Bibliography: leaves 193-224.

Pasteurella multocida causes diseases in many animal species including fowl cholera, a septicemic disease of poultry and other birds. Pathogenesis of the disease has been studied by many investigators by the systemic administration of the organism in poultry. However, only a few studies have been done as to the respiratory pathogenesis of the organism. The objective of the study was to investigate the fate of P. multocida after the intratracheal administration in turkeys The fate of four strains of Pasteurella multocida was studied after their intratracheal inoculation in young adult turkeys. Viable bacterial counts were made in respiratory tissues as well as in the liver, spleen and blood at 6 and 9 hrs after the inoculation of approximately 10⁹ viable organisms of each strain. A virulent, encapsulated strain, P-1059, invaded systemically by 6 hrs postinoculation (PI) and multiplied vigorously in all tissues and organs examined. A blue colony mutant of P-1059, T-325, which does not possess a thick layer of capsule, as well as CU vaccine strain, invaded the parenchymal organs, but did not show significant increase in viable counts at 9 hrs PI compared with at 6 hrs PI. Another vaccine strain, M-9, also invaded blood and internal organs by 6 hrs PI, however, its viable counts showed no significant change between 6 and 9 hrs PI, or in some tissues significant decrease at 9 hrs PI. The results indicate that all the four strains possess high capacity to invade respiratory tissues with varying capacity to persist in host tissues. The lesions caused by two strains of Pasteurella multocida (P-1059 and M-9) were observed after their intratracheal inoculation in young adult turkeys. The lesions were observed in the respiratory organs at 0, 0.25, 0.5, 1, 2, 3, and 6 hrs after inoculation of approximately 10⁹ viable organisms of each strain. Both virulent strain, P-1059 and non-virulent vaccine strain, M-9, have capacity to invade and multiply in the tissues examined. Macroscopicly, the lesions in the lung and in the airsac were found as early as 1 hr PI, including the infected lung was foamy and the airsac became cloudy. They became more severe by 2 to 6 hrs PI. Microscopicly, hecerophiles were present, occasionally, in the lung, trachea and airsac by 0 to 1 hr after inoculation. Then they became more severe by 2 to 6 hrs PI. By 6 hrs PI, there were diffuse heterophiles infiltration in the trachea, lung, anc airsac. The lung vascular was edema. The trachea ciliate and mucous gland was cystic or hyperplasia, and the airsac shewed increased in thickness and cloudiness. These results of study indicate that the lesion caused by P-1059 and vaccine strain, M-9, were not significantly different. / Graduation date: 1992

Thesis (M.S.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains xi, 157 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 135-148).

published_or_final_version / Dentistry / Master / Master of Orthodontics

Objectives : To investigate the impacts of traffic related air pollution (TRAP) on children’s respiratory health, and to investigate the policies and regulations implemented in other countries and the suggestions from the World Health Organization (WHO) to tackle this problem. Methods and Results: Using relevant keywords, 122 articles were acquired from PubMed and 15 were from MEDLINE via EBSCO host respectively. The articles were published between 1980 to 2013; all of which had examined the impacts of TRAP on children’s respiratory health. After assessing inclusion and exclusion criteria, 9 articles were finally included in this systematic review. Differences in demographic characteristics were studied and compared to determine the association between TRAP exposure and respiratory health impacts on children aged between 1 and 18. Four cross-section surveys and five cohort studies were selected in this review. The association between TRAP exposure and differences in children’s respiratory impacts were demonstrated in all studies. Multiple outcome measures were used to examine changes of children’s respiratory health such as the decline in lung function, incidences of asthma and inflammatory responses. There were 4 out of 9 articles suggesting the decline in lung function was related to TRAP exposure; 5 out of 9 articles showed the relationships between incidences of asthma and inflammatory responses and TRAP exposure and 2 articles mentioned other respiratory symptoms; notably, wheezing and sneezing, runny and stuffed nose. This review finally summarized the results of selected articles stressing that children who lived close to roadway within a 500 meter radius from home, with an early exposure to air pollution in the first year of age and a frequent exposure to heavy road traffic and outdoor air pollutants would experience greater impacts on respiratory health. Conclusion: The positive association between the impacts on children’s respiratory health and TRAP exposure has been determined through this systematic review. Stricter emission control strategies and updated guidelines are required to regulate traffic emission and improve air quality in order to reduce harm and provide a better living environment for our next generations. / published_or_final_version / Public Health / Master / Master of Public Health

Background: Contamination of the skin and clothing may lead to workers inadvertently bringing harmful materials home and exposing family members, so called para-occupational exposure. This study investigates whether workplace contamination with respiratory sensitisers such as laboratory animal allergens, flour, isocyanates and enzymes is transported from work to the home environment. Methods: 3 laboratory animal facilities, 92 bakeries, 47 car body workshops, and 2 hospitals in the Grampian region of Scotland were invited to take part in a series of linked studies to increase understanding of the ‘take-home' pathway. Control subjects were recruited from staff and students at the University of Aberdeen. Take-home exposure assessment was carried out using two techniques: surface wipe sampling and vacuum sampling in workplaces, cars and homes. Samples were also collected in the homes of control subjects. Samples from bakers were analysed for total protein, wheat flour antigen (WFA) and fungal alpha amylase (FAA) while samples from laboratory animal workers were analysed for mouse urinary protein (Mus m 1). Enzyme cleaning agents were analysed for subtilisin proteolytic activity. Similar methods using SWYPE™ aliphatic pads for isocyanate contamination assessment were conducted among car body repairers. The pads were scanned and images of SWYPE™ pads were used to estimate contamination against the quantitative assay MDHS 25/3. All analyses were done by the Health and Safety Laboratory (HSL) apart from the SWYPE™ RGB tests and gravimetric measurements. Results: A total of 13 laboratory animal workers in 3 animal facilities, 38 bakers in 5 bakeries, 13 car painters in 5 car body workshops and 20 control subjects participated in the study. Two hospitals were surveyed for enzyme exposures and 3 endoscope cleaning technicians were monitored. Evidence of take-home exposure was found for bakery workers, with potential contamination that could lead to home exposure in the car body repair and hospital workers. Higher levels of Mus m 1 contamination were detected on house door handles of non-exposed controls compared to the exposed laboratory workers (0.62 vs. 0.1 ng/wipe, p<0.001) probably due to exposure variability, might be because exposed laboratory workers being involved in a job that requires more hand washing than the general population, or suggesting widespread environmental contamination with this allergen, and these making it impossible to determine if work-home pathway exists for these workers. There was detectable WFA and FAA found on the hands, forehead, shoes, cars and homes of bakers. Compared to controls, bakers had higher median levels of WFA and FAA in house vacuum samples; the difference was statistically significant for WFA/total protein (516x10-6 vs. 164x10-6, p=0.031), FAA/total protein ratios (1.45x10-6 vs. 0.04x10-6, p<0.001) and FAA loading (1.2 pg/cm2 vs. 0.1 pg/cm2, p<0.001). Among car painters, SWYPE™ colorimetric colour changes score showed three positive SWYPE™ colour changes on skin, and three positive results on shoes of car body workshop workers. However quantitative colour analysis of the SWYPE™ pads proved ineffective for field measurements. Hand wipes of hospital workers during mid-shift and post-shift showed evidence of proteolytic activity, indicating possible spread of contamination from hands, unsatisfactory hygiene practices and the potential for take-home contamination of enzyme. Presence of contamination on footwear indicated that possible transfer of enzyme to other places including homes may occur. Conclusion: These data demonstrate the existence of pathways for take-home exposure of allergens among bakers via skin and clothing from workplaces to cars and workers' homes. The take-home pathway for laboratory animal allergens and isocyanates was not demonstrated and further investigation should be performed for enzyme cleaning agents used in healthcare settings by monitoring dermal take-home exposure with comparison to controls. Further work is needed to ascertain how widespread the take-home of respiratory sensitisers may be and the possible implications to the health of workers' families and the wider community. If parental occupation can lead to take-home exposure to respiratory asthmagens, and consequently to childhood asthma, then this represents a potentially modifiable risk factor for these cases of para-occupational asthma. There is a need for greater understanding of the take-home pathway of exposure to asthmagens and sensitisers and for a programme of education and control measures to limit the transfer of such material from the workplace to the home and wider community.

No description available.

The purpose of this study was to identify the complete scope, cognitive, affective and psychomotor, of clinical competencies required for the successful practice by entry-level associate degree respiratory care graduates entering the workforce. The study was conducted using a Delphi technique. American Association for Respiratory Care House of Delegates nominated a panel of experts to participate in the study. A total of 55 individuals were nominated and 21 agree to participate in the study. The individuals represented both college-based educators and hospital managers and educators. The initial questionnaire requested that each panel member list those cognitive, affective and psychomotor clinical competencies that they believed to be required for successful entrylevel practice. The responses from the first round were grouped into like categories and returned to the panel members to be rated on a four-point scale during the second and third rounds of the study. Consensus was achieved with the third round resulting in a final list of 26 cognitive, 20 affective and 28 psychomotor clinical competencies. The final list of competencies includes the most basic cognitive and psychomotor skills of the profession and did not include many of the areas listed by the National Board for Respiratory Care exam matrix. The study also lists 20 affective attributes as essential for successful practice. There are no current standardized methods in use to evaluate affective skills. Research will need to continue to clarify the skills needed for competent and successful entry-level practice. / Department of Educational Studies

Respiratory infection remains a leading cause of morbidity and death in severely immunocompromised febrile neutropenic haematology patients, despite the introduction of numerous prophylactic strategies and advances in diagnosis and treatment. Prognosis is improved if an organism can be isolated and specific therapy commenced as soon as possible. Current practice in this population group is to commence empirical antibiotics and perform flexible bronchoscopy (FB) if temperature does not settle or after patients develop clinical or radiological features suggesting a respiratory source. This delay may result in a lower procedural diagnostic yield due to prior or prolonged anti-microbial treatment, and increased risk of respiratory compromise and procedural complications due to advanced respiratory infections. We hypothesised that proceeding to FB as early as possible after developing febrile neutropenia would improve treatment outcomes. With this randomised, prospective trial, we aim to further define the role of FB with reference to optimal timing of the procedure and its impact on diagnostic yield, future management and complication rate. We also aim to analyse the impact of proven infection on the cytokine profile of immunocompromised patients. Methods: Patients with acute leukaemia, allogeneic bone marrow transplantation or chronic lymphocytic leukaemia (CLL) being treated with Fludarabine/ Mabthera without an obvious non-respiratory source of infection were prospectively randomised into early bronchoscopy or conventional management groups at onset of febrile neutropenia. Bronchoalveolar lavage (BAL) fluid chemokine levels (IP-10, RANTES, MIG, IL-8, MCP-1) were measured using a human Chemokine cytometric bead array (CBA) kit. Results: Thirty-one episodes of febrile neutropenia in 29 patients were analysed; 17 conventional and 14 early. There was an increased yield in fungal growth in the early bronchoscopy group, which was not predicted by prior clinical or radiological changes. However, this had no impact on clinical management in the short-term due to the delayed growth. Overall diagnostic yield was not significantly different between the two groups. Procedural complication rate was negligible overall and there was no difference associated with either group. IP-10 and MIG were significantly lower in those patients who had a fungal pathogen isolated, compared with those study patients who did not (175.17 vs 1157.8, p=0.03, 30.33 vs 247.8, p=0.03 respectively). IP-10 levels were higher in the conventional than early group (1253.0 vs 261.14, p = 0.035) and the study population had higher MCP-1 (734 vs 2.83, p=0.006) and IL-8 levels (606.9 vs 14.25, p=0.00655) than normal controls. Those cases with fungal infection had higher mean MCP-1, RANTES and IL-8 levels than in normal controls (844.0 vs 2.83, p=0.007; 17.5 vs 2.1, p=0.03; 156.0 vs 14.25, p=0.004). Conclusions: Early bronchoscopy as a component of the septic screen in febrile neutropenic patients was feasible and safe. A significant difference in fungal yield was seen in the early bronchoscopy group compared to conventional methods, with a negligible complication rate, but this did not result in a change in immediate clinical management or outcomes. / Thesis (M.Clin.Sc.) - University of Adelaide, School of Medicine, 2009

Thesis (M. P. H.)--University of Hong Kong, 2005. / Also available in print.