Gastrointestinal Endoscopic Exfoliative Cytology: Techniques and Clinical Application

Cytologic examination of exfoliative specimens obtained during endoscopy is a useful and reliable adjunct to mucosal biopsy for the diagnosis of gastrointestinal (GI) tract diseases in dogs and cats. Clinical advantages of endoscopic cytology include simplicity, rapidity of diagnosis and minimal invasiveness. Cytologic smears are graded on the basis of objective criteria, including the presence and number of inflammatory, atypical, and epithelial cells as well as the presence of bacteria, hemorrhage, debris/ingesta, and mucus. There is high correlation between results obtained from endoscopic cytology and histologic examination, and discordant results are infrequent. Brush cytology is useful in detecting mucosal inflammation, whereas touch cytology is more likely to detect acute purulent and erosive mucosal lesions. Alimentary lymphoma my be readily diagnosed using either technique. This article provides an overview of how cytologic smears are prepared and evaluates their diagnostic accuracy

Secret agonies, hidden wolves, leper-sins: the personal pains and prostitutes of Dickens, Trollope, and Gaskell

This dissertation explores the ways in which Charles Dickens writes Nancy in Oliver Twist, Anthony Trollope writes Carry Brattle in The Vicar of Bullhampton, and Elizabeth Gaskell writes Esther in Mary Barton to represent and examine some very personal and painful anxiety. About Dickens and Trollope, I contend that they turn their experiences of shame into their prostitute's shame. For Gaskell, I assert that the experience she projects onto her prostitute is that of her own maternal grief in isolation. Further, I argue that these authors self-consciously create biographical parallels between themselves and their prostitutes with an eye to drawing conclusions about the results of their anxieties, both for their prostitutes and, by proxy, for themselves. In Chapter II, I assert that in Nancy, Dickens writes himself and his sense of shame at his degradation and exploitation in Warren's Blacking Factory. This shame resulted in a Dickens divided, split between his successful, public persona and his secret, mortifying shame. Both shame and its divisiveness he represents in a number of ways in Nancy. In Chapter III, I contend that Trollope laces Carry Brattle with some of his own biographical details from his early adult years in London. These parallels signify Carry's personal importance to her author, and reveal her silences and her subordinate role in the text as representative of Trollope's own understanding and fear of shame and its consequences: its silencing and paralyzing nature, and its inescapability. In Chapter IV, I posit that Gaskell identifies herself with Esther, and that through her, Gaskell explores three personal things: her sorrow over the loss of not one but three of her seven children, her possible guilt over these deaths, and her emotional isolation in her marriage as she grieved alone. In her creation of Esther, Gaskell creates a way both to isolate her grief and to forge a close companion to share it, thus enabling her to examine and work through grief. In Chapter V, I examine the preface of each novel and find that these, too, reflect each author's identification with and investment of anxiety in his or her particular prostitute

Marital conflict, parent-child relations and children's psychological adjustment: a longitudinal investigation into the role of parental warmth and hostility

The corpus of research presented in this thesis applies a process-oriented perspective to understanding the interplay between marital conflict, parent-child relations and children's adjustment Specifically, this thesis focuses on the conceptually important question concerning the relative impact of parent-child warmth versus hostility on children's appraisals of the interparental and parent-child relationship, and how children's appraisals mediate the influence of parent-child relations on children's adjustment in the context of a discordant interparental relationship. Using data from a sample of over 500 children, parents and teachers living in the United Kingdom, a set of interlocking studies were conducted. First, two studies addressed the direction of effects between marital conflict and parent-child warmth and hostility, and between parent-child warmth and hostility and children's internalising symptoms and externalising problems. In addition, differences according to parent and child gender, and parent and child reports of interparental and parent-child relations were identified. This provided a necessary first step to confirm the orienting influence of marital conflict on the quality of parent-child relations, and to identify the influence of parent-child relations on children's adjustment, whilst also considering the theoretically plausible alternative that children's behaviour influences parents' expressions of warmth and hostility within parent-child relations, which, in turn, may influence the level of interparental conflict. Following on from this, a third study examined the mediating role of parent-child warmth and hostility in accounting for the relationship between interparental conflict and children's long-term internalising symptoms and externalising problems. This study examined the relative influence of parental hostile and rejecting behaviour versus warm and responsive behaviour on children's adjustment considered in the context of marital conflict. Finally, an integrative model examined whether the affective quality of parent-child relations determines children's appraisals of parent-child insecurity and children's perceptions of threat and self-blame derived from exposure to interparental conflict, and in turn, how these appraisals of marital and parent-child relations determine changes in children's symptoms of psychological and behavioural distress. Collectively, the studies contained within this thesis are among the very first to systematically consider the direction of effects between interparental conflict, parent- child warmth and hostility and children's adjustment and serve as a primer for researchers interested in factors that may reduce children's maladjustment in response to a discordant marital relationship

Fitness, Parks, and Active Transportation Organizations Support Community Recovery and Physical Activity After Disasters

Disaster-impacted communities face many threats to health and wellbeing during the recovery period. Fitness, parks, and active transportation organizations support physical activity and social connectedness on an everyday basis and are well-positioned to support communities’ diverse needs during disaster recovery. This research brief summarizes findings from a peer-reviewed study showing that fitness, parks, and active transportation organizations’ trusted relationships, large organizational networks, and health promotion expertise enables them to support disaster recovery efforts and community health after disasters

BUDGET PERSPECTIVES 2011. RESEARCH SERIES NUMBER 18 October 2010

The Budget Perspectives Conference, co‐hosted annually by the Economic and Social Research Institute (ESRI) and the Foundation for Fiscal Studies provides a forum for discussing key public policy issues of both immediate concern (in upcoming budgets) and longer term concern. In the context of the current fiscal and economic crisis, research insights aimed at making more efficient use of scarce resources are needed now more than ever. Furthermore, research on the allocation of benefits and tax burdens is critical not only for intrinsic reasons but also to ensure that policies are publicly acceptable. It is not enough for policy to promote efficiency and fairness – it must be seen to do so. The research papers presented at this year’s annual Budget Perspectives conference continue in this tradition, providing an opportunity for policymakers, social partners and researchers to engage on some of the major issues that we face today

Institutional pressures and sustainability assessment in supply chains

Purpose: Firms are increasingly held accountable for the welfare of workers across entire supply chains and so it is surprising that standard forms of governance for socially sustainable supply chain management have not yet emerged. Assessment initiatives have begun to develop as a proxy measure of social sustainable supply chain management. This research aims to examine how social sustainability assessment initiatives instigate and use institutional pressures to drive third-party accreditation as the legitimate means of demonstrating social sustainability in a global supply chain. Design/methodology/approach: Ten assessment initiatives focused on assuring social sustainability across supply chains are examined. Data are collected through interviews with senior managers and publicly available secondary material. Findings: The findings show how the social sustainability assessment initiatives act by instigating institutional pressures indirectly rather than directly. Coercive pressures are the most prevalent and are exerted through consumer and compliance requirements. The notion of pressures operating as a chain is proposed, and the recognition that actors within and outside of a supply chain are crucial to the institutionalization of social sustainability is discussed. Originality/value: Studies on sustainable supply chain management often focus on how companies sense and act upon institutional pressures. To add to the extant body of knowledge, this study focuses on the sources of the pressures and demonstrates how assessment initiatives use coercive, normative and mimetic pressures to drive the adoption of social sustainability assessment in supply chains

Depressive symptoms in people with vision impairment: a cross-sectional study to identify who is most at risk

Objective: To identify the risk factors for significant depressive symptoms in people with visual impairment in England and Wales to provide information on who is most at risk and to whom support services could be targeted in future. Design: A cross-sectional study using baseline data from a pragmatic randomised controlled trial. Setting and participants: 990 participants aged 18 or over attending 1 of 14 low-vision rehabilitation primary care optometry-based clinics in South Wales or two hospital clinics in London. Outcome measure: A score of ≥6 on the Geriatric Depression Scale-15 was classed as clinically significant depressive symptoms. Results: In a multivariable logistic regression model, significant depressive symptoms were associated with age (adjusted OR (AOR)=0.82, 95% CI: 0.66 to 0.90, p<0.001), ethnicity (AOR non-white compared with white=1.72, 95% CI: 1.05 to 2.81, p=0.031), total number of eye conditions (AOR for two vs one condition=0.98, 95% CI: 0.67 to 1.43; three or more vs one condition=0.34, 95% CI: 0.15 to 0.75, p=0.026), self-reported health (AOR for excellent vs poor=0.01, 95% CI: 0.00 to 0.12; very good vs poor=0.06, 95% CI: 0.03 to 0.13; good vs poor=0.14, 95% CI: 0.08 to 0.24; fair vs poor=0.28, 95% CI: 0.18 to 0.46, p<0.001) and self-reported visual functioning (AOR=1.45, 95% CI: 1.31 to 1.61, p<0.001). Conclusion: Younger age, a non-white ethnicity, fewer eye conditions and poorer self-reported health and visual function are risk factors for significant depressive symptoms in this population. Trial registration number: ISRCTN46824140; Pre-results

Acquisition of a large virulence plasmid (pINV) promoted temperature-dependent virulence and global dispersal of O96:H19 enteroinvasive Escherichia coli

Enteroinvasive Escherichia coli (EIEC) and Shigella are closely related agents of bacillary dysentery. It is widely viewed that EIEC and Shigella species evolved from E. coli via independent acquisitions of a large virulence plasmid (pINV) encoding a type 3 secretion system (T3SS). Sequence Type (ST)99 O96:H19 E. coli is a novel clone of EIEC responsible for recent outbreaks in Europe and South America. Here, we use 92 whole genome sequences to reconstruct a dated phylogeny of ST99 E. coli, revealing distinct phylogenomic clusters of pINV-positive and -negative isolates. To study the impact of pINV acquisition on the virulence of this clone, we developed an EIEC-zebrafish infection model showing that virulence of ST99 EIEC is thermoregulated. Strikingly, zebrafish infection using a T3SS-deficient ST99 EIEC strain and the oldest available pINV-negative isolate reveals a separate, temperature-independent mechanism of virulence, indicating that ST99 non-EIEC strains were virulent before pINV acquisition. Taken together, these results suggest that an already pathogenic E. coli acquired pINV and that virulence of ST99 isolates became thermoregulated once pINV was acquired

Shigella serotypes associated with carriage in humans establish persistent infection in zebrafish

Shigella represents a paraphyletic group of enteroinvasive Escherichia coli. More than 40 Shigella serotypes have been reported. However, most cases within the MSM (men who have sex with men) community are attributed to three serotypes: Shigella sonnei unique serotype and Shigella flexneri 2a and 3a serotypes. Using the zebrafish model, we demonstrate that Shigella can establish persistent infection in vivo. Bacteria are not cleared by the immune system and become antibiotic-tolerant. Persistence depends on O-Antigen, a key constituent of the bacterial surface and serotype determinant. Representative isolates associated with MSM transmission persist in zebrafish, while representative isolates of a serotype not associated with MSM transmission do not. Isolates of a Shigella serotype establishing persistent infections elicited significantly less macrophage death in vivo than isolates of a serotype unable to establish persistence. We conclude that zebrafish are a valuable platform to illuminate factors underlying establishment of Shigella persistent infection in humans