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Careful Description (careful + description)
Selected AbstractsThe prevalence of lipodystrophy in an ambulant HIV-infected population: it all depends on the definitionHIV MEDICINE, Issue 3 2001VM Carter Objectives This study's objective was to determine the prevalence of body shape changes and metabolic abnormalities in an ambulant population with HIV infection. Three different definitions of lipodystrophy were used to assess these changes. Patients' anthropometric measures and dual-energy X-ray absorptiometry (DEXA) scans were compared in order to estimate fat distribution in this population. We sought to evaluate potential predictors for lipodystrophy according to each of the three definitions. Methods We performed a cross-sectional study in the outpatient clinic of a tertiary referral hospital in Melbourne, Australia. We enrolled a total of 167 HIV-infected ambulatory patients over 3 months in mid-1998. Data on 159 males, 149 of whom were receiving triple combination antiretroviral therapy, were evaluated. Anthropometric measures, clinical examination, self-report of body shape changes, biochemical measures and DEXA scan were used to assess lipodystrophy and risk factors for cardiovascular disease. Patients described body shape changes in the face, trunk, arms and legs. Laboratory parameters measured included fasting triglyceride (TG), cholesterol, high-density lipoproteins (HDL), glucose, insulin, CD4 cell count and plasma HIV RNA. Current and past antiretroviral therapies were ascertained. Results According to one proposed Australian national definition of lipodystrophy (LDNC), the prevalence of lipodystrophy in this population was 65%. This definition included an objective assessment with major and minor criteria. Patient-defined lipodystrophy (LDP), which involved a subjective assessment of thinning arms and legs and central adiposity, occurred in 19%. Patient-defined lipoatrophy (LAP), which involved a subjective assessment of thinning arms and legs without central adiposity, occurred in 21.3%. No change in body habitus was noted by 37% of the cohort. Hypercholesterolaemia was recorded in 44%, hypertriglyceridaemia in 52% and elevated insulin levels in 23%. Anthropometry was predictive of the per cent total body fat recorded by DEXA scan, but produced consistently lower values. In multivariate analysis, LDP and LAP were significantly associated with stavudine (d4T) use, while LAP was also associated with zidovudine (ZDV) treatment. There were no treatment associations with LDNC. Protease inhibitor (PI) exposure was associated with metabolic changes but not patient perceived body shape changes, while d4T and ZDV exposure was associated with increased triglycerides and reduced peripheral fat stores. Conclusions The prevalence of body shape changes in a single population varied depending on the definition applied. The LDNC definition overestimated body shape abnormalities in comparison with patient perception. LAP was associated with significantly lower fat stores measured by anthropometry and DEXA scan than those identified under the LDNC definition. In contrast to LDNC, LAP was associated with d4T exposure, nucleoside reverse transcriptase inhibitor (NRTI) and ZDV duration of use, but not PI use. Until a consensus definition for lipodystrophy is developed, including agreement on objective measurement and thresholds for abnormality, careful description of the individual components of the syndrome is required to enable cohort comparisons so that predictors of the syndrome can be assessed more accurately and outcome studies made feasible. [source] The Galicia study of mental health of the Elderly I: general description of methodologyINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2000Professor R. Mateos Abstract Reports of epidemiological surveys do not always adequately provide a careful description of the methodology used and the sociocultural context involved. The objective of this paper is to describe the methodology used in a survey whose aim was to study the prevalence of the wide range of psychiatric disorders that were present in a population aged 60 and above who were living at home. The Galicia Community Study of Mental Health of the Elderly was designed in two phases. In the first, a random sample of 3,580 people over 60 years of age, representative of each of the nine public health authority areas, was interviewed at home. The 60-item version of Goldberg's General Health Questionnaire (GHQ) was the screening instrument. In the second phase, all the traced subjects with high GHQ scores (N = 532) and a representative sample (N = 149) of people below the cut-off point, were interviewed at home using the Diagnostic Interview Schedule (DIS-III). This paper analyses the sociodemographic context of Galicia (a natural region in south-western Europe with a population of 2.7 million inhabitants), the sampling method, the sociodemographic makeup of the sample, the fieldwork, and the method for obtaining the estimate of prevalence. Copyright © 2000 Whurr Publishers Ltd. [source] Ethmoid mucocele: A new feature of primary ciliary dyskinesiaPEDIATRIC PULMONOLOGY, Issue 2 2010Marco Berlucchi MD Abstract Primary ciliary dyskinesia (PCD) is a rare congenital autosomal recessive disease that produces impairment of mucosal ciliary movement. Children with this disorder usually manifest recurrent and chronic infections of the upper and lower airways. We describe the history of a 12-month-old boy in whom the correct diagnosis of PCD was achieved after the occurrence of ethmoid mucocele associated with omolateral proptosis. A careful description of this new feature of PCD and its dangerous complications are also presented. Pediatr Pulmonol. 2010; 45:197,201. ©2009 Wiley-Liss, Inc. [source] The Galicia study of mental health of the Elderly II: the use of the Galician DISINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2000Professor R. Mateos Abstract Reports of epidemiological surveys do not always provide adequate careful descriptions of the methodology used and the sociocultural context involved. Galicia, a natural region in south-west Europe, possesses certain characteristics that differ from those in other communities within the Spanish state. Galician is a Romance language, which is, in fact, closer to Portuguese than it is to Spanish. The population (2.7 million inhabitants) is widely dispersed, with two-thirds of them living in the countryside. More than 18% are older than 65, and the educational level of this elderly population is low. A total of 681 persons over 60 years of age were interviewed in their homes using the DIS-III as the main diagnostic instrument during the second phase of the Galicia Study of Mental Health of the Elderly. This paper analyses some methodological implications of this epidemiological study, focusing on the translation of the DIS into Galician and its performance and acceptability in this community. The possible cultural bias that can affect the rates of prevalence in some specific disorders, the limitations of lifetime prevalence and the advantages of using six-month prevalence rates is discussed. Besides some interesting anecdotes, which are described in the article, the main result is the very high acceptance of DIS-III in this elderly population. Copyright © 2000 Whurr Publishers Ltd. [source] A synergy between action-research and a mixed methods design for improving services and treatment for family members of heavy alcohol and drug usersJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2010Caterina Arcidiacono Abstract Our project first explored the patterns of disempowerment within 113 Italian families facing the problem of a heavy alcohol or drug user in the family. It then provided therapeutic interventions for the members of a further fifty-two families, and thirdly, as a part of the diffusion of the results, it provided brief training for 1,011 professionals supplying services for those suffering from alcohol and drug addiction. Research undertaken in the UK, Mexico and Australia (Copello, Templeton, & Velleman, 2006; Orford et al., 2005a; Orford, Templeton, Velleman, & Copello, 2005b; Velleman & Templeton, 2003) on the impact of substance misuse on families, and on the development of effective interventions to assist those families, supplied the models for this participatory research in Italy. This article discusses the mobilization of health professionals in developing a participatory project within a cross-cultural framework, focusing on research that involved more than 70 researchers and other professionals all over Italy. Research team discussions, peer validation of gathered data and reflexivity all had a significant role. The paper illustrates various issues, which are often not explicitly mentioned in research reports, related to recruitment, cooperation between researchers, interactions between researchers and participants, information about decision-making and the actual modalities of execution of the project. Moreover, the careful descriptions of qualitative research principles within the action research approach and a mixed methods design should enhance the research competencies of psychologists and social scientists involved in the community. Copyright © 2009 John Wiley & Sons, Ltd. [source] |