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Search Results: 1 - 10 of 5511 matches for " Susan Shepherd "
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Effects of L-Dopa and Dopamine D2 Agonists on Recollection and Familiarity in Idiopathic Nondementing Parkinson’s Disease  [PDF]
Nicola M. J. Edelstyn, Thomas A. Shepherd, Andrew R. Mayes, Susan M. Sherman, Simon J. Ellis
Neuroscience & Medicine (NM) , 2011, DOI: 10.4236/nm.2011.24042
Abstract: Idiopathic nondementing Parkinson’s disease (PD) is marked by progressive loss of dopaminergic neurons in the substantia nigra pars compacta and ventral tegmental area. Recent brain imaging work implicates these structures in dopamine modulated networks subserving episodic memory. These findings are of relevance to PD because they suggest that dopamine depletion contributes to the disease-dependent decline in episodic memory, and therefore, this decline should, at least partially, be remediated by dopaminergic medication. Recognition memory (RM), recollection and familiarity during recognition was examined in 17 PD patients, 12 of whom were medicated with a D2 dopamine agonist (pramipexole or ropinirole) and l-dopa, with a further 5 PD control patients on l-dopa but no D2 agonist. Memory was tested “ON” and, following a period of medication withdrawal, “OFF” and compared to a group of 14 matched healthy volunteers (HV). The HVs were also tested twice in the absence of medication. The patients on the agonists PD showed significant impairments in recollection ON- and OFF-medication, whereas the l-dopa control patients exhibited a decline in OFF-recollection only. RM and familiarity were spared in both groups ON- and OFF-medication. These findings suggest that D2 dopamine agonists (combined with l-dopa) contribute to disease-dependent episodic memory impairment.
Mid-Upper Arm Circumference Based Nutrition Programming: Evidence for a New Approach in Regions with High Burden of Acute Malnutrition
Sylvie Goossens, Yodit Bekele, Oliver Yun, Géza Harczi, Marie Ouannes, Susan Shepherd
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0049320
Abstract: Background In therapeutic feeding programs (TFP), mid-upper arm circumference (MUAC) shows advantages over weight-for-height Z score (WHZ) and is recommended by the World Health Organization (WHO) as an independent criterion for screening children 6–59 months old. Here we report outcomes and treatment response from a TFP using MUAC ≤118 mm or oedema as sole admission criteria for severe acute malnutrition (SAM). Methods Patient data from September 2007 to March 2009 for children admitted by MUAC ≤118 mm or oedema to a Médecins Sans Frontières (MSF) TFP in Burkina Faso were retrospectively analyzed. Analysis included anthropometric measurements at admission and discharge, program outcomes and treatment response. Results Of 24,792 patient outcomes analyzed, nearly half (48.8%; n = 12,090) were admitted with MUAC 116–118 mm. Most patients (88.7%; n = 21,983) were 6–24 months old. At admission, 52.7% (n = 5,041) of those with MUAC 116–118 mm had a WHZ <?3 SD. At discharge, 89.1% (n = 22,094) recovered (15% weight gain or oedema resolution), 7.9% (n = 1,961) defaulted, 1.5% (n = 384) failed to respond to treatment, and 1.0% (n = 260) died. Average weight gain was 5.4 g/kg/day, and average MUAC gain was 0.42 mm/day. Patients with MUAC ≤114 mm at admission had higher average daily weight and MUAC gains at discharge compared to those admitted with MUAC 116–118 mm, but those in the latter category required longer lengths of stay to achieve recovery (P<0.001). Conclusion This analysis suggests that MUAC ≤118 mm as TFP admission criterion is a useful alternative to WHZ. Regarding treatment response, rates of weight and MUAC gain were acceptable. Applying 15% weight gain as discharge criterion resulted in longer lengths of stay for less malnourished children. Since MUAC gain parallels weight gain, it may be feasible to use MUAC as both an admission and discharge criterion.
Prognostic Accuracy of WHO Growth Standards to Predict Mortality in a Large-Scale Nutritional Program in Niger
Nathanael Lapidus,Francisco J Luquero,Valérie Gaboulaud,Susan Shepherd,Rebecca F Grais
PLOS Medicine , 2009, DOI: 10.1371/journal.pmed.1000039
Abstract: Background Important differences exist in the diagnosis of malnutrition when comparing the 2006 World Health Organization (WHO) Child Growth Standards and the 1977 National Center for Health Statistics (NCHS) reference. However, their relationship with mortality has not been studied. Here, we assessed the accuracy of the WHO standards and the NCHS reference in predicting death in a population of malnourished children in a large nutritional program in Niger. Methods and Findings We analyzed data from 64,484 children aged 6–59 mo admitted with malnutrition (<80% weight-for-height percentage of the median [WH]% [NCHS] and/or mid-upper arm circumference [MUAC] <110 mm and/or presence of edema) in 2006 into the Médecins Sans Frontières (MSF) nutritional program in Maradi, Niger. Sensitivity and specificity of weight-for-height in terms of Z score (WHZ) and WH% for both WHO standards and NCHS reference were calculated using mortality as the gold standard. Sensitivity and specificity of MUAC were also calculated. The receiver operating characteristic (ROC) curve was traced for these cutoffs and its area under curve (AUC) estimated. In predicting mortality, WHZ (NCHS) and WH% (NCHS) showed AUC values of 0.63 (95% confidence interval [CI] 0.60–0.66) and 0.71 (CI 0.68–0.74), respectively. WHZ (WHO) and WH% (WHO) appeared to provide higher accuracy with AUC values of 0.76 (CI 0.75–0.80) and 0.77 (CI 0.75–0.80), respectively. The relationship between MUAC and mortality risk appeared to be relatively weak, with AUC = 0.63 (CI 0.60–0.67). Analyses stratified by sex and age yielded similar results. Conclusions These results suggest that in this population of children being treated for malnutrition, WH indicators calculated using WHO standards were more accurate for predicting mortality risk than those calculated using the NCHS reference. The findings are valid for a population of already malnourished children and are not necessarily generalizable to a population of children being screened for malnutrition. Future work is needed to assess which criteria are best for admission purposes to identify children most likely to benefit from therapeutic or supplementary feeding programs.
The purple line as a measure of labourprogress: a longitudinal study
Ashley Shepherd, Helen Cheyne, Susan Kennedy, Colette McIntosh, Maggie Styles, Catherine Niven
BMC Pregnancy and Childbirth , 2010, DOI: 10.1186/1471-2393-10-54
Abstract: This longitudinal study observed 144 women either in spontaneous labour (n = 112) or for induction of labour (n = 32) from admission through to final VE. Women were examined in the lateral position and midwives recorded the presence or absence of the line throughout labour immediately before each VE. Where present, the length of the line was measured using a disposable tape measure. Within subjects correlation, chi-squared test for independence, and independent samples t-test were used to analyse the data.The purple line was seen at some point in labour for 109 women (76%). There was a medium positive correlation between length of the purple line and cervical dilatation (r = +0.36, n = 66, P = 0.0001) and station of the fetal head (r = +0.42, n = 56, P < 0.0001).The purple line does exist and there is a medium positive correlation between its length and both cervical dilatation and station of the fetal head. Where the line is present, it may provide a useful guide for clinicians of labour progress along side other measures. Further research is required to assess whether measurement of the line is acceptable to women in labour and also clinicians.There are a number of ways of measuring progress in labour including assessment of contractions, descent and position of the fetal head by abdominal palpation and assessment of cervical dilatation by vaginal examination (VE). VE is currently considered to be the gold standard for assessment of labour progress [1], however there are a number of problems associated with this examination. Studies to assess the accuracy of the digital examination of the cervix are limited but those that do exist suggest that the assessment is imprecise. Some studies [2,3] have used hard cervical models in which the cervix is fixed in position to measure the accuracy of midwives and obstetricians in measuring cervical dilatation. They reported an overall accuracy for determining the exact cervical diameter of between 48.6% and 56.3% which improve
Reducing widespread pipe sharing and risky sex among crystal methamphetamine smokers in Toronto: do safer smoking kits have a potential role to play?
Charlotte Hunter, Carol Strike, Lorraine Barnaby, Adam Busch, Chantel Marshall, Susan Shepherd, Shaun Hopkins
Harm Reduction Journal , 2012, DOI: 10.1186/1477-7517-9-9
Abstract: Five focus groups were conducted with crystal methamphetamine smokers recruited by community health agencies and youth shelters in Toronto, Canada. Target groups included homeless/street-involved youth, sex workers, men who have sex with men, and youth in the party scene. Participants (n = 32) were asked questions about motivations for crystal methamphetamine use, the process of smoking, health problems experienced, sharing behaviour, risky sexual practices, and the ideal contents of a harm reduction kit.Pipe sharing was widespread among participants and was deemed integral to the social experience of smoking crystal methamphetamine. Heated pipes were unlikely to cause direct injuries, but participants mentioned having dry, cracked lips, which may be a vector for disease transmission. Many reported having sex with multiple partners and being less likely to use condoms while on the drug. Demand for harm reduction kits was mixed.Changing pipe sharing behaviours may be difficult because many participants considered sharing to be integral to the social experience of smoking crystal methamphetamine. Within the context of a broader health promotion and prevention program, pilot testing of safer smoking kits to initiate discussion and education on the risks associated with sharing pipes and unprotected sex for some communities (e.g., homeless/street-involved youth) is worth pursuing.Crystal methamphetamine smoking is associated with many negative health consequences and is linked with transmission of Hepatitis C virus (HCV) [1]. Heated and damaged pipes may lead to injuries to the lips and mouth [1] and when shared these pipes may be a vector for Hepatitis C virus (HCV) transmission. A systematic review concluded an HCV prevalence ranging from 2.3 to 5.3% among never-injecting drug users represents a serious health concern among this population but the causal mechanism of transmission was unclear [2]. Populations most often associated with smoking crystal methamphetamine i
Effect of Mass Supplementation with Ready-to-Use Supplementary Food during an Anticipated Nutritional Emergency
Emmanuel Grellety, Susan Shepherd, Thomas Roederer, Mahamane L. Manzo, Stéphane Doyon, Eric-Alain Ategbo, Rebecca F. Grais
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044549
Abstract: Background Previous studies have shown the benefits of ready-to-use supplementary food (RUSF) distribution in reducing the incidence and prevalence of severe acute malnutrition. Methods and Findings To compare the incidence of wasting, stunting and mortality between children aged 6 to 23 mo participating and not participating in distributions of RUSF, we implemented two exhaustive prospective cohorts including all children 60 cm to 80 cm, resident in villages of two districts of Maradi region in Niger (n = 2238). Villages (20) were selected to be representative of the population. All registered children were eligible for the monthly distributions between July and October 2010. Age, sex, height, weight, and Mid-Upper Arm Circumference (MUAC) were measured at baseline and two weeks after each distribution; the amount and type of distribution and the amount shared and remaining were also assessed. We compared the incidence of wasting, stunting, and mortality among children participating in the distribution (intervention) of RUSF versus children not participating in the distribution (comparison). The absolute rate of wasting was 4.71 events per child-year (503 events/106.59 child-year) in the intervention group and 4.98 events per child-year (322 events/64.54 child-year) in the comparison group. The intervention group had a small but higher weight-for-length Z-score gain (?0.2z vs. ?0.3z) and less loss of MUAC than the comparison group (?2.8 vs. ?4.0 mm). There was no difference in length gain (2.7 vs. 2.8 cm). Mortality was lower for children whose households received the intervention than those who did not (adjusted HR 0.55, 95% CI: 0.32–0.98). Conclusions Short-term distribution with RUSF for children 6 to 23 months improve the nutritional status of children at risk for malnutrition. Fewer children who participated in the RUSF distribution died than those who did not.
A Large-Scale Distribution of Milk-Based Fortified Spreads: Evidence for a New Approach in Regions with High Burden of Acute Malnutrition
Isabelle Defourny, Andrea Minetti, Géza Harczi, Stéphane Doyon, Susan Shepherd, Milton Tectonidis, Jean-Hervé Bradol, Michael Golden
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0005455
Abstract: Background There are 146 million underweight children in the developing world, which contribute to up to half of the world's child deaths. In high burden regions for malnutrition, the treatment of individual children is limited by available resources. Here, we evaluate a large-scale distribution of a nutritional supplement on the prevention of wasting. Methods and Findings A new ready-to-use food (RUF) was developed as a diet supplement for children under three. The intervention consisted of six monthly distributions of RUF during the 2007 hunger gap in a district of Maradi region, Niger, for approximately 60,000 children (length: 60–85 cm). At each distribution, all children over 65 cm had their Mid-Upper Arm Circumference (MUAC) recorded. Admission trends for severe wasting (WFH<70% NCHS) in Maradi, 2002–2005 show an increase every year during the hunger gap. In contrast, in 2007, throughout the period of the distribution, the incidence of severe acute malnutrition (MUAC<110 mm) remained at extremely low levels. Comparison of year-over-year admissions to the therapeutic feeding program shows that the 2007 blanket distribution had essentially the same flattening effect on the seasonal rise in admissions as the 2006 individualized treatment of almost 60,000 children moderately wasted. Conclusions These results demonstrate the potential for distribution of fortified spreads to reduce the incidence of severe wasting in large population of children 6–36 months of age. Although further information is needed on the cost-effectiveness of such distributions, these results highlight the importance of re-evaluating current nutritional strategies and international recommendations for high burden areas of childhood malnutrition.
The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial
Simon C Moore, Iain R Brennan, Simon Murphy, Ellie Byrne, Susan N Moore, Jonathan P Shepherd, Laurence Moore
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-607
Abstract: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations.A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises.The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level.The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level.UKCRN 7
Twittering in the OECD’s “Participative Web”: Microblogging and New Media Policy
Tamara Shepherd
Global Media Journal : Canadian Edition , 2009,
Abstract: The recent popularity of microblogging site Twitter raises regulatory concerns that outstrip the purview of emerging new media policy, such as the recommendations of the Organisation for Economic Cooperation and Development (OECD). The OECD’s 2007 report, Participative Web and User-Created Content: Web 2.0, Wikis and Social Networking, frames user-generated content as key to the development of public discourse. Yet the report tends to ultimately conceive of user creations in terms of their contributions to the production of market-based value. Sites like Twitter both challenge and uphold such a reading, which becomes apparent upon examining the ways that policy adheres to certain popular myths around the Internet and digital technology. These myths—including this paper’s main concern, the myth of the “End of Geography”—work in the service of policy recommendations that reflect neoliberal, capitalist value systems. As such, new developments in new media regulation need to integrate critical perspectives on techno-myths in order to take a more nuanced approach to the structural inequalities that pervade online culture.
Rock critics as 'Mouldy Modernists'
Becky Shepherd
PORTAL : Journal of Multidisciplinary International Studies , 2011,
Abstract: Contemporary rock criticism appears to be firmly tied to the past. The specialist music press valorise rock music of the 1960s and 1970s, and new emerging artists are championed for their ‘retro’ sounding music by journalists who compare the sound of these new artists with those included in the established ‘canon’ of rock music. This article examines the narrative tropes of authenticity and nostalgia that frame the retrospective focus of this contemporary rock writing, and most significantly, the maintenance of the rock canon within contemporary popular culture. The article concludes by suggesting that while contemporary rock criticism is predominately characterised by nostalgia, this nostalgia is not simply a passive romanticism of the past. Rather, this nostalgia fuels a process of active recontextualisation within contemporary popular culture.
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