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Biomedical subjects

N Amodei

Publications and source records attributed to N Amodei.

14 recordsLinked to original sources
PubMed2000

HIV-associated changes in adaptive, emotional, and behavioral functioning in children and adolescents with hemophilia: results from the Hemophilia Growth and Development Study.

OBJECTIVE: To assess changes in adaptive, emotional, and behavioral functioning over four years in children and adolescents with hemophilia and with or without HIV infection and to evaluate the relationship of these changes to immune status. METHODS: Participants were 277 HIV-seropositive and 126 HIV-seronegative boys with hemophilia. Participants with HIV infection were divided into three groups based on trajectory of immune functioning (CD4+ cell counts) over the course of the study. Caregivers completed the Vineland Adaptive Behavior Scales and Pediatric Behavior Scale (PBS). RESULTS: Results showed declining Vineland Communication scores for participants with consistently poor immune functioning. These participants also started with more PBS Attention Deficit and Deviation symptoms, which then decreased more sharply than for other groups. Low CD4+ counts were consistently associated with more Health and Depression-Anxiety symptoms on the PBS. However, with few exceptions, group means remained within normal limits. CONCLUSIONS: According to their caregivers, boys with hemophilia and HIV infection showed considerable resilience with regard to adaptive behavior and emotional and behavioral problems. However, over time changes occurred in these areas that appear to be related to immune functioning.

Adaptation, Psychological↗
PubMed1999

HIV/AIDS mental health training for health care providers: an evaluation of three models.

Three models of continuing education--full-day, half-day, and brief workshop--for health providers treating patients with HIV/AIDS were compared on measures of effectiveness with regard to knowledge, attitude, and practice outcomes. Analyses of pre- and postintervention data from two years of training events suggest consistent, modest, program effects in the full-day and half-day approaches, specifically in the area of knowledge enhancement.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Hemophilia growth and development study: relationships between neuropsychological, neurological, and MRI findings at baseline.

OBJECTIVE: To determine the effects of human immunodeficiency virus (HIV) infection on children's development by identifying neurological and environmental variables associated with neuropsychological measures of cognitive development in HIV-seronegative (HIV-) and HIV-seropositive (HIV+)children and adolescents with hemophilia. METHODS: Participants (N = 298; 60% HIV+) were males ages 7-19 years enrolled in the Hemophilia Growth and Development Study (HGDS). Least squares modeling was used to determine whether there was a difference at baseline in mean neuropsychological test scores by HIV status, age, and neurological baseline findings, adjusting for selected environmental and medical history variables. RESULTS: The participants were within age expectations for general intelligence. Variables associated with lowered neuropsychological performance included academic problems, coordination and/or gait abnormalities, parents' education, and previous head trauma. CONCLUSIONS: Hemophilia-related morbidity has a subtle adverse influence on cognitive performance. HIV infection was not associated with neuropsychological dysfunction in this group even when MRI abnormalities were present.

Adolescent↗
PubMed1997

Stress in families of HIV-positive children living in south Texas.

The purpose was to conduct a pilot study of the extent of stress and differences in sources of stress experienced by HIV+ and HIV- caregivers of HIV+ children living in South Texas. 13 infected and 9 uninfected caregivers each completed the Questionnaire on Resources and Stress for their preschool-aged HIV+ child. Both HIV+ and HIV- caregivers experienced clinically significant stress. HIV+ caregivers reported that relative to the HIV- group, they perceived themselves to be in poorer physical or emotional health, to receive less social support from others, and to be less pessimistic about the future of their child or family.

Adult↗
PubMed1997

An evaluation of two primary care interventions for alcohol abuse among Mexican-American patients.

AIMS: This study examined the effects of two primary care interventions (a physician intervention and a clinic-based psychoeducational group) on drinking patterns, psychosocial problems and blood test results (MCV, GGT, SGOT and SGPT). DESIGN: Subjects were randomized into one of four treatment groups: physician intervention, psychoeducation, both interventions, or no intervention. Follow-up data were collected at 12 and 18 months. SETTING: Subjects were recruited from a family practice outpatient clinic managed by a public hospital. PARTICIPANTS: Included 175 Mexican-American female and male primary care patients who screened positive for alcohol abuse or dependence. These patients were not seeking help for alcohol problems. INTERVENTIONS: Included a brief physician intervention and a 6-week patient psychoeducational group. MEASUREMENTS: The Diagnostic Interview Schedule assessed subjects for alcohol abuse; the Addiction Severity Index measured alcohol-related problems, including psychosocial issues. FINDINGS: All four treatment groups demonstrated significant improvement over time, with few differences between intervention and control groups. CONCLUSIONS: Assessment can be confounded with brief interventions; future investigators should use non-assessed control groups.

Adolescent↗
PubMed1996

Gender differences in medical presentation and detection of patients with a history of alcohol abuse or dependence.

Women and men with alcohol use disorders differ in many respects. A retrospective medical record review of 132 patients was performed to determine outpatient clinic utilization, presentation patterns and physician actions related to patient gender and lifetime DIS-status. Women, irrespective of DIS-status, utilized out-patient health care services more often than did DIS-positive or negative men. Of 16 specific alcohol-related complaints, gender differences were only detected for trauma. DIS-positive men were more likely to have had an alcohol history taken during the preceding 12 months than were DIS-positive women. Sedatives/minor tranquilizers were most often prescribed to DIS-positive women. This study supports the need in primary care settings for more screening to detect and diagnose alcohol-abusing patients, particularly women. Physicians should routinely screen for alcohol abuse before prescribing sedatives or minor tranquilizers.

Adult↗
PubMed1994

Psychiatric problems experienced by primary care patients who misuse alcohol.

Of 1936 primary care patients screened using the alcohol portion of the Diagnostic Interview Schedule, 100 met criteria for "alcohol abuse and/or dependence." Sixty of the individuals who misused alcohol were matched to 60 who did not. All 160 patients answered questions about psychiatric symptoms and psychotropic drug use. The lifetime prevalence of depression, suicidal thoughts, suicidal attempts, violent behavior, and trouble concentrating was consistently higher for those who misused alcohol. Depression and trouble concentrating were more likely to be experienced by alcohol misusers during the past month. Gender differences were also noted for prevalence of psychiatric symptoms.

Adult↗
PubMed1992

An instrument to evaluate alcohol-abuse interviewing and intervention skills.

At the University of Texas Health Science Center at San Antonio from 1988 through 1990, the authors developed the Alcoholism Intervention Performance Evaluation (AIPE), a rating instrument for the evaluation of alcohol-abuse interviewing and intervention skills. Factor analysis of 51 rating items identified seven factors that accounted for most of the variability among the items; 35 were retained and assigned to the factor with which they correlated most highly, thus resulting in a seven-factor instrument with 35 items. The AIPE overall score had an interrater reliability of .73 (for four raters each rating approximately 30 videotaped simulated-patient interviews) and a test-retest reliability of .89 (for one rater rescoring 20 interviews after one month). The authors suggest that the individual scores for the seven factors can be used to provide instructional feedback to trainees and that the overall score can be used to certify interviewer proficiency.

Alcoholism↗
PubMed1992

Single-subject experimental designs: a practical research alternative for practicing physicians.

Single-subject research designs offer a viable alternative to the more customary group-comparison designs. The flexibility and practicality of these designs make them particularly well suited for practicing family physicians interested in testing their clinical hunches. Three designs are described that are feasible in a practice setting: ABAB (reversal), multiple-baseline, and the alternating treatment design. Either visual inspection or statistical approaches can be used to evaluate these designs. By being aware of their limitations and by following simple practical steps, the practicing physician can use these designs to improve care of individual patients while simultaneously contributing to our general knowledge.

Clinical Trials as Topic↗
PubMed1992

Alcoholism prevalence and utilization of medical services by Mexican Americans.

BACKGROUND: Alcoholism is a common disorder that often results in increased use of medical services. Research describing alcoholism among both outpatients and ethnic minorities has been sparse. METHODS: In this study, the Short Michigan Alcoholism Screening Test was used as part of a health screening interview of patients attending a South Texas family health clinic. Screening was used to detect alcoholism and identify the health care needs in this predominantly Mexican American population. RESULTS: Consistent with other studies, alcoholism was more prevalent among men than among women. The prevalence of 24.4% among Mexican American men was similar to that among men from other ethnic backgrounds. The 4.2% prevalence among Mexican American women was comparable to that among other women. Equal percentages of alcoholics were identified in the primary care clinic and the "walk-in" clinic. Compared with nonalcoholic patients, alcoholic patients were more often unemployed or disabled, and reported more hospitalizations during the previous year. CONCLUSIONS: These findings suggest that alcoholism is as prevalent and costly a disease among Mexican Americans as it is in other ethnic groups in our society. Alcoholism can readily be detected in a variety of outpatient settings when screening is used. Employment status might serve as an indicator for alcoholism screening, but ethnicity did not. Research into socio-economic and cultural influences on alcoholism may improve the effectiveness of diagnosis and treatment of this prevalent disease.

Adult↗
PubMed1989

Reactions of dysmenorrheic and nondysmenorrheic women to experimentally induced pain throughout the menstrual cycle.

It has been proposed that dysmenorrheic women have a heightened pain sensitivity compared to nondysmenorrheic women, although previous studies investigating this hypothesis have yielded conflicting results. This study investigated the pain sensitivity of nondysmenorrheic women and of women suffering from spasmodic, congestive, and combined dysmenorrhea, across three phases of the menstrual cycle: premenstrual, menstrual, and intermenstrual. No interaction between type of dysmenorrhea and menstrual phase was found for either pain threshold or pain tolerance, using three procedures of experimentally induced pain. On a self-report measure of pain, however, the congestive and combined dysmenorrheics reported the highest degree of pain and distress, especially during the premenstrual and menstrual phases; nonsufferers reported the lowest degree and were stable across phases.

Adult↗
PubMed1987

Psychological treatments of dysmenorrhea: differential effectiveness for spasmodics and congestives.

Two studies are reported, examining the effectiveness of psychological treatments for dysmenorrhea. In Experiment 1, 33 women with spasmodic dysmenorrhea were treated with relaxation alone, or relaxation plus imagery, or assigned to a waiting-list control condition; and 29 women with congestive dysmenorrhea were treated with relaxation alone, or assigned to a waiting-list control condition. In Experiment 2, 18 additional congestives were treated with a coping skills package, or this package plus relaxation; these two groups were compared with the two congestive groups from Experiment 1. The dependent measures were reports of symptom severity, general discomfort, resting time, and medication use. Consistent with the literature, the main findings of the present studies are: (a) relaxation training (alone or with imagery) effectively reduces resting time for spasmodics; and (b) none of the treatments was shown to be effective for congestive sufferers.

Adaptation, Psychological↗
PubMedDate not supplied

Declining immune function in children and adolescents with hemophilia and HIV infection: effects on neuropsychological performance. Hemophilia Growth and Development Study.

OBJECTIVE: To determine whether declines in immune functioning are associated with changes in neuropsychological performance in children and adolescents with hemophilia who are infected with the human immunodeficiency virus (HIV). METHODS: Participants were 333 males with hemophilia, ages 6-19 years at entry. A baseline and four annual neuropsychological evaluations were given. A longitudinal growth curves analysis of data was performed to detect changes associated with declining immune function. The cohort was stratified into four groups: (1) HIV- (n = 126); (2) HIV+, average of first two and last two CD4 counts > or = 200, (n = 106; High CD4 group); (3) HIV+, average first two counts > or = 200, average last two counts < 200 (n = 41; CD4 Drop group); and (4) HIV+, average first two and last two counts < 200 (n = 60; Low CD4 group). RESULTS: There were significant differences among the four groups over time in nonverbal intelligence, perceptual/performance skills, nonverbal memory, academic achievement, and language. The Low CD4 group consistently showed the greatest decrement in performance. On measures showing a practice effect for repeated measurements, the Low CD4 group participants' scores remained stable over time, suggesting opposing effects of practice and HIV-related declines. Lowered academic performance relative to IQ was found in all groups. CONCLUSIONS: Declines in neuropsychological functioning are directly related to declines in immune functioning in HIV+ children, adolescents, and young adults with hemophilia. Hemophilia itself may be a risk factor for academic underachievement.

Adolescent↗