The history of disaster nursing: from Nightingale to nursing in the 21st century.

Background: Nurses have a rich history in performing their duty both domestically and internationally in response to a disaster. Comprising the largest proportion of the healthcare workforce, nurses possess a unique opportunity to inform disaster planning and management. With the ongoing threat from COVID-19 and continuing conflict, humanitarian aid needs, epidemics and natural disasters; the capacity of nurses to continue to respond in times of global need is unparalleled.

Evaluating simulations as preparation for health crises like CoVID-19: Insights on incorporating simulation exercises for effective response.

Today's health emergencies are increasingly complex due to factors such as globalization, urbanization and increased connectivity where people, goods and potential vectors of disease are constantly on the move. These factors amplify the threats to our health from infectious hazards, natural disasters, armed conflicts and other emergencies wherever they may occur. The current CoVID-19 pandemic has provided a clear demonstration of the fact that our ability to detect and predict the initial emergence of a novel human pathogen (for example, the spill-over of a virus from its animal reservoir to a human host), and our capacity to forecast the spread and transmission of the pathogen in human society remains limited.

The Promotion of 'Grab Bags' as a Disaster Risk Reduction Strategy.

Introduction: An all-of-society approach to disaster risk reduction emphasizes inclusion and engagement in preparedness activities. A common recommendation is to promote household preparedness through the preparation of a 'grab bag' or 'disaster kit', that can be used to shelter-in-place or evacuate. However, there are knowledge gaps related to how this strategy is being used around the world as a disaster risk reduction strategy, and what evidence there is to support recommendations.

Peer review: innovating change.

Medicine has traditionally focused on specialty and subspecialty expertise, which subsequently leads to fragmentation, inefficiencies, and lack of accountability. From this focus came a new idea: The Institute. The Institute has transformed our culture, fundamentally affecting the way we approach patient care and how we foster accountability rather than blame.

Beta-adrenergic stimulation enhances the heat-shock response in fish.

We have taken advantage of the unique properties of nucleated rainbow trout (Oncorhynchus mykiss) red blood cells (rbcs) to demonstrate that beta-adrenergic stimulation with the agonist, isoproterenol, significantly enhanced the heat-induced induction of heat-shock proteins (Hsps) in trout rbcs without affecting hsp expression on its own. Furthermore, this beta-adrenergic potentiation of hsp expression occurred only at physiologically relevant concentrations of adrenergic stimulation. In further experiments, we found that adrenaline increased 100-fold and noradrenaline increased 50-fold in trout after a 1-h heat shock at 25 degrees C, approximately 12 degrees C above acclimation temperature.

Neisserial outer membrane vesicles bind the coinhibitory receptor carcinoembryonic antigen-related cellular adhesion molecule 1 and suppress CD4+ T lymphocyte function.

Pathogenic Neisseria bacteria naturally liberate outer membrane "blebs," which are presumed to contribute to pathology, and the detergent-extracted outer membrane vesicles (OMVs) from Neisseria meningitidis are currently employed as meningococcal vaccines in humans. While the composition of these vesicles reflects the bacteria from which they are derived, the functions of many of their constituent proteins remain unexplored. The neisserial colony opacity-associated Opa proteins function as adhesins, the majority of which mediate bacterial attachment to human carcinoembryonic antigen-related cellular adhesion molecules (CEACAMs).

Outer membrane vesicles of Neisseria lactamica as a potential mucosal adjuvant.

The muscosal delivery of vaccines has many advantages including ease of administration and the induction of a mucosal immune response at the natural site of infection for many pathogens. Mice were immunised with outer membrane vesicles (OMV) prepared from Neisseria lactamica or Neisseria meningitidis by subcutaneous (SC) or intranasal (IN) routes, or live cells of N. lactamica given IN or by SC injection.

Experimental disease models for the assessment of meningococcal vaccines.

Animal infection models are valuable for the development and preclinical assessment of meningococcal vaccines in the absence of clear in vitro correlates of protection for protein-based serogroup B vaccines. It is only in animal models that interactions of the organism with the innate, humoral and cellular immune systems can be assessed. However, humans are the only natural host for Neisseria meningitidis and there is no ideal disease model using laboratory animals that mimics the course of human disease.

The development of a meningococcal disease vaccine based on Neisseria lactamica outer membrane vesicles.

Serogroup B meningococcal disease remains a serious problem in many countries and no effective vaccine is currently available. Immunological and epidemiological evidence suggests that carriage of commensal Neisseria species is involved in the development of natural immunity against meningococcal disease. Neisseria lactamica has many surface structures in common with Neisseria meningitidis and may be the most important of these species.

Expression of heterologous antigens in commensal Neisseria spp.: preservation of conformational epitopes with vaccine potential.

Commensal neisseriae share with Neisseria meningitidis (meningococcus) a tendency towards overproduction of the bacterial outer envelope, leading to the formation and release during growth of outer membrane vesicles (OMVs). OMVs from both meningococci and commensal neisseriae have shown promise as vaccines to protect against meningococcal disease. We report here the successful expression at high levels of heterologous proteins in commensal neisseriae and the display, in its native conformation, of one meningococcal outer membrane protein vaccine candidate, NspA, in OMVs prepared from such a recombinant Neisseria flavescens strain.

Rapid characterization of outer-membrane proteins in Neisseria lactamica by SELDI-TOF-MS (surface-enhanced laser desorption ionization-time-of-flight MS) for use in a meningococcal vaccine.

Immunological and epidemiological evidence suggests that the development of natural immunity to meningococcal disease results from colonization of the nasopharynx by commensal Neisseria species, particularly with Neisseria lactamica. We have reported previously that immunization with N. lactamica outer-membrane vesicles containing the major OMPs (outer-membrane proteins) protected mice against lethal challenge with meningococci of diverse serogroups and serotypes and has the potential to form the basis of a vaccine against meningococcal diseases [Oliver, Reddin, Bracegirdle et al.

Neisseria lactamica protects against experimental meningococcal infection.

Immunological and epidemiological evidence suggests that the development of natural immunity to meningococcal disease results from colonization of the nasopharynx by commensal Neisseria spp., particularly with N. lactamica.

Bordetella pertussis fimbriae are effective carrier proteins in Neisseria meningitidis serogroup C conjugate vaccines.

Serogroup C meningococcal conjugate vaccines generally use diphtheria or tetanus toxoids as the protein carriers. The use of alternative carrier proteins may allow multivalent conjugate vaccines to be formulated into a single injection and circumvent potential problems of immune suppression in primed individuals. Bordetella pertussis fimbriae were assessed as carrier proteins for Neisseria meningitidis serogroup C polysaccharide.

Formulation and characterisation of Bordetella pertussis fimbriae as novel carrier proteins for Hib conjugate vaccines.

Haemophilus influenzae type b (Hib) capsular polysaccharide (polyribosylribitol phosphate, PRP) is the active component of conjugate vaccines that have proven successful in preventing invasive Hib disease. Conjugation of PRP to a protein carrier greatly improves its immunogenicity providing protection in infants and subsequent antibody maturation upon boosting. In this study, fimbriae isolated from Bordetella pertussis have been assessed as novel carrier proteins.

Recombinant Neisseria meningitidis transferrin binding protein A protects against experimental meningococcal infection.

To better characterize the vaccine potential of Neisseria meningitidis transferrin binding proteins (Tbps), we have overexpressed TbpA and TbpB from Neisseria meningitidis isolate K454 in Escherichia coli. The ability to bind human transferrin was retained by both recombinant proteins, enabling purification by affinity chromotography. The recombinant Tbps were evaluated individually and in combination in a mouse intraperitoneal-infection model to determine their ability to protect against meningococcal infection and to induce cross-reactive and bactericidal antibodies.

Animal models for meningococcal disease.

There are many in vitro systems for the study of meningococcal pathogenesis, but it is only in animal models of infection that the interactions of the bacteria with whole tissues and the humoral and cellular immune systems can be assessed. Animal-infection models are also of great importance for the assessment of the protective efficacy of existing and candidate vaccines. However, the relevance of these animal models to human disease and how well protection assessed in them corresponds to protection against human disease, must always be considered.

Human opsonins induced during meningococcal disease recognize transferrin binding protein complexes.

Patient serum opsonins against transferrin binding protein A+B (TbpA+B) complexes from two Neisseria meningitidis strains (K454 and B16B6, with 85- and 68-kDa TbpB, respectively) were quantified by a functional phagocytosis and oxidative burst assay. TbpA+B complexes adsorbed to fluorescent beads were opsonized with individual acute and convalescent sera from 40 patients infected by a variety of meningococcal strains. Flow cytometric quantitation of leukocyte phagocytosis products (PP) demonstrated that disease-induced serum opsonins recognized TbpA+B, and the highest anti-TbpA+B serum opsonic activities were found between admission to hospital and 6 weeks later.

Comparison of the immunological and protective responses elicited by microencapsulated formulations of the F1 antigen from Yersinia pestis.

Purified native F1 antigen from Yersinia pestis was used to assess controlled-release vaccine delivery systems in poly(lactide-co-glycolide) (PLG) microparticles and liposomes. Antigen encapsulated in PLG microparticles induced high serum titres when injected i.p.

Periplasmic superoxide dismutase in meningococcal pathogenicity.

Meningococcal sodC encodes periplasmic copper- and zinc-cofactored superoxide dismutase (Cu,Zn SOD) which catalyzes the conversion of the superoxide radical anion to hydrogen peroxide, preventing a sequence of reactions leading to production of toxic hydroxyl free radicals. From its periplasmic location, Cu,Zn SOD was inferred to acquire its substrate from outside the bacterial cell and was speculated to play a role in preserving meningococci from the action of microbicidal oxygen free radicals produced in the context of host defense. A sodC mutant was constructed by allelic exchange and was used to investigate the role of Cu,Zn SOD in pathogenicity.

A new improved sub-unit vaccine for plague: the basis of protection.

In this study, we have determined the limit of protection achievable by immunisation with sub-units of Yersinia pestis against the development of plague in an experimental animal model. Co-immunisation with the purified culture-derived F1 and the recombinant V sub-units afforded a greater level of protection than with either sub-unit alone. The protection given by the combined sub-units was several orders of magnitude greater than that afforded by the whole cell killed (Cutter USP) vaccine and was equivalent to that achieved by vaccination with EV76, the live attenuated Y.