Developing culturally adapted lifestyle interventions for South Asian migrant populations: a qualitative study of the key success factors and main challenges.

OBJECTIVES: South Asian migrant populations have a high risk of non-communicable diseases, such as type 2 diabetes (T2D). The aim of this study is to provide in-depth insight into key success factors and challenges in developing culturally adapted lifestyle interventions to prevent T2D within South Asian migrant populations. STUDY DESIGN: The study has a qualitative research design. METHODS: In-depth interviews, using a semi-structured interview guide, were conducted with eight researchers and project leaders from five studies of culturally adapted lifestyle interventions for South Asian migrant populations. Data were analysed using a grounded theory approach. RESULTS: Four main themes emerged as key factors for success: 'approaching the community in the right way', 'the intervention as a space for social relations', 'support from public authorities' and 'being reflexive and flexible'. Two themes emerged as challenges: 'struggling with time' and 'overemphasising cultural differences'. CONCLUSIONS: Our findings augment existing research by establishing the importance of cooperation at the organisational and institutional levels, of fostering the creation of social networks through interventions and of acknowledging the multiplicity of identities and resources among individuals of the same ethnic origin.

Dermatophytes and dermatophytoses in the Milan area between 1970 and 1989.

Between 1970 and 1989 we examined 13,019 patients with dermatophytoses in the Milan area, Northern Italy. The results obtained during the 1980-89 period were compared with those obtained in the years 1970-79. From the data collected, tinea corporis emerged as the most frequently observed dermatophytosis, followed by tinea pedis and unguium. As far as dermatophytes are concerned, the dermatological pattern is dominated by Microsporum canis and Trichophyton rubrum. Other species, such as Epidermophyton floccosum, T. mentagrophytes, M. gypseum, T. violaceum, T. verrucosum, T. tonsurans and T. schoenleinii, have progressively become less evident. Other mycetes, such as T. megninii, T. soudanense, M. langeroni, T. vanbreuseghemii, M. ferrugineum, sporadically isolated in the 1970-79 period, have disappeared in recent years. An analysis of the distribution and frequency of the dermatophytes according to the cutaneous area affected is reported.

Tinea corporis bullosa.

The paper reports a case of tinea corporis bullosa in a 63-year-old woman. Near the classical annular lesions on the anterior surface of the left leg, the patient presented frank bullous lesions. Serous fluid from the bulla yielded Microsporum canis, the first report of the association of this fungus with bullous lesions in tinea corporis. The patient was investigated with routine examinations and immunological studies which showed an intense inflammatory process much greater than in usual cases of tinea corporis.

Pityriasis versicolor of the face.

Pityriasis versicolor (p.v.) is a superficial mycosis occurring frequently on the face. Epidemiological and clinical data regarding cases of p.v. on the face over a period of 11 years are discussed and some explanation given for conditions which favour facial involvement. This study underlines that face lesions of p.v. are more common in children than in adults and in females than in males. The forehead is the site of facial involvement usually affected. Clinical features are variable but we often observed achromic or hypopigmented scaling lesions, smaller than trunk patches.

Tinea pedis in children.

Tinea pedis is a superficial mycosis, unusual in children. Epidemiological and clinical data regarding cases of tinea pedis observed in children over a period of 20 years are discussed and some explanation given for the conditions which predisposed children to the infection. Clinical features are variable and similar to adults. Bullous lesions are more frequently seen in children. Most of the cases were seen in children over 10 years of age. Males are more often affected with tinea pedis: this is particularly true for 10 to 13 year-old children. As in adults, Trichophyton rubrum is the most frequently isolated etiological agent.

Pityriasis versicolor in the pediatric age.

Pityriasis versicolor (PV) is a superficial mycosis, theoretically unusual in children. Epidemiologic and clinical data for children with PV over 11 years was collected. Some explanations are given for the conditions that favored this mycotic infection in children. This study confirms that the face is a usual site of PV in children, in contrast to its rarity as a site in adults. Clinical features are variable and similar to adults. Both sexes are equally affected. The family history is often positive for PV.

Tinea capitis in adults.

Scalp ringworm is unusual after puberty. Etiological, epidemiological and clinical data regarding cases of tinea capitis in the elderly observed over a period of 15 years are discussed and some explanations are given for the conditions which favoured the mycotic infection of the scalp in adults. This study underlines that tinea capitis in the elderly is usually characterized by very variable and often atypical lesions and that female preponderance in adult cases of scalp ringworm is striking and unexplained. Moreover, all the dermatophytes we isolated from scalp lesions in children can cause tinea capitis in adults.