Coagulation and anticoagulation in idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is an incurable, progressive interstitial lung disease with a prognosis that is worse than that of many cancers. Epidemiological studies have demonstrated a link between IPF and thrombotic vascular events. Coagulation and fibrinolytic systems play central roles in wound healing and repair, processes hypothesised to be abnormal within the IPF lung. Animal models of pulmonary fibrosis have demonstrated an imbalance between thrombosis and fibrinolysis within the alveolar compartment, a finding that is also observed in IPF patients. A systemic prothrombotic state also occurs in IPF and is associated with increased mortality, but trials of anticoagulation in IPF have provided conflicting results. Differences in methodology, intervention and study populations may contribute to the inconsistent trial outcomes. The new oral anticoagulants have properties that may prove advantageous in targeting both thrombotic risk and progression of lung fibrosis

Increased platelet reactivity in idiopathic pulmonary fibrosis is mediated by a plasma factor

Introduction Idiopathic Pulmonary Fibrosis (IPF) is a progressive, incurable fibrotic interstitial lung disease with a prognosis worse than many cancers. Its pathogenesis is poorly understood. Activated platelets can release pro-fibrotic mediators that have the potential to contribute to lung fibrosis. We determine platelet reactivity in subjects with IPF compared to age-matched controls. Methods Whole blood flow cytometry was used to measure platelet-monocyte aggregate formation, platelet P-selectin expression and platelet fibrinogen binding at basal levels and following stimulation with platelet agonists. A plasma swap approach was used to assess the effect of IPF plasma on control platelets. Results Subjects with IPF showed greater platelet reactivity than controls. Platelet P-selectin expression was significantly greater in IPF patients than controls following stimulation with 0.1 µM ADP (1.9% positive ±0.5 (mean ± SEM) versus 0.7%±0.1; p = 0.03), 1 µM ADP (9.8%±1.3 versus 3.3%±0.8; p<0.01) and 10 µM ADP (41.3%±4.2 versus 22.5%±2.6; p<0.01). Platelet fibrinogen binding was also increased, and platelet activation resulted in increased platelet-monocyte aggregate formation in IPF patients. Re-suspension of control platelets in plasma taken from subjects with IPF resulted in increased platelet activation compared to control plasma. Conclusions IPF patients exhibit increased platelet reactivity compared with controls. This hyperactivity may result from the plasma environment since control platelets exhibit increased activation when exposed to IPF plasma

The applied ethics aid political philosophy of world poverty and famine

In essence, this thesis is concerned with whether manifest gross inequalities in wealth and evidence of 15,000 deaths each day attributable to poverty are consistent with the concept of a morally just world, and, if not, whether the affluent and those in a position of power are morally obliged to challenge the status quo and provide food and security for all. At the centre of the debate lies an examination of the nature of justice. A survey of utilitarian and Kantian theory lead to the conclusion that neither provide a satisfactory basis upon which to base one's moral principles and thus properly address the problem of poverty and famine. Despite a failure to discuss the specific problem of world poverty in any detail, John Rawls' doctrine of "justice as fairness" is found to provide a more adequate description of justice, reconciling liberal and egalitarian traditions, and forming the theoretical basis from which is derived an overriding obligation to bring about global redistribution to end poverty and guarantee basic standards of liberty and material wealth for the whole of humanity. The debate about world poverty and famine not surprisingly centres around redistributive justice and this raises many questions within the sphere of political philosophy. Significantly, given the important influence which the basic structure of society plays in determining the outcome of our lives, Rawlsian justice is shown to have considerable implications for the reform of contemporary social, political and economic institutions. While a blueprint for the eradication of poverty is beyond the scope of this work, it is clear that a solution is at hand given the necessary political and moral will. In conclusion global government, Itself under an obligation to strive for justice, far from being a humanistic pipedream, is seen to be an end that humanity is under an obligation to achiev

Children's conceptions of masculinity : The mask : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Media Studies at Massey University

Television's potential influence on its viewers is frequently the topic of heated debate, both in academia and wider society. This research uses media representations of masculinity embodied in the cartoon programme "The Mask" as a basis for the study of the social construction of masculinity. The research has two foci. Firstly, the observation of how children's talk about television, in particular, their understandings of masculinity, actively constructs subject position for them; and secondly, participant use of modality judgements. This thesis holds that modality judgements are a vehicle through which potentially conflicting information (in the form of internal and external modality markers) is actively synthesized. Particular attention is given to how the participants' understandings of masculinity are actively negotiated with the representations of masculinity as depicted by the cartoon. The influential work of Buckingham (1993), Morley (1980) and Hall (1980) provides the theoretical framework in which this thesis is structured. The overall results from the focus group research indicated that participants tended to use traditional understandings of the nature of masculinity to conceptualise how 'most men ought' to be. This research has potential implications for the ongoing societal debates regarding the censorship of children's viewing material