SANTRAUKA Vilniaus universiteto Medicinos fakultetas Reabilitacijos, sporto medicinos ir slaugos institutas Slaugos magistrantūros programa SERGANČIŲJŲ 2 TIPO CUKRINIU DIABETU GYVENIMO KOKYBĖS ĮVERTINIMAS Slaugos magistro baigiamasis darbas Darbo autorė: Aliona Zaborovskytė Darbo vadovė: prof. habil..dr. Danutė Kalibatienė Vilnius, 2008 m. Pagrindinės sąvokos: 2 tipo cukrinis diabetas, gyvenimo kokybė, SF-36 klausimynas. Tyrimo tikslas. Įvertinti 2 tipo sergančiųjų cukriniu diabetu gyvenimo kokybę. Tyrimo uždaviniai. Ištirti ir palyginti grupės sergančiųjų 2 tipo cukriniu diabetu gyvenimo kokybės skirtumus, atsižvelgiant į tiriamųjų lytį, amžių ir kūno masės indeksą. Įvertinti grupės sergančiųjų 2 tipo cukriniu diabetu gyvenimo kokybę, atsižvelgiant į socialinius veiksnius. Įvertinti grupės sergančiųjų 2 tipo cukriniu diabetu gyvenimo kokybę, atsižvelgiant į cukrinio diabeto komplikacijas. Tyrimo populiacija. Tyrime dalyvavo 196 asmenys, sergantys 2 tipo cukriniu diabetu. 67 vyrai (34,2 proc.) ir 129 moterys (65,8 proc.), kurių amžius buvo nuo 41 iki 77 metų (vidurkis – 60,5 ± 8,1 m.). Pacientai gydėsi Vilniaus miesto ligoninėse ir poliklinikose. Tyrimo metodai. Atliktas epidemiologinis tyrimas pritaikant anoniminės apklausos metodą. Analizuoti sergančiųjų 2 tipo cukriniu diabetu pacientų gyvenimo kokybės skirtumai, atsižvelgiant į tokius veiksnius, kaip lytis, amžius, KMI, socialinius veiksnius, diabeto trukmę, ligos kontrolę, diabeto gydymą, šeimos sergamumą cukriniu... [toliau žr. visą tekstą] / SUMMARY Vilnius University Faculty of Medicine Institute of Rehabilitation, Sport Medicine and Nursing Master’s degree Nursing Programme EVALUATION OF LIFE QUALITY OF PATIENS WITH TYPE 2 DIABETES Master’s degree final scientific research work Author of the master’s degree scientific research work: Aliona Zaborovskytė Head of the master’s degree scientific research work: prof. Danutė Kalibatienė Vilnius, 2008 Keywords: type 2 diabetes, quality of life, SF-36 questionnaire. The aim of research was to evaluate quality of life patients who has type 2 diabetes. The main tasks were to analyse and compare differences of quality of life patients with type 2 diabetes, considering their gender, age and the body mass index. To evaluate quality of life patients with type 2 diabetes considering social factors. To evaluate quality of life of patients with type 2 diabetes considering complications of diabetes. Population of research. This study focused on 196 subjects with Type 2 Diabetes between the age of 41 and 77 years-old (average 60,5 ± 8,1 year). They were recruited from Vilniaus hospitals and an Out patient Clinic. The distribution consisted of 67 males and 129 females. Methods. There was used epidemiologic research of prevalence method. A questionnaire was administered to determine and access specific demographic characteristics including the type and duration of onset of diabetes, prescribed treatments, complications, social factors and other relevant data. Short-Form Health... [to full text]

Doctor of Philosophy (PhD) / This thesis concerns the intersection of social semiotic theory and critical discourse analysis (CDA), applying systemic-functional (SF) theory to verbal-visual news media texts. The aim of the thesis is to develop social semiotic descriptions of visual meaning in order to facilitate analyses of evaluative stance in visual-verbal text. The texts studied are ‘factual’ daily broadsheet news photos and prominent visual-verbal ‘displays’ that incorporate these photos alongside headlines and captions. Such displays introduce investigative stories on the front page of broadsheet weekly news reviews and are referred to in the thesis as ‘standout’ texts. They are significant because they may also be read as independent texts and play a critical role in positioning a wide readership on the issues investigated in the story. The SF system of verbal appraisal was used in this thesis to develop a corresponding system of visual appraisal. The process involved applying general appraisal options to a corpus of news photos and proceeding to further delicacy in a repeated cycle of analysis and system-building. Once refined in this way the system was applied alongside the verbal appraisal system to account for evaluation in verbal-visual standouts. In the thesis four Australian and four Greek standouts introducing stories on asylum seekers were analysed in order to explore the potential for variation and the impact of context on evaluative meaning choices. The thesis contributes insights into SF theory, media discourse and CDA. The visual systems developed allow appraisal analysis to be extended to images and to verbalvisual texts. Visual appraisal analysis in the thesis provides new evidence for the ideological and evaluative power of news photos. Verbal-visual appraisal analysis shows how each semiotic contributes to evaluative meaning, and to its accumulation and spread across a text. In respect to media discourse, the thesis also provides evidence for the ‘standout’ as an orbital verbal-visual news genre. The comparison of evaluative stance in two sets of standouts demonstrates consistent editorial choices in texts within each context and contrasts across the two sites. The Australian texts display more evaluative complexity, greater emphasis on entertainment and offer two different stances, aligning a diverse target audience. The Greek texts are more straightforward and construct a single stance, aligning a narrower audience. By identifying the semiotic choices involved in the evaluative positioning of readers by visual-verbal texts, the thesis can contribute to more informed and reflective practice. Thus, as well as making theoretical advances, the findings have relevance for journalism and education at a time when the impact of images is changing our conception of literacy.

Doctor of Philosophy (PhD) / This thesis concerns the intersection of social semiotic theory and critical discourse analysis (CDA), applying systemic-functional (SF) theory to verbal-visual news media texts. The aim of the thesis is to develop social semiotic descriptions of visual meaning in order to facilitate analyses of evaluative stance in visual-verbal text. The texts studied are ‘factual’ daily broadsheet news photos and prominent visual-verbal ‘displays’ that incorporate these photos alongside headlines and captions. Such displays introduce investigative stories on the front page of broadsheet weekly news reviews and are referred to in the thesis as ‘standout’ texts. They are significant because they may also be read as independent texts and play a critical role in positioning a wide readership on the issues investigated in the story. The SF system of verbal appraisal was used in this thesis to develop a corresponding system of visual appraisal. The process involved applying general appraisal options to a corpus of news photos and proceeding to further delicacy in a repeated cycle of analysis and system-building. Once refined in this way the system was applied alongside the verbal appraisal system to account for evaluation in verbal-visual standouts. In the thesis four Australian and four Greek standouts introducing stories on asylum seekers were analysed in order to explore the potential for variation and the impact of context on evaluative meaning choices. The thesis contributes insights into SF theory, media discourse and CDA. The visual systems developed allow appraisal analysis to be extended to images and to verbalvisual texts. Visual appraisal analysis in the thesis provides new evidence for the ideological and evaluative power of news photos. Verbal-visual appraisal analysis shows how each semiotic contributes to evaluative meaning, and to its accumulation and spread across a text. In respect to media discourse, the thesis also provides evidence for the ‘standout’ as an orbital verbal-visual news genre. The comparison of evaluative stance in two sets of standouts demonstrates consistent editorial choices in texts within each context and contrasts across the two sites. The Australian texts display more evaluative complexity, greater emphasis on entertainment and offer two different stances, aligning a diverse target audience. The Greek texts are more straightforward and construct a single stance, aligning a narrower audience. By identifying the semiotic choices involved in the evaluative positioning of readers by visual-verbal texts, the thesis can contribute to more informed and reflective practice. Thus, as well as making theoretical advances, the findings have relevance for journalism and education at a time when the impact of images is changing our conception of literacy.

Streptococcus uberis is a Gram-positive, catalase-negative member of the family Streptococcaceae and is an important environmental pathogen primarily responsible for a significant amount of bovine intramammary infections. This thesis describes the sequencing and comparison of multiple strains from clinical and sub-clinical infections. Following de novo assembly, these are compared to the single reference strain (0140J). The assemblies of strains sequenced with two technologies (Illumina and SOLiD) were compared. From these assemblies, annotation allowed the comparison of gene content, the pan and core genomes and gene gain/loss of coding sequences associated with clustered regularly interspaced short palindromic repeats (CRISPRs), prophage and bacteriocin production. Identification of sequence variants allowed identification of highly conserved and highly variant genes. Inferred intraspecies and interspecies (host-S. uberis) protein-protein interaction networks revealed pathways of bovine proteins enriched with potentially interacting pathogen proteins. These identified known and predicted pathways and also novel interaction partners. This was the first “whole-genome” comparison of multiple S. uberis strains isolated from clinical vs non-clinical intramammary infections including the type virulent vs non-virulent strains. These data allowed the first insight into potential evolutionary forces behind virulence differences.

Over the last three decades, there has been increasing concern over environmental effects on human male reproductive health. Both temporal and regional trends in semen quality, testicular cancer and malformations at birth have been associated with changes or differences in exposure to chemicals present within the environment. These abnormalities are typically classified under one entity, Testicular Dysgenesis Syndrome [TDS]. Since temporal trends in sperm quality have also been reported in the dog, it was proposed that this may reflect a common cross-species environmental aetiology and that the dog is a sentinel for human exposure to ECs. The overarching hypothesis of this thesis is that the dog may exhibit regional differences symptomatic of TDS and may respond to environmental influences in a similar manner to the human. Experimental studies designed to test this hypothesis focused on (1) the sensitivity of sperm to environmental influences, (2) canine sentinel testicular chemical profiles and pathological features of testes from specific geographical regions and (3) possible environmental influences impacting on cryptorchidism in dogs. Humans and animals are not directly exposed to single chemicals but to a mixture of environmental toxicants present within the environment. Chapter 3 initiated investigations into mixture effects of ECs by utilising a novel full factorial chemical model of two chemicals known to be present in reproductive tissues. Concentrations of di (2-ethylhexyl) phthalate [DEHP] and polychlorinated biphenyl congener 153 [PCB-153] at environmentally relevant levels, as determined by testicular chemical profiling of dog testes, and their effects upon parameters of sperm quality, were tested in vitro. While subtle differences in motility were observed between species, DNA fragmentation was increased similarly in both the human and dog following EC exposure. Although this applied to individual and mixed chemicals, the effects of one chemical impacted on the activity of the other dependent on the concentration ratio. Interestingly, for DNA fragmentation, data presented suggests that PCB-153 is the driver behind increased sperm DNA damage in both species. Since the data alluded to above support the concept of utilising the domestic dog as a sentinel for human exposure to ECs, the dog was used to investigate regional variation upon testicular developmental, morphological and histopathological features. The regions selected for in this component of the thesis display different degrees of industrialisation and thus variation in exposure to environmental contaminants. Data presented demonstrate significant regional variation in chemical profiles, testicular developmental markers and histopathological features indicative of TDS. Specifically, testicular DEHP and PCB-153 with known geographical variation, were found to be positively associated with markers of proliferation and spermatogenesis. Interestingly, a further chemical present in dog testis, poly-brominated diphenyl ether congener 47 [PBDE-47], was negatively correlated with these markers. Furthermore, a novel system developed to assess and score histopathological abnormalities in testes, revealed a higher range of atypical features in testes from the UK compared to those collected from Scandinavia. A further novel element of this thesis was the development of a survey to assess environmental influences on cryptorchidism across several breeds of dog. Uniquely, a higher prevalence of cryptorchidism was observed in deerhounds originating from the East Midlands. Of the range of environmental influences investigated, a key observation was that some bitches of cryptorchid pups were fed a specific brand of feed previously reported to contain ECs. Assessment of further environmental factors covered by the survey such as exposure to pesticides, cigarette smoke and air fresheners provided preliminary information pending the further repeat release of the survey to the same breeders in future years. These data provide preliminary evidence into possible environmental factors that could influence canine and human reproductive health. In conclusion, the results presented in this thesis are significant since they add considerable weight to the paradigm that environmental factors impact directly on male reproductive function. Unique data presented within this thesis emphasises that specific chemical types perturb sperm function and these chemicals vary by region. Furthermore, the work presented here consolidate the suitability of the domestic dog as a sentinel for human exposure to contaminants thus providing the added benefit of enabling access to reproductive tissues from different regions as an index of human reproductive health.

This thesis provides new ways of thinking about human-bird encounters under domestication, providing the first substantive geographical study of ‘pigeon geographies’. It explores the spaces, practices, and human-pigeon relationships involved in pigeon showing and long-distance pigeon racing in Britain, from the mid-nineteenth century up until World War Two. The growth of fancy pigeon exhibitions was part of a wider Victorian passion for domesticating animals, at a time when human bodies were also subject to increasing aesthetic and moral scrutiny. Long-distance pigeon racing emerged at the end of this period, organised competitive sport more generally seen as an important means of moral improvement and identity expression. Like many other competitive pastimes in the second half of the nineteenth century, then, institutional bodies were formed to manage the expansion of showing and long-distance racing. The Pigeon Club and the Marking Conference were formed in 1885 to oversee British pigeon exhibitions, whilst the National Homing Union, formed in 1896, governed British long-distance pigeon racing. Both pastimes facilitated the formation of social worlds around varieties of domestic pigeon (Columba livia) and their respective practices. Whilst these pastimes historically had strong concentrations of male working-class followers – particularly in the north-west and north-east – they were both widespread throughout Britain and spanned all socio-economic classes, although accounts of female fanciers were rare. Through the exhibition of pigeons, fanciers debated and defined aesthetics, formulating breeding standards for each fancy breed, and questioning the ways in which pigeons were manipulated – sometimes contentiously – to produce the ‘ideal’. Long-distance pigeon racers, on the other hand, sought to understand and hone their birds’ athletic abilities, becoming entangled in scientific debate about homing, as well as geographical questions about the conduct and regulation of their sport. Racers were also drawn into aesthetic debates, exhibiting their racing birds during the off-season, the show pen becoming a fascinating frontier between showing and racing. Through the organisation of the spaces and practices that made up the fabric of these pastimes, pigeon showing and long-distance racing reconfigured both humans and their birds, the two becoming closely intertwined through collaborative encounters.

Veterinary Medicine does not have a history in the social sciences and is therefore a fascinating field of study. Despite the growth of education research in the veterinary schools, the social and relational aspects of veterinary training and practice are under-examined, and could have profound effects on the ability of students to make a successful transition into qualified work. This thesis explored the development of occupational identity in veterinary students and newly-qualified veterinary surgeons, using narrative interview techniques and organisational policy analysis. From interviewees’ stories, a clear distinction could be drawn between the majority, who were vocationally-motivated, and a smaller group who were drawn to a veterinary career by the high academic standards required. All identified several influences on their own professional identity development: role models, the need to perform as competent and confident, and presenting an approved personality type in order to gain access to the practical experience required during training. The predominant story arc is that of becoming increasingly ‘vetlike’ as they progress through the course. Animal welfare is a substantial silence in the organisational discourse of veterinary medicine. The discourse analysis revealed the overwhelming presentation of the elite academic nature of the profession, at the expense of any mention of animal care or welfare, or acknowledgement of vocational motivation. A compelling collective responsibility was also identifiable in terms of upholding a professional reputation and its high standards. A strong occupational history contributes to this, leading to a very bonded occupational group. The idea of veterinary medicine not being a nine-to-five job is expressed in policy and resonated very strongly with interview participants. However, there exists a very clear, organisationally-sanctioned, officially-approved attitude towards veterinary life and work, allowing very little deviation. This has the subsequent effect that tolerance of weakness, unhappiness, or complaint is low; so that members are forced to either internalise their unhappiness or leave the profession entirely. Veterinary medicine is perceived as a career with high job satisfaction and a positive public image. However, awareness is increasing of worryingly high levels of mental illness, stress, unhappiness and dissatisfaction with their work among the veterinary workforce. This thesis suggests that one factor that could underlie this is a mismatch between a new entrant’s ideas of what a vet is and does, and the reality of a working life in veterinary practice. From the conclusions presented in this thesis - in particular the finding that, as a profession, veterinary medicine strives to distance itself from an animal care or animal welfare focus - I suggest that it is the confused messages received as part of the process of socialisation during training that could connect to many of the problems facing the modern entrant to the veterinary profession. This research specifically focused on the development of occupational identity in veterinary students and newly-qualified veterinary surgeons in the UK and is the only current work to examine the processes, presentation and experiences of veterinary training in this comparative manner. As a relatively new, and very interdisciplinary, field of study, the capacity for future work in veterinary social sciences is considerable, with much to be learnt from allied fields as well as further explorations of just what makes veterinary medicine unique, and such a valuable source of social inquiry given the significance of pets and livestock to the lives of a nation of animal lovers. This is potentially a very rich field.

Poor adherence is an issue in clinical trials with a striking magnitude and negative impact. Recent studies indicate that two widely used clinical screening tools, Short Form (SF-36) Health Survey and Center for Epidemiologic Studies Depression Scale (CES-D) can be used as risk stratifiers to identify participants who require extra interaction to stay adherent in specific population. There is, however, little evidence to support the implication of these tools in elderly individuals with mobility limitations. These individuals may be particularly vulnerable to the risks of poor adherence in the context of a demanding interventional scheme. This study fulfills this gap by analyzing the quality of life and adherence data from the VIVE2 study, which is a double-blinded randomized explanatory clinical trial assessing the benefits of nutritional supplements and daily exercises to elderly patients with mobility limitation. The preliminary results showed that in clinical studies targeting elderly population with mobility limitations, the summary scores of SF-36 trended to have weak and nonsignificant association with a decreased risk of poor adherence to both exercise completion and product consumption while CES-D has no association.

Denna uppsats behandlar två forskningsfrågor; “Vilka kommunikationsstrategier använder SF media för att utforma målgruppspaket?” och ”På vilket sätt upprätthålls stereotyper genom SF medias målgrupper?” Teorier vi använt oss av i arbetet med denna uppsats är kommunikationsprocesser och målgruppsanalys med fokus på reklam. För att söka svar på våra forskningsfrågor som behandlar ämnen som SF medias reklamutformning och hur deras målgrupper fungerar i marknadsföringssyfte har vi valt att använda oss av två olika metoder för insamling av material. Dels har vi genomfört en egen observationsstudie där fyra biobesök på SF bio där varje film vi såg representerade en av de fyra målgrupper som SF media utformat i syfte att nå sin publik på bästa möjliga sätt. Vi har intervjuat marknadschefen på SF media, och ställt frågor med utgångspunkt i våra forskningsfrågeställningar. Vi har även talat med en person som är verksam för undersökningsföretaget Orvesto. Orvesto listas som källa till de målgruppsbeskrivningar SF media presenterar på sin hemsida. Vi redovisar vårt resultat i ett kodningsschema som har en kodningsmanual till bakgrund för en tydlig avläsning och tolkning av schemat. Därefter följer en analys där vi lägger fram och analyserar den information som kodningsschemat visar samt komparerar detta med data från de kvalitativa intervjuerna. Diskussionen behandlar således upptäckta skillnader mellan uttalanden från intervjupersonerna och den data vi fått in genom den egna observationsstudien. I slutsatsen kommer vi fram till att SF media arbetar utifrån ett systemperspektiv snarare än ett klassiskt perspektiv. De hävdar en sak men praktiserar en annan. Deras målgrupper upprätthåller stereotypa bilder av kärnfamiljen, unga kvinnor och män samt den äldre pensionären.

Depression is a heterogeneous condition characterised by low mood and a lack of motivation and enjoyment of regular activities. The response rate to current treatments coupled with adverse side effect profiles requires new avenues of investigation into the development of novel therapeutics to treat the condition. Rearing rats in isolation from weaning causes behavioural, cognitive and neurochemical changes which persist into adulthood; some of the symptoms produced have relevance to depression. In the current thesis, rats raised in social isolation from weaning consistently developed a hyperactive phenotype compared to group-housed littermates when placed into a novel environment. They also developed deficits in associative learning assessed by the conditioned fear response task. They displayed some anxiety-like behaviours in the open field and novelty-suppressed feeding task and deficits in visual memory in the novel object discrimination task, although these were not reliable across cohorts. There was a reduction in levels of hippocampal neurogenesis in a number of cohorts and for the first time it was demonstrated that rats reared in isolation exhibited changes in gut bacteria, opening up a potential new avenue of investigation into potential treatments. The efficacy of novel versus established antidepressant treatments was evaluated in isolated rats. Chronic fluoxetine had some anxiolytic effects in the open field, attenuated isolation induced changes in associative memory and increased neurogenesis but also had inconsistent effects on activity. Treatment with acute ketamine increased freezing time in the conditioned freezing response task, indicating an improvement in associative memory. The final study examined, for the first time, the effect of treatment with the JNK-1 inhibitor DJNKI in isolation reared rats. DJNKI had some positive cognitive effects in both the novel object discrimination task and the conditioned freezing response task. In conclusion, the isolation rearing model induced varying levels of depression-like deficits, which were responsive to some treatments. The model is a useful tool for investigating the symptoms of depression and evaluating novel treatment options.