"Secretary in Fashion" and "Love-Letters": a study of socio-cultural and pragmatic-linguistic features in the late 17th century English language

Epistolary manuals are conspicuous historical documents for the pedagogy of letter writing; however, their actual usage as manuals by letter writers is unknown. "Secretary in Fashion" by Serre (1668), an epistolary manual, and "Love-Letters between a Nobleman and his Sister" (1684), an epistolary novel attributed to Behn, both give insights into epistolary conventions. Their inception and nature is interesting, considering their historical context. Despite the Restoration of Charles II, 17th century England was in a confused political state; as a result, texts regarding social convention or politics interested contemporary readers (the novel is inspired by a scandal of Lord Grey, an ardent Whig opposing Charles II). Past epistolary studies focus on 18th rather than 17th century manuals; the latter is typically used as supplementary information. Similarly, past epistolary fiction studies focus on 18th century texts; moreover, linguistic studies on Behn and the novel are deficient. Thus, this study addresses the research questions: 1) What are the socio-cultural and pragmaticlinguistic features represented in "Secretary in Fashion"? 2) What are the socio-cultural and pragmatic-linguistic features represented in "Love-Letters between a Nobleman and his Sister", and do any of these features correlate with the features represented in "Secretary in Fashion"? How far do the characteristic linguistic features of "Love-Letters between a Nobleman and his Sister" correlate with the practices recommended by the manual? Both texts were qualitatively analysed from an historical pragmatic perspective, which observes the potential effects of the socio-cultural and historical context. Also, as the texts concern shared discourses, comparisons were made with Gricean and Politeness Theory. The results show that the manual is a typical 17th century epistolary manual, aligning particularly with the "Academies of Complements", as it concerns the social conventions of the gentry. The novel mainly upheld instructions on form and matter; deviations occurred due to the amatory nature of some letters, and the narrative force affecting the style. Unfortunately, neither research question elucidates the actual usage of manuals. However, this study does show the epistolary practices of two writers, within specific contexts. It reveals that their 17th century English language use is affected by socialisation, in terms of social conventions concerning social rank, age, and gender; therefore, context varies language use. Also, their popularity reveals the interests of the 17th century society. Interest in epistolary-related texts, surely piques the interest of the modern reader as to why such epistolary-related texts were interesting.

An investigation of the clinical utility of preoperative cardiopulmonary exercise testing in patients undergoing major pancreatic surgery

Pancreaticoduodenectomy with or without adjuvant chemotherapy remains the only modality of possible cure in patients with cancer involving the head of the pancreas and the periampullary region. While mortality rates after pancreaticoduodenectomy have improved considerably over the course of the last century, morbidity remains high. Patient selection is of paramount importance in ensuring that major surgery is offered to individuals who will most benefit from a pancreaticoduodenectomy. Moreover, identifying preoperative risk factors provides potential targets for prehabilitation and optimisation of the patient's physiology before undertaking surgery. In addition to this, early identification of patients who are likely to develop postoperative complications allows for better allocation of critical care resources and more aggressive management high risk patients. Cardiopulmonary exercise testing is becoming an increasingly popular tool in the preoperative risk assessment of the surgical patient. However, very little work has been done to investigate the role of cardiopulmonary exercise testing in predicting complications after pancreaticoduodenectomy. The impact of jaundice, systemic inflammation and other preoperative clinicopathological characteristics on cardiopulmonary exercise physiology has not been studied in detail before in this cohort of patients. The overall aim of the thesis was to examine the relationships between preoperative clinico-pathological characteristics including cardiopulmonary exercise physiology, obstructive jaundice, body composition and systemic inflammation and complications and the post-surgical systemic inflammatory response in patients undergoing pancreaticoduodenectomy. Chapter 1 reviews the existing literature on preoperative cardiopulmonary exercise testing, the impact of obstructive jaundice, perioperative systemic inflammation and the importance of body composition in determining outcomes in patients undergoing major surgery with particular reference to pancreatic surgery. Chapter 2 reports on the role of cardiopulmonary exercise testing in predicting postoperative complications after pancreaticoduodenectomy. The results demonstrate that patients with V˙O2AT less than 10 ml/kg/min are more likely to develop a postoperative pancreatic fistula, stay longer in hospital and less likely to receive adjuvant therapy. These results emphasise the importance of aerobic fitness to recover from the operative stress of major surgery without significant morbidity. Cardiopulmonary exercise testing may prove useful in selecting patients for intensive prehabilitation programmes as well as for other optimisation measures to prepare them for major surgery. Chapter 3 evaluates the relationship between cardiopulmonary exercise physiology and other clinicopathological characteristics of the patient. A detailed analysis of cardiopulmonary exercise test parameters in jaundiced versus non-jaundiced patients demonstrates that obstructive jaundice does not impair cardiopulmonary exercise physiology. This further supports emerging evidence in contemporary literature that jaundiced patients can proceed directly to surgery without preoperative biliary drainage. The results of this study also show an interesting inverse relationship between body mass index and anaerobic threshold which is analysed in more detail in Chapter 4. Chapter 4 examines the relationship between preoperative cardiopulmonary exercise physiology and body composition in depth. All parameters measured at cardiopulmonary exercise test are compared against body composition and body mass index. The results of this chapter report that the current method of reporting V˙O2, both at peak exercise and anaerobic threshold, is biased against obese subjects and advises caution in the interpretation of cardiopulmonary exercise test results in patients with a high BMI. This is particularly important as current evidence in literature suggests that postoperative outcomes in obese subjects are comparable to non-obese subjects while cardiopulmonary exercise test results are also abnormally low in this very same cohort of patients. Chapter 5 analyses the relationship between preoperative clinico-pathological characteristics including systemic inflammation and the magnitude of the postoperative systemic inflammatory response. Obstructive jaundice appears to have an immunosuppressive effect while elevated preoperative CRP and hypoalbuminemia appear to have opposite effects with hypoalbuminemia resulting in a lower response while elevated CRP in the absence of hypoalbuminemia resulted in a greater postoperative systemic inflammatory response. Chapter 6 evaluates the role of the early postoperative systemic inflammatory response in predicting complications after pancreaticoduodenectomy and aims to establish clinically relevant thresholds for C-Reactive Protein for the prediction of complications. The results of this chapter demonstrate that CRP levels as early as the second postoperative day are associated with complications. While post-operative CRP was useful in the prediction of infective complications, this was the case only in patients who did not develop a post-operative pancreatic fistula. The predictive ability of inflammatory markers for infectious complications was blunted in patients with a pancreatic fistula. Chapter 7 summarises the findings of this thesis, their place in current literature and future directions. The results of this thesis add to the current knowledge regarding the complex pathophysiological abnormalities in patients undergoing pancreaticoduodenectomy, with specific emphasis on the interaction between cardiopulmonary exercise physiology, obstructive jaundice, systemic inflammation and postoperative outcomes. The work presented in this thesis lays the foundations for further studies aimed at improving outcomes after pancreaticoduodenectomy through the development of individualised, goal-directed therapies that are initiated well before this morbid yet necessary operation is performed.

The influence of British rule on elite Indian menswear: the birth of the Sherwani

‘The Influence of British Rule on Elite Indian Menswear: The Birth of the Sherwani’ is a study of the influence of politics on fashion and the resulting development of new garments. This research is designed to demonstrate the effect on elite Indian menswear of the two centuries of British rule in India. It is an effort to understand how the flowing garments worn by elite Indian men in the 18th century gradually became more tailored and fitted with the passage of time. The study uses multiple sources to bring to light lesser known facts about Indian menswear, the evolution of different garments and especially of the sherwani. The sherwani is a knee-length upper garment worn by South-Asian men, and is considered to be India’s traditional menswear. My study highlights the factors responsible for the birth of the sherwani and dispels the myth that it was a garment worn by the Mughals. Simultaneously, this study examines the concept and value of ‘tradition’ in cultures. It scrutinises the reasons for the sherwani being labelled as a traditional Indian garment associated with the Mughal era, when in fact it was born towards the end of the 19th century. The study also analyses the role of the sherwani as a garment of distinction in pre- and post-independence India.