Moral competence in nursing practice

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88187/1/ketefian-moral_competence_nursing_practice.pd

Implementation of internal laboratory quality control procedures for the monitoring of ELISA performance at a regional veterinary laboratory.

Quality control (QC) procedures for antigen detection enzyme-linked immunosorbent assays (ELISAs) for hog cholera (HC) virus, foot and mouth disease (FMD) virus, and an antibody detection ELISA for FMD virus were established at a regional veterinary laboratory in northern Thailand. A recently developed computer software package, QCEL, was used to facilitate management and analysis of QC data. The program was used to assess test performance by producing Shewhart-CUSUM control charts which monitored control data for unacceptable fluctuations or trends. QCEL-generated control charts and analyses are presented and discussed. The use of a simple integrated computerised system for storage and analysis of QC control data provided the laboratory with the opportunity to achieve increased confidence in the results of tests performed

A comparison of type O foot and mouth disease virus field isolates from northern Thailand.

A survey of type O foot and mouth disease (FMD) virus isolates from northern Thailand was undertaken to determine the relationship between field viruses and the vaccine in use, and to gauge the range of antigenic variation among field viruses. Isolates were collected from the two most recent epizootics, 1986-1987 and 1989-1990, and assessed using a two-dimensional neutralisation test to determine their relationship to FMD type O1 Bangkok 1960 (O BKK/60) reference (vaccine challenge) virus. The critical r value for the survey was 0.259 and all isolates tested were found to have an r value considerably greater than this (range 0.66 to 0.80). The results showed close antigenic relationships between the isolates and the reference virus, and indicated a relatively small range of antigenic variation between the isolates

Use of combined Shewhart-CUSUM control charts in internal quality control of enzyme-linked immunosorbent assays for the typing of foot and mouth disease virus antigen.

An enzyme-linked immunosorbent assay (ELISA) for the typing of foot and mouth disease virus (FMDV) antigen was employed for the routine laboratory diagnosis of FMD at a regional veterinary laboratory in northern Thailand. An objective procedure was developed to monitor the test performance of the ELISA, using absolute test control limits in a Shewhart-CUSUM (cumulative sum) control chart method. The procedure detected significant data trends and 'beyond control limit' situations for each antigen typing system (types O, A and Asia 1), using an assay variable (gamma i). Retrospective analysis using Shewhart-CUSUM control charts of data from 42 ELISAs demonstrated that control limits were exceeded in two assays for FMDV type A. The Shewhart-CUSUM control chart is a simple and reliable internal quality control method for the detection of significant random and systematic variation in assays

An investigation of 11 outbreaks of foot-and-mouth disease in villages in northern Thailand

The results of investigations of 11 outbreaks of foot-and-mouth disease in villages in northern Thailand are described. The causative virus was Asia in one in seven outbreaks, Type O in two outbreaks and unknown in two outbreaks. The most probable sources of the outbreaks were co-mingling of cattle and/or buffalo with livestock from an infected neighbouring village (four) and recent introductions of infected cattle from a public livestock market (two) while the probable source could not be determined in five outbreaks. Attack rates in cattle and buffalo ranged from 0.28% to 50.9% but no pigs became sick during any of the outbreaks. Most outbreaks lasted 4 weeks or less. Adult cattle and buffalo were at higher risk of becoming a case when compared with work cattle. Beef cattle were at higher risk than buffalo and adult cattle and buffalo were at higher risk than calves less than 1 year of age. There was significant clustering of cases within households. Serological investigations indicated that many unaffected animals were probably not exposed to virus during the outbreaks. We concluded that close contact between animals was the main method of spread and that differences in attack rates between animal classes reflected differences in animal management. We further concluded that simple quarantine of early cases during outbreaks is likely to be effective in reducing spread within and between villages

Village level risk factors for foot-and-mouth disease in northern Thailand

A study was undertaken in northern Thailand to identify factors which put some villages at higher risk of foot-and-mouth disease (FMD) outbreaks than others. The number of FMD outbreaks experienced in the previous 5 years and data on 145 putative risk factors were obtained by interview from 60 villages during 1991–1992. Univariable analyses identified 27 factors for further investigation using logistic regression. When villages were classified into three FMD frequency groups of zero to one, two to three or four or more outbreaks in the last 5 years, the important factors explaining the differences in risk were the total number of cattle and buffaloes purchased in the previous year, the number of neighbouring villages which shared a common water source and whether agriculture was the most important source of cash income for the village. These factors were also the most important variables in explaining the difference in risk when comparing villages with zero or one outbreak with those having four or more. We concluded that the greatest impact on reducing spread of FMD among villages would be obtained through the development of strategies to reduce the likelihood of introduction through livestock purchases and for villagers to take greater care when livestock are grazed with those from neighbouring villages and when sharing common water supplies

Establishment of a typing enzyme-linked immunosorbent assay for foot and mouth disease antigen, using reagents against viruses endemic in Thailand.

Antisera were produced at a central laboratory in Thailand against the endemic serotypes (O, A and Asia 1) of foot and mouth disease (FMD) virus. At a regional veterinary laboratory, these antisera were used in an indirect sandwich enzyme-linked immunosorbent assay (ELISA) for the detection and serotyping of FMD virus (FMDV) antigen. ELISA readings of < 0.10 optical density (OD) units were considered negative. This was verified using fifty tissue samples which were known to be negative for FMDV. The highest mean sample value for three different dilutions was 0.02 OD units. Of a total of 93 samples submitted for antigen typing, 80 (86%) tested positive by ELISA and 13 (14%) were negative. No FMDV was detected in ELISA-negative samples following attempted tissue-culture virus isolation