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Biomedical subjects

A P Burgess

Publications and source records attributed to A P Burgess.

At least 19 recordsLinked to original sources
PubMed2001

Reasons for non-adherence to antiretroviral therapy: patients' perspectives provide evidence of multiple causes.

The objective of the study was to define common reasons for non-adherence (NA) to highly active antiretroviral therapy (HAART) and the number of reasons reported by non-adherent individuals. A confidential questionnaire was administered to HIV-seropositive patients taking proteinase inhibitor based HAART. Median self-reported adherence was 95% (n = 178, range = 60-100%). The most frequent reasons for at least 'sometimes' missing a dose were eating a meal at the wrong time (38.2%), oversleeping (36.3%), forgetting (35.0%) and being in a social situation (30.5%). The mean number of reasons occurring at least 'sometimes' was 3.2; 20% of patients gave six or more reasons; those reporting the lowest adherence reported a significantly greater numbers of reasons (rho = - 0.59; p < 0.001). Three factors were derived from the data by principal component analysis reflecting 'negative experiences of HAART', 'having a low priority for taking medication' and 'unintentionally missing doses', accounting for 53.8% of the variance. On multivariate analysis only the latter two factors were significantly related to NA (odds ratios 0.845 and 0.849, respectively). There was a wide spectrum of reasons for NA in our population. The number of reasons in an individual increased as adherence became less. A variety of modalities individualized for each patient are required to support patients with the lowest adherence.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The role of personality, coping style and social support in health-related quality of life in HIV infection.

OBJECTIVE: To determine the role of health status, personality and coping style, on self-report health-related quality of life (QoL). METHODS: Participants were HIV seropositive individuals at all disease stages from three samples (a) gay/bisexual men from the UK, (b) injecting drug users from the UK, (c) injecting drug users from Italy. All participants completed questionnaires evaluating QoL, personality, coping style and social support. Explicit models of the relationships between the measured variables based on a review of the literature were tested using structural equation modelling. RESULTS: Health status was modestly associated with the physical but not the psychological aspects of QoL (beta = 0.44). Neuroticism was strongly associated with psychological QoL (beta = -0.73) but only weakly with physical QoL (beta = -0.21). The samples did not differ in either the pattern or the magnitude of these relationships. Mediating factors such as coping style, social support and other personality variables had only a weak influence on the role of Neuroticism. CONCLUSIONS: Neuroticism had a strong influence on health-related QoL that was independent of health status. Neuroticism was more strongly associated with the psychological aspects of QoL than health status. Coping styles and the other psychological variables assessed had only a weak mediating influence on this relationship.

Adaptation, Psychological↗
PubMed2000

The relationship of psychological variables and disease progression among long-term HIV-infected men.

This study investigated the contribution of psychological factors to disease progression among long-term HIV-1 infected gay men. Participants completed self-report measures including coping strategies, life events, social support, personality and psychological morbidity and were followed clinically for up to 30 months. Cox proportional hazards survival analyses were carried out to CD4<200 x 106/1 and AIDS-related complex (ARC) or AIDS diagnosis controlling for viral load, antiretroviral drug use and CD4 count. Only acceptance coping was a significant predictor of time to ARC or AIDS diagnosis: the risk of ARC or AIDS was almost 5 times greater for those scoring within the lowest tertile compared with those scoring in the highest tertile (HR=4.7, 95% CI 1.8-12.3).

AIDS-Related Complex↗
PubMed2000

Short duration power changes in the EEG during recognition memory for words and faces.

Although memory has been widely studied using event-related potentials, memory-related changes in the electroencephalogram (EEG) have been relatively neglected. The aim of this study was to determine whether evidence could be found for memory-related changes in the EEG. EEG was recorded from a sample of healthy volunteers while they performed word and face recognition memory tasks. Data were analyzed using the method of event-related desynchronization. In the theta frequency range there was a short-duration increase in power that occurred in the first 250 ms that was maximal at temporal sites (T5/T6). For words, but not faces, there was a repetition effect in theta such that new words elicited greater synchronization than old words at the midline frontal electrode (Fz). In the alpha frequency range there was a lateralized repetition effect, which occurred from 750 ms. In upper alpha this effect was lateralized in the expected way with greater desynchronization at temporo-parietal sites on the left for words and on the right for faces. For lower alpha, the lateralization was reversed. The meanings of these findings are interpreted in the light of existing models of recognition memory.

Adult↗
PubMed1998

The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus.

Although quality of life evaluations are widely used throughout medicine, relatively little is known about the psychological processes involved in making these judgements. What is known is that quality of life judgements are not straightforwardly associated with objective measures of health status or clinician ratings. In particular, patient affect appears to be associated with quality of life ratings but whether this relationship is secondary to physical health or not is controversial. The aim of this study was to determine the role of anxiety and depression in the reporting of quality of life in a group of patients with diabetes mellitus. One hundred consecutive patients with diabetes (insulin-dependent diabetes mellitus n = 36 and non-insulin-dependent diabetes n = 64) were assessed using a self-report measure of quality of life, a symptom checklist and a questionnaire measure of anxiety and depression. In addition, they were independently rated for their level of physical impairment. The results showed that depression and, to a lesser extent, anxiety were significantly related to self-reported quality of life even when the differences in physical health and age were controlled for statistically. This study shows that, independent of the level of physical illness, affect, particularly depressive affect, is an important factor in the determination of quality of life.

Activities of Daily Living↗
PubMed1998

Psychological distress and burnout among buddies: demographic, situational and motivational factors.

Work-related psychological distress (burnout) is a probable cause of drop-out among emotional support volunteers (buddies) who work with people living with AIDS. In addition to the emotional suffering and disruption to both the buddy and the buddied, burnout has significant cost implications for voluntary organizations in terms of training and recruitment. The aim of this study was to identify the demographic, situational and motivational factors associated with burnout among buddies with the intention of identifying individuals at risk at the recruitment stage. A cross-sectional single cohort postal questionnaire study design was used. All buddies registered with the Terrence Higgins Trust, a non-profit making organization set up in the UK to provide education about HIV/AIDS and care for people affected by the virus, were invited to participate. Psychological morbidity was measured with the Hospital Anxiety and Depression Scale, burnout with the Maslach Burnout Inventory and motivation was assessed using the Calvert Motivation Checklist. Information on the buddy relationship and the demographic details of each buddy was also collected. Of 586 questionnaires distributed, 324 (55%) were returned. More than 24% of buddies were classified as probable cases of burnout on one or more of the MBI scales but this is lower than has been reported in medical and nursing staff working with people living with AIDS. Although a number of demographic, situational and motivational factors were associated with burnout, logistic regression models were unable to identify a useful proportion of individuals at risk. It was concluded that although burnout is an important psychological factor in retaining volunteers, it was not possible to identify individuals at risk of burning out either from their self-reported motivations or from demographic factors.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Short duration synchronization of human theta rhythm during recognition memory.

Structures within the medial temporal lobe, particularly the hippocampus, have long been implicated in human episodic memory. The same structures are known to generate EEG in the theta frequency range in animals. The aim of this experiment was to investigate the time course of changes in the human theta rhythm during a word recognition memory task. In the period 125-250 ms after the visual presentation of a word, theta power increased by an average of 13% compared with the prestimulus baseline period and this increase was more than twice as great for repeated words (18%) as for new ones (8%). These results show that there are short duration changes in the human theta rhythm associated with recognition memory.

Adult↗
PubMed1997

How reproducible is the topographical distribution of EEG amplitude?

If topographical EEG is to be a useful tool for localising cerebral processes, then the results of the same, or closely similar experiments, using different samples should yield similar results. Although the reliability of EEG is well established in other ways, there is little available data on the reproducibility of EEG topography across experiments. The aim of this study was to determine the reproducibility of topographical EEG by comparing the results of two independently conducted experiments. EEG was recorded during an Eyes Open baseline and a motor task condition (the Luria finger opposition task) in two independent samples of healthy subjects. EEG was recorded in 2.56-s epochs and analysed by FFT into conventional theta, alpha and beta 1 frequency bands. The EEG amplitude for each subject in each frequency range was averaged over a minimum of 60 s. Separate group averages for each sample were calculated and the resulting topographical distributions of electrical potential and current density were compared. The results indicated that the reproducibility of electrical potential in the theta and beta 1 frequency ranges was extremely poor and only approached acceptable levels in alpha. Reproducibility of current source density was poor in all frequency ranges. Although some improvement in reproducibility was obtained following spatial smoothing for alpha potential, the highest reproducibility achieved was only 0.65. Reasons for the poor reproducibility of topographical EEG and the implications of these findings are discussed.

Adolescent↗
PubMed1997

Sexual Risk Cognitions Questionnaire: a reliability and validity study.

The Sexual Risk Cognitions Questionnaire was designed to assess the type and frequency of cognitions associated with unsafe sex. It consists of 22 core items (SRCQ-22) with six subsections. Each subsection consists of 8-12 items designed for specific subgroups defined by gender, sexual orientation and HIV serostatus. Data on reliability and validity are presented based on a sample of 344 respondents in London. Reliability for all sections of the questionnaire was high but sample numbers were relatively small for some subsections. Validity for the SRCQ-22 was assessed in terms of its relationship with self-reported sexual behaviour among men who have sex with men who made up the largest proportion (70%) of the sample. The results indicate that the SRCQ-22 is a reliable measure for assessing cognitions related to HIV risk sexual behaviour in this population and supports the view that they are important determinants of safe and unsafe behaviour.

Adolescent↗
PubMed1997

Localization of word and face recognition memory using topographical EEG.

The aim of this study was to explore the ability of epoch-averaged electroencephalogram (EEG) to localize cognitive functions. The EEG was recorded in healthy individuals performing a task where, on the basis of evidence from other functional brain imaging techniques, there was a high expectation of where functional changes would be expected. Topographical EEG was recorded while individuals performed recognition memory tasks for words and faces. Comparison of the acquisition and recognition phases of the experiment showed significant attenuation of alpha, beta 1, and beta 2 in the right temporoparietal region for the faces but no significant changes for words. Left temporoparietal changes for the word task were only seen among the women. The results confirmed the validity of EEG for use in the localization of cognitive function for faces for men and women but in the case of words for the women only.

Adolescent↗
PubMed1996

Women and HIV infection: investigation of its psychosocial consequences.

HIV infection is associated with substantial psychological and social morbidity, although there is a dearth of studies of women with the infection. In recent years, developed countries have reported an increase in the prevalence of HIV infection in women, a fact that makes it all the more important to address the study of their psychological and social status. The study is a controlled investigation of HIV seropositive (n = 49) and seronegative women (n = 43), including study of psychological status and history, social functioning and perceived supports, coping style, life events, and sexual difficulties. The results show that about a third of women were psychiatric cases, regardless of HIV status, although more than half of symptomatic women were psychiatric cases. Seropositive women were less likely to use instrumental social supports and more likely to use mental disengagement as ways of coping. Regarding perceived social supports, positive women had lower scores on social integration and guidance. Positive women were more likely to experience sexual difficulties and not to be in a relationship. Negative women reported more adverse life events in the last 6 months. Psychiatric morbidity was associated with poorer social adjustment and more adverse life events, but not with serostatus. HIV positive women and those at risk of HIV infection have substantial levels of psychological and social morbidity that require recognition by those involved in their care and provision of adequate mental health intervention.

Adaptation, Psychological↗
PubMed1996

The reliability of event-related desynchronisation: a generalisability study analysis.

The aim of this study was to examine the spatio-temporal reliability of EEG power during the baseline period of an event-related desynchronisation (ERD) experiment. The data were analysed using ideas from generalisability theory. The largest sources of variance were found to be associated with differences between subjects (subject main effect), and to idiosyncratic topographical distributions (subject x electrode interaction). The resulting spatio-temporal reliabilities exceeded 0.7, except in theta and the absolute power values were relatively stable. Overall, this study gives further support for the reliability of quantitative EEG measures in general and for the method of ERD in particular.

Adult↗
PubMed1996

Reliability and validity of an HIV-specific health-related quality-of-life measure for use with injecting drug users.

OBJECTIVE: To assess the reliability and validity of an HIV-specific quality of life (QoL) questionnaire for use with injecting drug users (IDU). METHOD: One hundred IDU with HIV infection (27 asymptomatic, 48 symptomatic, 25 with AIDS) completed the HIV adaptation of the Medical Outcomes Study questionnaire (MOS-HIV). Validity of the scale was assessed by comparing the scores on the MOS-HIV with measures of health and psychological status. Measures of health status used included Centers for Disease Control and Prevention (CDC) stage, CD4 cell count and number of HIV-related illnesses. Psychological status was assessed using the Hospital Anxiety and Depression Scale. Sociodemographic data and information on illegal drug consumption were also collected. RESULTS: The MOS-HIV showed a good internal reliability on all scales and the factor structure was comparable with that reported from previous studies. The psychological scales from the MOS-HIV showed good concurrent validity. For the physical aspects of QoL, however, some scales were poor at discriminating between different HIV disease stages. One reason for this may have been that factors associated with a history of injecting drug use had a significant negative impact on QoL, particularly for asymptomatic patients. It was notable that QoL in asymptomatic infection was found to be substantially lower than has been reported for gay/bisexual men using the same instruments and was more strongly associated with factors related to drug use rather than to HIV disease status. CONCLUSION: The MOS-HIV is a reliable and valid measure, but in patients with a history of injecting drug use some of the scales measuring the physical aspects of QoL may be relatively insensitive to changes in health.

Adult↗
PubMed1995

Post-hepatitis syndrome revisited.

To examine the role of acute hepatitis A and B infection in the aetiology of chronic fatigue syndrome and psychiatric morbidity we studied 40 patients with acute viral hepatitis A or B consecutively admitted to an infectious diseases unit and studied at least 6 months after recovery. Liver function tests (LFT) had returned to normal in each case. Forty-seven patients with other infectious diseases, of which 12 were presumed viral, admitted immediately after each hepatitis patient during the same period acted as controls. The main outcome measures were scores on a fatigue and muscle pain questionnaire, general health questionnaire (GHQ-12) and supplementary questions. The hepatitis cases scored significantly higher fatigue scores, GHQ-12 scores and muscle pain scores. Length of time since recovery from illness, age and sex were not confounding factors. Hepatitis cases were also less energetic, had greater weight change, had altered alcohol tolerance, had less exercise tolerance and felt less fit than the control group and compared with their premorbid state. Hence fatigue is more common after recovery in patients hospitalized for hepatitis A and B up to 30 months post-infection compared with matched controls hospitalized for other infectious diseases. Hepatitis A and B infection is a risk factor for post-infection fatigue, intermittent fatigue, as well as for psychiatric morbidity.

Adolescent↗
PubMed1994

A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. I. Neuropsychological performance and neurological status at baseline and at 12-month follow-up.

The aim of this study was to determine whether HIV infection is associated with neurological or neuropsychological impairment in the asymptomatic and early symptomatic stages of disease. Subjects included 61 gay men (41 HIV-, 20 HIV+) who were assessed at the time of requesting their first HIV test and again 12 months later. The assessments at baseline were conducted double-blind to HIV serostatus. Measures included a neuropsychological battery, neurological examination and full psychiatric assessment. There were no differences between the asymptomatic HIV+ and HIV- groups at baseline or at follow-up in terms of mean scores on neuropsychological tests. Mean scores were within the normal range for all neuropsychological tests for both groups. Multiple regression analysis was used to predict each individual's performance at follow-up on the basis of their baseline performance, psychiatric state, neurological history and drug use for each of the neuropsychological tests. HIV+ subjects were more likely than control subjects to perform at a significantly lower level at follow-up on one or more tests than predicted on the basis of their baseline performance.

AIDS Dementia Complex↗
PubMed1994

A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. II. Psychological and health status at baseline and at 12-month follow-up.

The aim of this study was to determine whether HIV infection is associated with increased psychosocial distress in the asymptomatic and early symptomatic stages of disease and to determine the factors associated with reporting health symptoms. Subjects included 61 gay men (41 HIV--, 20 HIV+) who were assessed at the time of requesting their first HIV test and again 12 months later. Measures included a detailed standardized psychiatric interview (Present State Examination, PSE), a range of psychosocial self-report measures and a physical symptom checklist. There were no differences between the HIV+ and HIV-- groups in terms of self-reported symptoms. Multiple regression analysis showed that the symptom reporting was not associated with clinical or immunological markers of disease progression but was associated with measures of psychosocial distress. Although both groups showed elevated levels of psychosocial distress at the time of HIV testing, there were no differences between serostatus groups at follow-up. Multiple regression analysis indicated that the best predictors of PSE scores at follow-up were baseline PSE score and a history of psychiatric illness. Early HIV disease is not associated with increased psychosocial distress and symptom reporting is more closely related to psychological measures than to clinical or immunological markers of disease.

AIDS Dementia Complex↗