatory capacity of Theileria annulata-infected ovine lymphoblastoid cells.

T. annulata, the causative agent of tropical theileriosis in cattle, is transmitted by ticks of the genus Hyalomma. Sporozoites of this parasite invade their target cells, where they differentiate to macroschizonts.

[Eradication of Chorioptes bovis mange in a dairy herd with turn-out to graze by Eprinex Pour-On].

The possibility to control or even eradicate chorioptes manage by a single herd treatment with EPRINEX Pour-On (dosage: 0.5 mg Eprinomection/kg bodyweight) during pasture season was investigated in a dairy herd of 320 dairy cows. A further aim of the study was to evaluate whether such mid-summer treatment with EPRINEX Pour-On due to its endo-ectocide action would at the same time also result in a metaphylaxis of gastro-intestinal and lung worms and in a reduction of fly infestation.

'Babesia gibsoni' of dogs from North America and Asia belong to different species.

18S rDNA sequences from 4 isolates of Babesia gibsoni originating from Japan, Malaysia and Sri Lanka were compared with a previously published, 0.5 kb portion of the 18S rDNA from a B. gibsoni isolate from California, USA, and with the corresponding 18S rDNA sequences of other Babesia spp.