Epidemiological studies suggest that inflammatory bowel disease (IBD) is common in developed countriesIn the present study, we investigated the effect of polarizing the immune response toward the Th2 type, using intestinal nematode infection, on subsequent experimental colitis. Mice were infected with the intestinal nematode Trichinella spiralis and allowed to recover before colitis was induced with dinitrobenzene sulfonic acid. The mice were sacrificed postcolitis to assess colonic damage macroscopically, histologically, and by myeloperoxidase (MPO) activity and Th cytokines. Prior nematode infection reduced the severity of colitis both macroscopically and histologically together with a decreased mortality and was correlated with a downregulation of MPO activity, Th1-type cytokine expression in colonic tissue, and emergence of a Th2-type immune response. These results indicate a protective role of nematode infection in Th1 cell-driven inflammation and prompt consideration of a novel therapeutic strategy in IBD based on immunological distraction.

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In our previous studies, we demonstrated that during Trichinella spiralis infection, T helper (Th) 2 cells contribute to the development of intestinal muscle hypercontractility and worm expulsion from the gut via STAT6. In addition, we have linked the altered muscle contractility to the eviction of the parasite and thereby to the host defense. However, the initial events linking infection to the development of muscle hypercontractility are poorly understood. In this study, we examined the contribution of CD40-CD40 ligand (CD40L) interaction in the development of intestinal muscle hypercontractility, in monocyte chemoattractant protein-1 (MCP-1) production, and in the Th2 response in CD40 ligand-deficient (CD40L -/-) mice infected with T. spiralis. Expulsion of intestinal worms was substantially delayed in CD40L -/- mice compared with the wild-type mice after T. spiralis infection. Consistent with delayed worm expulsion, there was a significant attenuation of intestinal muscle contractility in CD40L -/- mice. Infected CD40L -/- mice also exhibited marked impairment in the production of MCP-1, IL-4, IL-13, IgG1, IgE, and mouse mucosal MCP 1 (MMCP-1), and in goblet cell response. These results demonstrate that CD40-CD40 ligand interaction plays an important role in MCP-1 production, Th2 response, intestinal muscle hypercontractility, and worm expulsion in nematode infection. The present data suggest that the early events leading to the generation of Th2 response include CD40-CD40 ligand interaction, which subsequently influences the production of Th2 cytokines, most likely via upregulation of MCP-1.

The Indian bureaucracy suffers from indecision and risk aversion, resulting in an inordinate focus on routine tasks, coordination failures, process overload, poor perception, motivational issues, and a deterioration in the quality of service delivery. We argue that bureaucratic indecision, in large part, is a form of rational self- preservation exercised by bureaucrats from the various legal and extra-legal risks to their person, careers and reputation. These risks originate from problems of organizational design, institutional norms, and other political factors. The research for this paper included a review of interdisciplinary literature on bureaucracy and policy decisions, combined with semi-structured interviews. We interviewed current and ex-bureaucrats from India and other Asian and African countries, political scientists, and other policy researchers. We also conducted a document analysis of historical and contemporary, administrative, and legal documents, including committee reports, acts and rules, annual reports, and other government publications. We summarise the evidence on factors such as penal transfers, overload, inadequate training, process accountability, contradictory rules, and political patronage.

Background: Burnout is a widely reported syndrome consisting of emotional exhaustion, depersonalization, and a lowered sense of accomplishment. Mindfulness practices have been shown to be useful in lowering distress and burnout in clinical and non-clinical cohorts. Our aim was to explore the potential personal and occupational benefits of a structured mindfulness intervention on a cohort of mental health professionals. A mixed-methods approach was utilised in order to enhance the exploratory power of the study. Methods: We conducted a pilot study involving healthcare practitioners employed at a community outpatient mental health clinic. As a pilot, we relied on a single group and implemented a quasi-experimental, simultaneous mixed methods design by incorporating both quantitative pre- and post- testing alongside written qualitative post-test responses. Results: Analysis of the data demonstrated a significant difference between overall mindfulness when comparing post-test (mean=140.8, standard deviation=18.9) with pre-test data (mean=128.3, standard deviation=28.6). Participants also showed a statistically significant difference in three of the subscales: observation, describing, and non-reactivity. A moderate effect size was seen for each of the above differences.  Analysis of the qualitative data revealed a range of potential themes which may be used to explain the differences exhibited across participants’ personal and professional lives, which can be grouped into two thematic overarching groups: emotional reactivity and listening/communicating. Conclusions: The results of this pilot study indicate that a structured, six-week mindfulness program has the potential to benefit clinicians, personally by reducing emotional reactivity and professionally by promoting deep listening and communication.

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