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Lutein is selectively taken up by the primate retina and plays an important role as a filter for harmful blue light and as an antioxidant. Recent studies have shown that lutein has systemic anti-inflammatory properties. Dietary lutein has been associated with reduced circulating levels of inflammatory biomarkers such as CRP and sICAM. Whether lutein also affects activation of the complement system has not yet been addressed and was the purpose of the study described here. Seventy-two subjects with signs of early macular degeneration were randomly assigned to receive either a 10 mg lutein supplement or a placebo during one year. EDTA blood samples were collected at 0, 4, 8 and 12 months. Complement factor D (CFD), a rate limiting component of the alternative pathway of complement activation and the complement activation products C5a and C3d were determined in the plasma samples by ELISA. A significant 0.11 µg/ml monthly decrease in plasma CFD concentration was observed in the lutein group (p<0.001), resulting in a 51% decrease from 2.3 µg/ml at baseline to 1.0 µg/ml at 12 months. The C5a concentration showed a significant 0.063ng/ml monthly decrease in the lutein group (p<0.001) resulting in a 36% decrease from 2.2ng/ml at baseline to 1.6ng/ml at 12 months. The C3d concentration showed a significant 0.19µg/ml monthly decrease in the lutein group (p=0.004) that gave rise to a 9% decrease from 15.4µg/ml at baseline to 14.4µg/ml at 12 months. In the placebo group we found a significant 0.04 µg/ml monthly decrease in plasma CFD concentration, whereas no changes were observed for C5a and C3d. Lutein supplementation markedly decreases circulating levels of the complement factors CFD, C5a and C3d levels, which might allow a simple method to control this inflammatory pathway of the innate immune system.

The study presented here had two main objectives: 1) to evaluate and test under clinical conditions a new device (MPS 9000) designed for Macular Pigment Optical Density (MPOD) measurements and 2) to investigate whether MP enhancement due to lutein supplementation has any functional benefits in early stage AMD. The MPS 9000 measures MPOD based on the principles of Heterochromatic Flicker Photometry (HFP). The device was calibrated, tested for repeatability and evaluated against an optical technique for measuring MPOD, the Macular Pigment Reflectometer (MPR). The validity of a novel feature the MPS 9000 incorporates, that makes feasible the estimation of MPOD based on the age of the observer, was investigated. The outcomes of three pilot studies designed for testing the performance of the MPS 9000 under clinical conditions are reported. They investigate the relation of MPOD to ethnicity, MPOD distribution in a large data set (5616 eyes) and MPOD differences between ARM patients and age-matched normals. In chapter five are presented MPOD spatial profiles collected with the MPS 9000 and the MPR. This study provides insight into the systematic differences widely described in the literature between optical based and flicker based techniques for estimating MPOD. A 12 month double-blind placebo-controlled lutein supplementation clinical trial was conducted in the University of Manchester and the University of Maastricht. The thirty seven ARM patients recruited in Manchester were asked to take either lutein supplements or placebo capsules for the period of 12 months. During the time course of the study, their Visual Acuity (VA), Contrast Sensitivity (CS) and Dark Adaptation (DA) were measured. MPOD levels were recorded with the MPS 9000. The outcomes of the Lutein Supplementation study suggest a positive effect of lutein on MPOD levels and the kinetics of DA of the participants taking lutein. No statistically significant effect was found for the CS and the VA.

This portfolio represents the culmination of the three year training of becoming a Counselling Psychologist. It aims to reflect my personal and professional development through the presentation of three different dossiers, an academic, a therapeutic and a research dossier. The academic dossier incorporates three essays from three different years. The first year essay explores how the literature on the development of eating disorders in males may be of use to Counselling Psychologists working with this client group. The second year essay provides a comparative analysis of Freud's and Jung's views on religion, and finally the third year essay discusses depression through an evolutionary perspective. The therapeutic dossier aims to shed light on my clinical experience through descriptions of my placements and my placement activities and also it addresses my therapeutic practice through a reflective account of my personal and professional development as an emerging Counselling Psychologist. Finally, the research dossier consists of my literature review and my two qualitative projects. My literature review critically explores relevant research regarding the experience and psychological well-being for carers of relatives who experience psychosis. My first qualitative study employed Interpretative Phenomenological Analysis (IPA) to explore the experience for carers of relatives with psychosis and particularly their understanding and responses to voice hearing. Finally my second qualitative study employed Grounded Theory so as to provide the basis for theory building regarding the experience of facilitators of groups for carers of people experiencing severe mental health difficulties.

This portfolio represents the culmination of the three year training of becoming a Counselling Psychologist. It aims to reflect my personal and professional development through the presentation of three different dossiers, an academic, a therapeutic and a research dossier. The academic dossier incorporates three essays from three different years. The first year essay explores how the literature on the development of eating disorders in males may be of use to Counselling Psychologists working with this client group. The second year essay provides a comparative analysis of Freud's and Jung's views on religion, and finally the third year essay discusses depression through an evolutionary perspective. The therapeutic dossier aims to shed light on my clinical experience through descriptions of my placements and my placement activities and also it addresses my therapeutic practice through a reflective account of my personal and professional development as an emerging Counselling Psychologist. Finally, the research dossier consists of my literature review and my two qualitative projects. My literature review critically explores relevant research regarding the experience and psychological well-being for carers of relatives who experience psychosis. My first qualitative study employed Interpretative Phenomenological Analysis (IPA) to explore the experience for carers of relatives with psychosis and particularly their understanding and responses to voice hearing. Finally my second qualitative study employed Grounded Theory so as to provide the basis for theory building regarding the experience of facilitators of groups for carers of people experiencing severe mental health difficulties.

Lutein is selectively taken up by the primate retina and plays an important role as a filter for harmful blue light and as an antioxidant. Recent studies have shown that lutein has systemic anti-inflammatory properties. Dietary lutein has been associated with reduced circulating levels of inflammatory biomarkers such as CRP and sICAM. Whether lutein also affects activation of the complement system has not yet been addressed and was the purpose of the study described here. Seventy-two subjects with signs of early macular degeneration were randomly assigned to receive either a 10 mg lutein supplement or a placebo during one year. EDTA blood samples were collected at 0, 4, 8 and 12 months. Complement factor D (CFD), a rate limiting component of the alternative pathway of complement activation and the complement activation products C5a and C3d were determined in the plasma samples by ELISA. A significant 0.11 mu g/ml monthly decrease in plasma CFD concentration was observed in the lutein group (p<0.001), resulting in a 51% decrease from 2.3 mu g/ml at baseline to 1.0 mu g/ml at 12 months. The C5a concentration showed a significant 0.063ng/ml monthly decrease in the lutein group (p<0.001) resulting in a 36% decrease from 2.2ng/ml at baseline to 1.6ng/ml at 12 months. The C3d concentration showed a significant 0.19 mu g/ml monthly decrease in the lutein group (p=0.004) that gave rise to a 9% decrease from 15.4 mu g/ml at baseline to 14.4 mu g/ml at 12 months. In the placebo group we found a significant 0.04 mu g/ml monthly decrease in plasma CFD concentration, whereas no changes were observed for C5a and C3d. Lutein supplementation markedly decreases circulating levels of the complement factors CFD, C5a and C3d levels, which might allow a simple method to control this inflammatory pathway of the innate immune system.

A rapid portable technique for estimating macular pigment optical density (MPOD) in large populations is described. The new instrument utilises a novel method for setting flicker thresholds which is undemanding for naive and elderly observers and easily operated by a non-technical person. The method has good repeatability (r = 0.97) and the data are comparable with an optical method based on retinal reflectometry (r = 0.78). MPOD spatial profiles are presented for seven normal observers and these are well described (r = 0.99) by a decaying exponential function consistent with previous reports. MPOD values are presented from 5581 (2435 females and 3146 males) individuals measured in 48 optometric practices. The mean MPOD of this population was 0.33 (S.D. ± 0.187) which is similar to previous large scale studies of MP. (11 pages)

In Figure 2a we present MP data, collected using the M-POD for 166 patients from an optometrist practice in the Midwest of the US. Figure 2b shows the age distribution of this population; the oldest was 86 years old and the youngest 27. There were 106 females. The x-axis indicates the MPOD at baseline and the y-axis represents the increase in MPOD following daily supplementation over an 18-month period with Eye Promise Restore (ZeaVision LLC, MO, USA) which contains 4mg L and 8mg Z.

Background Brucellosis is a zoonotic disease whose causative agent, Brucella spp., is endemic in many countries of the Mediterranean basin, including Greece. Although the occurrence of brucellosis must be reported to the authorities, it is believed that the disease is under-reported in Greece, and knowledge about the genomic diversity of brucellae is lacking. Methods Thus, 44 Brucella isolates, primarily B. melitensis , collected between 1999 and 2009 from humans and small ruminants in Greece were subjected to whole genome sequencing using short-read technology. The raw reads and assembled genomes were used for in silico genotyping based on single nucleotide substitutions and alleles. Further, specific genomic regions encoding putative virulence genes were screened for characteristic nucleotide changes, which arose in different genotype lineages. Results In silico genotyping revealed that the isolates belonged to three of the known sublineages of the East Mediterranean genotype. In addition, a novel subgenotype was identified that was basal to the other East Mediterranean sublineages, comprising two Greek strains. The majority of the isolates can be assumed to be of endemic origin, as they were clustered with strains from the Western Balkans or Turkey, whereas one strain of human origin could be associated with travel to another endemic region, e.g. Portugal. Further, nucleotide substitutions in the housekeeping gene rpoB and virulence-associated genes were detected, which were characteristic of the different subgenotypes. One of the isolates originating from an aborted bovine foetus was identified as B. abortus vaccine strain RB51. Conclusion The results demonstrate the existence of several distinct persistent Brucella sp. foci in Greece. To detect these and for tracing infection chains, extensive sampling initiatives are required.

Water distribution systems in hotels have been related to outbreaks caused by spp. Certain measures, including disinfection by chlorination, maintaining increased temperatures are usually undertaken to prevent outbreaks. However, these preventive strategies are not always effective, since there are several factors (e.g., synergistic interactions with other microbes, physico-chemical factors, biofilm formation, availability of nutrients) that promote survival and proliferation of the pathogen in water pipes., Accordingly, there is a need of a holistic approach in development of preventive models for outbreaks associated with water distribution systems. Water samples were collected from hotel water systems and were tested for the presence of , , total coliforms, total mesophilic count and . In each sample, temperature and chlorine were also tested. Other epidemiological factors were additionally recorded including number of rooms, stars, proximity of sampling point to the boiler, etc. Data were processed by generalized linear analysis, and modeling based on logistic regression analysis to identify independent predictive factors associated with the presence of in hotel water systems. According to the generalized linear model, temperature affected (p<0.05) the presence of regardless of the species or the water supply (hot or cold). Additionally, opportunistic ( ) or non-opportunistic ( , coliforms) pathogens were significantly associated (p<0.05) with the presence of all species. Temperature also exhibited a positive effect to all pathogens tested except for according to the linear model. Multivariate analysis showed that , total coliforms, HPC and temperature had a statistically significant effect on the presence of . Based on a binomial model, cold water had a positive effect on . Type of sampling and proximity of the sample to the boiler seemed to pose different effect on depending on the cfu/L. The number of hotel stars and rooms did not appear to have any effect in all tested models. Collectively, these results indicate the need for development of individualized water safety plans tailored by the presence of other microbiological agents, and unique physico-chemical factors, which could facilitate the survival of .in hotel water systems.

Tick-borne infections are the most common vector-borne diseases in the USA. Ticks harbor and transmit several infections with Lyme disease being the most common tickborne infection in the US and Europe. Lack of awareness about tick populations, specific diagnostic tests, and overlapping signs and symptoms of tick-borne infections can often lead to misdiagnosis affecting treatment and the prevalence data reported especially for non-Lyme tick-borne infections. The diagnostic tests currently available for tick-borne diseases are severely limited in their ability to provide accurate results and cannot detect multiple pathogens in a single run. The multiplex protein microarray developed at Vibrant was designed to detect multiple serological antibodies thereby detecting exposure to multiple pathogens simultaneously. Our microarray in its present form can accommodate 400 antigens (molecules that can bind to specific antibodies) and can multiplex across antigen types, whole cell lysates, recombinant proteins, and peptides. A designed array containing multiple antigens of several microbes including Borrelia burgdorferi , the Lyme disease spirochete, was manufactured and evaluated. The immunoglobulin M (IgM) and G (IgG) responses against several tick-borne microbes and other infectious agents were analyzed for analytical and clinical performance. The microarray improved IgM and IgG sensitivities and specificities of individual microbes when compared with the respective gold standards. The testing was also performed in a single run in comparison to multiple runs needed for comparable testing standards. In summary, our study presents a flexible multiplex microarray platform that can provide quick results with high sensitivity and specificity for evaluating exposure to varied infectious agents especially tick-borne pathogens.