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Biomedical subjects

J M Sheppard

Publications and source records attributed to J M Sheppard.

14 recordsLinked to original sources
PubMed2006

An evaluation of a new test of reactive agility and its relationship to sprint speed and change of direction speed.

The purpose of this study was to evaluate the reliability and validity of a new test of agility, the reactive agility test (RAT), which included anticipation and decision-making components in response to the movements of a tester. Thirty-eight Australian football players took part in the study, categorized into either a higher performance group (HPG) (n=24) or lower performance group (LPG) (n=14) based on playing level from the previous season. All participants undertook testing of a 10m straight sprint (10mSS), a 8-9m change of direction speed test (CODST), and the RAT. Test-retest and inter-tester reliability testing measures were conducted with the LPG. The intra-class correlation (ICC) of the RAT was 0.870, with no significant (p<0.05) difference between the test results obtained on the first and second test sessions using a t-test. A dependent samples t-test revealed no significant (p<0.05) difference between the test results of two different testers with the same population. The HPG were significantly (p=0.001) superior to those of the LPG on the RAT, with no differences observed on any other variable. The RAT is an acceptably reliable test when considering both test-retest reliability, as well as inter-rater reliability. In addition, the test was valid in distinguishing between players of differing performance level in Australian football, while the 10mSS and CODST were not. This result suggests that traditional closed skill sprint and sprint with direction change tests may not adequately distinguish between players of different levels of competition in Australian football.

Adolescent↗
PubMed2006

Agility literature review: classifications, training and testing.

At present, no agreement on a precise definition of agility within the sports science community exists. The term is applied to a broad range of sport contexts, but with such great inconsistency, it further complicates our understanding of what trainable components may enhance agility. A new definition of agility is proposed: "a rapid whole-body movement with change of velocity or direction in response to a stimulus". Agility has relationships with trainable physical qualities such as strength, power and technique, as well as cognitive components such as visual-scanning techniques, visual-scanning speed and anticipation. Agility testing is generally confined to tests of physical components such as change of direction speed, or cognitive components such as anticipation and pattern recognition. New tests of agility that combine physical and cognitive measures are encouraged.

Acceleration↗
PubMed2001

Neuropsychiatric disturbance in Alzheimer's disease clusters into three groups: the Cache County study.

OBJECTIVE: We investigated the frequency and inter-relationship of neuropsychiatric disturbances in a population sample of persons suffering from Alzheimer's disease (AD). METHOD: Screening 5,092 elderly residents (90% of the population aged 65 and older) of Cache County, Utah, for dementia, we identified 198 persons with AD using a comprehensive neuropsychiatric examination protocol. This examination included the Neuropsychiatric Inventory (NPI), a widely used measure of dementia-associated neuropsychiatric disturbances. RESULTS: Overall, 60% of individuals with AD reported one or more neuropsychiatric symptoms. A latent class analysis revealed that these participants could be classified into three groups (classes) based on their neuropsychiatric symptom profile. The largest class included cases with no neuropsychiatric symptoms (40%) or with a mono-symptomatic disturbance (19%). A second class (28%) exhibited a predominantly affective syndrome, while a third class (13%) had a psychotic syndrome. CONCLUSION: Data from this first US population-based study of AD-associated neuropsychiatric disturbances suggest that a significant majority of persons with AD suffer from one or more neuropsychiatric disturbance. Based on phenomenological study, the spectrum of neuropsychiatric symptoms in AD can be empirically classified into three groups: an affective syndrome, a psychotic syndrome and other neuropsychiatric disturbance. The biologic and predictive validity of this classification merits further investigation.

Aged↗
PubMed2000

Perioperative intracranial hemorrhage in achondroplasia: a case report.

We report a case of a 35-year-old man with achondroplasia who previously had thoracolumbar decompressive laminectomies, who developed recurrence of spinal stenosis at the thoracolumbar junction. The patient underwent standard repeat thoracolumbar decompression, removal of a disc, and spinal fusion with instrumentation in the prone position. Postoperatively the patient was confused. Computed tomography (CT) revealed hemorrhages in both cerebellar hemispheres with surrounding edema and mild mass effect. These were interpreted as venous hemorrhages. Conservative therapy was successful. This is the first case report of perioperative venous intracranial hemorrhage in the context of spinal surgery for achondroplasia. Distinctive anatomic characteristics of achondroplasia, combined with several potentially modifiable aspects of his management, may have predisposed the patient to this complication.

Achondroplasia↗
PubMed2000

Randomized, placebo-controlled, double-blind clinical trial of sertraline in the treatment of depression complicating Alzheimer's disease: initial results from the Depression in Alzheimer's Disease study.

OBJECTIVE: This study evaluated the efficacy and safety of sertraline in the treatment of major depression in 22 outpatients with Alzheimer's disease. METHOD: Twelve of the 22 patients were given sertraline and 10 were given placebo by random group assignment for 12 weeks. Response to treatment was measured by using the Cornell Scale for Depression in Dementia. The patients were also assessed with the Hamilton Depression Rating Scale, the activities of daily living subscale of the Psychogeriatric Dependency Rating Scales, and the Mini-Mental State. RESULTS: After 12 weeks of double-blind, placebo-controlled treatment, nine of the patients given sertraline and two of those given placebo were at least partial responders. Patients given sertraline had significantly greater mean declines from baseline in Cornell Scale for Depression in Dementia scores; the bulk of antidepressant response occurred by the third week of treatment. CONCLUSIONS: Sertraline is superior to placebo in reducing depression in patients with Alzheimer's disease who also suffer from major depression.

Aged↗
PubMed2000

Dementia in elderly persons in a general hospital.

OBJECTIVE: This study investigated the prevalence of dementia in a general hospital, reasons for which patients with dementia were admitted, and the relationship between dementia and length of stay, cost, and in-hospital mortality rate. METHOD: The study focused on data from the hospital database on 21,251 patients aged 60 and older who were discharged in 1996 and 1997. Patients were grouped as with or without a discharge diagnosis of dementia by ICD-9-CM criteria. The groups were compared on sociodemographic characteristics, principal discharge diagnoses, lengths of stay, costs, and in-hospital mortality rates. RESULTS: The prevalence of dementia among discharged patients was 3.9% (N=823); it was dependent on age (age 60-64, prevalence=2.6%; age 85 and older, prevalence=8.9%). The primary discharge diagnoses of the groups were different. The mean length of stay was 10.4 days for patients with dementia and 6.5 days for patients without dementia. Per capita hospital costs were $4,000 higher for patients with dementia. Differences in lengths of stay and per capita costs were statistically significant after adjusting for age, race, and sex. Lengths of stay and hospital costs for patients with dementia were significantly higher for eight primary discharge diagnoses after adjusting for age, race, and sex. CONCLUSIONS: Dementia is present in a significant proportion of patients admitted to general inpatient units. Patients with dementia are admitted for different reasons than patients without dementia and appear to have longer stays, which are associated with higher costs. Efforts to identify dementia early during hospitalization could improve patient care and reduce costs.

Age Distribution↗
PubMed1999

Wandering behaviour in community-residing persons with dementia.

OBJECTIVES: To examine wandering behaviour in elderly demented persons in the community setting with respect to dementia characteristics and other factors that might influence wandering behaviour; to generate a statistical model to assess the relative importance of these various factors in predicting wandering behaviour. DESIGN: Cross-sectional, case-control investigation. SETTING: University-affiliated outpatient neuropsychiatric assessment center. PARTICIPANTS: Six hundred and thirty-eight consecutive community-residing new patients with dementia referred for evaluation. MEASUREMENTS: Comprehensive neuropsychiatric evaluation, including rating with Mini-Mental State Examination; General Medical Health Rating; Comell Scale of Depression in Dementia and caregiver interview. RESULTS: Wandering behaviour occurred in 17.4% of participants. It was significantly more prevalent in patients with Alzheimer Dementia (AD), patients with dementia of longer duration, and patients with more severe dementia. Wandering behaviour was associated with moderate to severe depression, delusions, hallucinations, and sleep disorder. Other significant associations of wandering behaviour included use of neuroleptic medication and male gender. After statistical adjustment for other variables, duration of dementia, severity of dementia and presence of sleep disorder retained significant statistical association with wandering behaviour. CONCLUSIONS: Wandering behaviour among community-residing elderly dementia patients is associated with a number of factors, some of which may be subject to modification. It is possible that management of coexistent psychopathology, particularly of sleep disorder, and of the underlying disease process of AD would help to ameliorate this problematic behavioural disorder. Further investigation is warranted into the relationship between neuroleptic medication and wandering behaviour and into possible alternative measures to control agitation in elderly dementia patients.

Age Distribution↗
PubMed1999

The General Medical Health Rating: a bedside global rating of medical comorbidity in patients with dementia.

OBJECTIVE: Dementia is a serious public health problem. General medical comorbidity is common in dementia patients and critical to their care. However, little is known about medical comorbidity in these patients, and there are no straightforward bedside global rating scales for the seriousness of comorbid medical illness. This paper describes the development and measurement properties of the General Medical Health Rating (GHMR), a rapid global rating scale of medical comorbidity in dementia patients. DESIGN: Interrater reliability, concurrent validity, and predictive validity of the GMHR are reported. SETTING: An outpatient dementia clinic, assisted living, and nursing home. PARTICIPANTS: A total of 819 consecutive dementia clinic outpatients and 180 consecutive admissions to Copper Ridge, a long-term care residence for people with dementia, were included in the study. RESULTS: GMHR was found to be highly reliable (weighted kappa = .91). Across all stages and types of dementia, GMHR ratings were correlated with number of comorbid medical conditions, number of medications being taken for comorbid conditions, and with activity of daily living impairment, even after adjustment for severity of dementia. GMHR ratings were also a strong predictor of falls and of mortality in long-term care residents after adjustment for age and severity of dementia. CONCLUSION: GMHR is a reliable, valid, global bedside measure of severity of general medical comorbidity for patients with dementia that can be used for clinical and research purposes.

Accidental Falls↗
PubMed1999

Physical aggression in dementia patients and its relationship to depression.

OBJECTIVE: The goal of this study was to determine the frequency of physically aggressive behavior in community-residing patients with dementia and its relationship to depression. METHOD: A consecutive series of 541 patients with DSM-IV-defined dementia underwent comprehensive neuropsychiatric evaluation and were rated on the Cornell Scale for Depression in Dementia, the Mini-Mental State, the Psychogeriatric Dependency Rating Scale, and the General Medical Health Rating. RESULTS: Physically aggressive behavior was exhibited by 79 patients in the 2 weeks before evaluation. Aggressive behavior was closely associated with moderate to severe depression, male gender, and greater impairment in activities of daily living, even after adjustment for delusions, hallucinations, sleep disturbance, and severity of cognitive impairment. After adjustment for depression, gender, and impairment in activities of daily living, there was no association between physically aggressive behavior and the presence of either delusions or hallucinations. CONCLUSIONS: A substantial minority of patients with dementia exhibit physically aggressive behavior, and this aggression is strongly linked with the presence of depressive symptoms. It is possible that the identification and treatment of depression in dementia may be a means of preventing and managing physically aggressive behavior.

Activities of Daily Living↗
PubMed1989

Transmitral velocities measured by pulsed Doppler in healthy volunteers: effects of acute changes in blood pressure and heart rate.

The effect of a two minute cold pressor test on transmitral velocities measured by pulsed Doppler was studied in 11 healthy volunteers. Blood pressure increased significantly during cold immersion but peak atrial and peak early diastolic transmitral velocities and their ratio (A:E) were unchanged. There was no correlation between changes in Doppler variables and changes in calculated mean arterial blood pressure during the test. Heart rate changes were variable and not related to changes in blood pressure. In individual people the change in pulse interval during cold immersion was significantly and inversely correlated with the change in the A:E ratio. The large acute increase in arterial pressure seen during the cold pressor test in normal volunteers had no consistent effect on the transmitral velocity profile although small changes in heart rate were associated with large changes in A:E ratio. The effect of small changes in heart rate may be of considerable importance in determining transmitral velocity profiles. Thus in clinical and experimental studies in which the heart rate is not controlled, Doppler data on transmitral flow should be interpreted with caution.

Adult↗
PubMed1978

Malignant fibrous histiocytoma of the heart presenting as an atrial myxoma.

A 37-year-old woman presented with signs and symptoms suggestive of mitral stenosis and insufficiency. Subsequent evaluation demonstrated a left atrial tumor which was suspected clinically and at the time of initial surgery to be an atrial myxoma. Histologic examination revealed that the tumor was actually a malignant fibrous histiocytoma. Despite near total removal at surgery and subsequent radiotherapy, the tumor recurred within six months in the left atrium. Re-excision was followed by a third recurrence in the same site.

Adult↗
PubMed1978

The acute and chronic effects of cadmium on the estuarine mysid, Mysidopsis bahia.

Mysids, small shrimp-like crustacea, proved to be a practical bioassay animal for investigating the effects of cadmium in seawater and may serve this purpose for other pollutants. In the laboratory under flow-through test conditions, the mysid, Mysidopsis bahia, was more sensitive to cadmium than other crustaceans tested. LC50 values were 15.5 microgram/l within 96 hrs and 11.3 microgram/l during a 17-day life cycle, whereas LC50's for other selected crustaceans were between 120 and 720 microgram/l. Results of life-cycle bioassays can aid in the establishment of water quality criteria for marine and estuarine organisms.

Animals↗