Pattern of serum lipid profile of type 2 diabetes patients in a tertiary hospital in Nigeria

Background: Diabetes mellitus is a metabolic disorder characterised by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. Diabetic patients have an increased risk of developing dyslipidemia with various lipid abnormalities which makes them prone to develop cardiovascular disease. The aim of the study is to determine the patterns of lipid profile in patients with Type 2 diabetes mellitus.Methods: Lipid profile data for a total of 104 known type 2 DM patients from the medical outpatient clinic were collected. The profile of the study sample was analysed for dyslipidemia using the ATP III classification. Data obtained were analysed using Analyse-it v3.0 statistical software for Microsoft Excel.Results: This study showed that there were more females 53.8% than males 46.2% with type 2 diabetes mellitus with the mean age of 52.5±11.9 years. The pattern of dyslipidaemia revealed elevated LDL 51.9%, TG 37.5%, TC 36.5% and low HDL 27.9%. We had more patients who were overweight 33.7% than obese 32.7%.Conclusions: It was observed from the study that a significant number of diabetic patients have dyslipidaemia and most common lipid abnormalities are elevated LDL, triglyceride and low HDL

Prevalence of metabolic syndrome and associated factors among human immunodeficiency virus patients on highly active antiretroviral therapy in North central Nigeria

Background: Metabolic syndrome (MS) is a complex disorder defined by cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus. The Use of Highly active antiretroviral therapy in HIV patients is associated with metabolic syndrome which increases the risk of cardiovascular disease (CVD). The aim of the study was to determine the prevalence of MS among HAART treated HIV patients and HAART naïve patients.Methods: This was a cross-sectional study that evaluated 581 (396 females, 184 males) consenting HIV patents in the hospital. Clinical characteristics, anthropometry, blood pressure, lipid profile, fasting blood glucose, fasting plasma insulin, CD4 cell counts and viral load were determined using appropriate standard techniques. MS was defined using International Diabetes Federation (IDF) cut-off values.Results: The overall prevalence of MS was 10.7%, with more females 52 (13.1%) than males 10 (5.4%), p=0.005. MS in patients on HAART was 58 (15.1%) and HAART naive 4 (2.0%). Overall, waist circumference, BMI, systolic blood pressure (BP), diastolic blood pressure (BP), triglycerides and fasting blood glucose were 82.7±11.5, 22.7±, 120.6±17.6, 77.5±10.6, 1.1±0.7 and 5.1±1.9 respectively. Patients with MS had significantly higher (p<0.05) waist circumference (94.1 vs 81.3 cm), BMI (24.8 vs 22.5 kg/m2), systolic BP (135.4 vs 118.8 mmHg), diastolic BP (86.2 vs 76.5 mmHg), triglycerides (1.3 vs 1.0 mmol/l) and fasting blood glucose (6.3 vs 4.9 mmol/l).  Insulin resistance (IR) was higher in patients with MS 11.8(7.9) compared with patients without MS 5.5 (6.8) p=0.02.Conclusions: Prevalence of metabolic syndrome in this study was lower than that reported in previous works, the prevalence is much higher in the HAART treated patients. The risk of MS were high triglycerides, hypertension and abnormal fasting blood glucose. There was significant association with the traditional risk factors, age, female gender and HIV duration.

The Therapeutic Interview Process in Qualitative Research Studies

The purpose of this paper is to describe the systemic strategies used in marriage and family therapy relevant to interviews, via what we call the therapeutic interview process, that expand the meaning of a research study for both the counselor researcher and the participant(s). We outline the therapeutic interview process for conducting transformative - based interviews via similar strategies from a family systems perspective conceptualized by Charlés (2007). The central core of the interview process is the therapeutic conversation itself that involves the systemic whole. This therapeutic conversation is facilitated by debriefing interviews, whereby the counselor researcher is interviewed to promote reflexivit

Prevalence and determinants of glucose intolerance among HIV/AIDS patients in north-central Nigeria

Background: The advent of potent antiviral drugs has revolutionalised the clinical course of HIV / AIDS resulting in increased survival and improved quality of life. Metabolic derangements in HIV infected patients are becoming more common probably due to this increased survival from the use of HAART. There is limited data on the occurrence of glucose intolerance among HIV patients in Nigeria.Objective: To determine the prevalence of glucose intolerance and associated risk factors in HIV/AIDS patients.Methods: Consenting adult HIV patients at the HIV clinic of the Jos University Teaching Hospital (JUTH), Jos , Nigeria were evaluated were evaluated for the presence of glucose intolerance using a 75g oral glucose tolerance test (OGTT). There clinical characteristics, anthropometry, CD4 cell counts and viral load were determined using appropriate standard techniques. Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT), and Diabetes Mellitus (DM) were defined based on the American Diabetes Association (ADA) cut-off values.Results: Of the 584 patients studied, 384 (130 males and 251 females) with mean±SD age of 38±15 years were HAARTtreated; while 200 (61 males and 139 females) with mean±SD age of 33±17 years were HAART-naive. Overall, the prevalence of GI was 40.4% (IFG) 19.5%, IGT 11.5% and DM 9.4%. The prevalence of IFG (27.1%) and DM (11.2%) in HAART - treated patients were observed and those in HAART-naive patients were (IFG 5.0%,DM 6.0%), p&lt;0.005. IGT was more prevalent in HAART-naive than in HAART-treated patients (19.5%, and 7.3% respectively), p&lt;0.05. The proportions of patients with GI were higher in overweight and obese HAART-treated patients with moderate CD4 cell count (200-500 x106 cell/L); while in the HAART-naive patients, GI was more prevalent in underweight subjects with CD4 cell count (&lt;200 x 106 cell/L). The Determinants of GI were age, increasing BMI, low CD4 cell count, metabolic syndrome and HAART treatment duration. The independent predictors of glucose intolerance in HIV / AIDS patients were low CD4 cell count and prolonged HAART treatment duration.Conclusion: The prevalence of GI among HIV/AIDS patients in North-Central Nigeria is high. Treatment with HAART and low CD4 cell count are strong determinants of glucose intolerance in our HIV / AIDS patients. Regular screening for glucose intolerance among our HIV / AIDS patients is recommended.Keywords: HIV, Glucose Intolerance, Prevalence, North-Central Nigeri

Toward a meta-framework for conducting mixed methods representation analyses to optimize meta-inferences

Abstract: The purpose of this article is to propose a meta-framework for conducting what we term mixed methods representation analyses (MMRA). We define MMRA as the appropriate selection of sampling design (i.e., the sampling frame [random] or sampling boundary [purposive]; sampling combination, comprising the mixing dimension [partial/fully], time dimension [concurrent/sequential], emphasis dimension [dominant/equal status], and relationship among/between samples [identical/parallel/nested/multilevel]; sample size; and number of sampling units [e.g., of people, cases, words, texts, observations, events, incidents, activities, experiences, or any other object of study]) in order to obtain representation and concomitantly meta-inferences consistent with the study’s generalization goal(s). Thus, the goal of conducting MMRA is to attain representation and interpretive consistency in order to enhance the rigor of mixed methods research studies

Attitudes toward mixed methods research in psychology: the best of both worlds?

In psychology, there has been a growing interest in mixed methods approaches, however, only a minority of published research explicitly use this methodology. This study aimed to explore the full range of attitudes toward mixed methods research in psychology held by students and academics, using the model of attitudes by Eagly and Chaiken as a framework. Fourteen psychology students and seven academics (48% male and 52% female with ages ranging from 19- to 64-years old) were interviewed about their attitudes toward mixed methods research. Interviews were transcribed and analyzed using thematic analysis. Findings indicate that while participants were generally open to the methodology, misunderstandings were common, most felt they lacked the skills and experience necessary to conduct this research and many were sceptical of mixed methods researchers’ motivations and practices. Identifying attitudes toward mixed methods research has the potential to dispel myths, promote attitudinal change, and increase both the use and teaching of this approach in psychology

Use of mixed methods designs in substance research: a methodological necessity in Nigeria

The utility of mixed methods (qualitative and quantitative) is becoming increasingly accepted in health sciences, but substance studies are yet to substantially benefit from such utilities. While there is a growing number of mixed methods alcohol articles concerning developed countries, developing nations are yet to embrace this method. In the Nigerian context, the importance of mixed methods research is yet to be acknowledged. This article therefore, draws on alcohol studies to argue that mixed methods designs will better equip scholars to understand, explore, describe and explain why alcohol consumption and its related problems are increasing in Nigeria. It argues that as motives for consuming alcohol in contemporary Nigeria are multiple, complex and evolving, mixed method approaches that provide multiple pathways for proffering solutions to problems should be embraced

We are all one together : peer educators\u27 views about falls prevention education for community-dwelling older adults - a qualitative study

Background: Falls are common in older people. Despite strong evidence for effective falls prevention strategies, there appears to be limited translation of these strategies from research to clinical practice. Use of peers in delivering falls prevention education messages has been proposed to improve uptake of falls prevention strategies and facilitate translation to practice. Volunteer peer educators often deliver educational presentations on falls prevention to community-dwelling older adults. However, research evaluating the effectiveness of peer-led education approaches in falls prevention has been limited and no known study has evaluated such a program from the perspective of peer educators involved in delivering the message. The purpose of this study was to explore peer educators’ perspective about their role in delivering peer-led falls prevention education for community-dwelling older adults. Methods: A two-stage qualitative inductive constant comparative design was used.In stage one (core component) focus group interviews involving a total of eleven participants were conducted. During stage two (supplementary component) semi-structured interviews with two participants were conducted. Data were analysed thematically by two researchers independently. Key themes were identified and findings were displayed in a conceptual framework. Results: Peer educators were motivated to deliver educational presentations and importantly, to reach an optimal peer connection with their audience. Key themes identified included both personal and organisational factors that impact on educators’ capacity to facilitate their peers’ engagement with the message. Personal factors that facilitated message delivery and engagement included peer-to-peer connection and perceived credibility, while barriers included a reluctance to accept the message that they were at risk of falling by some members in the audience. Organisational factors, including ongoing training for peer educators and formative feedback following presentations, were perceived as essential because they affect successful message delivery. Conclusions: Peer educators have the potential to effectively deliver falls prevention education to older adults and influence acceptance of the message as they possess the peer-to-peer connection that facilitates optimal engagement. There is a need to consider incorporating learnings from this research into a formal large scale evaluation of the effectiveness of the peer education approach in reducing falls in older adults

Survival Strategies: Doctoral Students’ Perceptions of Challenges and Coping Methods

The purpose of this collective case study was to use a critical dialectical pluralistic (CDP) philosophical lens to investigate select doctoral students’ perceptions about the challenges that they encountered while in a doctorate program and the coping strategies that they found effective in mitigating these challenges. A major goal of CDP is to empower research participants maximally by giving them the role of participant-researchers. Participants were 10 doctoral students enrolled at a Tier-II university in the United States, who were selected via convenience sampling. Each student participated in a face-to-face interview with a member of the research team—consistent with a CDP approach. A qualitative-dominant crossover mixed analysis was used wherein both quantitative and qualitative analyses were used to analyze the qualitative data, with the qualitative analysis phase being dominant. The qualitative analyses (e.g., constant comparison analysis, classical content analysis) revealed the following five themes: compartmentalization of life, outside support systems, justification for participation in program, emotional status, and structure of program. These themes indicated that although challenges are plentiful, particularly in terms of balancing one’s academic life with other obligations, participants found support and encouragement from family, friends, and other doctoral students to be the most beneficial coping strategy. These findings have important implications for the structuring of doctoral programs

Mechanical versus manual chest compressions in the treatment of in-hospital cardiac arrest patients in a non-shockable rhythm : a randomised controlled feasibility trial (COMPRESS-RCT)

Background Mechanical chest compression devices consistently deliver high-quality chest compressions. Small very low-quality studies suggest mechanical devices may be effective as an alternative to manual chest compressions in the treatment of adult in-hospital cardiac arrest patients. The aim of this feasibility trial is to assess the feasibility of conducting an effectiveness trial in this patient population. Methods COMPRESS-RCT is a multi-centre parallel group feasibility randomised controlled trial, designed to assess the feasibility of undertaking an effectiveness to compare the effect of mechanical chest compressions with manual chest compressions on 30-day survival following in-hospital cardiac arrest. Over approximately two years, 330 adult patients who sustain an in-hospital cardiac arrest and are in a non-shockable rhythm will be randomised in a 3:1 ratio to receive ongoing treatment with a mechanical chest compression device (LUCAS 2/3, Jolife AB/Stryker, Lund, Sweden) or continued manual chest compressions. It is intended that recruitment will occur on a 24/7 basis by the clinical cardiac arrest team. The primary study outcome is the proportion of eligible participants randomised in the study during site operational recruitment hours. Participants will be enrolled using a model of deferred consent, with consent for follow-up sought from patients or their consultee in those that survive the cardiac arrest event. The trial will have an embedded qualitative study, in which we will conduct semi-structured interviews with hospital staff to explore facilitators and barriers to study recruitment. Discussion The findings of COMPRESS-RCT will provide important information about the deliverability of an effectiveness trial to evaluate the effect on 30-day mortality of routine use of mechanical chest compression devices in adult in-hospital cardiac arrest patients