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Sepsis-induced delayed gastric emptying is a significant clinical problem for patients in intensive care units worldwide. A series of studies were carried out to examine the nature and mechanisms of sepsis-induced delayed gastric emptying using a novel mouse model which used a standard food source and was devoid of upper gastrointestinal tract trauma and restraint. Using this model, lipopolysaccharide (LPS) injection produced a dose-dependent decrease in gastric emptying which onset by one hour. LPS produced an alteration in mouse behavior and piloerection at 30 minutes, increased resting respiratory rate at 3 hours, and did not impact body temperature. The onset of sepsis-induced delayed gastric emptying was closer to those centrally-mediated clinical signs of sepsis (altered behavior and piloerection) than to the peripherally-mediated clinical signs (respiratory rate) suggesting a central mechanism. C-Fos activation of the area postrema (AP), the nucleus of the solitary tract (NTS), and the dorsal motor nucleus of the vagus (DMV) was examined 30 minutes after LPS injection which is the onset time for sepsis-induced delayed gastric emptying. LPS exposure produced significantly more activated neurons in the AP and NTS, and less in the DMV. These results may suggest a central mechanism with the AP and NTS inhibiting the DMV. Examination of isolated strips of gastric antrum in a tissue bath showed a decreased contractile response to electrical field stimulation and carbachol after injection of LPS. This occurred at 18 hours post LPS injection, but not at 6 hours. Using the mouse model, sepsis-induced delayed gastric emptying was shown to be occurring at 6 hours when no difference in contractility was measurable suggesting intrinsic changes are not the cause. These studies suggest a new mechanistic paradigm for sepsis-induced delayed gastric emptying in which there is a biphasic response. This involves an initial rapid, centrally-mediated delay in gastric emptying occurring the first hour and followed by an intrinsic tissue-level response several hours later characterized by a decrease in gastric muscle contractility. / Thesis (Ph.D, Biology) -- Queen's University, 2012-05-02 16:17:55.564

Thesis (doctoral)--University of Copenhagen.

Thesis (doctoral)--University of Copenhagen.

Some diabetic patients - particularly those with nausea and vomiting - frequently have evidence of delayed gastric emptying while other diabetic patients may in fact exhibit accelerated gastric emptying. Whether the presence or absence of symptoms of upper gastrointestinal dysfunction correlated with objective measures of gastric emptying in insulin dependent diabetic subjects was investigated. Twenty one insulin dependent diabetic patients underwent a solid phase gastric emptying scintiscan using in vivo labelled chicken patients had symptoms Thirteen patients had symptoms suggestive of gastrointestinal dysfunction (nausea, vomiting, early satiety, or constipation), while eight patients had no gastrointestinal symptoms. Eleven patients had orthostatic hypotension. All patients had been diabetic since childhood or adolescence. As a group, the diabetic patients showed a half time (T50) of gastric emptying (mean (SD) 150.0 min (163.7) that was not significantly different from that of 12 healthy control subjects (148.1 min (62.4)). Those diabetic patients without gastrointestinal symptoms and without orthostatic hypotension, however, showed a gastric emptying half time (70.1 min (41.6)) that was significantly faster than that of the control subjects. Conversely, those diabetic patients with nausea, vomiting, and early satiety (or early satiety alone) showed T50 values that were significantly greater than those of the diabetic patients without these symptoms. No correlation was found between the T50 value and the duration of diabetes, the fasting blood glucose at the time of study, or the respiratory variation in heart rate (E:I ratio). These observations indicate that highly variable rates of gastric emptying occur in insulin dependent diabetic patients, and that accelerated gastric emptying may occur in diabetic patients who have no symptoms of gastrointestinal dysfunction.

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Thesis advisor: Frederick G. Lawrence / Contemporary religious believers tend to conceive of the sacraments as objective expressions of grace distinct from their ritual enactment and often exclusive of ethical obligations. Ecclesial structures have reinforced these understandings by associating the sacraments with Christological interpretations that diminish the active participation of Christians in worship by emphasizing Christ's eminence and power. By highlighting Christ's self-emptying love in the act of kenosis, I argue for new Christological understandings to support ongoing liturgical and ecclesial renewal. My research explores two major areas: the resurgence of sacramental theology after Vatican II, especially within the work of Chauvet, and the rise of a critical theology of the cross in the writings of Jürgen Moltmann and its kenotic implications for the church. By bringing together these two areas, I argue for an alternative sacramental framework that combines internal conceptions of grace with outward expressions of meaning that bear fruit in liturgical inculturation and acts of solidarity. This dissertation begins with a study of the liturgical renewal following Vatican II and its world-wide implementation. I pay special attention to the development of postconciliar liturgical renewal in light of the principle of active participation (actuosa participatio) in the Constitution on the Sacred Liturgy, and examine the relationship of structuralist approaches to liturgy to Christology. In chapter two, I explore sources for Christology that point to fresh understandings about the nature and person of Christ and the work of salvation. In chapters three and four, I present a thorough study of the work of Louis-Marie Chauvet on the sacraments, and Jürgen Moltmann on the cross. In doing so, I construct a relationship between sacraments and Christology centered on Christ's kenosis as a means of supporting ongoing liturgical and ecclesial renewal. In the final chapter, I explore how kenotic Christology can shape our understanding of the liturgy and contribute to greater inculturation in worship and acts of solidarity in the world. I conclude by proposing new ways to think about the liturgy that may become the ground for future ecclesial transformation. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Graduate School of Arts and Sciences. / Discipline: Theology.

No description available.

No description available.

Rates of population growth in developing country cities are straining the capacity of sanitation service providers. In spite of widespread sector recognition of the need to adopt low-cost, people centred approaches, 80 per cent of investments in the water and sanitation sector continue to be allocated to high cost technologies for urban elites. Household level, on-plot sanitation systems potentially offer a solution to the sanitary needs of the urban poor. Nevertheless, commonly held assumptions amongst sector professionals that lower cost, on-plot systems are inappropriate and unacceptable in urban communities impede-their wider application. There is little empirical evidence to justify this position. The scope of this work examines the technical appropriateness and user acceptability of on-plot sanitation options. The thesis contributes to an improved understanding of the context in which on-plot systems operate, what factors constrain their application, and what issues need consideration when deciding on sanitary options in low-income communities. The research adopted a mix of methodological techniques to improve the reliability and validity of findings, with both quantitative and qualitative methods applied during fieldwork. Findings from Ghana, Mozambique and India are included in the thesis in order to permit sampling of key latrine types used internationally. The thesis concludes that user based perceptions of the performance and acceptability of on-plot systems varies markedly to those of sector professionals, particularly in relation to plot size, satisfaction levels and reasons for absence of household latrine. Furthermore, user based criteria of performance are developed for consideration practitioners when narrowing decision making on sanitary options. The implications of the study highlight the need for integration of user concerns into strategic planning for sanitation, more effective stimulation and negotiation of demand for sanitation systems and challenges for agencies in adopting a user oriented approach. The recommendations from the thesis include practitioner focused policy changes that affect project planning and support systems for user education. Potential areas of further research interest include ranking user perceptions, an holistic understanding of excreta management processes and institutional constraints affecting user-service provider consultations.