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Kinds of UK Terms modified by UK Selected AbstractsAllergic contact dermatitis from modified colophonium in wound dressingsCONTACT DERMATITIS, Issue 1 2007Teresa M. Pereira This study concerns a 69-year-old female patient with a longstanding history of venous ulcerations on both lower legs and multiple sensitivities, who developed eczematous lesions with the hydrocolloid dressing Combiderm® (Convatec Ltd., a Bristol-Myers Squibb division, Ickenham, Middlesex, UK). Epicutaneous tests were positive to this dressing and to a modified colophonium derivative, i.e. glyceryl rosinate, however not to the unmodified colophonium from the standard series. A review of the literature showed several case reports about sensitization to similar hydrocolloids being distributed under various brand names in different countries and which contain the pentaerythritol ester of the hydrogenated rosin as the tackifying agent. Some of the patients described did, while others did not, react to colophonium but only to a modified derivative. In our patient, the reaction to glyceryl rosinate most probably represent cross-sensitivity with the modified colophonium derivative used in Combiderm®, the presence (but not the exact nature) of which was showed by the company. In patients where allergic contact dermatitis from hydrocolloid dressings is strongly suspected and colophonium tests negatively, patch testing to modified colophonium derivatives should therefore be performed. As the complete composition of wound dressings is most often unknown, we urgently advocate legal requirements for labelling of those and in fact all medically used devices. [source] A multicentre review of the hairdressing allergens tested in the UKCONTACT DERMATITIS, Issue 3 2005Ruwani P. Katugampola Allergens used for patch testing in the hairdressing series vary between dermatology centres in the UK. The aim of our study is to ascertain the hairdressing allergens currently in use and their test results in several dermatology centres in the UK. Data were obtained from databases in 9 dermatology departments. The allergens with positive results and current/past relevance were included in a new hairdressing series based on collective experience, for wider use and further evaluation. [source] FS11.1 Primula obconica , a falling allergenCONTACT DERMATITIS, Issue 3 2004Maureen Connolly Objective:, We believe the incidence of primula contact allergic dermatitis has fallen since the introduction of primin-free primula onto the European market and thus our study aims were twofold. Firstly to see if the incidence of primula contact allergic dermatitis was truly on the decline and secondly to confirm the presence and document retailers' knowledge and awareness of primin-free primula in the UK. Methods:, A questionnaire was sent to 22 contact dermatitis departments throughout the UK and Ireland looking at the number of primin positive patch tests in the years 1995/96, 1998, 2000 and 2002 compared with the total number of patch tests. 10 seed suppliers and 12 plant retailers were asked to complete a telephone survey. Results:, We showed a significant fall in the yearly incidence of contact allergy to primin from 0.785% in 1995/96 to 0.457% in 2002. This downward trend was statistically significant (p = 0.001). The telephone survey showed 90% of seed suppliers were aware that the older varieties of P. obconica could cause an allergic reaction whereas only 60% of them were aware that new primin-free varieties were now being bred. 50% of suppliers were in fact selling these primin-free varieties with 60% of them stocking a primin-free variety exclusively. 90% of retailers were not currently selling any variety of P. obconica. Conclusion:, Our study shows that the incidence of primula contact dermatitis is falling. The overall trend is moving towards primin-free varieties provided they continue to be horticulturally viable long term. [source] Solidarity and Difference: A Contemporary Reading of Paul's EthicsCONVERSATIONS IN RELIGION & THEOLOGY, Issue 1 2006Article first published online: 24 APR 200 Books reviewed: Solidarity and Difference: A Contemporary Reading of Paul's Ethics, David G. Horrell Reviewed by Leslie Houlden Temple Balsall, UK Response to Leslie Houlden By David G. Horrell University of Exeter, UK [source] Roman Wives, Roman Widows: The Appearance of New Women and the Pauline CommunitiesCONVERSATIONS IN RELIGION & THEOLOGY, Issue 1 2006Article first published online: 24 APR 200 Books reviewed: Roman Wives, Roman Widows: The Appearance of New Women and the Pauline Communities, Bruce W. Winter Reviewed by Helen K. Bond School of Divinity Edinburgh University, UK Response to Helen Bond By Bruce W. Winter University of Cambridge, UK [source] Antecedents of Shareholder Activism in Target Firms: Evidence from a Multi-Country StudyCORPORATE GOVERNANCE, Issue 4 2010William Q. Judge ABSTRACT Manuscript Type: Empirical Research Question/Issue: This study seeks to better understand the antecedents of shareholder activism targeted at firms located in three common law countries (i.e., USA, UK, and Australia) and three civil law countries (Japan, Germany, and South Korea) during the 2003,07 time period. Research Findings/Insights: Our findings suggest that the antecedents of shareholder activism vary by the motivation of the activist. We demonstrate that activists target firms with two motives (a) to improve the financial performance, and (b) to improve the social performance of the firm. With respect to the target firm level antecedents, we find that firm size is unrelated to financial activism, but positively related to social activism; ownership concentration is negatively related to both financial and social activism; and prior profitability is negatively related to financial activism, but positively related to social activism. Further, these relationships in the case of financial activism are generally stronger in common law legal systems, whereas those in the case of social activism are generally stronger in environments with a greater level of income inequality. Theoretical/Academic Implications: Our findings suggest that future research should differentiate between the motivations of the activism event. Further, we find that while agency logic works well for financial activism, institutional theory provides stronger explanations for social activism. Overall, we demonstrate the complementary nature of these two theories in explaining shareholder activism. Practitioner/Policy Implications: We found that the "exposure" to shareholder activism varies by the motivation of the activist, and the nature of the firm and its national context. An understanding of these issues would help firms develop proper response strategies to activism events. [source] Corporate Governance Codes and the Supply of Corporate Information in the UKCORPORATE GOVERNANCE, Issue 5 2006Lynsey Sheridan There have been a number of changes in United Kingdom corporate governance regulation since the financial scandals of the late 1980s and early 1990s. These developments, commencing with the publication of the Cadbury Report in 1992, address "the frequency, clarity and form in which information should be provided" (Cadbury Report, 1992, p. 60). This paper examines the increased flow of corporate news announcements by UK listed companies following the introduction of corporate governance codes. Our results indicate that the introduction of the Cadbury, Greenbury and Hampel reports was accompanied by a significant increase in the number of news announcements. [source] Corporate Governance and Social Responsibility: a comparative analysis of the UK and the US,CORPORATE GOVERNANCE, Issue 3 2006Ruth V. Aguilera This paper argues that key differences between the UK and the US in the importance ascribed to a company's social responsibilities (CSR) reflect differences in the corporate governance arrangements in these two countries. Specifically, we analyse the role of a salient type of owner in the UK and the US, institutional investors, in emphasising firm-level CSR actions. We explore differences between institutional investors in the UK and the US concerning CSR, and draw on a model of instrumental, relational and moral motives to explore why institutional investors in the UK are becoming concerned with firms' social and environmental actions. We conclude with some suggestions for future research in this area. [source] Comparative Corporate Governance: the experience between China and the UKCORPORATE GOVERNANCE, Issue 1 2005Guy S. Liu First page of article [source] Prolonged exposure to inhaled nitric oxide transiently modifies tubular function in healthy piglets and promotes tubular apoptosisACTA PHYSIOLOGICA, Issue 4 2009W. Go, dzik Abstract Aim:, Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator. We hypothesized that those piglets exposed to prolonged iNO react with a modified renal function. Methods:, Randomized, placebo-controlled exposure to 40 p.p.m. iNO (30 h) in piglets (n = 20). Plasma and urine were sampled during three periods (first and second 12 h periods, and finally a 6 h period). We measured urine volumes, plasma and urine electrolytes (UNa, UK, UCl), plasma creatinine and urea. We calculated creatinine clearance (Ccr), and fractional excretions of sodium and potassium (FENa, FEK) and urinary excretions of electrolytes (UENa, UEK, UECl). Haemodynamic data were recorded and renal tubular apoptosis detected. Results:, For the first 12 h, certain parameters significantly increased in the iNO group (mean ± SD): UNa (mmol L,1), 87.7 (±35.0) vs. 39.3 (±22.9), UCl (mmol L,1) 80.4 (±32.8) vs. 48.0 (±26.7), FENa (%) 2.1 (±0.8) vs. 0.7 (±0.5), FEK (%) 31.7 (±7.0) vs. 20.7 (±12.3), as well as UENa (mmol) 61.0 (±21.1) vs. 27.6 (±17.9) and UECl (mmol) 57.3 (24.5) vs. 37.6 (29.0). These changes were absent in the second and third periods of the study. Significant differences in percentage of apoptotic cell nuclei in the renal cortex and medulla were found after iNO exposure: 39% vs. 15%. Conclusion:, Exposure to 40 p.p.m. iNO in healthy anaesthetized piglets has a transient natriuretic effect that disappears after 12 h. We also found evidence of renal tubular apoptosis promotion after 30 h of iNO. [source] How can SMEs effectively implement the CSR agenda?CORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 3 2004A UK case study perspective This paper focuses on implementation of the CSR agenda in small-to-medium enterprises (SMEs) and reports on research findings from an action research case study that has been conducted in a UK based SME. The case study research demonstrates how the CSR agenda has been implemented using ISO 9001:2000 as a platform and what benefits the case study organization has gained from this approach. These results are compared with a UK survey on feasibility of CSR for SMEs conducted by the UK's Department of Trade and Industry and parallels are drawn. Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment. [source] Managing the interface between suppliers and organizations for environmental responsibility , an exploration of current practices in the UKCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 2 2004Diane Holt This paper examines the supplier management activities undertaken by a sample of 149 UK based organizations, with particular focus on the role of supplier assessment and supplier coaching, education or mentoring. This study identifies that larger, higher risk organizations are beginning to reach out to their suppliers, primarily through assessment and evaluation, and to a lesser extent through supplier education, mentoring or coaching. Copyright © 2004 John Wiley & Sons, Ltd and ERP Environment. [source] Stakeholder accountability or stakeholder management: a review of UK firms' social and ethical accounting, auditing and reporting (SEAAR) practicesCORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 1 2002Ataur Rahman Belal The main aim of this study is to undertake an evaluation of the initial wave of stand-alone social reports issued by the major market players in the UK using AA1000 as an evaluative tool, or benchmark, in order to ascertain the extent to which they conform to the provisions of AA1000, in particular the core principles of accountability and inclusivity. Applying the lens of the stakeholder model the paper examines to what extent contemporary SEAAR practices in the UK are likely to promote stakeholder accountability, or whether they are simply exercises in stakeholder management. Copyright © 2002 John Wiley & Sons, Ltd and ERP Environment. [source] Prison staff and women prisoner's views on self-harm; their implications for service delivery and development: A qualitative studyCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2010Cassandra Kenning Background,Rates of self-harm are high among women in prison in the UK. This is the first study to compare the views and attitudes of prison staff and women prisoners and to look at the effects of these attitudes on prisoner/staff relationships. Aims,To explore understanding of self-harm among women prisoners, prison officers and health-care staff and how their perceptions might influence service provision and development. Method,Semi-structured interviews were conducted with women prisoners who self-harm and with staff at a women's prison. Data were analysed thematically. Results,Prison officers often attributed motives to self-harm such as ,manipulation' and ,attention-seeking', whereas descriptions by women prisoners, prison governors and health-care staff suggested explanations in affect regulation or self-punishment. Conclusions,Differences between prison officers and other staff working in the prison in their understanding of self-harm by women prisoners may lie in training differences, but there may be other explanations such as self-protection/coping strategies. More training and support for officers may result in improved staff,prisoner relationships and thus, safer service provision. Copyright © 2010 John Wiley & Sons, Ltd. [source] The significance of protective factors in the assessment of riskCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2010Charlotte E. Rennie Background,Few studies have explored protective factors in the assessment of risk, despite acknowledgement that protective factors may play an important role. Aim,To examine the significance of protective factors in assessment of risk using the Structured Assessment of Violence Risk in Youth (SAVRY). Method,The SAVRY was completed on 135 male adolescents in custody in the UK. Data on previous offending and childhood psychopathology were collected. Participants were prospectively followed up at 12 months using data from the Home Office Police National Computer (HOPNC). Results,Participants with protective factors were older when first arrested, were less prolific offenders and had fewer psychopathological problems. The number of protective factors present was significantly higher for participants who did not re-offend during the follow-up. The total number of SAVRY protective factors significantly predicted desistance at follow-up and resilient personality traits constituted the only significant individual protective factor. Conclusions and implications,Protective factors might buffer the effects of risk factors and a resilient personality may be crucial. Recognition of protective factors should be an essential part of the risk management process and for interventions with high-risk adolescents to reduce re-offending. Copyright © 2010 John Wiley & Sons, Ltd. [source] Evaluation of a treatment programme for alcohol-related aggressionCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2008Anna McCulloch Background,The development of effective treatments for alcohol-related aggression and violence is important in binge drinking cultures, as in parts of the UK. Aim,The aim was to evaluate the progress and experience of 10 participants in Control of Violence for Angry Impulsive Drinkers (COVAID) using a single case methodology. Method,Participants completed 10 individual weekly sessions with trained facilitators following the COVAID manual. Change scores on psychometric questionnaires were examined by calculating clinical significance and reliability of change. Self-reports of alcohol consumption and aggression were examined. Follow-up data on convictions were collected. Participants were asked their opinions about COVAID. Results,Scores on the Alcohol-Related Aggression Questionnaire (ARAQ) improved for nine participants; change was both clinically significant and reliable in five cases. Nine participants improved on the Controlled Drinking Self-Efficacy Scale (CDSES), with seven showing clinically significant improvement. Six participants reported a reduction in alcohol consumption from the first to the second half of the programme. At a mean of 29 weeks post-treatment, none of the participants had been reconvicted for a violent offence. Participants reported finding COVAID useful and interesting. Conclusion,Overall, our findings support the possibility that COVAID may assist in reducing alcohol-related violence and violent offending. Copyright © 2008 John Wiley & Sons, Ltd. [source] Psychometric properties of the Beck Depression Inventory-II with incarcerated male offenders aged 18,21 yearsCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2008Emma J. Palmer Background,The Beck Depression Inventory , Second Edition (BDI-II) is a self-report measure of depression. Studies have shown it to have good psychometric properties with adult and adolescent clinical and non-clinical populations. However, this research has mostly been conducted with North American samples. Aims/hypotheses,To examine the psychometric characteristics of the BDI-II with male young adult offenders in the UK. Methods,The BDI-II was administered to 117 incarcerated male young adult offenders aged 18,21 years from the UK. Results,The BDI-II showed good internal consistency and concurrent validity. Factor analysis revealed two factors, relating to cognitive-affective items and somatic items. The items loading on the two factors were very similar to those found in a North American adolescent (13,17 years) psychiatric inpatient sample. Conclusions and implications for future research,The findings suggest that the BDI-II can be used with confidence in young adult male offenders. It would be useful to confirm its psychometric properties in other offender samples and establish offender population norms. Copyright © 2008 John Wiley & Sons, Ltd. [source] An exploration of research into substance misuse and psychiatric disorder in the UK: what can we learn from history?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2007Ilana B. Crome Background and aim,This review explores UK-based research developments in substance misuse and mental illness over the last 25 years. The main body of work comprises policy-orientated projects funded by the Department of Health from the late 1990s. Early research tended to focus on alcohol, especially alcoholic hallucinosis: the relationship of the latter with schizophrenia-like illness was examined, with the finding that very few cases did develop into schizophrenia. Method and implications,Parallels are drawn with the current debate around the link between cannabis and psychosis, urging caution in too rapid an assertion that cannabis is necessarily ,causal'. The clinical and policy implications of the misinterpretation of evidence are discussed. A proposal is put forward that the genesis of psychotic illness in alcohol misuse be revisited using more sophisticated research methodologies. Given the changing landscape of substance use in the UK, particularly the fashion of polysubstance use and the recognition that this is associated with psychotic illness, other drugs that are associated with psychotic illness should be similarly investigated to determine whether there is a common mechanism that might throw light on understanding the relationship between substance use and psychotic illness or schizophrenia. Copyright © 2007 John Wiley & Sons, Ltd. [source] Using the SWAP-200 in a personality-disordered forensic population: is it valid, reliable and useful?CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2005Luisa E. Marin-Avellan Background Treatment and risk management of forensic patients relies heavily on diagnosing psychopathology, yet the reliability of clinical diagnoses of personality disorder has been found to be only fair to low. Structured instruments for the global assessment of personality disorder are infrequently used in clinical assessments possibly due to their limited validity and clinical utility. Aims/methods The Shedler-Westen Assessment Procedure-200 (SWAP-200) was developed in an effort to address these limitations. Although good reliability and validity in relation to clinicians' diagnosis of personality disorder has been reported, to date the validity of this instrument has not been assessed in relation to other standardized instruments or in a personality-disordered, forensic population. This study aims to establish the reliability and validity of the SWAP-200 against other diagnostic instruments and measures of interpersonal functioning in a personality disordered forensic population. Results This paper reports the results of 30 subjects from a high secure hospital in the UK who were assessed with the SWAP-200, the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II), the Adult Attachment Interview (AAI) and the Chart of Interpersonal Reactions in Closed Living Environments (CIRCLE). Preliminary results suggest that the SWAP-200 is a reliable instrument for the diagnosis of personality disorder in forensic patients. Conclusions Although the small sample size allows only preliminary conclusions about the validity of this instrument, early results show a reduction of the diagnosis of comorbidity compared with the SCID-II, together with an increased number of expected associations between independent measures of interpersonal functioning and categories of personality disorder. Copyright © 2005 Whurr Publishers Ltd. [source] Quality of life for patients with a personality disorder , comparison of patients in two settings: an English special hospital and a Dutch TBS clinicCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2001Dr Mark Swinton Consultant Forensic Psychiatrist Introduction There are differing approaches to the management of people with a severe personality disorder in the UK and The Netherlands. Few comparative studies exist. This study describes the use of an adapted version of the Lancashire Quality of life profile as a patient based-outcome measure. Method A cross-sectional sample of 37 patients was interviewed at each site. Result Patients in the Dutch service reported a significantly higher quality of life which could not be explained by better objective circumstances. Discussion The data collected do not explain why the Dutch patients reported a higher quality of life. It is suggested that this finding was related to more extensive therapeutic activity and greater therapeutic optimism in the Dutch service. There is a need for critical scrutiny of the appropriateness of quality of life measures in offender patients before they are accepted for use as an outcome measure. Copyright © 2001 Whurr Publishers Ltd. [source] Universities in the UK: drowning by numbers IntroductionCRITICAL QUARTERLY, Issue 1-2 2005Gillian Howie First page of article [source] The politics of risk and trust in mental healthCRITICAL QUARTERLY, Issue 3 2004John Wilkinson This essay provides a critical account of Risk Society theory through analysis of an article by ,I,ek on human genetics research, using this as a basis for distinguishing a range of meanings of 'risk' and describing their interplay within the mental health domain. The paper argues that mental health policy in the UK has been distorted through a preoccupation with a supposedly scientific practice of risk assessment which uncannily reflects popular and tabloid prejudice. It is argued that Risk Society theory does not, as its proponents claim, supersede the politics of inclusion and exclusion, so much as overlay and disguise them. The importance of Risk Society theory in the development of Third Way politics would invite a similarly critical view of a range of contemporary British social policy. [source] The BSCC Code of Practice , exfoliative cytopathology (excluding gynaecological cytopathology)CYTOPATHOLOGY, Issue 4 2009A. Chandra Exfoliative cytopathology (often referred to as non-gynaecological cytology) is an important part of the workload of all diagnostic pathology departments. It clearly has a role in the diagnosis of neoplastic disease but its role in establishing non-neoplastic diagnoses should also be recognised. Ancillary tests may be required to establish a definitive diagnosis. Clinical and scientific teamwork is essential to establish an effective cytology service and staffing levels should be sufficient to support preparation, prescreening, on-site adequacy assessment and reporting of samples as appropriate. Routine clinical audit and histology/cytology correlation should be in place as quality control of a cytology service. Cytology staff should be involved in multidisciplinary meetings and appropriate professional networks. Laboratories should have an effective quality management system conforming to the requirements of a recognised accreditation scheme such as Clinical Pathology Accreditation (UK) Ltd. Consultant pathologists should sign out the majority of exfoliative cytology cases. Where specimens are reported by experienced biomedical scientists (BMS), referred to as cytotechnologists outside the UK, this must only be when adequate training has been given and be defined in agreed written local protocols. An educational basis for formalising the role of the BMS in exfoliative cytopathology is provided by the Diploma of Expert Practice in Non-gynaecological Cytology offered by the Institute of Biomedical Science (IBMS). The reliability of cytological diagnoses is dependent on the quality of the specimen provided and the quality of the preparations produced. The laboratory should provide feedback and written guidance on specimen procurement. Specimen processing should be by appropriately trained, competent staff with appropriate quality control. Microscopic examination of preparations by BMS should be encouraged wherever possible. Specific guidance is provided on the clinical role, specimen procurement, preparation and suitable staining techniques for urine, sputum, semen, serous cavity effusion, cerebrospinal fluid, synovial fluid, cyst aspirates, endoscopic specimens, and skin and mucosal scrapes. [source] Head and neck cancer in the UK: what is expected of cytopathology?CYTOPATHOLOGY, Issue 2 2009G. Kocjan Objective:, This review highlights the role of cytopathology in cancer management within UK Head and Neck Cancer Networks and informs on the issues raised by recent UK Department of Health documents and other UK professional guidance. UK guidance requires the formal involvement of cytopathologists within multidisciplinary cancer teams, with medical and non-medical cytopathology staff setting up and running rapid access lump clinics, and support for image-guided fine needle aspiration cytology (FNAC) services. UK guidance also makes recommendations for training, resources and quality control. This review also highlights the resource gap between best practice evidence-based guidance for head and neck (HN) cancer services and existing UK provision for cytopathology, as evidenced by lack of availability of experienced staff and adequacy of training and quality control (QC). Finally, it stresses the importance in the UK of the Royal College of Pathologists' guidance, which defines the need for training, the experience needed for new consultants, the requirements for audit and QC. The implications for the additional resources required for HN cancer cytopathology services are discussed. Recent professional guidance specifying the provision of HN cancer services in the UK includes a cytopathology service for cancer networks, such as rapid access FNAC clinics. Although these clinics already operate in some institutions, there are many institutions where they do not and where the provision of cytopathology services would have to be restructured. This would need the support of local cancer networks and their acceptance of the detailed requirements for cytopathology, including resources, training and QC. The standards are not defined locally, as Strategic Health Authorities and Primary Care Trusts have been instructed by the Department of Health to support, invest and implement them. [source] Cervical screening policies 2008 and beyondCYTOPATHOLOGY, Issue 2007R. Winder There are many developments in cytology and in the NHS that will impact on the NHS Cervical Screening Programme over the next few years. In the short term HPV is a major issue, whether triage, primary screening or vaccination with further evidence coming forward from NHS early implementers and from research trials. Cytology automation is also already being trialled for the UK. So far as NHS developments go, we already have the two Carter reports, one on pathology modernisation and one on commissioning are both likely to impact on our service, as is the forthcoming Cancer Reform Strategy which should be out in a few months time. This will set out a blue print for cancer services in 2012, by which time the cervical screening programme could have a very different shape. [source] Trials update in walesCYTOPATHOLOGY, Issue 2007A. Fiander Three ongoing studies will be presented and discussed. Prevalence of Human Papillomavirus Infection in a South Wales Screening population Methods: A total of 10 000 consecutive, anonymous liquid based cytology screening samples were collected over a five month period in 2004. Age, cytology result and social deprivation score was provided for each specimen. The methodology was chosen to ensure inclusion of all women attending routine cervical screening, avoiding potential constraints associated with obtaining individual informed consent. The liquid based cytology samples were processed and reported by the receiving cytology laboratory and the residual specimens sent to the HPV Research Laboratory, Wales College of Medicine, where they were processed and stored at -80°C until analysis. High risk and low risk HPV Typing was undertaken using PCR , EIA (Jacobs et al 1997). Full high risk typing was performed on HPV positive specimens. Results: The study population had a mean age of 38 years with 92% negative, 5% borderline and 3% dyskaryotic cytology. The average social deprivation score was 17.4 (based upon the Welsh Index of multiple deprivation). The following results will be presented: HPV prevalence by age. HPV prevalence by cytology result. Type specific HPV prevalence in single and multiple infection. Conclusion: This study represents the largest type specific HPV Prevalence Study in the UK to date. As such it will form a useful base line against which to access performance of marketed HPV tests and evaluating the impact following implementation of HPV vaccination. [Funded by Welsh Office for Research and Development] CRISP , 1 Study (Cervical Randomized Intervention Study Protocol -1) Background: Indole-3-carbinol (I3C) and Diindolylmethane (DIM) are found in cruciferous vegetables and have been identified as compounds that could potentially prevent or halt carcinogenesis. I3C spontaneously forms DIM in vivo during acid digestion. I3C has been shown to prevent the development of cervical cancer in HPV 16 transgenic mice and both I3C and DIM have been shown to promote cell death in cervical cancer cell models. DIM is the major active bi-product of I3C and preliminary data indicate that DIM is active in cervical dysplasia and may be better tolerated than I3C. Aim: To investigate chemoprevention of high grade cervical neoplasia using Diindolylmethane (DIM) supplementation in women with low grade cytological abnormalities on cervical cytology. Objectives: To observe any reduction in the prevalence of histological proven high-grade cervical intraepithelial neoplasia (CIN) after 6 months of supplementation. ,,To observe any reduction in the prevalence of cytological abnormalities. ,,To observe any changes in the clinical appearance of the cervix. To assess acceptability and monitor any side effects of DIM supplementation. ,,To assess whether any benefit is seen in relation to Human Papillomavirus (HPV) status including HPV Type, Viral load and integration. Methods: This is a double blind randomized placebo-controlled trial involving 600,700 women with low grade cytological abnormalities on a cervical smear. Randomization is in the ratio of 2 : 1 in favour of active medication. Women with first mildly dyskaryotic smear or second borderline smear are eligible. They are asked to take two capsules daily for 6 months. At the end of 6 months they undergo repeat cervical cytology, HPV testing and colposcopy. Results: A progress report will be given for this ongoing study. [Funded: - Cancer Research UK] Type Specific HPV Infection in Welsh Cervical Cancers Background: Whilst there have been numerous studies of HPV infection associated with cervical cancer and on prevalence of Human Papillomavirus in diverse populations there have been no studies of these variables in the same population. Against a background of prophylactic HPV vaccination it is important to assess potential protection against cervical cancer within a given population. The most comprehensive analysis of HPV type specific cervical cancer is a meta-analysis published by the IARC in 2003. This however included only three UK based studies, totalling 118 cases, 75 of which were only investigated by HPV type PCR for four high risk types. None of this data was presented with associated population based prevalence data. Therefore, the research objectives for this study in combination with the first study above, are as follows: To determine the frequency of specific HPV types in cervical cancers in Wales. To compare the distribution of specific HPV types amongst cervical cancers with their prevalence in the general population. This will allow accurate delineation of the relationship between prevalence of specific HPV types in the general population and their association with clinically relevant disease. This information is a pre-requisite to assess the potential impact of prophylactic vaccination against HPV infection in Wales. Methods: Welsh Cervical Cancer specimens from 2000,2005 will be identified from pathology departments within Wales. The pathology of each tumour will be reviewed by a single Gynaecological Pathologist. The age of the patient and pathological features of the tumour will be noted. DNA will be extracted from the paraffin sections and HPV typed by PCR-EIA. Results: A progress report will be given for this ongoing study. [Funded by Welsh Office for Research and Development] [source] CPA assessment , the regional assessors' experienceCYTOPATHOLOGY, Issue 2007E. Welsh Many individuals within Laboratory Medicine will be unaware that CPA conducts assessments to two different sets of CPA Standards. There are the Standards for the Medical Laboratory and the Standards for EQA Schemes in Laboratory Medicine. The style and format of both sets of standards is very similar with each being presented in eight sections A , H. The EQA standards are almost identical to the laboratory standards with the exception of the E.F and G standards which are specific to EQA schemes. There are approximately 40 EQA Schemes registered with CPA compared with almost 2 500 laboratories. These EQA schemes vary from very large national/international schemes with numerous analytes to small interpretive schemes run by one individual with a personal interest in that specific subject. The large schemes usually come under the UKNEQAS consortia banner and due to their size and configuration do not present undue problems in the assessment process. Smaller interpretive EQA schemes present a challenge both for the scheme and CPA in gaining accreditation. These schemes are usually within the discipline of Histopathology and are regarded as educational rather than proficiency testing schemes. Very frequently, the scheme is organized by a single individual with a collection of microscope slides, storage facilities for the slides and a computer. This presents the Scheme Organizer with great difficulty in complying with the Quality Management System requirements of the CPA Standards. There are a number of models which can be applied in order to satisfy the requirement of the Quality Management System, but ultimately it must be recognized that in some circumstances it is not possible to accredit these small schemes. The NHSCSP Gynae Cytology EQA Scheme is probably the largest EQA scheme within the UK, in respect of the number of participants and the number of staff supporting the scheme. Scheme Management decided that all nine regions of England would apply for accreditation under one CPA Reference Number. This process meant that the scheme would be assessed as a Managed Pathology Network. This is unique in terms of EQA schemes and presented a number of problems not previously encountered in EQA scheme accreditation. This decision meant that all nine regions must comply with a single Quality Management System and other CPA standards whilst allowing flexibility within the system for each region to facilitate the assessment process specific to their user's requirements. The process worked in a satisfactory manner and the overall outcome was not dissimilar to that of other large EQA schemes. The assessment to the current EQA Standards only commenced in April 2006 whilst the Standards for Medical Laboratories commenced in 2003, and it is perhaps not surprising to find that the principal non-conformities are related to the Quality Management System. This parallels the findings encountered in laboratory accreditation. There is an ongoing educational process for Scheme Management and the Facilitators in each region in how to comply fully with the standards and a commitment to quality improvement which ultimately is beneficial to the participant's of the scheme and to patient safety. [source] DEFINING DYSKARYOSIS , THE BSCC CLASSIFICATION IN 2006CYTOPATHOLOGY, Issue 2006K. Denton The terminology used for reporting cervical samples in the UK is the BSCC classification, which has evolved over many years. In 2002 the BSCC held a consensus conference to review the BSCC classification, with the intention of providing clearer results for women, improving concordance with other terminologies and facilitating consistency with new scientific developments and technologies. The consensus conference was well attended and robust. In the intervening years there have also been other further advances on morphometry, data on outcomes, data from EQA and other sources. Liquid Based cytology (LBC) has been implemented by the NHS CSP. All of these developments have impacted on the proposed classification, which will be presented in full. The term ,dyskaryosis' will be retained and several of the current reporting categories will be relatively unchanged, though additional information on LBC will be provided. The major proposed changes are: (1) A move to a single category of ,High Grade Dyskaryosis' to replace the existing categories of moderate and severe dyskaryosis. (2) Sub-division of Borderline change into three categories. Borderline change in glandular cells Borderline change ?high grade Borderline change, NOS (3) The current grades of Mild Dyskaryosis and Borderline change with Koilocytosis to be merged. Details of these proposals, together with illustrations and the evidence base for change will be presented. [source] O-13 ENDOMETRIAL CARCINOMA DETECTED WITH SUREPATH LIQUID BASED CERVICAL CYTOLOGY: COMPARISON WITH CONVENTIONAL CERVICAL CYTOLOGYCYTOPATHOLOGY, Issue 2006C. J. Patel Introduction:, Conventional Pap Smear (CPS) has had little impact on the detection of endometrial carcinoma (MC). Although Liquid Based Cytology (LBC) is replacing CPS in the UK, experience with identification of endometrial cancers with this is limited. A few studies of ThinPrep LBC show promise with reported increased detection rate, but to date, there has been no reported study of detection with SurePath LBC. Aim:, The purpose of this 2-year retrospective study was to compare the accuracy of the SurePath LBC with that of conventional smear in detecting endometrial cancers. Methods:, Our study group consisted of all SurePath cases of endometrial atypia/carcinoma diagnosed between 1st Jan 2004 and 31st Dec 2005, following 100% conversion of our laboratory to the SurePath system in 2001. Conventional smears reported over a 6-year period (1993,1998), comprised the control group. Histological follow up was obtained. Results:, Endometrial lesions were reported in 95 (0.07%) of 130352 SurePath LBC smears. These included 70 (0.053%) reports of endometrial atypia, 05 (0.003%) suspicious and 20 (0.015%) diagnostic of endometrial carcinoma. A total of 58 (0.014%) cases of 409495 CPS were diagnosed as endometrial carcinoma. Adequate histological follow up was available in 47 (49.5%) SurePath LBC and 52 (89.6%) conventional cases. In these, the positive predictive value (PPV) for endometrial carcinoma of SurePath LBC was 73.3% compared to 55.4% of CPS. The PPV for endometrial carcinoma of the atypical and suspicious LBC categories was 14.3% and 40% respectively. No categorisation as atypical or suspicious in the conventional study was available for comparison. The sensitivity of the SurePath LBC, calculated from retrograde analysis of histologically diagnosed endometrial cancers during the same period was 40%. Conclusion:, The SurePath LBC is at least an as accurate and sensitive method for detecting endometrial cancer as CPS. [source] Glandular prediction: the pride and the prejudiceCYTOPATHOLOGY, Issue 4 2004C. Waddell For the cytologist and clinician alike, glandular lesions pose possibly the greatest challenge in cervical screening. Worldwide, with increasing confidence in cytological prediction, terminology is evolving. In the UK, with the adoption of liquid based methods, the technical aspects of cervical cytology are being addressed, it is now time to standardise our terminology in glandular reporting. Consideration of the cytological complexity, clinical needs and international protocols is essential in this endeavour. [source] | ||||||||||||||||||||||||||||||||||||||||||||||