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Background:   Research evidence published 10 to 15 years ago has shown that the type of vasectomy surgical technique performed can influence the effectiveness and the safety of the procedure.  The objective of this study was to determine if evidence-based vasectomy surgical techniques are integrated in the vasectomy programs of selected low-resource countries. Methods: The surgical techniques recommended to perform the two steps of the vasectomy procedure (isolation/exposition and occlusion of the vas deferens) were extracted from current evidence-based clinical practice guidelines. Documents describing male sterilisation standards and practice from Kenya, Rwanda, India, Nepal, Mexico, Honduras, Colombia and Haiti were reviewed to assess adequacy with international guideline recommendations. Results: Best recommended techniques are 1) a minimally invasive technique including the no-scalpel technique (known as the no-scalpel vasectomy (NSV)) to isolate and expose the vas deferens, and 2) cautery of the mucosa of the vas preferably combined with interposition of the fascia (FI) to occlude the vas deferens. The NSV is largely adopted and performed to isolate the vas in selected low-resources countries. Ligation and excision (LE) of a small segment of the vas deferens combined with FI is the most common vas occlusion technique mentioned in the country standards. Cautery as recommended in the guidelines is seldom used in selected countries. Conclusions:   Effective and adapted vasectomy vas occlusion techniques are available, but are still underused in many low-resource countries. Providing the most effective vasectomy surgical techniques increases users’ confidence and satisfaction regarding male sterilization and may lead to higher acceptability and uptake.

Background:   Research evidence published 10 to 15 years ago has shown that the type of vasectomy surgical technique performed can influence the effectiveness and the safety of the procedure.  The objective of this study was to determine if evidence-based vasectomy surgical techniques are integrated in the vasectomy programs of selected low-resource countries. Methods: The surgical techniques recommended to perform the two steps of the vasectomy procedure (isolation/exposition and occlusion of the vas deferens) were extracted from current evidence-based clinical practice guidelines. Documents describing male sterilisation standards and practice from Kenya, Rwanda, India, Nepal, Mexico, Honduras, Colombia and Haiti were reviewed to assess adequacy with international guideline recommendations. Results: Best recommended techniques are 1) a minimally invasive technique including the no-scalpel technique (known as the no-scalpel vasectomy (NSV)) to isolate and expose the vas deferens, and 2) cautery of the mucosa of the vas preferably combined with interposition of the fascia (FI) to occlude the vas deferens. The NSV is largely adopted and performed to isolate the vas in selected low-resources countries. Ligation and excision (LE) of a small segment of the vas deferens combined with FI is the most common vas occlusion technique mentioned in the country standards. Cautery as recommended in the guidelines is seldom used in selected countries. Conclusions:   Effective and adapted vasectomy vas occlusion techniques are available, but are still underused in many low-resource countries. Providing the most effective vasectomy surgical techniques increases users’ confidence and satisfaction regarding male sterilization and may lead to higher acceptability and uptake.

This systematic review of mixed methods studies focuses on factors that can facilitate or limit the implementation of information and communication technologies (ICTs) in clinical settings. Systematic searches of relevant bibliographic databases identified studies about interventions promoting ICT adoption by healthcare professionals. Content analysis was performed by two reviewers using a specific grid. One hundred and one (101) studies were included in the review. Perception of the benefits of the innovation (system usefulness) was the most common facilitating factor, followed by ease of use. Issues regarding design, technical concerns, familiarity with ICT, and time were the most frequent limiting factors identified. Our results suggest strategies that could effectively promote the successful adoption of ICT in healthcare professional practices.

As waste from engineered landfills decomposes, it produces nitrogen (N)-laden leachate that cannot be directly released into the environment. Plants such as willows have the potential to phytofilter this polluted water but must be able to tolerate large loads of contaminants and flooding conditions. To date, however, it is mainly exotic species that have been used in for the treatment of leachates in a pilot project conducted on a technical landfill. It would be useful to compare the effectiveness of native species from eastern Canada with that of the Salix miyabeana ‘SX64’, a willow cultivar used in the pilot project. Three willows indigenous to Canada: S. amygdaloides, S. bebbiana and S. nigra , were tested alongside S. miyabeana . A mesocosm experiment was conducted under semi-controlled conditions over six weeks to document the impact of various nitrogen overfertilization and flooding treatments on plant development, and to test the plants’ tolerance to these constraints to evaluate their suitability for large-scale vegetative filters. Overall, growth and biomass production of S. nigra and S. amygdaloides were not affected by the treatments. Furthermore, S. nigra was ten times more efficient than the cultivar of S. miyabeana in terms of decontamination capacity. While still in the juvenile phase, S. nigra plants removed the equivalent of 240m 3 per hectare of the N-contaminated water initially applied (60 kg of N), under both permanent and cyclic flooding. These results suggest that native species could be given greater in future projects.

Salix L. is the largest genus in the family Salicaceae (450 species). Several classifications have been published, but taxonomic subdivision has been under continuous revision. Our goal is to establish the phylogenetic structure of the genus using molecular data on all American willows, using three DNA markers. This complete phylogeny of American willows allows us to propose a biogeographic framework for the evolution of the genus. Material was obtained for the 122 native and introduced willow species of America. Sequences were obtained from the ITS (ribosomal nuclear DNA) and two plastid regions, matK and rbcL. Phylogenetic analyses (parsimony, maximum likelihood, Bayesian inference) were performed on the data. Geographic distribution was mapped onto the tree. The species tree provides strong support for a division of the genus into two subgenera, Salix and Vetrix. Subgenus Salix comprises temperate species from the Americas and Asia, and their disjunction may result from Tertiary events. Subgenus Vetrix is composed of boreo-arctic species of the Northern Hemisphere and their radiation may coincide with the Quaternary glaciations. Sixteen species have ambiguous positions; genetic diversity is lower in subg. Vetrix. A molecular phylogeny of all species of American willows has been inferred. It needs to be tested and further resolved using other molecular data. Nonetheless, the genus clearly has two clades that have distinct biogeographic patterns.

Continuing professional development (CPD) activities are one way that new knowledge can be translated into changes in practice. However, few tools are available for evaluating the extent to which these activities change health professionals' behavior. We developed a questionnaire called CPD-Reaction for assessing the impact of CPD activities on health professionals' clinical behavioral intentions. We evaluated its responsiveness to change in behavioral intention and verified its acceptability among stakeholders. We enrolled 376 health professionals who completed CPD-Reaction before and immediately after attending a CPD activity. We contacted them three months later and asked them to self-report on any behavior change. We compared the mean rankings on each CPD-Reaction construct before and immediately after CPD activities. To estimate its predictive validity, we compared the median behavioral intention score (post-activity) of health professionals reporting a behavior change three months later with the median behavioral intention score of physicians who reported no change. We explored stakeholders' views on CPD-Reaction in semi-structured interviews. Participants were mostly family physicians (62.2%), with an average of 19 years of clinical practice. Post-activity, we observed an increase in intention-related scores for all constructs (P < 0.001) with the most appreciable for the construct beliefs about capabilities. A total of 313 participants agreed to be contacted at follow up, and of these only 69 (22%) reported back. Of these, 43 (62%) self-reported a behavior change. We observed no statistically significant difference in intention between health professionals who later reported a behavior change and those who reported no change (P = 0.30). Overall, CPD stakeholders found the CPD-Reaction questionnaire of interest and suggested potential solutions to perceived barriers to its implementation. The CPD-Reaction questionnaire seems responsive to change in behavioral intention. Although CPD stakeholders found it interesting, future implementation will require addressing barriers they identified.

Traditional treatment of wastewaters is a burden for local governments. Using short rotation coppice willow (SRCW) as vegetal filter has several environmental and economic benefits. Here, we investigated the effect of primary wastewater irrigation on wood structure and composition of the willow cultivar Salix miyabeana ‘SX67’ following two years of growth. Compared to unirrigated plants (UI), stem sections of plants irrigated with primary wastewater (WWD) showed an unexpected decrease of hydraulic conductance (K S ) associated with a decrease in vessel density but not vessel diameter. The majority (86%) of vessels had diameters range groups [20-30[, [30-40[and [40-50[µm and contributed to > 75% of theoretical K S , while the group class [50-60[µm (less than 10% of vessels) still accounted for > 20% of total K S regardless irrigation treatments. WWD significantly alters the chemical composition of wood with an increase of glucan content by 9 to 16.4% and a decrease of extractives by 35.3 to 36.4% when compared to UI or to plants irrigated with potable water (PW). The fertigation did also increase the proportion of the tension wood which highly correlated with glucan content. In the context of energetic transition and mitigation of climate change, such results are of high interest since WWD effectively permit the phytofiltration of large amounts of organic contaminated effluents without impairing SRCW physiology.

Arsenic (As) is a toxic element for plants and one of the most common anthropogenic pollutants found at contaminated sites. Despite its severe effects on plant metabolism, several species can accumulate substantial amounts of arsenic and endure the associated stress. However, the genetic mechanisms involved in arsenic tolerance remains obscure in many model plant species used for land decontamination (phytoremediation), including willows. The present study assesses the potential of cv. 'Fish Creek' for arsenic phytoextraction and reveals the genetic responses behind arsenic tolerance, phytoextraction and metabolism. Four weeks of hydroponic exposure to 0, 5, 30 and 100 mg/L revealed that plants were able to tolerate up to 5 mg/L arsenic. Concentrations of 0 and 5 mg/L of arsenic treatment were then used to compare alterations in gene expression of roots, stems and leaves using RNA sequencing. Differential gene expression revealed transcripts encoding proteins putatively involved in entry of arsenic into the roots, storage in vacuoles and potential transport through the plant as well as primary and secondary (indirect) toxicity tolerance mechanisms. A major role for tannin as a compound used to relieve cellular toxicity is implicated as well as unexpected expression of the cadmium transporter CAX2, providing a potential means for internal arsenic mobility. These insights into the underpinning genetics of a successful phytoremediating species present novel opportunities for selection of dedicated arsenic tolerant crops as well as the potential to integrate such tolerances into a wider ideotype alongside traits including biomass yield, biomass quality, low agricultural inputs and phytochemical production.

The aim of this study was to investigate the bioremediation impacts of willows grown in short rotation intensive culture (SRIC) and supplemented or not with spent mushroom substrate (SMS) and ramial chipped wood (RCW). Results did not show that SMS significantly improved either biomass production or phytoremediation efficiency. After the three growing seasons, RCW-amended S. miyabeana accumulated significantly more Zn in the shoots, and greater increases of some PAHs were found in the soil of RCW-amended plots than in the soil of the two other ground cover treatments’ plots. Significantly higher Cd concentrations were found in the shoots of cultivar ‘SX61’. The results suggest that ‘SX61’ have reduced the natural attenuation of C10-C50 that occurred in the unvegetated control plots. The presence of willows also tended to increase the total soil concentrations of PCBs. Furthermore, we found that many contaminant concentrations were subject to seasonal oscillations, showing average increases throughout the whole experimental site after a growing period, while showing significantly different variations, such as lesser increases or even decreases, after a dormant period. These observations suggest that contaminants may have leached or degraded faster in untreated conditions, and conversely to have mobilized towards trees through water flow driven by plant transpiration during growing seasons.

The Salix genus includes shrub species that are widely used in phytoremediation and various other phytotechnologies due to their advantageous characteristics, such as a high evapotranspiration (ET) rate, in particular when cultivated in short rotation intensive culture (SRIC). Observations made in past field studies suggest that ET and its impact on soil hydrology can also lead to increases in soil pollutant concentrations near shrubs. To investigate this, sections of a mature willow plantation (seven years old) were cut to eliminate transpiration (Cut treatment). Soil concentrations of polychlorinated biphenyls (PCBs), aliphatic compounds C10–C50, polycyclic aromatic hydrocarbons (PAHs) and five trace elements (Cd, Cr, Cu, Ni and Zn) were compared between the Cut and the uncut plots (Salix miyabeana ‘SX61’). Over 24 months, the results clearly show that removal of the willow shrubs limited the contaminants’ increase in the soil surface, as observed for C10–C50 and of 10 PAHs under the Salix treatment. This finding strongly reinforces a hypothesis that SRIC of willows may facilitate the migration of contaminants towards their roots, thus increasing their concentration in the surrounding soil. Such a “pumping effect” in a high-density willow crop is a prominent characteristic specific to field studies that can lead to counterintuitive results. Although apparent increases of contaminant concentrations contradict the purification benefits usually pursued in phytoremediation, the possibility of active phytoextraction and rhizodegradation is not excluded. Moreover, increases of pollutant concentrations under shrubs following migration suggest that decreases would consequently occur at the source points. Some reflections on interpreting field work results are provided.