AIMS AND HYPOTHESES Sample Clauses

AIMS AND HYPOTHESES. A considerable amount of literature has been published on asthma and the airways. It is only during the past 20 years or so, however, that information has become available on the impact of the complement system on asthma. Numerous studies have attempted to explain the role of complement components in the asthmatic airway using patients as well as animal models. So far, however, these attempts to establish a link between asthma and anaphylatoxins are somewhat controversial, circumstantial and inconclusive. The objectives of the studies presented here aim to examine the expression of certain components of the complement pathway and its receptors in the asthmatic bronchial epithelium and on structural cells of the airways, investigate the effects of anaphylatoxins on structural cells of the airways which may be relevant to remodelling, and compare these with the effects of established remodelling mediators, in particular the cytokines IL-4 and IL-13. It was hypothesised that: ◼ There is elevated expression/deposition of the complement fragments C3, C3d and C5b-9 in the bronchial mucosa of asthmatics compared to controls ◼ There is elevated expression/deposition of the complement fragments C3, C3d and C5b-9 in the bronchial mucosa of atopic asthmatics following bronchial allergen challenge ◼ C3a and C5a play a role in effecting airway remodelling by acting on structural cells, including epithelial cells, endothelial cells, fibroblasts and smooth muscle cells to induce remodelling changes or production of remodelling mediators. The specific aims of this thesis were to: 1) Measure expression/deposition of C3, C3d and C5b-9 fragments in the bronchial epithelium, submucosa, ASM and glands of asthmatics & controls 2) Detect expression of C3aR and C5aR in the bronchial epithelium, submucosa, ASM and glands of asthmatics & controls, and in addition to study the effects of allergen challenge of atopic asthmatics 3) Detect expression of C3aR and C5aR on structural cells of the airway involved in remodelling propagated in vitro 4) Investigate C3a and C5a-stimulated production of remodelling mediators (FGFs, IL-8) by these cells at the mRNA and protein level 5) Assess biological functions of C3a and C5a on those structural cell types which may be relevant to remodelling (i.e. by proliferation assays) This would allow for a better insight into the role of anaphylatoxins, their receptors and remodelling growth factors in human asthma.

AIMS AND HYPOTHESES. The study consisted of a sample of Turkish women recruited at baseline in their third trimester of pregnancy and followed at 2, 12 and 18 months postpartum. Funding was obtained from two Wellcome Trust fellowships awarded to the author: a Masters Fellowship which included support for assessments at baseline and 2 months postpartum, and a PhD Fellowship applied for while baseline interviews were still underway and supporting the additional interviews at 12 and 18 months. The initial Masters Fellowship supported investigations of social correlates of antenatal depression and predictors of onset and maintenance between the antenatal and 2-month postnatal periods. The PhD Fellowship supported investigations of perinatal depression as a predictor of changes in social support and of child development at 18 months. Both additionally sought to investigate traditional vs. nuclear family structure as a potential modifier of these associations. The principle objectives of the study were therefore as follows: 1. To investigate factors associated with antenatal and postnatal depression in Turkish women: in particular focusing on social support from their husband, mother and mother-in-law, and to investigate the role of nuclear and traditional family structures in modifying these associations. 2. To investigate the association between depression and subsequent changes in these levels of social support over the perinatal period. 3. To investigate the association between antenatal or postnatal depression and child development The following hypotheses were tested: 1. Antenatal depression will be associated independently with reduced reported social support (i.e. lower emotional and practical support, and increased reported negative aspects of the index relationship) from the husband, mother and mother-in-law. 2. Lower reported social support (emotional support, practical support and negative aspects) from the husband, mother and mother-in-law in the antenatal period will be associated with increased incidence and maintenance of case-level depressive symptoms into the postnatal period. 3. On the assumption that traditional families will provide some buffering of the index relationships through a wider social network, the strength of association between antenatal social support, particularly that from the husband, and ante- and postnatal depression will be stronger in nuclear family settings than in traditional family settings. 4. Antenatal (baseline) depression will be asso...

AIMS AND HYPOTHESES. To summarise, OCD is a heterogeneous condition encompassing a wide range of symptoms. Transformation obsessions refer to a ‘fear of turning into someone else or another object or acquiring unwanted characteristics’. Little is known about the clinical presentation and nature of transformation obsessions. Whilst NICE guidelines for paediatric OCD recommend E/RP-based CBT as the first-line treatment, studies on adult OCD samples have suggested that these obsessions may be more treatment-resistant than other symptoms of OCD and may require a modified treatment approach. The OCD and Related Disorders Clinic has developed a standardised CBT protocol for OCD, and previous audits have demonstrated that this treatment protocol is effective for the majority of individuals treated at the clinic. To date, however, it is unclear whether this treatment protocol is appropriate for individuals presenting with ‘transformation obsessions’. The aim of the present audit is to examine and compare clinical features and CBT outcomes for OCD patients with and without transformation obsessions; this audit will help identify issues that need to be addressed when working with the specified group of young people and therefore highlight potential areas for possible improvement in service provision. In light of the above, the objectives of the present service evaluation project are as follows: 1) To identify the rate of pediatric OCD patients seen at the National Specialist OCD service endorsing transformation obsessions 2) To examine the clinical presentation of OCD patients endorsing transformation obsessions in comparison to those with other forms of OCD 3) To assess how this cohort of patients responded to the standardized CBT protocol used the OCD & Related Disorders Clinic, in comparisons to young people with other OCD symptoms. The audit addressed these objectives using routinely collected baseline and end-of-treatment data. Examination of the nature and impact of transformation obsessions on treatment and service provision is important to ensure the needs of these users are being met.

AIMS AND HYPOTHESES. The present study investigated whether self-informant agreement on personality trait ratings varies as a function of whether the individual has a diagnosis of major depressive disorder (MDD), PD, or comorbid MDD and PD. We examined self-informant agreement on broad composites of PA and NA determined from multiple scales. Although we anticipate that anxiety sensitivity will load onto the broad NA factor (▇▇ et al., 2011; ▇▇▇▇, 2010; ▇▇▇▇▇▇▇, ▇▇▇▇▇▇, ▇▇▇▇▇ & ▇▇▇▇▇, 2006), we will also examine the relationship between self- and informant-reports of anxiety sensitivity separately due to its’ strong association with PD relative to MDD and other anxiety disorders (▇▇▇▇▇▇▇, 2002; ▇▇▇▇▇▇▇, ▇▇▇▇▇ & ▇▇▇▇▇▇▇, 1997). Mean- level differences between self and informant reports will also be examined. Based on findings to date, we expected informant-reports to be positively associated with self-reports of personality across all participants. Due to the limited extant literature on the potential moderating effects of anxiety on the concordance between self- and informant-ratings on questionnaire measures of personality, we did not have specific hypotheses as to whether the relationship between self- and informant reports will differ between diagnostic groups (i.e., healthy controls, MDD, PD, or comorbid PD and MDD). However, as discussed above, some have suggested that informant-reports may provide a more valid index of personality than self- reports among those with psychopathology (▇▇▇▇▇▇ & ▇▇▇▇, 1993; ▇▇▇▇▇▇▇ & ▇▇▇▇, 1990; ▇▇▇▇ et al., 1999). Thus, it is possible that self-informant agreement may be poorer among those with PD or MDD, relative to those with no history of psychopathology. Alternatively, it may be that individuals with a disorder exhibit a specific trait more outwardly than those without that disorder, which could result in superior self-informant agreement for those with that disorder (Funder & ▇▇▇▇▇▇, 1988; Funder & ▇▇▇▇▇▇▇, 1987; ▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇ & ▇▇▇▇▇▇▇▇, 2004). For example, anxiety sensitivity may be a more prominent, or observable trait to informants of those with PD than those without PD. Consequently, self-informant agreement on anxiety sensitivity may be stronger for those with PD, relative to those without.

AIMS AND HYPOTHESES. 1.10.1. Aims of the study