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Biomedical subjects

S G Wright

Publications and source records attributed to S G Wright.

At least 19 recordsLinked to original sources
PubMed2002

Single-tube, nested PCR for the diagnosis of human brucellosis in Kuwait.

The polymerase chain reaction (PCR) offers a sensitive and specific way of detecting microbial DNA in clinical samples. The aims of the present study were to develop an assay, based on a single-tube, nested PCR, for identifying Brucella in samples of human blood and then to explore the use of this test in diagnosis. The primers chosen were derived from IS711, the insertion sequence gene found in all species of Brucella. The assay amplified a 52-bp final product which was detected colorimetrically. The PCR was sensitive and specific, giving positive reactions with 14 strains of Brucella from five species. The lower limit of detection in vitro was 30 organisms. There were no false-positive reactions either with a range of bacteria known to evoke serological cross-reactions with Brucella (Vibrio cholerae, Yersinia enterocolitica, Serratia marcescens, Haemophilus influenzae, Pseudomonas aeruginosa and Escherichia coli K12) or with organisms producing similar clinical syndromes (Mycobacterium tuberculosis and Salmonella typhi). The results of a preliminary field trial of the assay in Kuwait indicate that the assay may be a valuable technique in the diagnosis of human brucellosis, meriting further study with larger numbers of cases. All 28 subjects with brucellosis (diagnosed on the basis of typical clinical features and confirmed by positive serology and, in three cases, by positive blood cultures) were PCR-positive whereas 28 healthy controls and 28 patients with febrile illness attributable to infections other than brucellosis were PCR-negative.

Animals↗
PubMed2000

Risk factors for human brucellosis in Yemen: a case control study.

Brucellosis is known to occur in Yemen but its epidemiology has not been extensively studied. The present investigation examined risk factors for human brucellosis in Yemen using a hospital-based case-control study. A total of 235 consecutive patients with brucellosis attending the Central Health Laboratory in Sana'a, Yemen, were matched in respect of age, sex, and place of residence, rural or urban, with 234 controls selected from individuals attending the Central Health Laboratory for unrelated health problems. Clinical information on patients and controls was supplemented with occupational and socio-economic data obtained by interview of cases and controls using a standard questionnaire. After controlling for confounding factors significant risk factors for infection related to occupation as a farmer (OR 2.5 (95% CI 1.4-4.5, P < 0.0001)), shepherd (OR 7.8 (95% CI 1.0-61, P 0.05)) or microbiologist (OR 24.5 (95% CI 2.9-204, P 0.003)); and drinking fresh milk (OR 2.0 (95% CI 1.3-4.3, P 0.001)) and laban (OR 22.7 (95% CI 1.7-4.2 P < 0.0001)). Taking other milk products and offal were not risk factors. Socio-economic and educational factors were also independent risk factors. Occupational, food and socio-economic risk factors significantly confounded one another. Yemen shares some but not all of the risk factors of neighbouring countries. The interrelation between the various factors is complex and studying any one in isolation may give a false impression of its public health significance. Control through education of the population to minimize exposure to, and contact with, animals and their milk and milk products and to boil milk before drinking it or using it to make buttermilk, would be difficult as these would represent such fundamental changes to established patterns of behaviour of this society. Ideally there would be a campaign to control the infection by animal vaccination but the costs and logistic difficulty would be great. Presently there is a clear need for doctors in Yemen to be made aware of the frequency of this infection, the means available for clinical and laboratory diagnosis and effective treatment, while strategies to control the disease in Yemen are formulated and field tested.

Adolescent↗
PubMed2000

Picking up the pieces.

This paper examines some of the current evidence of stress and burnout among nurses and other health care workers. Even in environments where pay and conditions are good, nurses still experience significant difficulties in healing relationships, stress and burnout sufficient to render them dysfunctional at work. The paper, using the case study of a unit set up to provide care for nurses, examines how the needs of nurses can also be taken into account in the holistic perspective on caring.

Burnout, Professional↗
PubMed1998

Enzyme-linked immunosorbent assay for brucella antigen detection in human sera.

A sandwich enzyme-linked immunosorbent assay (ELISA) with monoclonal antibody coupled to the solid phase was evaluated for the detection of brucella antigen in serum samples. Under optimum conditions, 100 brucella cells/well or 10(5) fg/ml of lipopolysaccharide (LPS) were detected in spiked specimens. The standardised assay was performed on 1607 sera from random blood donors, 146 patients with brucellosis, 20 persons in high risk groups and 264 sera from patients with diseases other than brucellosis. Sensitivity was 100% compared with positive blood culture, and 44% compared with serological tests for brucella antibodies. Specificity was 99.5% among random blood donors and 99.2% in the patient population. These data showed a strong agreement between ELISA antigen detection and blood culture for the detection of brucella positive blood samples. Moreover, the results indicated that antigen detection by ELISA could be an acceptable alternative to blood culture for the diagnosis of brucellosis.

Anti-Bacterial Agents↗
PubMed1997

A networking approach to clinical supervision.

Clinical supervision offers support in clinical and professional development. This article discusses a number of approaches to supervision and describes the use of a networking model when a nursing development unit was created.

Education, Nursing, Continuing↗
PubMed1997

Towards a defence of nursing routine and ritual.

Healing routines and rituals have been an essential part of life since time in memorial. Rather than dismiss modern healing rituals because, in many instances, they appear to have no empirically proven manifest function, an argument is proposed in defence of routine and ritual, suggesting that there is an urgent need to explore their meaning or latent function.

Ceremonial Behavior↗
PubMed1996

Clinical and laboratory features of patients with loiasis (Loa loa filariasis) in the U.K.

To assess differences between Africans and expatriates, we reviewed records of 100 patients with loiasis presenting to The Hospital for Tropical Diseases, London. Fifty-one were black Africans, and 49 were white expatriates. A history of Calabar swellings was more common amongst expatriates (P = 0.0001, OR 8.1), whilst eyeworm was reported more frequently in Africans (P = 0.0038, OR 4.2). Higher eosinophil levels (P < 0.0001) and filarial antibody levels, whether measured by immunofluorescence (P = 0.047) or ELISA (P < 0.0001) were present in the expatriates. Africans were more likely to have microfilaraemia (P < 0.0025, OR 7.3), and among microfilaraemic patients, Africans had denser microfilaraemia (P = 0.012). The sensitivity of microfilaremia as a screening test for loiasis was 75% in Africans and 29% in expatriates. The sensitivities of filarial antibody tests in Africans and expatriates were 81% and 100% for IFAT, and 28% and 93% for ELISA. Following treatment, 63% of patients were considered cured, 25% were lost to follow-up and 12% had a documented relapse. The differences between the two groups of patients could be caused by differences in the chronicity of loiasis, but other explanations are also discussed.

Adolescent↗
PubMed1996

The need to develop nursing practice through innovation and practice change.

This paper examines some of the strategies that can be used to produce change in nursing. These strategies range from the power-coercive through rational-empirical to the normative-re-educative. Strategies that promote a 'bottom-up' approach are advocated for clinical nursing and some of the principal factors towards success, such as team building, the presence of a clinical leader and planning are indicated. The paper will also expand on what needs to be changed in nursing, and what the purpose of such changes are. It is argued that externally focused efforts of change, such as the organization of care or new practices are only part of the picture. The journey of change also requires an inner exploration of who we are and what are we seeking to achieve in nursing.

Clinical Nursing Research↗
PubMed1996

The CIO's position in today's emerging health care system: lessons learned.

The integrated delivery network is a new concept. Using information technology as a rallying point has allowed people to come together in a non-threatening way. They discuss new ideas and possibilities for improving the performance of their individual institution and thus, the entire Network. How quickly and how well business adapts to this new model will dictate long-term viability in the marketplace. Technology will not be the limiting factor to success in this new endeavor. It will be a facilitator that can help the organizational transition from single institutions to an IDN. The challenge is in managing how well personnel accept this change and seek ways to work together in this new endeavor. The ability to perform competently at these new levels comes from the ability to perform as a senior executive, acting in partnership and peer relationships as a facilitator and leader. To manage the change required in these new organizations, there must be common vision, the creation of new roles, agreed upon priorities, flexibility, and standardization when necessary. While there is not one right solution, leadership and shared vision and the ability to deliver are key success factors.

Administrative Personnel↗
PubMed1996

The distribution of resources in health care.

Perceived advances in medicine lead to raised public expectations of care. Resources are finite, but governments can choose how they spend health service funds. Decisions on health "priorities' have implications for nursing practice as well as patient choice.

Decision Making, Organizational↗
PubMed1995

Bringing the heart back into nursing.

This paper examines the growth in interest in complementary therapies in recent years; specifically in relation to nursing. A number of reasons appear to underpin the expansion into nursing practice--including their effects in the therapeutic potential of nursing and the desire by nurses to 'humanise' health care. The rise of complementary therapies, however, is seen as more than a desire to seek alternative treatments, or to seek help where orthodox medicine's role is disputed or as a reaction to our touch deprived 'high-tech' culture. Indeed it is argued, that seeing the complementary therapies as just another 'treatment' is to adopt a reductionist view as inappropriate and as limiting as orthodox methods. Nor is growth in interest in the complementary therapies an end in itself; rather it is a product of a wider, greater shift of circumstances that is taking place as a new millenium approaches.

Complementary Therapies↗