We determined almost complete flagellin gene sequences of various Borrelia species and aligned them with previously published sequences. A neighbor-joining phylogenetic analysis showed that the genus Borrelia was divided into the following three major clusters: New World relapsing fever borreliae (BorreZia turicatae, Burreliu parkeri, and Borrelia hermsii), Old World relapsing fever borreliae (Borrelia crocidurae, Borrelia duttonii, and Borrelia hispanica), and Lyme disease borreliae (Borrelia burgdurferi sensu stricto, Borrelia garinii, and Borrelia afzelii). Agents of animal spirochetosis (Borrelia coriaceae and Borrelia anserina) and species of unknown pathogenicity (Borrelia rniyamotoi and Borrelia Zonestari) were related to relapsing fever borreliae. Although the Lyme disease borreliae, two related species (Borrelia japonica and Borrelia andersonii), and some newly described genomic groups (groups PotiB2, VS116, DN127, Hk501, and Ya501) were closely related to each other, each taxon formed an independent branch on the phylogenetic tree. The data obtained in this study indicate that the flagellin genes are useful in Borrelia taxonomy. To distinguish the Lyme disease borreliae from related organisms easily, we designed an oligonucleotide primer set for the flagellin gene and performed a PCR-restriction fragment length polymorphism (PCR-RFLP) analysis. The primer set amplified an approximately 580-bp DNA fragment that included species-specific restriction sites, and HapII, HhaI, CelII, HincII, or DdeI digestion of the product resulted in distinctively different PCR-RFLP patterns. The PCR-RFLP typing method which we developed should facilitate rapid identification of Lyme disease borreliae and related organisms obtained from biological and clinical specimens.
Background
The purpose of the study was to better understand the practice and meaning of spiritual care among cancer care professionals and ultimately provide a rationale for developing internationally focused spiritual care guidelines.
Methods
We developed a 16-question survey to assess the spiritual care practices. We sent 635 MASCC members 4 e-mails each inviting them to complete the survey via an online survey service. Demographic information was collected. The results were tabulated, and summary statistics were used to describe the results.
Results
Two hundred seventy-one MASCC members (42.7%) from 41 countries completed the survey. Of the respondents, 50.5% were age ≤50 years, 161 (59.4%) were women and 123 (45.4%) had ≥20 years of cancer care experience. The two most common definitions of spiritual care the respondents specified were “offering emotional support as part of addressing psychosocial needs” (49.8%) and “alleviating spiritual/existential pain/suffering” (42.4%). Whether respondents considered themselves to be “spiritual” correlated with how they rated the importance of spiritual care (P≤0.001). One hundred six respondents (39.1%) reported that they believe it is their role to explore the spiritual concerns of their cancer patients, and 33 respondents (12.2%) reported that they do not feel it is their role. Ninety-one respondents (33.6%) reported that they seldom provide adequate spiritual care, and 71 respondents (26.2%) reported that they did not feel they could adequately provide spiritual care.
Conclusions
The majority of MASCC members who completed the survey reported that spiritual care plays an important role in the total care of cancer patients, but few respondents from this supportive care focused organization actually provide spiritual care. However, in order to be able to provide a rationale for developing spiritual care guidelines, we need to understand how to emphasize the importance of spiritual care and at minimum, train MASCC members to triage patients for spiritual crises.
Exposure to an ADS aggravates upper and lower tract respiratory symptoms in patients with adult asthma. ADS airborne particles may increase airway inflammation through enhancement of interleukin-8 transcriptional activity.
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