Biomedical subjects

K L Smith

Publications and source records attributed to K L Smith.

At least 73 records · Page 4Linked to original sources

PubMed1999

Making sense of problem-based learning: the perceptions and experiences of undergraduate nursing students.

This paper reports the findings of one stage of an ongoing project to evaluate a problem-based learning (PBL) curriculum. Focusing on the students themselves, the ethnographic study explored how undergraduate nursing students (n=17) managed and made sense of a PBL programme. Fieldwork and ethnographic interviews revealed the students' perceptions of the purpose of PBL and further issues that were of concern were identified and labelled the uncertainty of functioning without a clearly delineated educational structure, perceptions of knowledge acquisition, understanding of group interaction processes, and the role of the facilitator. These findings and the implications that arise as a result are discussed.

Anthropology, Cultural↗

PubMed1999

Meso-scale ecology of anthrax in southern Africa: a pilot study of diversity and clustering.

It has only recently been possible to detect sufficient genetic diversity among anthrax isolates to allow genotype grouping (Keim et al. 1997). Early results of such grouping suggest that the southern African subcontinent may be the geographical origin of Bacillus anthracis. This report describes a pilot investigation of the genetic diversity of a study group of isolates from the Kruger National Park, South Africa, and efforts to detect spatio-temporal clustering within the study group. This study has also served as further validation for the newly developed Multi-Locus VNTR Analysis (MLVA), designed to simplify genotyping of B. anthracis isolates. The results reveal a diverse range of genotypes within the park allied with three genotype reference groups, and show that the MLVA procedure is robust for rapid analysis of B. anthracis genotypes. We also observed multiple genotype groups within epidemics and between geographically and temporally close epidemic episodes. This is in contrast to earlier characterizations of anthrax epidemics. The result of a Mantel test for time-space clustering indicates clustering of the anthrax isolates selected for the study.

Africa↗

PubMed1999

Molecular diversity in Bacillus anthracis.

Molecular typing of Bacillus anthracis has been extremely difficult due to the lack of polymorphic DNA markers. We have identified nine novel variable number tandemly repeated loci from previously known amplified fragment length polymorphism markers or from the DNA sequence. In combination with the previously known vrrA locus, these markers provide discrimination power to genetically characterize B. anthracis isolates. The variable number tandem repeat (VNTR) loci are found in both gene coding (genic) and non-coding (non-genic) regions. The genic differences are 'in frame' and result in additions or deletion of amino acids to the predicted proteins. Due the rarity of molecular differences, the VNTR changes represent a significant portion of the genetic variation found within B. anthracis. This variation could represent an important adaptive mechanism. Marker similarity and differences among diverse isolates have identified seven major diversity groups that may represent the only world-wide B. anthracis clones. The lineages reconstructed using these data may reflect the dispersal and evolution of this pathogen.

Animals↗

PubMed1999

Following the forsaken: a procedural description of a problem-based learning program in a school of nursing studies.

This paper reports the findings of one stage in an ongoing project to evaluate, from the students' perspectives, a student-centered problem-based learning (PBL) program in a School of Nursing Studies. We begin by making a comparison between teacher-centered education and religious devotion, and liken PBL to a congregation without a priest. A topographical account of the setting follows, describing the typical activities and events that characterize the program. Throughout the course of this account, a number of issues arise: the role of the facilitator, group dynamics, mutual responsibility and motivation for learning. These are touched on briefly, but we do not attempt to make a substantive theoretical contribution. Despite the widespread popularity of PBL in nursing schools, there have been few empirical studies conducted and, consequently, the adoption of PBL in nursing has been dependent upon the research of the very different discipline of medicine and medical education.

Anthropology, Cultural↗

PubMed1999

Antigenic homology of the inducible ferric citrate receptor (FecA) of coliform bacteria isolated from herds with naturally occurring bovine intramammary infections.

Expression of ferric citrate receptor FecA by Escherichia coli and Klebsiella pneumoniae isolated from bovine mastitis was investigated. Transformant E. coli UT5600/pSV66, which produces large quantities of FecA in the presence of citrate, was constructed. The FecA of E. coli UT5600/pSV66 was purified by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis and used to prepare polyclonal antiserum in rabbits. All coliform isolates of E. coli (n = 18) and K. pneumoniae (n = 17) from naturally occurring bovine intramammary infections in five herds induced iron-regulated outer membrane proteins when grown in Trypticase soy broth containing 200 microM alpha-alpha'-dipyridyl and 1 mM citrate. Polyclonal antiserum against FecA was used in conjunction with an immunoblot technique to determine the degree of antigenic homology of FecA among isolates. In the presence of citrate, each isolate expressed FecA that reacted with the anti-FecA polyclonal antiserum. The molecular mass of FecA ( approximately 80.5 kDa) was also highly conserved among isolates. Therefore, the ferric citrate iron transport may be induced in coliform bacteria and utilized to acquire iron in milk for survival and growth. The FecA is an attractive vaccine component for controlling coliform mastitis during the lactation period.

Animals↗

PubMed1999

Orthopaedic residency training: a survey of the graduates' perspective.

STUDY DESIGN: A survey of residency graduates. OBJECTIVES: To establish a profile of the typical graduate and to determine the value and influence of residency training on professional development, particularly on clinical expertise. BACKGROUND: Physical therapists are involved in direct access in some states as a result of health care reform. There is increasing interest within the physical therapy profession in evaluating residency education as an avenue for providing physical therapists with the advanced skills to meet the changing nature of providing care. METHODS AND MEASURES: A questionnaire was sent to 98 graduates of a year long advanced orthopaedic manual therapy residency program. A response rate of 94.9% was obtained. RESULTS: Influence of residency training on clinical skills and expertise received high ("major positive") ratings on the abilities to logically reason (94%), thoroughly examine (95%), treat effectively (84%) and efficiently (79%), and to "diagnose" (85%). Graduates spend 23% of their time teaching in some manner. Autonomy of decision making was the primary factor (43%) in determining place of work. CONCLUSIONS: The results of this survey suggest that residency education assists physical therapists to refine and expand their clinical knowledge and skills that are important for health care roles requiring increasing autonomy of practice, such as primary care. Our questionnaire may also serve as a template for the measurement of outcome in clinical physical therapy residency programs.

Adult↗

PubMed1999

Growth responses of coliform bacteria to purified immunoglobulin G from cows immunized with ferric enterobactin receptor FepA.

The ability of purified bovine immunoglobulin (Ig) G from cows immunized with ferric enterobactin receptor FepA to inhibit the growth of coliform bacteria derived from bovine intramammary infection was investigated in iron-restricted media. All isolates of Escherichia coli (n = 21) and Klebsiella pneumoniae (n = 21) were tested for growth in a chemically defined medium containing 0.5 mg/ml of apolactoferrin and in a pooled source of dry cow secretion. The addition of 4 mg/ml of purified bovine IgG directed against FepA in the synthetic medium resulted in significant growth inhibition for both E. coli and K. pneumoniae isolates. Growth reduction of E. coli was greater than that of K. pneumoniae. In dry cow secretions, the growth of each E. coli isolate but of less than half of K. pneumoniae isolates (43%) was inhibited by IgG from cows immunized with FepA. Purified bovine IgG from cows immunized with E. coli J5 had a minimal inhibitory effect on the growth of both E. coli and K. pneumoniae isolates in the synthetic medium. In dry cow secretions, IgG from cows immunized with E. coli and K. pneumoniae isolates. Supplementation with 50 microM of ferric chloride to the medium completely reversed the inhibitory effects of the antibodies and lactoferrin. Bovine IgG directed against FepA apparently inhibited the growth of coliform bacteria by interfering with the binding of the ferric enterobactin complex to the cell surface receptor FepA.

Animals↗

PubMed1999

Efficacy of an Escherichia coli J5 bacterin administered to primigravid heifers.

The efficacy of an Escherichia coli J5 bacterin for reducing the incidence of intramammary infections and clinical signs of mastitis was tested in first lactation heifers. Ten primigravid heifers were immunized with an E. coli J5 bacterin. Four heifers received a placebo. The bacterin and placebo were injected subcutaneously approximately 60 d prior to calving, 28 d later, and within 48 h after calving. Vaccinated and placebo-injected heifers were challenged by intramammary infusion of E. coli 727 in one mammary gland between 23 and 37 d after calving. All challenged quarters were diagnosed with an intramammary infection within 6 h after bacteria were infused. The severity and duration of local signs of clinical mastitis were reduced in vaccinated heifers compared with placebo-injected heifers. Systemic signs of clinical mastitis were limited and did not differ between treatment groups. Bacteria counts in milk from challenged quarters were lower in vaccinated heifers than in control heifers at 12, 15, and 48 h after challenge. Serum immunoglobulin G titers against whole-cell E. coli J5 antigen at calving were higher in vaccinated heifers than they were in controls. Vaccinated heifers had higher immunoglobulin G titers than did controls in mammary secretions at calving and immediately prior to challenge. Immunization of primigravid heifers with an E. coli J5 bacterin during the last trimester of gestation and at calving reduced the severity and duration of clinical signs following intramammary challenge with a heterologous strain of E. coli.

Animals↗

PubMed1999

Bacterial counts associated with sawdust and recycled manure bedding treated with commercial conditioners.

Bacteria counts associated with untreated organic bedding materials were compared with those of bedding treated with either an alkaline commercial bedding conditioner, acidic commercial bedding conditioner, or hydrated lime. Bedding materials were recycled manure and kiln-dried sawdust. The effects of bedding treatments on bacteria counts differed between bedding types. Each of the bedding treatments significantly reduced bacteria in recycled manure prior to use. The alkaline conditioner and hydrated lime effectively inhibited bacteria in recycled manure for 1 d. Bedding counts and teat swabs of cows housed on recycled manure treated with the alkaline conditioner were reduced on d 2. The use of the acid conditioner in recycled manure had little effect on bacteria in bedding. Sawdust differed from recycled manure in that bacteria in untreated sawdust prior to use were minimal, and populations increased rapidly during the first 2 d after use as bedding. The acid conditioner had a bacteriostatic effect in sawdust, evident by the reduction of bacteria on d 2. The alkaline conditioner and hydrated lime did not alter bacteria counts in sawdust compared with untreated sawdust. Antibacterial activity of each conditioner deteriorated between d 2 and d 6 in both beddings. The antibacterial activities of conditioners were related to the pH of bedding materials. The use of commercial bedding conditioners initially reduced bacterial counts; however, the antibacterial effects had diminished between d 2 and 6 after use in bedding.

Animals↗

PubMed1999

Efficacy of intramammary immunization with an Escherichia coli J5 bacterin.

Intramammary immunization was investigated as a procedure to reduce the clinical signs of coliform mastitis. Twenty-four cows were equally distributed to the following Escherichia coli J5 immunization schedules: 1) Subcutaneous injection 14 d prior to the end of lactation, intramammary immunization 7 d after drying off, and subcutaneous injection 30 d into the dry period; 2) subcutaneous injections at drying off, at 30 d into the dry period, and within 12 h after calving; and 3) unimmunized controls. Intramammary immunizations were the infusion of vaccine via the teat canal into each of the four mammary glands. Cows were challenged by infusion of E. coli 727 into one uninfected mammary quarter at approximately 30 d after calving. Intramammary immunization enhanced antibody titers against E. coli J5 and E. coli 727 compared with subcutaneous immunization. Immunoglobulin G titers against E. coli J5 and E. coli 727 in whey were greater at the time of challenge and 7 d after challenge for cows that received the intramammary immunization than for cows immunized by only subcutaneous injections. Serum IgG titers against E. coli 727 were enhanced at 7 d after challenge for cows receiving intramammary immunizations compared with conventionally immunized cows. Serum IgM titers against E. coli 727 were higher at calving for cows receiving intramammary immunization compared with conventionally immunized cows. Immunization schedule had minimal effect on systemic and local signs of clinical mastitis following challenge.

Animals↗

PubMed1999

Developmental neuroplasticity: roles in early life seizures and chronic epilepsy.

Both clinical and experimental studies suggest that the immature nervous system is unusually susceptible to seizures during critical periods in postnatal life. A late onset of gamma-aminobutyric acid (GABA)-mediated synaptic inhibition could conceivably play a contributing role in this phenomenon. Numerous studies have shown that neural systems that use GABA in the neonatal brain are different than those of adulthood. GABA is an excitatory neurotransmitter that likely plays a neurotrophic role in neuronal differentiation. Other reports suggest that unique, possibly transient, GABAergic interneuron populations exist in the embryonic and neonatal nervous system. At these early times in development, the immature nervous system is remarkably resistant to seizure generation. However, as the hippocampus and neocortex enter the critical period of enhanced seizure susceptibility, inhibitory GABA systems mature rapidly. At this time, blockade of GABA type A (GABAA) receptors produce unusually severe seizure discharges. In hippocampus, concurrent exuberant outgrowth of recurrent excitatory axon collaterals and synapses appear to play a role in the generation of these seizures. As the hippocampus matures, these axons are morphologically remodeled and nearly 50% of branches within arbors are pruned. This pruning of axon branches corresponds in time with the decrease in seizure susceptibility that characterizes adulthood. Developmental remodeling of neuronal connectivity is a common feature of most areas of the central nervous system. Results from an audiogenic seizure model of early onset epilepsy suggest that prevention of axon arbor remodeling by transient sensory deprivation can lead to a permanent overinnervation of target nuclei and chronic seizure susceptibility. Early life seizures may have a similar effect. Recent results in one model have shown that repeated seizures induced by intrahippocampal injections of tetanus toxin during a critical period results in a chronic epilepsy. Future studies should attempt to determine if the synchronized discharging of early-life seizures prevents the remodeling of neuronal connectivity that normally takes place during postnatal development and results in an overinnervated and chronically hyperexcitable hippocampus.

Aging↗

PubMed1998

Spine loss and other persistent alterations of hippocampal pyramidal cell dendrites in a model of early-onset epilepsy.

To explore the anatomical substrates for network hyperexcitability in adult rats that become chronically epileptic after recurrent seizures in infancy, the dendritic and axonal arbors of biocytin-filled hippocampal pyramidal cells were reconstructed. On postnatal day 10, tetanus toxin was unilaterally injected into the hippocampus and produced brief but recurrent seizures for 1 week. Later, hippocampal slices taken from these rats exhibited synchronized network bursts in area CA3C. Both the apical and basilar dendritic arbors of CA3C pyramidal cells were markedly abnormal in these epileptic rats. There was a considerable reduction in the density of dendrite spines, although the extent of this loss could vary among dendritic segments. Spine density on terminal segments of the basilar and apical dendrites was reduced on average by 35 and 20%, respectively. In addition, the diameters of these same dendritic segments were markedly reduced. Dendritic spine loss has previously been suggested to indicate a partial deafferentation of epileptic neurons, but this interpretation is difficult to reconcile with the critical role recurrent excitatory synaptic transmission plays in the generation of synchronized network burst. In this study, axonal arbors of CA3C pyramidal cells exhibited normal branching patterns, branching complexity, and varicosity density. This suggests that if deafferentation occurs, synapses other than recurrent excitatory ones are lost. The morphological abnormalities reported here would be expected to significantly alter electrical signaling within dendrites that may contribute importantly to seizures and other behavioral sequelae of early-onset epilepsy.

Action Potentials↗

PubMed1998

Exploring the potential of problem-based learning in nurse education.

It could be argued that the role of the nurse is beginning to change from that of a medical assistant to one of a more research-aware, reflective professional. As a result, the education of nursing students has needed to adapt. This paper explores how problem-based learning (PBL) may be an appropriate means of achieving an educational preparation that can respond to changing needs. Particular attention is paid to the theoretical underpinnings of PBL, especially the concepts of adult education, cognitive processes and learning in context. Some of the relevant empirical studies are reviewed, and the authors attempt to identify the gaps in the literature, concluding by recommending a course of action to expand the existing levels of understanding and evidence that supports, or otherwise, the use of PBL.

Adult↗

PubMed1998

Total shoulder arthroplasty versus hemiarthroplasty. Current trends.

Currently, a debate exists regarding the indications for hemiarthroplasty and total shoulder arthroplasty. A number of factors are important in making this decision. The article discusses some of the variables related to choosing the appropriate procedure for every patient. The authors also discuss their approach to various arthritic conditions of the shoulder, the rationale behind their approach, and their results. Future work will be necessary before more definitive recommendations can be made, and they may well be different for each individual surgeon.

Arthritis↗

PubMed1998

Syllabic effects in word processing: evidence from the structural induction paradigm.

Spoken words have a rich structural organization in memory, consisting of syllabic and subsyllabic representations. A phoneme monitoring paradigm, in which the target phoneme occurs more frequently in one syllabic position than another (e.g., onset of the 2nd syllable vs. the coda of the 1st syllable: neu-tral vs. nut-meg; C. Pallier, N. Sebastian-Galles, T. Felguera, A. Christophe, & J. Mehler, 1993) was used to explore the formation of syllabic structure during word processing. Experiment 2 investigated how a recognition system that uses syllabic structure processes words with unclear syllable boundaries (e.g., pa-lace or pal-ace?). Two methodological issues were explored: The importance of a baseline condition for measuring effects of induction (Experiment 1) and the form of the representation used in the induction paradigm (Experiment 3). Findings suggest that syllabic structure begins to form early in word processing, and they demonstrate the adequacy of the induction procedure for measuring such processes.

Brain↗

PubMed1998

'The buck stops here': accepting responsibility for learning and actions after graduation from a problem-based learning nursing education curriculum.

Despite the increased attention that problem-based learning has received as an appropriate pedagogical technique for educating adults for professional practice, reports that evaluate the process are rare and usually relate to professions other than nursing. A study was undertaken in order to discover the graduates' own perceptions of a problem-based learning programme and its effectiveness in preparing them for the reality of their chosen profession. Twelve practising graduate nurses who had completed the programme were interviewed according to the ethnographic method. Three categories were identified from the data: 'and all of a sudden...', which describes the transition from PBL student to staff nurse; 'not an unthinking assistant', where the characteristics that the PBL graduates believe make them different from traditionally trained nurses are described; and 'the buck stops here', which describes the sense of personal responsibility that the graduates experience in terms of their learning and actions.

Anecdotes as Topic↗

PubMed1998

Reproducibility of antibiogram of bovine mammary gland staphylococci under conditions of repeated subculturing.

The reproducibility of antibiogram profiles of 10 staphylococcal isolates of bovine mammary gland origin was tested under conditions of repeated subculturing. Prototype (original or index) antibiogram profiles were determined by subculturing these isolates from stock cultures stored at -70 degrees C. The isolates were then subcultured four times on blood agar and antibiogram profiles determined at each subculture on Mueller-Hinton agar. The antibiogram profiles of each isolate at each subculture were compared with the prototype profiles of that isolate. At repeat antibiogram determinations, deviations of < or = 5 mm in the individual zones of inhibition of penicillin, ampicillin and streptomycin from the prototype antibiogram profiles, resulted in a shift of only three isolates from the resistant to intermediate and one isolate from intermediate to resistant status of antibiotic susceptibility classification. It is suggested that in the interpretation of antibiogram, susceptibility classification (resistant, intermediate, or susceptible) variations accruing from a few millimetres differences in the diameter of the zones of inhibition should probably be disregarded.

Ampicillin↗

PubMed1998

Local circuit abnormalities in chronically epileptic rats after intrahippocampal tetanus toxin injection in infancy.

In vitro slice experiments were undertaken in adult rats to investigate the physiological origins of a chronic epileptic condition that was initiated in infancy. A unilateral injection of a minute quantity of tetanus toxin into hippocampus on postnatal day 10 produced a severe convulsive syndrome characterized by brief but repeated seizures that lasted for 5-7 days. Hippocampal slices were then taken from these rats in adulthood because at this time previous studies have shown the occurrence of electrographic and behavioral seizures. Dramatic alterations in local circuit functioning were observed. In normal artificial cerebrospinal fluid (ACSF), spontaneous epileptiform network bursts were recorded in a majority (73%) of experimental rats. Network bursts occurred in area CA3 of both the injected and contralateral hippocampus. These consisted of intracellular depolarization shifts that were coincident with extracellularly recorded network bursts. Often they occurred at frequencies of 0.05-0.1 Hz and although variable in amplitude and duration, had all-or-none-like qualities. These events appeared to arise largely from local circuits in the CA3C subfield. Network bursts were rarely recorded in area CA1 and were never observed in the dentate gyrus. However in 31% of rats, a novel, higher frequency (2-8 Hz) field potential was recorded in area CA1. This was coincident with rhythmic, intracellularly recorded, inhibitory postsynaptic potentials (IPSPs). These summated IPSPs blocked action potential firing and reversed polarity near -75 mV. To understand the origins of network bursting in area CA3C, comparisons were made of the fundamental neurophysiological properties of pyramidal cells in epileptic and control rats. Of the passive and active membrane properties examined, all appeared normal. Unusually prolonged bursts of action potentials were observed in a small subset of pyramidal cells. However on average the duration of intrinsic bursts were unaltered in the CA3 neurons analyzed from experimental rats. To explore the role that alterations in CA3 recurrent excitatory network excitability may play in epileptiform discharges, picrotoxin was bath applied. On blockade of gamma-aminobutyric acid (GABAA) receptors, slices from experimental rats underwent prolonged electrographic seizures that were up to 10 s in duration. In contrast, slices from control rats produced only brief 100-ms network bursts. These results suggest that a change in excitability within CA3C recurrent excitatory networks likely contributes to seizures in chronically epileptic rats. However, at the same time, this hyperexcitability is controlled to an important degree by functional GABAA-mediated synaptic inhibition.

Action Potentials↗