7,164 research outputs found
Garriga, Ramon D. interview
No full textOral History interview of Ramon Garriga. Interview conducted by Weeks, Andrew; Orr, Terrell at Garriga\u27s Residence
[Letter from Andrew D. Campbell to Elizabeth Upshur Teackle]
No full textLetter from Andrew D. Campbell to Elizabeth Upshur Teackle, written over the course of a few weeks
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Predictors of Stunting, Wasting and Underweight among Tanzanian Children Born to HIV-Infected Women.
No full textChildren born to human immunodeficiency virus (HIV)-infected women are susceptible to undernutrition, but modifiable risk factors and the time course of the development of undernutrition have not been well characterized. The objective of this study was to identify maternal, socioeconomic and child characteristics that are associated with stunting, wasting and underweight among Tanzanian children born to HIV-infected mothers, followed from 6 weeks of age for 24 months. Maternal and socioeconomic characteristics were recorded during pregnancy, data pertaining to the infant's birth were collected immediately after delivery, morbidity histories and anthropometric measurements were performed monthly. Multivariate Cox proportional hazards methods were used to assess the association between potential predictors and the time to first episode of stunting, wasting and underweight. A total of 2387 infants (54.0% male) were enrolled and followed for a median duration of 21.2 months. The respective prevalence of prematurity (<37 weeks) and low birth weight (<2500 g) was 15.2% and 7.0%; 11.3% of infants were HIV-positive at 6 weeks. Median time to first episode of stunting, wasting and underweight was 8.7, 7.2 and 7.0 months, respectively. Low maternal education, few household possessions, low infant birth weight, child HIV infection and male sex were all independent predictors of stunting, wasting and underweight. In addition, preterm infants were more likely to become wasted and underweight, whereas those with a low Apgar score at birth were more likely to become stunted. Interventions to improve maternal education and nutritional status, reduce mother-to-child transmission of HIV, and increase birth weight may lower the risk of undernutrition among children born to HIV-infected women
Graduate recital, trumpet. Weeks, T., 1973
No full textRecorded during a live performance at Oakland Recital Hall, Western Michigan University, Kalamazoo, Michigan, March 28, 1973, the 191st concert of the Department of Music's 1972-1973 season.Tom Weeks, trumpet. Assisted by: Gayle Petrick, Anne Rubner, oboes ; Pat Nancarrow, cello ; Joan Nottke, harpsichord ; Marty Otto, Steve Reed, Britt Theurer, Anthony Womack, trumpets ; John Dickey, Dave Kalfsbeek, Tom Shannon, trombones ; Carl Marsman, Barb Deaton, Janet Graham, Tim Griffin, french horns ; Rick Watts, Andy Hagenbuch, tubas.In partial fulfillment of the requirements of the Master of Music degree in brass pedagogy, Western Michigan University, 1973.Information from performance program.Konzert D-dur / George Philip Telemann -- Suite for brass quintet (1971). (15:03) I. Toccata - Allegro ; (19:08) III. Scherzo - Vivace ; (26:47) IV. Arioso - Adagio ; (32:18) V. March - Allegro / Verne Reynolds -- (35:58) Caprice for trumpet and piano, op. 47 / Eugene Bozza -- Sonneries for brass choir (1971). (43:03) I. Allegro con brio ; (45:05) II. Adagio ; (49:04) III. Allegro / Donald Erb
Rethinking our approach to postpartum haemorrhage and uterotonics
No full textAnalysis
Rethinking our approach to postpartum haemorrhage and uterotonics
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3251 (Published 08 July 2015)
Cite this as: BMJ 2015;351:h3251
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Andrew D Weeks, professor of international maternal health1, James P Neilson, professor of obstetrics and gynaecology1
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Correspondence to: AD Weeks [email protected]
Accepted 30 March 2015
Andrew Weeks and James Neilson suggest that we have inappropriately generalised evidence on the use of uterotonics from uncomplicated births to all births. They call for stronger focus on women with complex births to reduce deaths from postpartum haemorrhage
Postpartum haemorrhage (defined as a bleed >500 mL) is estimated to affect 1-15% of vaginal births, depending on the definition used, the method of assessing blood loss, the setting, and the population studied. Risk factors include Asian ethnicity, obesity, previous postpartum haemorrhage, multiple pregnancy, anaemia, large baby, age over 40, induction of labour, prolonged labour, placental abruption, and caesarean delivery.1
Although global mortality from postpartum haemorrhage is falling, its incidence is increasing in high resource settings, the reasons for which are unclear.2 3 4 Many of those who survive have severe anaemia, renal failure, or psychological trauma, and the offspring may have difficulties in breast feeding and bonding.
Current best practice globally is for all pregnant women to receive a uterotonic drug at the time of childbirth to prevent postpartum haemorrhage. This recommendation has been in place since the 1980s when randomised trials showed that routine prophylaxis with oxytocin based uterotonic drugs reduced the rate of postpartum haemorrhage.5 The assumption that this would translate into fewer maternal deaths—based on the understanding that atony was the most common cause of haemorrhage related deaths—led to the promotion of active management of the third stage of labour, which comprises a prophylactic uterotonic drug, early cord clamping, and controlled cord traction.
Here we discuss the problems with generalising data from spontaneous vaginal (“normal”) births to complex births, and call for a change in global strategy on postpartum haemorrhage
Interventions to reduce psychological morbidities associated with infertility in Nigeria
No full textIntroduction: Infertility affects up to 30% of Sub Sahara Africa population. In African societies, having infertility can come with dire consequences, depending on the level of empowerment and the ability to resist infertility related stigma, leading to psychological distress, anxiety and depression for those affected. Cognitive Behavioural Therapy (CBT) has been shown to be more effective than the pharmacological treatment of infertility-related depression (Faramarzi et al, 2008), therefore a need for the development of a culturally appropriated CBT based intervention for the management infertility-related psychological distress. Objectives: 1. To determine the prevalence of psychological morbidities amongst infertility patients in 2 Nigerian hospitals 2. To develop and test Fertility Life Counselling Aid (FELICIA), an intervention for the management psychological morbidities associated with infertility 3. To understand patients' perspectives of the potential benefits of the FELICIA intervention, 6 weeks post intervention Methods: An intervention was developed using the MRC framework for development of complex health interventions (Craig et al, 2008). Research was carried out using mixed methods involving ... (continues
The effectiveness of interventions to treat severe acute malnutrition in young children: a systematic review
No full textSevere acute malnutrition (SAM) arises as a consequence of a sudden period of food shortage and is associated with loss of a person’s body fat and wasting of their skeletal muscle. Many of those affected are already undernourished and are often susceptible to disease. Infants and young children are the most vulnerable as they require extra nutrition for growth and development, have comparatively limited energy reserves and depend on others. Undernutrition can have drastic and wide-ranging consequences for the child’s development and survival in the short and long term. Despite efforts made to treat SAM through different interventions and programmes, it continues to cause unacceptably high levels of mortality and morbidity. Uncertainty remains as to the most effective methods to treat severe acute malnutrition in young children.ObjectivesTo evaluate the effectiveness of interventions to treat infants and children aged < 5 years who have SAM.Data sourcesEight databases (MEDLINE, EMBASE, MEDLINE In-Process & Other Non-Indexed Citations, CAB Abstracts Ovid, Bioline, Centre for Reviews and Dissemination, EconLit EBSCO and The Cochrane Library) were searched to 2010. Bibliographies of included articles and grey literature sources were also searched. The project expert advisory group was asked to identify additional published and unpublished references.Review methodsPrior to the systematic review, a Delphi process involving international experts prioritised the research questions. Searches were conducted and two reviewers independently screened titles and abstracts for eligibility. Inclusion criteria were applied to the full texts of retrieved papers by one reviewer and checked independently by a second. Included studies were mapped to the research questions. Data extraction and quality assessment were undertaken by one reviewer and checked by a second reviewer. Differences in opinion were resolved through discussion at each stage. Studies were synthesised through a narrative review with tabulation of the results.ResultsA total of 8954 records were screened, 224 full-text articles were retrieved, and 74 articles (describing 68 studies) met the inclusion criteria and were mapped. No evidence focused on treatment of children with SAM who were human immunodeficiency virus sero-positive, and no good-quality or adequately reported studies assessed treatments for SAM among infants < 6 months old. One randomised controlled trial investigated fluid resuscitation solutions for shock, with none adequately treating shock. Children with acute diarrhoea benefited from the use of hypo-osmolar oral rehydration solution (H-ORS) compared with the standard World Health Organization-oral rehydration solution (WHO-ORS). WHO-ORS was not significantly different from rehydration solution for malnutrition (ReSoMal), but the safety of ReSoMal was uncertain. A rice-based ORS was more beneficial than glucose-based ORSs, and provision of zinc plus a WHO-ORS had a favourable impact on diarrhoea and need for ORS. Comparisons of different diets in children with persistent diarrhoea produced conflicting findings. For treating infection, comparison of amoxicillin with ceftriaxone during inpatient therapy, and routine provision of antibiotics for 7 days versus no antibiotics during outpatient therapy of uncomplicated SAM, found that neither had a significant effect on recovery at the end of follow-up. No evidence mapped to the next three questions on factors that affect sustainability of programmes, long-term survival and readmission rates, the clinical effectiveness of management strategies for treating children with comorbidities such as tuberculosis and Helicobacter pylori infection and the factors that limit the full implementation of treatment programmes. Comparison of treatment for SAM in different settings showed that children receiving inpatient care appear to do as well as those in ambulatory or home settings on anthropometric measures and response time to treatment. Longer-term follow-up showed limited differences between the different settings. The majority of evidence on methods for correcting micronutrient deficiencies considered zinc supplements; however, trials were heterogeneous and a firm conclusion about zinc was not reached. There was limited evidence on either supplementary potassium or nicotinic acid (each produced some benefits), and nucleotides (not associated with benefits). Evidence was identified for four of the five remaining questions, but not assessed because of resource limitation.LimitationsThe systematic review focused on key questions prioritised through a Delphi study and, as a consequence, did not encompass all elements in the management of SAM. In focusing on evidence from controlled studies with the most rigorous designs that were published in the English language, the systematic review may have excluded other forms of evidence. The systematic review identified several limitations in the evidence base for assessing the effectiveness of interventions for treating young children with severe acute malnutrition, including a lack of studies assessing the different interventions; limited details of study methods used; short follow-up post intervention or discharge; and heterogeneity in participants, interventions, settings, and outcome measures affecting generalisability.ConclusionsFor many of the most highly ranked questions evidence was lacking or inconclusive. More research is needed on a range of topic areas concerning the treatment of infants and children with SAM. Further research is required on most aspects of the management of SAM in children < 5 years, including intravenous resuscitation regimens for shock, management of subgroups (e.g. infants < 6 months old, infants and children with SAM who are human immunodeficiency virus sero-positive) and on the use of antibiotics.FundingThe National Institute for Health Research Technology Assessment programme.<br/
Endoscopic tumour characteristics: (a) number of tumours; (b) size of largest tumour, and (c,d) % change from baseline after 6 and 12 weeks’ netazepide treatment, and at follow-up at 24 weeks, 12 weeks after end of treatment.
No full text<p>Endoscopic tumour characteristics: (a) number of tumours; (b) size of largest tumour, and (c,d) % change from baseline after 6 and 12 weeks’ netazepide treatment, and at follow-up at 24 weeks, 12 weeks after end of treatment.</p
D-lactic Acidosis: Successful Suppression of D-lactate-Producing Lactobacillus by Probiotics.
No full textIntestinal microbiota composition in children with short bowel syndrome (SBS) is an important factor influencing the clinical outcome. An increase of D-lactate-producing bacteria can lead to D-lactic acidosis, also referred to as D-lactate encephalopathy, with severe neurologic impairment. Antibiotic treatments for D-lactic acidosis in children with SBS offer often only short-term relief. Here, we present the case of a boy with SBS who developed recurrent episodes of D-lactic acidosis even under continuous cycling antibiotic treatment. Microbiological analyses were used to detect the presence of D-lactate-producing species in the stool samples. A probiotic cocktail was introduced to alter the intestinal microbiota. During follow-up under treatment with probiotics, the patient remained stable, and there was no additional need for antibiotic therapy for more than a year. Stool composition of the patient was sequenced regularly over that period. His microbiota profile changed completely in species richness, and a clustering of species according to probiotic usage was seen. Importantly, D-lactate-producing strains disappeared within a few weeks after probiotic introduction and were no longer detected in the subsequent follow-up specimens
Cognitive and mood effects in healthy children during 12 weeks' supplementation with multi-vitamin/minerals
No full textAdequate levels of vitamins and minerals are essential for optimal neural functioning. A high proportion of individuals, including children, suffer from deficiencies in one or more vitamins or minerals. This study investigated whether daily supplementation with vitamins/minerals could modulate cognitive performance and mood in healthy children. In this randomised, double-blind, placebo-controlled, parallel groups investigation, eighty-one healthy children aged from 8 to 14 years underwent laboratory assessments of their cognitive performance and mood pre-dose and at 1 and 3 h post-dose on the first and last days of 12 weeks' supplementation with a commercially available vitamins/mineral product (Pharmaton Kiddi). Interim assessments were also completed at home after 4 and 8 weeks at 3 h post-dose. Each assessment comprised completion of a cognitive battery, delivered over the Internet, which included tasks assessing mood and the speed and accuracy of attention and aspects of memory (secondary, semantic and spatial working memory). The vitamin/mineral group performed more accurately on two attention tasks: 'Arrows' choice reaction time task at 4 and 8 weeks; 'Arrow Flankers' choice reaction time task at 4, 8 and 12 weeks. A single task outcome (Picture Recognition errors) evinced significant decrements at 12 weeks. Mood was not modulated in any interpretable manner. Whilst it is possible that the significant improvements following treatment were due to non-significant numerical differences in performance at baseline, these results would seem to suggest that vitamin/mineral supplementation has the potential to improve brain function in healthy children. This proposition requires further investigation
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