Guidelines for international collaborative research

OBJECTIVE: As the global village becomes a reality, there is an increasing need to conduct international collaborative studies in family practice. A workshop at the WONCA meeting in Hong Kong used international attendees to produce a set of guidelines for international research. METHODS: At the workshop four completed international projects, each using a different strategy, were presented so that common themes might become apparent. The themes were then discussed and guidelines emerged from the process. RESULTS: Seven guidelines emerged for consideration before embarking on an international collaborative research project in family medicine. The guidelines deal with the characteristics of the research question and the importance of communication. The need for simple, brief methods of data collection, funding and pilot testing were identified. CONCLUSION: The question must be relevant to all participants to maintain interest and measurement tools must be validated to understand the impact of cultural differences in understanding.      

Case report: Liver function abnormalities in a severe case of hyperreactio luteinalis

Rare causes of liver dysfunction in pregnancy may pose a challenge to the consulting gastroenterologist or hepatologist from both the diagnostic and therapeutic standpoints. We describe here liver function abnormalities in a case of hyperreactio luteinalis with light and electron microscopic findings.     

Mounting and calibration of stairs on piezoelectric force platforms

To calculate the centre of pressure using piezoelectric force plates mounted on pads, no net tensile stresses may be imposed on the surface of the plate. This condition is violated when stairs are attached to the plates, unless the plates are preloaded. Typical shear forces encountered when climbing stairs were used to determine required preloads of approximately 16.4 N/cm step height. Vertical and horizontal loads were applied at known locations on the steps, and points of application were calculated. Deviations were within ± 3 mm. The effect of point of application inaccuracy on calculated joint moments is considerable. A 2 cm medial shift in the point of application resulted in calculated peak knee abduction/adduction moment errors of 35%.     

Altered maternal psychological profile as health risk factor in poor urban infants

To test the hypothesis that the increased health risk of children selected by a previously calculated and validated predictive model is associated with some maternal psychological characteristics, the universe of 107 mothers of children selected by this model was evaluated by means of Goldberg's General Health Questionnaire (GHQ-30), Raven (Ra) and Rorschach (Ro) tests; 37.4% were cases according to GHQ-30, 80.9% were < 50th percentile in Ra and 85% exhibited deviant responses in Ro tests. Children whose mother's IQ was < 50th percentile suffered more episodes of total morbidity (Tm) and of diarrhoea (p = 0.0364). Children whose mothers were normal in Ro had less Tm (p = 0.0364) and fewer respiratory symptoms (p = 0.0300) and tended to have less diarrhoea (p = 0.0690). In poor urban families in Santiago psychological maternal characteristics are associated with an increased health risk for the infants. Supportive programmes should consider both biological characteristics of the infants and maternal psychological needs.