Systemic lupus erythematosus (SLE) is a relatively rare autoimmune disease with no known aetiology or cure. In addition to numerous physical symptoms, those living with SLE have also been shown to experience significant emotional and psychosocial difficulties. There has been little psychological research into SLE despite the rapidly increasing interest in health psychology and quality of life issues over the last two decades. One such issue that has commanded particular attention is that of cognitive bias in individuals with chronic pain and/or chronic illness. Cognitive bias toward illness-related information is theorised to indicate the presence of an illness self-schema, and is a valuable tool of investigation as it permits access to a level of cognitive structure that is inaccessible via self-report instruments. The primary focus of the present study is to investigate recall bias for pain- and illness-related words in SLE patients. This bias is explored relative to the recall of neutral words and depression-related words, and also relative to the responses of rheumatoid arthritis (RA) patients and healthy controls. Two hypotheses are proposed: firstly, that bias is related to disease activity; and secondly, that bias is related to the combination of illness and depression. The findings provide support for the second hypothesis, with the additional caveat that the nature of the pain/illness stimuli used is important in determining the presence of cognitive bias. No recall bias for illness-related words as a whole was found in any of the groups, nor was there evidence of a recall bias in the SLE and RA patients when they were divided according to depression status. However, when the illness words were examined separately according to �sensory pain� and �disability-related� words, a clear bias for disability words was found in the depressed patient group. It is concluded that there is a relationship between depression in chronically ill individuals, and the way in which such individuals process disability-related words. In accordance with the schema-enmeshment model (Pincus & Morley, 2001), it is suggested that both a pain-schema and an illness-schema exist, and it is when these two schemas become enmeshed with the self-schema that depression occurs in chronic pain/chronically ill patients. The cognitive bias assessment paradigm adopted in this study-one that is typically used in similar investigations-is lengthy, requires sophisticated equipment and can be difficult to interpret on an individual level. The present study investigates the relationship between cognitive biases in SLE patients and a recently-developed task, PRISM, which appears to symbolise the enmeshment of illness-, pain- and self-schemas. Analyses confirmed that recall of negative illness words was the only independent predictor of PRISM scores. This suggests that PRISM, a quick and easy task to administer, may have considerable usefulness as a clinical tool to assess information relevant to the enmeshment of illness- and self-schema. A greater understanding of schema and the processing styles of chronically ill patients will allow for more effective psychological treatment such that quality of life can be improved.

Thesis (M. Phil.)--University of Hong Kong, 2005. / Title proper from title frame. Also available in printed format.

The goal of this inductive study was to identify factors that facilitate and inhibit binational collaboration in the recovery of endangered species in the northern Mexico borderlands, focusing on the Mexican wolf (Canis lupus baileyi). A conceptual model was developed using qualitative techniques, providing the basis for design of a mail survey. The target population included participants with experience in recovery efforts for over a dozen species at risk in the region. Long interviews were recorded with 44 participants from Mexico and the United States. Thematic hierarchical analysis was used to develop a conceptual model of how interviewees talked about factors influencing binational collaboration. Issues were classified in five thematic clusters: project, organization, people, resources, culture/history. The survey was used to conduct a needs assessment, measuring respondents' attitudes about the relative priority of issues identified in the conceptual model. High priority needs were identified from each thematic cluster: (a) equitable participation in project design and implementation, (b) continuity of personnel, (c) coordination of federal, state and local efforts, (d) increased funding, managed with accountability, and (e) exchange visits to facilitate understanding of diverse perspectives. Responses to almost half the survey items indicated accord among the sample of respondents, providing a basis for shared common ground. The nature of discord was within the range of "manageable", with no clear polarization of attitudes measured. This exploratory data analysis suggested that the structure of the conceptual model developed from the Mexican wolf case study was generally a valid basis for future deductive analysis and reflection by practitioners. For 82% of 22 statements of need, priorities of participants in the Mexican wolf recovery efforts did not differ significantly from other respondents. Nationality (of respondents) significantly affected priority rankings for only 18% of the need statements. Significant effects of five demographic variables indicated that interactive effects should be examined in future multivariate analyses to determine how respondents' attitudes on issues related to priority rankings. Recommendations were provided for a more efficient and effective approach to collaborative problem-solving, engaging reflective practitioners from the private and public sectors in principled negotiation processes to better understand diverse perspectives.

The presence of autoantibodies in systemic lupus erythematosus (SLE) suggests a breach of tolerance. Recently, the IgM-IgD+ naïve B cell population has been shown to be enriched for self-reactive cells that are anergic in healthy subjects. Therefore, to determine whether there is altered selection of self-reactive cells in SLE, this population was examined using multiparameter flow cytometry. SLE patients had increased proportions of IgM-IgD+ cells in mature and transitional B cell compartments that were activated as compared to controls. Comparison of mature and transitional IgM-IgD+ B cell proportions suggested altered selection between the transitional to mature stages in SLE. There was no correlation between altered B cell function or genetic polymorphisms in B cell signalling molecules and the expansion or activation of IgM-IgD+ cells. Thus, selection of self-reactive B cells appears to be abnormal in SLE, but this does not appear to result from altered responses to Ig crosslinking.

The presence of autoantibodies in systemic lupus erythematosus (SLE) suggests a breach of tolerance. Recently, the IgM-IgD+ naïve B cell population has been shown to be enriched for self-reactive cells that are anergic in healthy subjects. Therefore, to determine whether there is altered selection of self-reactive cells in SLE, this population was examined using multiparameter flow cytometry. SLE patients had increased proportions of IgM-IgD+ cells in mature and transitional B cell compartments that were activated as compared to controls. Comparison of mature and transitional IgM-IgD+ B cell proportions suggested altered selection between the transitional to mature stages in SLE. There was no correlation between altered B cell function or genetic polymorphisms in B cell signalling molecules and the expansion or activation of IgM-IgD+ cells. Thus, selection of self-reactive B cells appears to be abnormal in SLE, but this does not appear to result from altered responses to Ig crosslinking.

<p>Habitat fragmentation and anthropogenic development influence the level of isolation and security in and around protected habitats affecting wolf movements and the distribution and abundance of their prey. In light of recent concern about the ecology of animals in protected areas, I initiated a research project to investigate the molecular and foraging ecology of grey wolves in and around Prince Albert National Park (PANP), Saskatchewan. <p>Estimates of genetic diversity and population structure can be used as surrogates to detect effects of habitat degradation on wolves. Genetic diversity was high in these populations relative to other North American wolf populations. My results suggest that wolves in central Saskatchewan form a panmictic population, however there is some evidence showing partial isolation of one group of wolves within PANP. I speculate that the level of human activity such as road networks, hunting, and trapping act as dispersal impediments to this isolated group. Further, the genetic homogenization, indicating high population turnover, of wolf groups that use the periphery and adjacent areas of PANP may also contribute to the observed genetic subdivision. The partially isolated NW group, characterized by slightly lower diversity indices, low migration rates, and higher levels of allele fixation, indicated this group was a more stable social unit comprised of more related individuals.</p><p>Knowledge of wolf food habits and how they change over time is a fundamental component to understanding wolf ecology. Using scat analysis I evaluated wolf foraging ecology by calculating indices of occurrence/faeces (OF) and percent prey biomass contribution: white tailed deer contributed 43% and 33% respectively to wolf diet; elk (33%, 50%), moose (7%, 14%), beaver (5%, 2%), and snowshoe hare (2%, <1%). I found no evidence of livestock depredation nor did wolves prey on bison or caribou. There were no differences in OF indices between years. Prey selectivity was apparent in both years with wolves selecting elk and avoiding beaver. A diversity of ungulate prey are readily available to wolves in this system; however, scat analysis and tests for prey selection indicate a preference for elk. I presume this is a choice made to balance risk with profitability of food items in concordance with optimal foraging theory.</p><p>I examined trophic relationships between the grey wolf and 18 mammalian species from the boreal forest of central Saskatchewan, Canada, using ä13C and ä15N stable isotope values measured in hair samples. Variance in isotope values for wolves and other carnivores was investigated as a proxy for dietary variation. IsoSource, an isotopic source partitioning model, quantified the relative proportions of 5 most likely prey items in the diets of wolves.</p><p>I compared these results with investigations of faecal contents using percent biomass contributions of prey items in wolf diet. I found no difference between percent biomass measures and mean percent contributions derived from IsoSource. Despite social foraging, my results indicate highly variable diets among individual wolves and I discuss this in terms of boreal wolf ecology.

<p>Habitat fragmentation and anthropogenic development influence the level of isolation and security in and around protected habitats affecting wolf movements and the distribution and abundance of their prey. In light of recent concern about the ecology of animals in protected areas, I initiated a research project to investigate the molecular and foraging ecology of grey wolves in and around Prince Albert National Park (PANP), Saskatchewan. <p>Estimates of genetic diversity and population structure can be used as surrogates to detect effects of habitat degradation on wolves. Genetic diversity was high in these populations relative to other North American wolf populations. My results suggest that wolves in central Saskatchewan form a panmictic population, however there is some evidence showing partial isolation of one group of wolves within PANP. I speculate that the level of human activity such as road networks, hunting, and trapping act as dispersal impediments to this isolated group. Further, the genetic homogenization, indicating high population turnover, of wolf groups that use the periphery and adjacent areas of PANP may also contribute to the observed genetic subdivision. The partially isolated NW group, characterized by slightly lower diversity indices, low migration rates, and higher levels of allele fixation, indicated this group was a more stable social unit comprised of more related individuals.</p><p>Knowledge of wolf food habits and how they change over time is a fundamental component to understanding wolf ecology. Using scat analysis I evaluated wolf foraging ecology by calculating indices of occurrence/faeces (OF) and percent prey biomass contribution: white tailed deer contributed 43% and 33% respectively to wolf diet; elk (33%, 50%), moose (7%, 14%), beaver (5%, 2%), and snowshoe hare (2%, <1%). I found no evidence of livestock depredation nor did wolves prey on bison or caribou. There were no differences in OF indices between years. Prey selectivity was apparent in both years with wolves selecting elk and avoiding beaver. A diversity of ungulate prey are readily available to wolves in this system; however, scat analysis and tests for prey selection indicate a preference for elk. I presume this is a choice made to balance risk with profitability of food items in concordance with optimal foraging theory.</p><p>I examined trophic relationships between the grey wolf and 18 mammalian species from the boreal forest of central Saskatchewan, Canada, using ä13C and ä15N stable isotope values measured in hair samples. Variance in isotope values for wolves and other carnivores was investigated as a proxy for dietary variation. IsoSource, an isotopic source partitioning model, quantified the relative proportions of 5 most likely prey items in the diets of wolves.</p><p>I compared these results with investigations of faecal contents using percent biomass contributions of prey items in wolf diet. I found no difference between percent biomass measures and mean percent contributions derived from IsoSource. Despite social foraging, my results indicate highly variable diets among individual wolves and I discuss this in terms of boreal wolf ecology.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease. Genetic factors playing an important role in disease susceptibility have long been suggested. Transforming growth factor-beta (TGF-beta) regulates differentiation and proliferation of T cells. Therefore, it could be a candidate gene for the development of systemic lupus erythematosus. Allelic polymorphisms in TGF-beta promoter region (-988, -800, -509) and in exon 1 (codon 10 and codon 25) have been suggested to associate with SLE susceptibility. Allelic polymorphisms at positions -988, -800, -509, codon 10 and codon 25 on TGF-beta gene in 138 SLE patients and 182 healthy controls were analyzed in this study. TGF-beta polymorphisms were determined by PCR amplification and sequencing. With the previous polymorphic data of interleukin-4 (IL-4) -590 and interleukin-10 (IL-10) -819, associations of cytokine genotyoe and allele frequencies were analyzed. Results showed that there were differences in the genotype distribution of TGF-beta promoter region at position -509 and in the signal sequence at codon 10 (Leu¡÷Pro) between case and control groups in this study. However, no significant differences were found for all the TGF-beta polymorphisms. Allele frequency of IL-10 -819 was significantly associated with the susceptibility of SLE (p = 0.011). No significant associations were found between lupus nephritis with all the cytokine polymorphisms, but CNS involvement and lung involvement were associated with the polymorphisms studied in this research.

名古屋大学博士学位論文 学位の種類 : 博士(医学)(論文) 学位授与年月日:平成5年9月14日 水谷大裕氏の博士論文として提出された

El objetivo del estudio fue determinar la incidencia de reacciones adversas medicamentosas (RAM) producidas por el uso de ciclofosfamida endovenoso (CFA- EV) en un grupo de 30 pacientes con Lupus Eritematoso Sistémico en el Servicio de Reumatología del Hospital Nacional Guillermo Almenara Irigoyen que iniciaron el tratamiento entre enero de 1999 a diciembre del 2001, los datos se obtuvieron por la evaluación de las historias clínicas entre los meses de junio a septiembre del 2002 determinándose que el 100% de los pacientes presentaron RAM. La leucopenia fue la RAM más frecuente presentándose en el 76,7% de los pacientes durante el tratamiento. Utilizando el Algoritmo de Decisión aplicado por el Centro Nacional de Farmacovigilancia e Información de Medicamentos de la Dirección General de Medicamentos, Insumos y Drogas del Ministerio de Salud (CENAFIM – DIGEMID – MINSA), determinamos que del total de las RAM identificadas el 38,2% fueron de causa definida y el 58,4% corresponde a RAM serias. El medico clínico tuvo que suspender definitivamente el tratamiento con CFA-EV a 9 de los 30 pacientes, por presentar RAM severas. A través de la medida de asociación estadística Odds Ratio se determinó que existe relación entre las dosis administradas por superficie corporal de CFA-EV y la presencia de náuseas, vómitos y leucopenia. Se propone una guía para el manejo de las RAM a CFA-EV en los pacientes con LES, elaborada en base a la experiencia recogida durante nuestro estudio. / The goal of this study was to determine the effect of drug adverse reactions (DAR) produced by the use of intravenous cyclophosphamide in a group of 30 patients with Systemic Lupus Erythematosus (SLE) in the Rheumatology's Service of the National Hospital Guillermo Almenara Irigoyen from Lima-Perú. These patients initiated the treatment between January 1999 to December 2001, the information was obtained by the evaluation of the clinical histories between June to September 2002. We determined that 100 % of the patients presented DAR. The leucopenia was the most frequent DAR appearing in 76,7 % of the patients during the treatment. Using the Algorithm of Decision applied by Farmacovigilancia's National Center and Information of Dirección General de Medicamentos, Insumos y Drogas - Ministerio de Salud (CENAFIM - DIGEMID - MINSA), of the identified DARs, 38,2 % was from definite cause and 58,4 % corresponds to serious DAR The clinical doctor had to suspend definitively the treatment with intravenous cyclophosphamide to 9 of 30 patients, for presenting severe RAM. By the measurement of statistical association Odds Ratio we determined that it exists relation between the administered doses by cyclophosphamide's corporal surface and the presence of nauseas, vomits and leucopenia. We propose a guide for the managing of DAR to intravenous cyclophosphamide in patients with SLE, elaborated on the basis of the experience gathered along the present study.