Perceptions of Barriers and Benefits to Physical Activity Among Outpatients in Psychiatric Rehabilitation

PURPOSE: To explore perceived barriers and benefits to physical activity in people with serious and persistent mental illness (SPMI) who were enrolled in community-based psychiatric rehabilitation. DESIGN AND METHODS: Four focus groups, two for men and two for women, were held with a total of 34 outpatients from two program sites. The investigators used a semistructured interview guide to facilitate the discussions. Audiotapes of the discussions were transcribed and analyzed for concepts and themes. FINDINGS: Significant barriers to physical activity were: mental illness symptoms, medications, weight gain from medications, fear of discrimination, and safety concerns. Being in a psychiatric rehabilitation program offered comfort and belonging, but it also had the effect of leaving activity initiation up to the program staff, which some participants perceived was part of required program compliance. However, participants viewed physical activity positively, and they linked being active to improved mental health. CONCLUSIONS: Outpatients in psychiatric rehabilitation valued physical activity, but mental illness symptoms, medication sedation, weight gain, fear of unsafe conditions, fear of discrimination, and interpretations of program compliance were barriers. Confronting how attitudes and barriers specific to this population can affect activity and reframing program compliance to include the independent initiation of activity as part of improving health might help clients of mental health services to become more active.     

Residential aged care: the last frontier for palliative care

AIM: This paper is a report of an explorative study describing the perceptions and beliefs about palliative care among nurses and care assistants working in residential aged care facilities in Australia. BACKGROUND: Internationally, the number of people dying in residential aged care facilities is growing. In Australia, aged care providers are being encouraged and supported by a positive policy platform to deliver a palliative approach to care, which has generated significant interest from clinicians, academics and researchers. However, a little is known about the ability and capacity of residential aged care services to adopt and provide a palliative approach to care. METHODS: Focus groups were used to investigate the collective perceptions and beliefs about palliative care in a convenience sample of nurses and care assistants working in residential aged care facilities in Australia. Thematic content analysis was used to analyse the data, which were collected during 2004. RESULTS: Four major themes emerged: (1) being like family; (2) advocacy as a key role; (3) challenges in communicating with other healthcare providers; (4) battling and striving to succeed against the odds. Although participants described involvement and commitment to quality palliative care, they also expressed a need for additional education and support about symptom control, language and access to specialist services and resources. CONCLUSION: The residential aged care sector is in need of support for providing palliative care, yet there are significant professional and system barriers to care delivery. The provision of enhanced palliative care educational and networking opportunities for nurses and care assistants in residential aged care, augmented by a supportive organizational culture, would assist in the adoption of a palliative approach to service delivery and requires systematic investigation.     

'Best practice' in focus group research: making sense of different views

AIM: The aim of this paper is to identify the broad epistemological debates which underpin conflicting statements on 'rigour' and 'good practice' in qualitative research; to relate divergences in statements of 'good practice' in focus group design made by the pre-eminent commentators on focus group methodology to these broader epistemological debates; and to stimulate further reflection on the range of possible uses for focus groups in health services research. Considerations of the analysis of focus group data are beyond the scope of this paper. DISCUSSION: Focus groups are a popular form of qualitative data collection, and may be defined as a particular form of group interview intended to exploit group dynamics. While qualitative research may be broadly characterized as concerned with exploring people's lived experiences and perspectives in context, it is a heterogeneous field incorporating many theoretical traditions. Consequently, qualitative researchers may be informed by a wide range of assumptions about the nature of knowledge (epistemology). These assumptions, whether implicit or explicit, have important consequences for claims about rigour and 'good practice' in data collection. Thus, while there is broad agreement over the general form of focus groups, statements of 'good practice' in terms of its application are varied. A close reading of texts by the two pre-eminent commentators on the practical application of focus groups identifies differences in 'best practice' focus group design related to their respective epistemological assumptions, and differences principally related to sampling techniques, composition of groups, the perceived role of group interaction and the nature of inference. CONCLUSION: Explicit consideration of the epistemological basis of divergent statements of 'best practice' in focus group design forces health services researchers to balance the demands of theory with the practicalities of conducting focus group research within complex host organisations; and encourages readers to apply appraisal criteria appropriate to the stated intentions of researchers.     

Phylogenetic group B2 Escherichia coli strains from the bowel microbiota of Pakistani infants carry few virulence genes and lack the capacity for long-term persistence

Escherichia coli strains of phylogenetic group B2 obtained from Western human hosts are enriched in virulence-associated genes and have a superior capacity to persist in the colonic microbiota. Here, E . coli strains from 22 infants born in Pakistan whose rectal flora was sampled regularly over the first 6 months of life were examined. B2 strains did not carry the virulence-associated genes sfaD/E , papC , neuB or hlyA more often than strains of other phylogenetic groups . B2 origin was not associated with persistence in the bowel microbiota. As compared with B2 strains from Swedish infants, Pakistani B2 strains carried significantly less often the virulence genes fimH (p 0.04), papC (p 0.02), papG class III (p 0.01), sfaD / E (p ≤0.0001), neuB (p ≤0.0001), and hlyA (p 0.005), and also the high-pathogenicity island (p ≤0.0001). A minority of Pakistani B2 strains belonged to recognized uropathogenic O-groups, which are common among 'Western' B2 strains. Thus, extra-intestinal pathogenicity may be the foremost characteristic of B2 strains colonizing Western populations.     

中国45个民族群体SDF1-3’A等位基因多态性分析

通过文献检索收集近年来国内外有关基质细胞衍生因子(SDF1)与人类免疫缺陷病毒1型(Human im-munodeficiency virus-1,HIV-1)感染相关的研究结果,对研究结果进行整理、汇总和总结,探讨中国45个民族群体SDF1-3’A等位基因多态性分布情况。SDF1-3’A在中国45个民族群体中的分布存在种族和地域差异,无明显地域上的趋势性变化,多数民族突变频率与美国白人、高加索人及亚洲黄种人水平比较接近,但明显高于美国黑人和西班牙人。     

Effect of sulfhydryl groups on automatic activity of the cardiac pacemakers

Experiments on isolated rabbit hearts and also on hearts with a complete atrioventricular block were carried out to study the effect of an excess or deficiency of sulfhydryl groups on automatic activity of the cardiac pacemakers. Unithiol and cysteine in concentrations of 1·10^–6–1·10^–4 g/ml were used as donors of sulfhydryl groups and a deficiency of these groups was produced by addition of alloxan in concentrations of 1·10^–5–5·10^–5 g/ml. Changes in the concentration of sulfhydryl groups were found to have no marked action on automatic activity of the sinoatrial node. An excess of sulfhydryl groups led to poststimulation depression of automatic activity of potential pacemakers of the ventricles and could lead to the development of Luciani's periods. Conversely, with a deficiency of sulfhydryl groups, automatic activity of the ventricular pacemakers increased shaprly, atrioventricular conduction was disturbed, and poststimulation depression of automatic activity was considerably reduced. Disturbances of cardiac activity evoked by a deficiency of sulfhydryl groups were completely abolished by unithiol or cysteine.Laboratory of Experimental Cardiology, P. K. Anokhin Institute of Normal Physiology, Academy of Medical Sciences of the USSR. Department of Pharmacology, Pharmaceutical Faculty, I. M. Sechenov First Moscow Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR P. A. Fedorov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 82, No. 10, pp. 1165–1168, October, 1976.     

四川地区彝族ABO等8个血型的分子遗传学研究

目的了解四川地区彝族人群ABO、Duffy、Kidd、MNs、Diego、Lutheran、Dombrock、Colton血型的分子遗传背景及其基因频率的分布规律。方法采集四川省凉山彝族自治州布拖市和冕宁县共120名彝族无血缘关系健康者血样,对ABO基因第6、7外显子作测序分析;对Duffy等另外7个血型系统采用聚合酶链式反应-序列特异性引物(PCR-SSP)作基因分型。结果 120例四川凉山彝族无血缘关系标本中,共检测出5种常见ABO等位基因:A101[0.020 8(5/240)]、A102[0.166 6(40/240)]、B101[0.245 8(59/240)]、O01[0.304 2(73/240)]和O02[0.2625(63/240)]。其他7个血型的基因频率依次为M=0.683 3(164/240)、N=0.316 7(76/240)、S=0.091 7(22/240)和s=0.908 3(218/240);Lua=0(0/240)、Lub=1(240/240);Fya=0.945 8(227/240)、Fyb=0.029 2(7/240)、FyES=0.025 0(6/240);Jka=0.525 0(126/240)、Jkb=0.475 0(114/240);Dia=0.016 7(4/240)Dib=0.983 3(236/240);Doa=0.120 8(29/240)、Dob=0.879 2(211/240);Coa=1(240/240)、Cob=0(0/240)(经χ2检验,均符合Hardy-Weinberg平衡)。结论四川凉山地区彝族人的红细胞血型系统具有一定的分子遗传学特征:等位基因M频率>0.6,Dia频率<0.05,这均符合中国南方人的血型分布特点;FyES等位基因存在一定的分布(Jka>Jkb),Doa频率稍微偏高,显示出该民族一定的特异性。     

护理干预对宫颈癌根治术后尿潴留的影响

[目的]探讨护理干预对宫颈癌根治术后尿潴留的影响。[方法]将56例宫颈癌根治术病人随机分为实验组和对照组各28例,对照组给予常规护理,实验组在常规护理的基础上给予护理干预,比较两组病人术后尿潴留的发生率。[结果]术后第14天拔除尿管后实验组尿潴留的发生率明显低于对照组（P〈0.05）。[结论]对宫颈癌根治术病人实施护理干预可有效减少术后尿潴留的发生。     

新疆维吾尔族与汉族老年高血压患者靶器官损害特点分析

目的探讨新疆维吾尔族与汉族老年高血压患者靶器官损害的临床特点。方法选择年龄≥75岁的高血压患者264例,分为汉族组138例,维吾尔族组(维族组)1 26例。检测血压昼夜节律及血压负荷值,动态心电图检测心律失常、心率变异性,颈部多普勒超声检测颈动脉内膜中层厚度,并进行分析比较。结果与汉族组比较,维族组患者24 h平均动脉压、24 h收缩压负荷,昼夜平均收缩压、昼夜平均动脉压、夜间平均收缩压,房性期前收缩、短阵房性心动过速、缺血ST-T改变、平均心率、夜间心率均明显升高(P<0.05,P<0.01);汉族组颈动脉斑块和狭窄检出率明显低于维族组(P<0.05)。结论维吾尔族老年高血压患者血压偏高,易于合并冠心痛和(或)糖尿病,发生代谢紊乱、房性心律失常、心肌缺血及颈动脉斑块形成等靶器官损害的比率高于汉族,同时心率变异性减低。     

Prevalence and specificity of red-blood-cell antibodies in a multiethnic South and East Asian patient population and influence of using novel MUT+Mur+ kodecytes on its detection

Background and Objectives Appropriate screening for irregular red‐cell antibodies is essential for ensuring transfusion compatibility and for antenatal management of mothers at risk of haemolytic disease of the foetus and newborn. Screening for all relevant antibodies is, however, limited by screening cells that do not express antigens present in the patient and donor population. Technology to artificially incorporate antigens into red cells is currently available and may be an option for customizing screening cells. Materials and Methods We sought to identify retrospectively the changing patterns of alloantibody prevalence in our multiethnic population on change of screening cells. Antibody screening records of 143 501 patients tested from 2004 to 2010 were retrieved and divided into two groups: period‐1 (2004–2008) and period‐2 (2009–2010). During period‐1, standard screening cells were used while in period‐2, MUT+Mur+ KODE^? transformed red cells (kodecytes) were used. Results Four per cent of samples tested during period‐2 were positive on antibody screening compared to 3·2% in period‐1. Specific antibodies, excluding anti‐D, were identified in 1·66% and 1·52% of patients in period‐2 and ‐1, respectively. When confined to antibodies of clinical significance only, period‐2 showed higher alloantibody prevalence of 1·16% as compared to 0·66% in period‐1. Antibodies to glycophorin variants of MNS (vMNS) were more commonly detected while antibodies to Lewis antigens declined during period‐2. Conclusion Antibodies to vMNS antigens are common in South and East Asian populations and are often missed when using standard screening cells. Use of specifically engineered screening cells to express red‐cell antigens artificially is beneficial in detecting the diverse alloantibodies present in our population.