Browsing by Author "Shepherd D"

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    Diverse Streptococcus pneumoniae Strains Drive a Mucosal-Associated Invariant T-Cell Response Through Major Histocompatibility Complex class I-Related Molecule-Dependent and Cytokine-Driven Pathways.
    (Oxford University Press, 2018-03-15) Kurioka A; van Wilgenburg B; Javan RR; Hoyle R; van Tonder AJ; Harrold CL; Leng T; Howson LJ; Shepherd D; Cerundolo V; Brueggemann AB; Klenerman P
    Mucosal-associated invariant T (MAIT) cells represent an innate T-cell population that can recognize ligands generated by the microbial riboflavin synthesis pathway, presented via the major histocompatibility complex class I-related molecule (MR1). Streptococcus pneumoniae is a major human pathogen that is also associated with commensal carriage; thus, host control at the mucosal interface is critical. The recognition of pneumococci by MAIT cells has not been defined nor have the genomics and transcriptomics of the riboflavin operon. We observed robust recognition of pneumococci by MAIT cells, using both MR1-dependent and MR1-independent pathways. The pathway used was dependent on the antigen-presenting cell. The riboflavin operon was highly conserved across a range of 571 pneumococci from 39 countries, dating back to 1916, and different versions of the riboflavin operon were also identified in related Streptococcus species. These data indicate an important functional relationship between MAIT cells and pneumococci.
  • Thumbnail Image
    Item
    Factors associated with self-reported health among New Zealand military veterans: a cross-sectional study
    (BMJ Publishing Group Ltd, 2022-05-25) McBride D; Samaranayaka A; Richardson A; Gardner D; Shepherd D; Wyeth E; de Graaf B; Derrett S
    Objective To identify factors associated with better or poorer self-reported health status in New Zealand military Veterans. Design A cross-sectional survey. Participants The participants of interest were the 3874 currently serving Veterans who had been deployed to a conflict zone, but all Veterans were eligible to participate. Study variables The EQ-5D-5L, asking about problems across five dimensions (mobility, self-care, usual activities, pain or discomfort and anxiety or depression), with five levels of severity (eg, no, slight, moderate, severe or extreme problems), also containing a Visual Analogue Scale (EQ-VAS) to self-assess health state, scaled from 0 (worst) to 100 (best) imagined health. Hypothetical relationships with better health were positive social support, sleep and psychological flexibility; with poorer health, post-traumatic stress, exposure to psychological trauma, distress and hazardous drinking. Results The EQ5-D-5L was completed by 1767 Veterans, 1009 serving, a response rate of 26% from that group, 1767 completing the EQ5-D, 1458 who had deployed, 288 who had not and the 21 who did not provide deployment data. Of these, 247 were not used in the analysis due to missing values in one or more variables, leaving 1520 for analysis. A significantly higher proportion of Veterans reported ‘any problems’ rather than ‘no problems’ with four EQ-5D dimensions: mobility, self-care, usual activities and pain or discomfort, but no difference in anxiety or depression. Age, length of service, deployment, psychological flexibility and better sleep quality were associated with higher EQ-VAS scores; distress with lower EQ-VAS scores. Conclusion In this sample of New Zealand Veterans, psychological flexibility and good sleep are associated with better self-rated health, and distress and poor sleep with diminished health. These factors might be used as sentinel health indicators in assessing Veteran health status, and cognitive–behavioural therapy encompassing these domains may be useful in improving the health of New Zealand Veterans.
  • Thumbnail Image
    Item
    Factors predicting parenting stress in the autism spectrum disorder context: A network analysis approach
    (PLOS, 2025-04-21) Buchwald K; Shepherd D; Siegert RJ; Vignes M; Landon J; Singh AS
    Elevated levels of parenting stress have been reported in parents raising an Autistic child. Previous studies have identified a multitude of predictors of parenting stress, including both child-related and parent-related factors, though findings across studies are not always in agreement. In the present study we investigate the determinants of parenting stress using a Network Analysis approach, which is then used to inform a subsequent structural equation model. New Zealand parents (n = 490) of a child diagnosed with Autism Spectrum Disorder (ASD) provided data on their Autistic child (e.g., ASD core symptoms, problem behaviours) and themselves (i.e., parenting stress). The analysis revealed that both child and parent demographic factors were poor predictors of parenting stress, while the child’s current language and communication ability were correlated with diagnostic age and parenting stress. An earlier diagnostic age, in turn, suggested better behavioural and emotional outcomes for children. Overall, the Network Analysis showed itself to be an informative approach to understanding parenting stress in the ASD context. Findings further advocate for the implementation of ASD-related and language-related interventions as early as possible, and that language delays during early infancy justify prompt clinical assessment.
  • Thumbnail Image
    Item
    Health effects of transport noise
    (Taylor and Francis Group, 2023-04-26) Welch D; Shepherd D; Dirks KN; Reddy R
    The relationship between transport noise and health outcomes is complex, in part because of the large number of factors involved as well as the range of health impacts, both direct and indirect. To enable the reader to come to grips with the complexity, we have divided the health outcomes into groups: those that are more directly linked to transport noise exposure and those that are more indirectly linked. Four health outcomes, namely annoyance, cognitive disruption, sleep problems, and noise-induced hearing loss, can be directly attributable to transport noise exposure. Less direct outcomes are stress, mental health, metabolic health, cardiovascular health, and overall health-related quality of life. Stress may occur as a direct response to noise, or may occur in response to the aforementioned direct effects. The stress response is a survival mechanism in the short term, but in the long term, stress may lead to systemic health conditions, namely metabolic and cardiovascular outcomes, and to mental health conditions. Finally, a global health outcome that incorporates all of the more direct outcomes is health-related quality of life. Other exposures associated with transport noise that may explain parts of the health outcomes need to be acknowledged, including exposure to social inequities, air pollution, and vibration. These may all be more likely to be experienced by people who are exposed to transport noise in the community and may thus influence the outcomes. Finally, transport noise appears to have more impact on health in those who are noise sensitive, thus noise sensitivity is a key moderator of all the effects observed.
  • Thumbnail Image
    Item
    Using network analysis to identify factors influencing the heath-related quality of life of parents caring for an autistic child
    (Elsevier Ltd., 2024-09-01) Shepherd D; Buchwald K; Siegert RJ; Vignes M
    BACKGROUND: Raising an autistic child is associated with increased parenting stress relative to raising typically developing children. Increased parenting stress is associated with lower parent wellbeing, which in turn can negatively impact child wellbeing. AIMS: The current study sought to quantify parenting stress and parent health-related quality of life (HRQOL) in the autism context, and further understand the relationship between them by employing a relatively novel statistical method, Network Analysis. METHODS AND PROCEDURES: This cross-sectional study involved 476 parents of an autistic child. Parents completed an online survey requesting information on parent and child characteristics, parent's perceptions of their autistic child's symptoms and problem behaviours, and assessed their parenting stress and HRQOL. OUTCOMES AND RESULTS: Relative to normative data, parent HRQOL was significantly lower in terms of physical health and mental wellbeing. The structure extracted by the Network Analysis indicated that child age and externalising behaviours were the main contributors to parenting stress, and that externalising behaviours, ASD core behavioural symptoms, and parenting stress predicted HRQOL. CONCLUSIONS AND IMPLICATIONS: Parental responses to child-related factors likely determine parent HRQOL. Findings are discussed in relation to the transactional model, emphasising the importance of both parent and child wellbeing.