Biomedical subjects
Publications and source records attributed to L Baillie.
The sequencing of the Bacillus anthracis genome and virulence plasmids represents the greatest advance in anthrax research in the past 100 years. The data will provide the foundation of all future work on this organism and will be invaluable to researchers in their battle to understand the basis of the host-microbe interaction.
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The primary prevention of disease, including cancer, has been a major part of health promotion and health education for decades. However, the long-term results of these strategies have been mixed, and primary prevention as an instrument of cancer control continues to fail to live up to either public or professional expectations. The authors identify and critique two possible factors contributing to this failure and then offer a model for the development and implementation of primary prevention strategies that addresses these factors. The model used is based on Habermas's theory of communicative action and recognizes the importance of a critical dialogue in health education and health promotion. The primary prevention programs currently being conducted by the Cancer Centre for the Southern Interior are presented as an example of the model in action.
Exosporium components from endospores of Bacillus cereus ATCC 10876 were purified and separated by gel electrophoresis. Several of the proteins for which N-terminal sequences were recovered were found to have homologues in protein databases which have been demonstrated to have enzymic activity in other organisms. Amongst these is a zinc metalloprotease, immune inhibitor A, already described in B. thuringiensis. This has been shown to be present in an active 73 kDa form on the exosporium of B. cereus. Other proteins associated with the exosporium include the molecular chaperone GroEL and a homologue of RocA (1-pyrroline-5-carboxylate dehydrogenase (EC 1.5.1.12)) of B. subtilis. Although these are unlikely to represent integral structural proteins of the exosporium, the observation that they are selectively present in the spore surface layer suggests that this layer may have functional significance.
Bacillus anthracis is the causative organism of the disease anthrax. The ability of the organism to form resistant spores and infect via the aerosol route has led to it being considered as a potential biological warfare agent. The current available human vaccines are far from ideal, they are expensive to produce, require repeated doses and may invoke transient side-effects in some individuals. There is also evidence to suggest that they may not give full protection against all strains of B. anthracis. A new generation of anthrax vaccine is therefore needed. The use of Lactobacillus as a vector for expression of heterologous proteins from pathogens supplies us with a safe system, which can be given orally. Lactobacilli are commensals of the gut, generally regarded as safe and have intrinsic adjuvanticity. Oral vaccines may stimulate the mucosol immune system to produce local IgA responses in addition to systemic responses. These vectors are delivered at the mucosal surface, the site where the infection actually occurs and where the first line of defence lies. The gene encoding the protective antigen (PA) of B. anthracis, an immunogenic non-toxic component of the two toxins produced, is being cloned into different homologous vectors and subsequently transformed to various Lactobacillus strains. High intracellular expression levels for the PA in Lact. casei were achieved. Mucosal antigen presentation and humoral and cellular immune responses following immunization with transformants expressing PA in various ways (intracellular, surface-anchored and extracellular) are being studied.
AIM: This action research project aimed to investigate students', newly qualified staff nurses' and ward managers' views about the management skills and knowledge required by staff nurses, and how best students could be prepared for their management role. BACKGROUND: The importance of the staff nurse's management role is increasingly being recognized but the literature highlights the difficulties in preparing students for management, and personal experience confirmed this. METHODS: Focus group interviews were held with senior students and newly qualified staff nurses. A questionnaire was then developed which was completed by 23 ward managers. FINDINGS: A good insight into the management skills and knowledge expected of newly qualified staff nurses, and useful ideas about preparation for the role emerged. An extra 2 weeks in practice, supernumerary and with specific management learning outcomes, was implemented and evaluated well. CONCLUSIONS: Preparation of students for their management role as staff nurses benefits from being closely linked to practical experience, with clear learning outcomes and supportive clinical staff. Using an action research approach to investigate the problem and develop a strategy was found to be an appropriate methodology.
The efficacy of recombinant Bacillus anthracis Protective Antigen (rPA) produced in Bacillus subtilis and formulated in Alhydrogel or MPL-TDM-CWS (Ribi adjuvant) has been tested and compared to the licensed UK human vaccine in guinea pigs challenged by the aerosol route with the Ames strain of B. anthracis. rPA combined with the Ribi adjuvant was found to be the only formulation to provide 100% protection from challenge. Analysis of immunological parameters in the individual animals revealed significant differences between the rPA/Ribi vaccine group and rPA/Alhydrogel and human vaccine groups for antigen specific lymphocyte proliferation, PA neutralisation and antigen specific IgG2 levels, but indicated no significant differences in PA-specific IgG1 levels. rPA formulated in Alhydrogel induced a mainly IgG1 response whilst the rPA/Ribi vaccine produced a predominantly IgG2 response.
The expression of Bacillus anthracis protective antigen (PA) in B. subtilis from the pag gene in pPA101-1 was explored in different genetic backgrounds in an attempt to identify opportunities to maximize expression. Introduction of AtxA, which positively regulates PA expression in B. anthracis did not improve expression levels in the protease-deficient strain WB600. Plasmid pPA101-1 was found to carry a deletion which created a new fusion point between vector and insert sequence, and which removed part of the AtxA binding site. The deletion may have occurred as a consequence of recombination between TCTAT sequences within both the vector and insert. Host mutations could influence expression; PA levels from pPA101-1 are threefold higher in a ccpA mutant than in an otherwise isogenic parent, and eightfold higher in an abrB mutant. These data demonstrate that the introduction of mutations affecting catabolite repression and growth phase regulation results in an increase in the yield of PA in this host-vector system. Combining these mutations with a multiply protease-negative background could potentially allow further improvements in PA yield.
Given the requirement for diploma students to 'use relevant literature and research to inform the practice of nursing' (Statutory Instrument No. 1456 1989 p 5), it is imperative that nurse educators develop effective strategies to promote student interest in research, and develop the knowledge and skills required to understand and use research in practice. This article presents the teaching strategy developed for adult branch students at one college of nursing. The strategy is based on the use of journal clubs and presentations of individuals' research. Both the organizational strategy, and the process adopted are described in some detail. A discussion on the underlying rationale and an evaluation to date are incorporated.
Transactional analysis (TA) can be a useful framework for promoting effective communication. This article outlines the theoretical constructs of TA and suggests a strategy for teaching the model to diploma student nurses. The authors argue that an understanding of TA will allow nurses to analyse and adjust their skills to communicate more effectively.
The purpose of this study was to gain an understanding of the nature of empathy, as perceived and experienced by registered nurses. A phenomenological approach was selected, with nine experienced staff nurses working in surgical settings being interviewed using an open, unstructured approach. Empathy was evidently felt to be beneficial, displayed both nonverbally and through the nurse's actions, and therefore the ability to empathize, and to feel empathy with the individual patient, needs supporting and promoting in nurses. The importance of learning from experience (both personal and professional), and the ability to communicate effectively, are both highlighted by this study. The nature of empathy is evidently multi-faceted, and the presence of empathy is influenced by a complex relationship between the individual nurse, patient and the environment. It should be recognized that environmental issues, such as high workload and stress, also affect ability to empathize.
The aim of this small study was to explore nurse teachers' feelings about participating in clinical practice. An exploratory design was used entailing focused interviews with 10 nurse teachers which explored their current participation in clinical practice and their feelings about this. Other areas addressed were the perceived benefits and negative effects of participating in practice, as well as the factors which may inhibit or enable teachers participating in practice. It was found that while half the teachers had some participation in practice, only one participated on a regular basis. The teachers were generally dissatisfied with their current level of clinical practice. The teachers identified a number of potential benefits of practising, including keeping in touch with clinical practice, maintenance of clinical skills, improved relationships with trained staff and the opportunity to use knowledge and skills in practice. Perceived negative effects were that their clinical participation may be misinterpreted, or may impinge on other aspects of the role. Some also felt that the limited time which they would have available, would lead to their clinical practice being ineffective. The two major factors which affected whether nurse teachers were able to participate in practice were time and the college philosophy/culture. Other important factors were support from clinical staff, clinical confidence, and the teacher's role perception and attitude towards practice. As recent publications have inferred the need for nurse teachers to remain involved in clinical practice, teachers need to identify how clinical practice may best be achieved, and clarify their aims for practising. Different models of practice may be appropriate for individual teachers. It seems that a supportive environment and a college culture which values nurse teachers practising would be beneficial if clinical practice is to become part of the teacher's role.
The study aimed to explore the question, what factors affect student nurse learning in a community setting? A phenomenological approach was taken by carrying out in-depth interviews with eight Project 2000 students who had just completed 8 weeks of community placements. The factors which emerged centred around three themes: the students themselves, the mentors and the placements. Students recognized that their own approach to the placement was important. They found that the role they fulfilled in the placements affected their learning, preferring a participative role to observation only. The role of the mentor was found to be crucial for learning. Important factors were the mentors' knowledge and attitude towards the Project 2000 course and their professionalism (particularly communication skills), as perceived by the students. Also significant were the mentors' skills at facilitating learning in the placements, by encouraging questions and reflection, and organizing a variety of experiences. Factors relating to the placements concerned their relevance to the course (as perceived by the students) and the breadth of experience available. Whilst this was a small sample, from which no generalizations can be made, the study gives insight into students, teachers and community staff of the experience of learning in the community setting.
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Seventy-four of 155 catheter specimens of urine yielded organisms resistant to chlorhexidine. The inhibitory effect of urine against chlorhexidine is reported.
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