Novel monoclonal antibodies against Menangle virus nucleocapsid protein.

Menangle virus (MenV) is a member of the family Paramyxoviridae isolated in Australia that causes a reproductive disease of pigs. There is a need for specific immunoassays for virus detection to facilitate the diagnosis of MenV infection. Three novel monoclonal antibodies (MAbs) of the IgG1 subtype were generated by immunizing mice with recombinant yeast-expressed MenV nucleocapsid (N) protein self-assembled to nucleocapsid-like structures. One MAb was cross-reactive with recombinant N protein of Tioman virus. The epitopes of MAbs were mapped using a series of truncated MenV N proteins lacking the 29-119 carboxy-terminal amino acid (aa) residues. The epitopes of two MAbs were mapped to aa 430-460 of the MenV N protein, whilst the epitope of one MAb was mapped to residues 460-490. All three MAbs specifically recognized MenV, as indicated by immunohistochemical staining of brain tissue isolated from a field case (a stillborn piglet) of MenV infection. The MAbs against MenV N protein may be a useful tool for immunohistological diagnosis of MenV infection.

Generation of Tioman virus nucleocapsid-like particles in yeast Saccharomyces cerevisiae.

Tioman virus (TioV) was isolated from a number of pooled urine samples of Tioman Island flying foxes (Pteropus hypomelanus) during the search for the reservoir host of Nipah virus. Studies have established TioV as a new virus in the family Paramyxoviridae. This novel paramyxovirus is antigenically related to Menangle virus that was isolated in Australia in 1997 during disease outbreak in pigs. TioV causes mild disease in pigs and has a predilection for lymphoid tissues. Recent serosurvey showed that 1.8% of Tioman Islanders had neutralizing antibodies against TioV, indicating probable past infection. For the development of convenient serological tests for this virus, recombinant TioV nucleocapsid (N) protein was expressed in the yeast Saccharomyces cerevisiae. High yields of recombinant TioV N protein were obtained. Electron microscopy demonstrated that purified recombinant N protein self-assembled into nucleocapsid-like particles which were identical in density and morphology to authentic nucleocapsids from paramyxovirus-infected cells. Different size nucleocapsid-like particles were stable and readily purified by CsCl gradient ultracentrifugation. Polyclonal sera raised in rabbits after immunization with recombinant TioV N protein reacted reliably with TioV infected tissues in immunohistochemistry tests. It confirmed that the antigenic properties of yeast derived TioV N protein are identical to authentic viral protein.

The Human Capital Competencies Inventory for developing nurse managers.

BACKGROUND: Nurse managers play a vital role in healthcare delivery systems. Psychometrically sound measures of management practices grounded in empirical practice data are needed. METHOD: An integrative review provided content domain for the Human Capital Competencies Inventory (HCCI). Analyses from nurse managers in one northeastern state revealed considerable consistency in performance of activities. RESULTS: There is validity and reliability for the HCCI with the sample used. CONCLUSIONS: There is early support for the Mastery Path as a competency-based model for developing nurses for management in healthcare organizations. Development and testing of four other management practices in the Mastery Path is ongoing.

Assessment of a point-of-care lactate monitor in emergency admissions of adult horses to a referral hospital.

BACKGROUND: Blood lactate concentration [LAC] is considered a useful indicator of disease severity in horses. Agreement of point-of-care (POC) lactate monitors with laboratory standards has not been established for clinically abnormal horses. HYPOTHESIS: It was hypothesized that results from a POC lactate monitor would be in agreement with a laboratory-based measurement of [LAC]. ANIMALS: The study included adult horses presented for emergency evaluation. METHODS: A prospective observational study was performed. [LAC] was measured with whole blood (AWB) and plasma (APL) by means of a POC monitor (Accutrend) and compared with results from whole blood measured by a laboratory blood gas analyzer (NOVA). RESULTS: Samples from 221 horses were used to compare the 2 lactate measurement techniques. Agreement (p +/- SE) was closest between APL and NOVA (0.97 +/- 0.01); an average observed difference of 0.15 +/- 0.89 (mean +/- SD) and 95% limits of agreement (LOA) -1.89, 1.59 also were found. Agreement was preserved and 95% LOA further decreased in horses with NOVA [LAC] of <5 mM and PCV <40%. Agreement was modest when testing whole blood samples on the POC monitor with increased 95% LOA. CONCLUSIONS AND CLINICAL IMPORTANCE: Results indicate close agreement between NOVA and the POC monitor when [LAC] was measured with plasma. Results were less consistent at higher [LAC] but sufficiently reliable to follow trends. Although whole blood may be used with the POC monitor to identify clinically important hyperlactatemia, results may be insufficiently reliable to monitor trends.

Adrenocorticotropin concentration following administration of thyrotropin-releasing hormone in healthy horses and those with pituitary pars intermedia dysfunction and pituitary gland hyperplasia.

OBJECTIVE: To compare the effect of thyrotropin-releasing hormone (TRH) administration on endogenous ACTH concentrations in healthy horses and those with pituitary pars inter-media hyperplasia and compare the test with the dexamethasone suppression test (DST). DESIGN: Prospective case series. ANIMALS: 15 horses with clinical signs of pituitary pars intermedia dysfunction (PPID), 4 horses with equivocal signs of PPID, and 29 horses without signs of PPID. PROCEDURES: ACTH concentrations prior to and after administration of TRH were measured 61 times in 48 horses. Results of the DST (cortisol response) were compared with those of the TRH test in 29 horses. Thirty-three horses (24 with no clinical signs of PPID, 5 with clinical signs of PPID, and 4 with equivocal clinical signs of PPID) were euthanized and necropsied and their pituitary glands evaluated. RESULTS: ACTH concentrations increased in all horses, but magnitude and duration of increase were significantly higher in horses with PPID. Endogenous ACTH concentrations were influenced by season. The ACTH baseline concentrations and response to TRH were not correlated with results of the DST. Results of DST were abnormal only in clinically abnormal horses or those with pars intermedia hyperplasia, but were within reference range in 17 of 26 tests in these horses. CONCLUSIONS AND CLINICAL RELEVANCE: The ACTH response to TRH is a useful test for diagnosis of pituitary gland hyperplasia, particularly in horses in which baseline ACTH concentrations are within reference range. The DST was specific but not sensitive and was inconsistent for individuals, and results often did not agree with the TRH test response.

Embedded, engaged, evolving: a consortium of nurse researchers and clinicians.

This article describes the journey of an innovative partnership among nurse researchers and nurse clinicians. The Chronic Illness Consortium (CIC) is an academic-service partnership between a university and its neighbors in a region without an academic medical center. It began with a small group of nurse researchers seeking a strategy to maximize research output and knowledge development and has evolved over 6 years into a forum that bridges scholars and clinicians, specialists and generalists, current and former students. The CIC engages in the scholarship of discovery, integration, application, and teaching,(1) and seeks to radically reform the way nursing and health care in general is delivered to people living with chronic illness. Finally, it is evolving as both knowledge development and practice address the demands of an increasingly large and complex patient population. As with any journey, many opportunities and lessons were learned. More importantly, there are implications for nursing knowledge development and application. Each of these areas is addressed.

Feline model of acute nipah virus infection and protection with a soluble glycoprotein-based subunit vaccine.

Nipah virus (NiV) and Hendra virus (HeV) are paramyxoviruses capable of causing considerable morbidity and mortality in a number of mammalian species, including humans. Case reports from outbreaks and previous challenge experiments have suggested that cats were highly susceptible to NiV infection, responding with a severe respiratory disease and systemic infection. Here we have assessed the cat as a model of experimental NiV infection and use it in the evaluation of a subunit vaccine comprised of soluble G glycoprotein (sG). Two groups of two adult cats each were inoculated subcutaneously with either 500 or 5,000 50% tissue culture infective dose(s) (TCID(50)) of NiV. Animals were monitored closely for disease onset, and extensive analysis was conducted on samples and tissues taken during infection and at necropsy to determine viral load and tissue tropism. All animals developed clinical disease 6 to 9 days postinfection, a finding consistent with previous observations. In a subsequent experiment, two cats were immunized with HeV sG and two were immunized with NiV sG. Homologous serum neutralizing titers were greater than 1:20,000, and heterologous titers were greater than 1:20,000 to 16-fold lower. Immunized animals and two additional naive controls were then challenged subcutaneously with 500 TCID(50) of NiV. Naive animals developed clinical disease 6 to 13 days postinfection, whereas none of the immunized animals showed any sign of disease. TaqMan PCR analysis of samples from naive animals revealed considerable levels of NiV genome in a wide range of tissues, whereas the genome was evident in only two immunized cats in only four samples and well below the limit of accurate detection. These results indicate that the cat provides a consistent model for acute NiV infection and associated pathogenesis and an effective subunit vaccine strategy appears achievable.

The prevalence of blood pressure and cholesterol monitoring in Boston among non-Hispanic blacks, Hispanics, and non-Hispanic whites.

OBJECTIVES: Racial and ethnic minorities are at increased risk for hypertension and hypercholesterolemia. Appropriate blood pressure and cholesterol monitoring is a critical first step in identification, treatment, and control of these conditions and the prevention of coronary artery disease. This study examines blood pressure and cholesterol monitoring among non-Hispanic Black, Hispanic, and non-Hispanic White subjects. DESIGN: Data were drawn from the 1999 Massachusetts Behavioral Risk Factor Surveillance Survey (BRFSS) Boston oversample. Monitoring for hypertension and hypercholesterolemia were compared across 2515 respondents to the 1999 Boston BRFSS oversample, including (67.6% White non-Hispanic, 18% Black non-Hispanic, and 14.4% Hispanic, any race). Chi-square analyses were used to test unadjusted race- and ethnicity-specific differences, and logistic regression was used to estimate the odds of inadequate blood pressure and cholesterol monitoring by race/ ethnicity, adjusting for demographic characteristics, insurance, source of care, psychosocial factors, and neighborhood characteristics. RESULTS: No significant differences were seen in the adequacy of blood pressure and cholesterol monitoring among the racial/ethnic groups of interest, despite significant differences in sociodemographic characteristics and morbidity. CONCLUSIONS: In this local dataset, non-Hispanic Blacks and Hispanics, as compared to non-Hispanic Whites, were not more likely to report inadequate blood pressure or cholesterol monitoring. The data suggest that safety net factors in place in Boston may have contributed to the observed parity in access to preventive care among the racial/ethnic groups of interest. The data also suggest that factors antecedent/subsequent to blood pressure and cholesterol monitoring may explain the observed disparities in blood pressure and cholesterol morbidity and control reported for racial/ethnic minorities.

The conceptual model for nursing and health policy revisited.

A conceptual model of nursing and health policy was proposed by the authors in 2001. Revisions in the model have been made, and the model has been used to guide the evolution of a nursing doctoral program and doctoral dissertation research. The revised model provides a framework for analysis and evaluation of public, organizational, and professional policies influencing the quality, cost, and access to nursing and other health care services, as well as for nursing-discipline specific and health services research at any one of four interacting levels: Level 1--efficacy of nursing practice processes; Level 2--effectiveness of nursing practice processes and effectiveness and efficiency of health care delivery subsystems; Level 3--equity of access to effective and efficient nursing practice processes and efficient nursing practice delivery systems, and equity in distribution of costs and burdens of care delivery; Level 4--justice and the social changes and market interventions addressing equity.

Reactivity of anti-Nipah virus monoclonal antibodies to formalin-fixed, paraffin-embedded lung tissues from experimental Nipah and Hendra virus infections.

The immunohistochemical reactivity of seven clones of mouse monoclonal antibodies raised to Nipah virus antigens were investigated using formalin-fixed, paraffin embedded porcine and equine lung tissues from experimental Nipah and Hendra virus infection, respectively. Either microwave irradiation or enzymatic digestion effectively unmasked the viral antigens in formalin-fixed, paraffin-embedded tissue sections. Four clones showed positive reaction to both Nipah virus-infected porcine lung tissue and Hendra virus-infected equine lung tissue. Two clones (11F6 and 13A5) reacted with Nipah virus-infected porcine lung tissue, but not with Hendra virus-infected equine lung tissue. These Nipah virus-specific monoclonal antibodies may therefore be useful for immunohistological diagnosis of Nipah virus infection and for further research on Nipah virus pathogenesis.

Mastery path for developing nurses for management: a conceptual model.

The demand for knowledgeable and skilled nurses in health care management positions highlights the importance of identifying management practices, competencies, and skills of effective managers. Once these attributes are identified, then approaches can be identified for developing nurses for these positions. This article describes a conceptual model, the Mastery Path for Developing Nurses for Management, that serves as a tool for the profession of nursing, health care organizations, and academic institutions to identify and educate nurses in the health care system.

Federal CAT policy: politics and practice.

The critical care nurse encounters a patient in a setting that is charged with overt physiologic needs that are addressed by an array of healthcare providers in a setting dominated by covert political dynamics. Understanding these dynamics can empower critical care nurses to create a voice of agency to advocate disciplinary nursing concerns. Policy skills enable nurses to participate in meaningful ways in the policy process. As conventional and complementary practitioners interact, critical care nurses are likely to confront difficult issues. Insight into the processes that shape the federal CAT agenda allows nurse educators, researchers, and clinicians to anticipate likely effects on their own domains of practice. The ability of nursing as a professional discipline to engage in appropriate political and policy activity concerning CAT policy is enhanced by understanding the complex nature of that discourse.

Vision 2020, part 2: Educational preparation for the future nurse manager.

The demand for knowledgeable and skilled nursing leaders at the first, middle, and executive levels of management in healthcare organizations drove a multiphased project concerning the types of nurse managers that will be needed in the future and their educational needs. In Part 1 (June 2003), national nurse leaders identified the increased need for knowledgeable and skilled nurses in first-line, mid-level, and executive management positions in the healthcare delivery system. This article describes the second Vision 2020 survey of nurse managers in Massachusetts on the current and future demand for nurse managers and their academic preparation and continuing education needs. It concludes with a model curriculum revision for a master's program in nursing management for the public urban university in Boston.

Vision 2020, part I: profile of the future nurse leader.

The demand for knowledgeable and skilled nursing leaders at the first, middle, and executive levels of management in healthcare organizations drove a multi-phased project about the kinds of nurse managers who will be needed in the future and their educational needs. This first article in a two-part series describes seasoned nurse leaders' opinions about the educational preparation, experiences, and competencies desired in nurse managers for the year 2020.