Lyme borreliosis is increasing rapidly in many parts of the world and is the most commonly occurring vector-borne disease in Europe and the USA. The disease is transmitted by ticks of the genus Ixodes. They require a blood meal at each stage of their life cycle and feed on a wide variety of wild and domestic animals as well as birds and reptiles. Transmission to humans is incidental and can occur during visits to a vector habitat, when host mammals and their associated ticks migrate into the urban environment, or when companion animals bring ticks into areas of human habitation. It is frequently stated that the risk of infection is very low if the tick is removed within 24–48 hours, with some claims that there is no risk if an attached tick is removed within 24 hours or 48 hours. A literature review has determined that in animal models, transmission can occur in <16 hours, and the minimum attachment time for transmission of infection has never been established. Mechanisms for early transmission of spirochetes have been proposed based on their presence in different organs of the tick. Studies have found systemic infection and the presence of spirochetes in the tick salivary glands prior to feeding, which could result in cases of rapid transmission. Also, there is evidence that spirochete transmission times and virulence depend upon the tick and Borrelia species. These factors support anecdotal evidence that Borrelia infection can occur in humans within a short time after tick attachment.

We present HST spectroscopy for 45 cataclysmic variables (CVs), observed with HST/COS and HST/STIS. For 36 CVs, the white dwarf is recognisable through its broad Ly α absorption profile and we measure the white dwarf effective temperatures (T eff ) by fitting the HST data assuming log g = 8.35, which corresponds to the average mass for CV white dwarfs ( 0.8 M ). Our results nearly double the number of CV white dwarfs with an accurate temperature measurement. We find that CVs above the period gap have, on average, higher temperatures ( T eff 23 000 K) and exhibit much more scatter compared to those below the gap ( T eff 15 000 K). While this behaviour broadly agrees with theoretical predictions, some discrepancies are present: (i) all our new measurements above the gap are characterized by lower temperatures (T eff 16 000-26 000 K) than predicted by the present-day CV population models (T eff 38 000-43 000 K); (ii) our results below the gap are not clustered in the predicted narrow track and exhibit in particular a relatively large spread near the period minimum, which may point to some shortcomings in the CV evolutionary models. Finally, in the standard model of CV evolution, reaching the minimum period, CVs are expected to evolve back towards longer periods with mean accretion ratesṀ 2 × 10 −11 M yr −1 , corresponding to T eff 11 500 K. We do not unambiguously identify any such system in our survey, suggesting that this major component of the predicted CV population still remains elusive to observations.

Clinical leadership has been acclaimed widely as a major factor influencing the quality of patient care but research has revealed a paucity of preparation for this significant role. Leadership literature has rarely addressed clinical leadership specifically or referred to the difficulties in characterizing effective clinical leaders. The research informing this paper focused on clinical leadership and identified five attributes of effective clinical leaders: creativity, highlighting, influencing, respecting, and supporting. Effective clinical leaders adopted a transformational leadership style and improved care, through others, by including transformational (soft) knowledge as an integral part of their effective practice repertoire. Phronesis is introduced as practical wisdom that is gained through immersion in relevant experience, and as an essential element of preparation for clinical nursing leadership practice. It is argued, that learning to transform care requires opportunities to work within an environment that engenders and supports aspiring leaders. The paper describes the research process, elucidates the attributes through illustrative examples from the research data, and discusses an emergent educational strategy for the development of these attributes by clinicians in their practice environments. The paper also describes the application of this research through an interdisciplinary programme for staff leading teams in both health and social services sectors.

The results imply that to enhance clinical nursing, leadership factors that enable and constrain clinical nursing leadership have to be identified and acted upon by individuals and those who they report to professionally.

Students prepared for classroom examinations by completing practice tests, with selected items from these practice tests repeated, in either the original or in a modified wording, on classroom examinations and a final examination. The availability of immediate self-corrective feedback on Study 1 practice tests (0, 3, or 6 practice tests) was varied , while in Study 2, the timing of feedback provided during practice tests (immediate, end of test, 24-hour delay, control) was varied . Performance on examinations was elevated by the provision of immediate feedback on practice tests in both studies, especially when test items were presented in their original wording, with some generalization observed on items presented in a modified wording. Predictions made in accordance with the interference-perseveration hypothesis and the delayretention effect were not supported. These results demonstrate considerable potential for immediate self-corrective feedback, delivered during test preparation through the Immediate Feedback Assessment Technique, to enhance performance on classroom examinations and to promote the retention of factual information during the academic semester.