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Conrad NL, Zorzi VSG, Pinheiro NB, Borchard JL, de Moura MQ, Leite FPL. Dynamics of ex vivo cytokine transcription during experimental Toxocara canis infection in Balb/c mice. Rev Bras Parasitol Vet 2024; 33:e014223. [PMID: 38511816 PMCID: PMC10954251 DOI: 10.1590/s1984-29612024017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/09/2024] [Indexed: 03/22/2024]
Abstract
The cytokine microenvironment is crucial in generating and polarizing the immune response. A means of monitoring this environment would be of great value for better understanding Toxocara canis immune modulation. The aim of this study was to analyze the dynamics of cytokine transcription ex vivo, during early (24-48 hours) and late (15-30 days) times post-infection, in the mesenteric lymph nodes, spleen and intestinal mucosa of Balb/c mice experimentally infected with T. canis larvae. Mice in the treated group were infected with 100 third-stage larvae (L3), whereas mice in the control group were not infected. Analyses were performed at different times: 24-48 hours post-infection (HPI), 15-30 days post-infection (DPI). IL4, IL10, IL12 and Ym1 mRNA transcriptions were analyzed through qPCR. This study showed cytokine transcription mediated by migrating larvae in the mesenteric lymph nodes and spleen at 24-48 HPI, whereas cytokine transcription in the intestinal mucosa was observed only at late times (15-30 DPI). These results suggest that the T. canis larvae migration during infection might play a role in cytokine dynamics. Since the cytokine microenvironment is crucial in modulating immune response, knowledge of cytokine dynamics during T. canis infections pave the way to better understand its interaction with the host.
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Affiliation(s)
- Neida Lucia Conrad
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Vitória Sequeira Gonçalves Zorzi
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Natália Berne Pinheiro
- Programa de Pós-graduação em Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Jéssica Lopes Borchard
- Programa de Pós-graduação em Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Micaele Quintana de Moura
- Programa de Pós-graduação em Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
| | - Fábio Pereira Leivas Leite
- Programa de Pós-graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
- Programa de Pós-graduação em Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas - UFPel, Pelotas, RS, Brasil
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Silveira MM, Crespo da Silva PA, Conrad NL, Oliveira TL, Hartwig DD, Trotter C. Surveillance of invasive meningococcal disease in southern Brazil: considerations of an immunization programme. J Med Microbiol 2023; 72. [PMID: 36753430 DOI: 10.1099/jmm.0.001658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Invasive meningococcal disease (IMD) is a major cause of meningitis and septicaemia worldwide. Changes in serogroup predominance contribute to the unpredictable nature of the disease, with significant health impact. This study aimed to determine the epidemiological profile of IMD in Rio Grande do Sul, Santa Catarina and Paraná, three states in southern Brazil. We analysed 1024 IMD cases that had been confirmed by clinical and/or laboratory criteria and reported to the national information system for notifiable diseases between 2015 and 2019. Additionally, we calculated the proportions of serogroup and incidence by age. Of 1024 cases, 562 (55 %) were caused by serogroup C. Furthermore, serogroup W was responsible for almost half of the cases among children younger than 5 years between 2017 and 2018, with an overall incidence of 1.5 cases/100 000 infants. IMD remains a significant healthcare issue in southern Brazil despite reduced serogroup C incidence after the introduction of the meningococcal C conjugate vaccine into the childhood immunization programme. Changes in disease epidemiology were observed, and serogroup W was the most common serogroup among children younger than 5 years in 2017 and 2018. Although future cost-effectiveness studies are necessary, our results could have future implications for meningococcal vaccination programmes.
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Affiliation(s)
- Marcelle Moura Silveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Neida Lucia Conrad
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Thaís Larré Oliveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Daiane Drawanz Hartwig
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil.,Biology Institute, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Borchard JL, Conrad NL, Pinto NB, Moura MQD, Berne MEA, Leite FPL. Acute and chronic immunomodulatory response mechanisms against Toxocara canis larvae infection in mice. Rev Bras Parasitol Vet 2022. [DOI: 10.1590/s1984-29612022056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract The objective of this work was to evaluate the early and late immunological modulation of an experimental infection of T. canis larvae in mice. Mice were infected with 100 infective larvae and euthanized at different period: 24, 48 hours post infection (HPI), 15- and 30 days post infection (DPI). The humoral response was evaluated by indirect ELISA. Quantitative RT–PCR (qPCR) was used to quantify the mRNA transcription of cytokines IL4, IL10, IL12 and Ym1 in the early and late infection periods. Infection with T. canis was able to generate specific total IgG at 15- and 30- DPI. Analyzing the IgG isotype revealed a significant differentiation for IgG1 compared with IgG2a, IgG2b and IgG3, characterizing a Th-2 response. Evaluating the gene transcription at the early phase of infection, higher transcription levels of IL10, IL4 and Ym1 and a downregulation of IL12 were observed. By the late phase, increased transcription levels of IL4, Ym1 and IL12 were observed, and downregulation of IL-10 transcription was observed. The data obtained suggest that during experimental infection with T. canis, the participation of the IL4, IL10, IL12 cytokines and Ym1 can play an important role in T. canis immunomodulation.
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Abstract
During the COVID-19 pandemic, recommendations for maintaining physical distance, restricted mobility measures, as well as fear of mass transmission by going to health centers have significantly contributed to the general vaccination coverage, which by and large is decreasing worldwide; thus, favoring the potential re-emergence of vaccine-preventable diseases. In this study, we have used the existing data on vaccination coverage during the pre-pandemic (2019) as well as the pandemic (2020) period to evaluate the impact of coronavirus outbreaks during the vaccination drive in Brazil. Furthermore, we have accumulated data since 2015 among the different regions of the country to acquire more consistent information. The various vaccines analyzed in our study were meningococcal C conjugate, Triple antigen vaccine, 10-valent pneumococcal conjugate, and BCG; subsequently, the data were obtained from the National Disease Notification System. This study revealed that the ongoing immunization drive saw a steep decline of around 10 to 20% during the (2019-2020) pandemic period in Brazil. These results provide strong evidence towards the decreasing trends following the vaccination programs during the COVID-19 pandemic period in Brazil. Furthermore, our results also highlight the importance of adopting widespread multi-component interventions to improve vaccination uptake rates.
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Affiliation(s)
| | - Neida Lucia Conrad
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, Brazil
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Piraine REA, Gonçalves VS, Dos Santos Junior AG, Cunha RC, de Albuquerque PMM, Conrad NL, Leite FPL. Expression cassette and plasmid construction for Yeast Surface Display in Saccharomyces cerevisiae. Biotechnol Lett 2021; 43:1649-1657. [PMID: 33934257 DOI: 10.1007/s10529-021-03142-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/23/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Develop a Cell Surface Display system in Saccharomyces cerevisiae, based on the construction of an expression cassette for pYES2 plasmid. RESULTS The construction of an expression cassette containing the α-factor signal peptide and the C-terminal portion of the α-agglutinin protein was made and its sequence inserted into a plasmid named pYES2/gDαAgglutinin. The construction allows surface display of bovine herpesvirus type 5 (BoHV-5) glycoprotein D (gD) on S. cerevisiae BY4741 strain. Recombinant protein expression was confirmed by dot blot, and indirect immunofluorescence using monoclonal anti-histidine antibodies and polyclonal antibodies from mice experimentally vaccinated with a recombinant gD. CONCLUSIONS These results demonstrate that the approach and plasmid used represent not only an effective system for immobilizing proteins on the yeast cell surface, as well as a platform for immunobiologicals development.
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Affiliation(s)
- Renan Eugênio Araujo Piraine
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Vitória Sequeira Gonçalves
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Rodrigo Casquero Cunha
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Programa de Pós-Graduação em Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Neida Lucia Conrad
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Fábio Pereira Leivas Leite
- Núcleo de Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Pelotas, RS, Brazil. .,Programa de Pós-Graduação em Veterinária, Faculdade de Veterinária, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
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Gonçalves VS, Santos FDS, Dos Santos Junior AG, Piraine REA, Rodrigues PRC, Brasil CL, Conrad NL, Leite FPL. Recombinant bovine IL17A acts as an adjuvant for bovine herpesvirus vaccine. Res Vet Sci 2021; 136:185-191. [PMID: 33677208 DOI: 10.1016/j.rvsc.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/23/2021] [Accepted: 02/14/2021] [Indexed: 12/24/2022]
Abstract
The Bovine herpes virus type 5 glycoprotein D (gD) is essential for viral penetration into host permissive cells. The Herpes virus gD glycoprotein has been used for bovine immunization, being efficient in reduction of viral replication, shedding and clinical signs, however sterilizing immunity is still not achieved. Recombinant subunit vaccines are, in general, poorly immunogenic requiring additional adjuvant components. Interleukin 17A (IL17A) is a pro-inflammatory cytokine produced by T helper 17 cells that mediate mucosal immunity. IL17 production during vaccine-induced immunity is a requirement for mucosal protection to several agents. In this study, we investigated the potential of a recombinant IL17A to act as an adjuvant for a recombinant BoHV-5 glycoprotein D vaccine in cattle. Three cattle groups were divided as: group 1) rgD5 + alumen + rIL-17A; 2) rgD5 + alumen; and 3) PBS + alumen. The cattle (3 per group) received two doses of their respective vaccines at an interval of 21 days. The group that received rIL17 in its vaccine formulation at the 7th day after the prime immunization had significant higher levels of specific rgD-IgG than the alumen group. Addition of rIL17 also led to a significant fold increase in specific anti-rgD IgG and neutralizing antibodies to the virus, respectively, when compared with the alumen group. Cells stimulated with rIL17A responded with IL17 transcription, as well IL2, IL4, IL10, IL15, Bcl6 and CXCR5. Our findings suggest that the rIL17A has adjuvant potential for use in vaccines against BoHV-5 as well as potentially other pathogens of cattle.
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Affiliation(s)
- Vitória Sequeira Gonçalves
- Núcleo de Biotecnologia - Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Francisco Denis Souza Santos
- Núcleo de Biotecnologia - Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | | | - Renan Eugênio Araujo Piraine
- Núcleo de Biotecnologia - Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | | | - Carolina Litchina Brasil
- Departamento de Microbiologia e Parasitologia, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Neida Lucia Conrad
- Núcleo de Biotecnologia - Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Fábio Pereira Leivas Leite
- Núcleo de Biotecnologia - Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
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Silveira MM, Crespo da Silva PA, Conrad NL, Oliveira TL, Hartwig DD, Trotter C. Surveillance of invasive meningococcal disease in the south of Brazil: considerations of immunization programme. J Med Microbiol 2021; 70. [PMID: 33544069 DOI: 10.1099/jmm.0.001323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Invasive meningococcal disease (IMD) is a major cause of meningitis and septicaemia worldwide. The switches in serogroup predominance contribute to the unpredictable nature of the disease with significant health impacts. The aim of this study was to determine the epidemiological profile of IMD in Rio Grande do Sul, Santa Catarina and Paraná, three states in the south of Brazil. All meningitis cases confirmed by clinical and/or laboratory criteria notified to the national information system for notifiable diseases between 2015 and 2019 were analysed. Proportions of serogroup and incidence by age were calculated. A total of 17 894 cases of IMD were reported during this period. Of these, 9029 cases (50 %) were due to serogroup C. Furthermore, serogroup W was responsible for almost half of the cases among children younger than 5 years old during 2017 and 2018, with an overall incidence of 33.3 cases per 100 000 infants. Despite the reduction in serogroup C after the introduction of meningococcal C conjugate vaccine into a childhood immunization programme in Brazil, it remains a significant healthcare issue in the south of the country. Changes in disease epidemiology were observed and serogroup W was the most common among children below 5 years of age in 2017 and 2018. Although future cost-effectiveness studies are necessary, our results could have future implications for meningococcal vaccination programmes.
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Affiliation(s)
- Marcelle Moura Silveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Neida Lucia Conrad
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Thaís Larré Oliveira
- Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Daiane Drawanz Hartwig
- Biology Institute, Department of Microbiology and Parasitology, Federal University of Pelotas, Pelotas, RS, Brazil.,Biotechnology Unit, Technological Development Centre, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Caroline Trotter
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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Rosa MC, Conrad NL, Moraes CM, Leite FP. Immunogenicity of Streptococcus equi subsp. equi recombinant SeM protein and bacterin in mice. Pesq Vet Bras 2021. [DOI: 10.1590/1678-5150-pvb-6910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT: The infection caused by Streptococcus equi, known as strangles, affects the respiratory system of horses, causing high morbidity and rapid spread among the herd. Bacterin vaccines, composed of inactivated whole cells of S. equi, have variable efficacy and duration. Infected animals produce specific antibodies against SeM, the immunodominant antigen of S. equi. This makes it a promising target for vaccine development. In this context, the objective of this work was to evaluate a vaccine combining S. equi bacterin and recombinant SeM protein. Mice were vaccinated with bacterin (S. equi ~1.2 × 108CFU/ml); rSeM protein (20μg); bacterin-rSeM combination; or PBS (Control Group) and challenged with a suspension of S. equi, containing 10 × LD50. All vaccinated mice survived the challenge and produced anti-rSeM and anti-S. equi antibodies, which were assessed by indirect ELISA. The Control Group reached endpoint criteria 96 h after infection. These results demonstrate that a vaccine combining the S. equi bacterin with rSeM protein protects mice against strangles. This combination vaccine could potentially protect horses and overcome the limitations of currently available strangle vaccines.
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Silveira MM, Conceição FR, Mendonça M, Moreira GMSG, Da Cunha CEP, Conrad NL, Oliveira PDD, Hartwig DD, De Leon PMM, Moreira ÂN. Saccharomyces boulardii improves humoral immune response to DNA vaccines against leptospirosis. J Med Microbiol 2017; 66:184-190. [DOI: 10.1099/jmm.0.000414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Marcelle Moura Silveira
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Fabricio Rochedo Conceição
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Marcelo Mendonça
- Curso de Medicina Veterinária, Universidade Federal Rural de Pernambuco, Unidade Acadêmica de Garanhuns, Avenida Bom Pastor, S/N, Boa Vista, 55292-270 Garanhuns, PE, Brazil
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Gustavo Marçal Schmidt Garcia Moreira
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Carlos Eduardo Pouey Da Cunha
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Neida Lucia Conrad
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Patrícia Diaz de Oliveira
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Daiane Drawanz Hartwig
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Priscila Marques Moura De Leon
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
| | - Ângela Nunes Moreira
- Programa de Pós-Graduação em Biotecnologia, Centro de Desenvolvimento Tecnológico, Universidade Federal de Pelotas, Campus Universitário S/N, Caixa Postal 354, 96010-900 Pelotas, RS, Brazil
- Departamento de Nutrição, Faculdade de Nutrição, Universidade Federal de Pelotas, Campus Porto/Anglo, Rua Gomes Carneiro, 01 – Centro, Caixa Postal 354, 96010-610 Pelotas, RS, Brazil
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Affiliation(s)
- N L Conrad
- Southwestern Medical School, Dallas, USA
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Abstract
Cultural competence is expected of nurses and educators in transcultural relationships. The author describes the Ugandan setting, where she taught registered nurse students for 9 months, and her process of assimilation leading to cultural competence. Concepts and issues pertinent to the acculturation of a nurse educator into international nursing in a developing country are discussed.
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Affiliation(s)
- N L Conrad
- Southwestern College, Chula Vista, California, USA.
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Conrad NL. Spiritual support for the dying. Nurs Clin North Am 1985; 20:415-26. [PMID: 3846983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Diversity of spiritual beliefs and practice is respected as guidelines and practical interventions for the nurse providing spiritual support are presented. Spirituality and spiritual support are defined, and four areas of spiritual needs of dying clients are identified. Interdisciplinary collaboration is also discussed.
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Conrad NL. Safety shoes: professional memo. J Am Podiatry Assoc 1979; 69:683. [PMID: 501025 DOI: 10.7547/87507315-69-11-683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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