Investigation of registered nurses' clinical decision-making processes in aged care

An ageing global population places increasing humanitarian and financial loads on government, health and welfare agencies; necessitating change and innovation to meet and manage clinical and physically complex needs and demands. Australian residential aged care has been influenced by these international and jurisdictional socio-political forces. This thesis aims to inform healthcare professionals and others about Australian aged care registered nurse (RN) decision-making processes, as well as convey understanding of the responsibilities and contextual influences upon RNs working in this sector and scope of practice according to their professional responsibilities..

Characterization of colostrum from dams of BLV endemic dairy herds

Bovine Leukemia Virus (BLV) is endemic in Argentina, where the individual prevalence is higher than 80% in dairy farms. The aim of this work was to find preliminary evidence to know if the high level of infection of the dam would implicate a higher challenge to her own offspring. We collected 65 sets of samples consisting of dam's blood and colostrum from two heavily infected dairy farms, and investigated the correlation between the dam's blood proviral load and the presence of provirus in colostrum. We also described the dual antibody/provirus profile in the colostrum. Provirus was detected in 69.23% of the colostrum samples, mostly from dams with a high proviral load, 36/45 (80%). Colostrum proviral load was significantly higher in dams with high blood proviral load (. p<. 0.0001). Provirus was detected in colostrum samples all along the antibody distribution, even in those with a low amount of antibodies. These results show that even when high blood proviral load dams offer higher levels of infected cells to their offspring through colostrum they also offer higher levels of protection of antibodies. On the contrary, low blood proviral load dams also offer infected cells but a poor content of antibodies, suggesting that these animals could play an important role in the epidemiological cycle of transmission.Fil: Gutiérrez, Gerónimo. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Lomonaco, Marina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; ArgentinaFil: Alvarez, Irene. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; ArgentinaFil: Fernandez, Fernando. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; ArgentinaFil: Trono, Karina Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; Argentin

Influence of the incubation conditions on the detection of antibodies to bovine leukemia virus by ELISA

En este trabajo se modificaron las condiciones de incubación del ensayo de ELISAp24 que detecta anticuerpos contra el Virus de la Leucosis bovina, con el propósito de evaluar si se reduce el número de resultados falsos y en consecuencia la factibilidad de usarlo con fines diagnósticos confirmatorios, ya que fue desarrollado y validado en nuestro laboratorio para el análisis y monitoreo de seroprevalencia a nivel rodeo y/o para tamizaje de muestras individuales. Se analizaron 128 muestras de suero pertenecientes a 2 rodeos infectados naturalmente de distinto sistema productivo y prevalencia individual, utilizando las condiciones estándar (20-25ºC-30 minutos) y las modificadas (4-8ºC-16-24hs). Los resultados evidencian que las condiciones modificadas no sólo mejoran la capacidad de detección de individuos infectados, sino que disminuyen el número de resultados falsos positivos. Estos hallazgos evidencian la factibilidad de utilizar el ensayo de ELISAp24 como método confirmatorio, y abren camino hacia la realización de un protocolo integral de validación para evaluar su performance diagnóstica, ya que la mejora independiente de la sensibilidad y la especificidad resulta de importancia crítica cuando se utiliza un ensayo para determinar el estado sanitario individual.The p24ELISA assay has been developed in our laboratory for screening, seroprevalence analysis and/or surveillance of Bovine Leukemia Virus natural infection. In this work we modified the incubation conditions of the p24ELISA, with the final purpose to evaluate if the total number of false results can be reduced. We analyzed 128 samples from cattle of two herds naturally infected, an artificial insemination center and a commercial dairy farm using the previously defined (20-25ºc-30min) and the modified (4-8ºC-16-24hs) incubation conditions. The results show that the modified conditions not only improve the sensitivity but also the specificity of detection, since not only the number of false negative but also false positive results can be reduced. This evidence permits to lucubrate about the factibility to use the p24ELISA system for confirmatory diagnosis, and show the importance to follow up a complete validation protocol to finally evaluate the diagnostic performance of the assay. This is important since the independent modification of sensitivity and specificity is critical when some assay is used for confirmatory diagnosis.Fil: Lomonaco, Marina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; ArgentinaFil: Martínez, Cecilia. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; ArgentinaFil: Alvarez, Irene. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gutiérrez, Gerónimo. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Politzki, Romina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; ArgentinaFil: Trono, Karina Gabriela. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Virología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Influencia de las condiciones de incubación en la detección de anticuerpos contra el Virus de la Leucosis bovina por ELISA = Influence of the incubation conditions on the detection of antibodies to bovine leukemia virus by ELISA

En este trabajo se modificaron las condiciones de incubación del ensayo de ELISAp24 que detecta anticuerpos contra el Virus de la Leucosis bovina, con el propósito de evaluar si se reduce el número de resultados falsos y en consecuencia la factibilidad de usarlo con fines diagnósticos confirmatorios, ya que fue desarrollado y validado en nuestro laboratorio para el análisis y monitoreo de seroprevalencia a nivel rodeo y/o para tamizaje de muestras individuales. Se analizaron 128 muestras de suero pertenecientes a 2 rodeos infectados naturalmente de distinto sistema productivo y prevalencia individual, utilizando las condiciones estándar (20-25ºC-30 minutos) y las modificadas (4-8ºC-16-24hs). Los resultados evidencian que las condiciones modificadas no sólo mejoran la capacidad de detección de individuos infectados, sino que disminuyen el número de resultados falsos positivos. Estos hallazgos evidencian la factibilidad de utilizar el ensayo de ELISAp24 como método confirmatorio, y abren camino hacia la realización de un protocolo integral de validación para evaluar su performance diagnóstica, ya que la mejora independiente de la sensibilidad y la especificidad resulta de importancia crítica cuando se utiliza un ensayo para determinar el estado sanitario individual.The p24ELISA assay has been developed in our laboratory for screening, seroprevalence analysis and/or surveillance of Bovine Leukemia Virus natural infection. In this work we modified the incubation conditions of the p24ELISA, with the final purpose to evaluate if the total number of false results can be reduced. We analyzed 128 samples from cattle of two herds naturally infected, an artificial insemination center and a commercial dairy farm using the previously defined (20-25ºc-30min) and the modified (4-8ºC-16-24hs) incubation conditions. The results show that the modified conditions not only improve the sensitivity but also the specificity of detection, since not only the number of false negative but also false positive results can be reduced. This evidence permits to lucubrate about the factibility to use the p24ELISA system for confirmatory diagnosis, and show the importance to follow up a complete validation protocol to finally evaluate the diagnostic performance of the assay. This is important since the independent modification of sensitivity and specificity is critical when some assay is used for confirmatory diagnosis.Instituto de VirologíaFil: Lomonaco, Marina. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Martinez, Cecilia. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Alvarez, Irene. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Gutierrez, Gerónimo. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Politzki, Romina Paula. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Trono, Karina Gabriela. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; Argentin

Efficacy of the spray-drying treatment to inactivate the bovine leukemia virus in bovine colostrum

Previous studies have shown the presence of bovine leukemia virus (BLV) in colostrum and milk of naturally infected cows. The relationship between virus or provirus and specific antibodies in these secretions is particular to each infected cow and will probably determine whether the consumption of colostrum or milk from these naturally infected dams provides an infective or a protective effect in recipient calves. Our recent findings suggest that this issue is a key point in BLV transmission in very young calves. Based on this, the aim of the present study was to determine the effect of the spray-drying treatment of colostrum on BLV infectivity. The treatment was done on scale-down conditions, using fresh colostrum from BLV-negative cows spiked with infective BLV. Residual infectivity was tested in susceptible lambs. Lambs inoculated with colostrum spiked with BLV-infected cells or cell-free BLV showed evidence of infection 60 d after inoculation, whereas none of the lambs inoculated with spray-dried colostrum showed evidence of infection 60 d after inoculation. These results provide direct evidence that the experimental spray-drying process used in this study was effective in inactivating infectious BLV in colostrum. These findings suggest that the risk for BLV transmission could be reduced if milk and colostrum were treated by spray-drying prior to consumption in dairy facilities. The effect of spray-drying on the functional properties and stability of the antibodies present in colostrum under long-term storage should be further investigated.Instituto de VirologíaFil: Lomonaco, Marina. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Sowul, Mariana. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Gutierrez, Gerónimo. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Malacari, Darío Amilcar. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Alvarez, Irene. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Porta, Natalia Gabriela. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Zabal, Osvaldo Alfredo. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Trono, Karina Gabriela. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Virología; ArgentinaFil: Sowul, Mariana. Servicio Nacional de Sanidad y Calidad Agroalimentaria (SENASA); ArgentinaFil: Alvarez, Irene. Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET); ArgentinaFil: Porta, Natalia Gabriela. Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET); ArgentinaFil: Trono, Karina Gabriela. Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET); Argentin

Bovine leukemia virus p24 antibodies reflect blood proviral load

Abstract Background Bovine leukemia virus (BLV) is worldwide distributed and highly endemic in Argentina. Among the strategies to prevent BLV dissemination, a control plan based on the selective segregation of animals according to their proviral load (PVL) is promising for our dairy productive system. The objective of this work was to study the relationship between the blood PVL and the antibody level, in order to identify whether the individual humoral response, i.e. the anti-p24 or anti-whole-BLV particle, could be used as a marker of the blood level of infection and thus help to recruit animals that may pose a lower risk of dissemination under natural conditions. Results The prevalence of p24 antibodies on the 15 farms studied was over 66%. The prevalence of p24 and whole-BLV antibodies and PVL quantification were analyzed in all the samples (n = 196) taken from herds T1 and 51. ROC analysis showed a higher AUC for p24 antibodies than whole-BLV antibodies (Zreactivity: 3.55, P titer: 2.88, P T1 = 0.7, P 51 = 0.71, P  Conclusions We found that the humoral response reflected the level of in vivo infection, and may therefore have useful epidemiological applications. Whereas the quantitative evaluation of blood proviral load using real-time PCR is expensive and technically demanding, the measurement of antibodies in blood by ELISA is relatively straightforward and could therefore constitute a cost-effective tool in a BLV control intervention strategy, especially in highly infected herds such as Argentinean dairy ones.</p