Analysis of response to enteral infusion of levodopa in patients with Parkinson's disease

Objective: We present a new evaluation of levodopa plasma concentrations and clinical effects during duodenal infusion of a levodopa/carbidopa gel (Duodopa ) in 12 patients with advanced Parkinson s disease (PD), from a study reported previously (Nyholm et al, Clin Neuropharmacol 2003; 26(3): 156-163). One objective was to investigate in what state of PD we can see the greatest benefits with infusion compared with corresponding oral treatment (Sinemet CR). Another objective was to identify fluctuating response to levodopa and correlate to variables related to disease progression. Methods: We have computed mean absolute error (MAE) and mean squared error (MSE) for the clinical rating from -3 (severe parkinsonism) to +3 (severe dyskinesia) as measures of the clinical state over the treatment periods of the study. Standard deviation (SD) of the rating was used as a measure of response fluctuations. Linear regression and visual inspection of graphs were used to estimate relationships between these measures and variables related to disease progression such as years on levodopa (YLD) or unified PD rating scale part II (UPDRS II).Results: We found that MAE for infusion had a strong linear correlation to YLD (r2=0.80) while the corresponding relation for oral treatment looked more sigmoid, particularly for the more advanced patients (YLD>18).

To achieve safe and respectful maternity care in tertiary level hospitals in Nepal, relatives are a valued addition to the provision of maternity care

Introduction: The White Ribbon Alliance for safe motherhood believes respectful maternity care is the universal right of every childbearing woman. Methods: NHRC in 2012 approved an inquiry of respectful care at facility-based childbirth. Individual-, focus group interviews and content analysis was used for gathering and analysis of data. Findings: The participating women and the SBAs shared similar views, and this was that together the SBAs and relatives ensured the women remained within the comfort and safety zone when giving birth in a tertiary level maternity unit. Conclusion: The SBAs strategy of having relatives provides basic care alongside the provision of medical care by the SBAs is a strategy that Nepal could use to improve the quality of its maternity care without any additional costs. Clinical implication: Prenatal classes might contribute to preparing relatives. Further Research: Further research could evaluate such a strategy in order to determine its effectiveness in reduction of morbidity and mortality.

Consumer reactions to different forms of CSR communication

Aim Companies around the world are making sizeable investments into CSR initiatives, but ensuring appropriate returns on these investments remains challenging. Therefore, it is of value to study the communication of corporate CSR efforts. The purpose of this study is to investigate how consumers react to rational versus emotional message strategies in CSR communication. Two categories of consumer reactions were considered: trust and purchase intention. Methods Qualitative research with four focus groups was conducted. Participants discussed three texts regarding a CSR project, utilising a rational, emotional and a hybrid rational-emotional message strategy respectively. The conversations focused on trust towards the communication and purchase intention. Results Trust - All of the respondents viewed the rational text over the emotional text as more trustworthy, but they most positively reacted to the combined strategy. Rational information was viewed as more reliable by many participants, with emotional cues adding value by better holding their attention. Purchase intention – Participants more positively reacted to the rational CSR communication strategy, compared to an emotional strategy. For approximately half of respondents, the hybrid strategy targeting both rational and emotional cues was the most successful in terms of purchase intention. Upon further analysis, it was identified that this division in respondents’ opinions may reflect a gender difference, where men portrayed the more task oriented and women the socially sensitive consumers. Conclusions The findings support previous research championing the use of rational strategies over emotional strategies in CSR communication. A number of managerial implications that can be used by companies in order to better communicate their CSR activities and increase returns on CSR-related investments are provided.