Patient perspectives of managing fatigue in ankylosing spondylitis, and views on potential interventions: a qualitative study

<p>Background: Fatigue is a major component of living with ankylosing spondylitis (AS), though it has been largely over-looked, and currently there are no specific agreed management strategies.</p> <p>Methods: This qualitative exploratory study involved participants who are members of an existing population-based ankylosing spondylitis (PAS) cohort. Participants residing in South West Wales were invited to participate in a focus group to discuss; (1) effects of fatigue, (2) self-management strategies and (3) potential future interventions. The focus groups were audio-recorded and the transcripts were analysed using thematic analysis.</p> <p>Results: Participants consisted of 3 males/4 females (group 1) and 4 males/3 females (group 2), aged between 35 and 73 years (mean age 53 years). Three main themes were identified: (1) The effects of fatigue were multi-dimensional with participants expressing feelings of being ‘drained’ (physical), ‘upset’ (emotional) and experiencing ‘low-mood’ (psychological); (2) The most commonly reported self-management strategy for fatigue was a balanced combination of activity (exercise) and rest. Medication was reluctantly taken due to side-effects and worries over dependency; (3) Participants expressed a preference for psychological therapies rather than pharmacological for managing fatigue. Information on Mindfulness-Based Stress Reduction (MBSR) was received with interest, with recommendations for delivery in a group format with the option of distance-based delivery for people who were not able to attend a group course.</p> <p>Conclusions: Patients frequently try and manage their fatigue without any formal guidance or support. Our research indicates there is a need for future research to focus on psychological interventions to address the multi-faceted aspects of fatigue in AS.</p&gt

Middle Eastern mothers in Sweden, their experiences of the maternal health service and their partner's involvement

<p>Abstract</p> <p>Background</p> <p>Traditional patterns relating to how to handle pregnancy and birth are often challenged due to migration. The purpose of this study was to describe Middle Eastern mothers' experiences of the maternal health care services in Sweden and the involvement of their male partner.</p> <p>Methods</p> <p>Thirteen immigrant mothers from the Middle East who had used the maternal health services in Sweden were interviewed using focus group discussions and individual interviews. These were taped, transcribed and analysed according to Content analysis.</p> <p>Results</p> <p>The four main categories that developed were:</p> <p>• Access to the professional midwife</p> <p>• Useful counselling</p> <p>• Stable motherhood in transition</p> <p>• Being a family living in a different culture</p> <p>Conclusion</p> <p>According to the respondents in this study, understanding the woman's native language or her culture was not vital to develop a good relationship with the midwife. Instead the immigrant woman developed trust in the midwife based on the knowledge and the empathy the midwife imparted.</p> <p>Increasing the amount of first trimester antenatal visits could avoid spontaneous visits to the emergency clinic. There was a greater need for involvement and support by the father during the perinatal period, such as caring for older children and carrying out household chores since the mothers' earlier female network was often lost.</p> <p>Clinical implications</p> <p>There is a need to involve immigrant parents in the available parental education in order to prepare them for parenthood in their new country as well as to explore their altered family situation. Collecting immigrant women and their partner's, experiences of maternal health care services offers a possibility to improve the existing care, both in content, access and availability where the timing of visits and content require further evaluation.</p

Biomaterials for Building Skins

Bio-based materials are considered a promising resource for buildings in the twenty-first century due to their sustainability and versatility. They can be produced locally, with minimum transportation costs and in an ecological manner. This chapter describes the potential of biomaterials for use in façades. It presents several examples of natural resources, including innovative alternative materials that are suitable for implementation as a building skin. Novel products resulting from material modifications and functionalization are presented, including a brief discussion on their environmental impacts. Alternative strategies for optimal biomaterials' recycling, reuse, and other end-of-life strategies are presented and supported with case study examples

Helium solubility in olivine and implications for high ³He/⁴He in ocean island basalts

High 3He/4He ratios found in ocean island basalts are the main evidence for the existence of an undegassed mantle reservoir1, 2, 3. However, models of helium isotope evolution depend critically on the chemical behaviour of helium during mantle melting. It is generally assumed that helium is strongly enriched in mantle melts relative to uranium and thorium, yet estimates of helium partitioning in mantle minerals have produced conflicting results4, 5, 6. Here we present experimental measurements of helium solubility in olivine at atmospheric pressure. Natural and synthetic olivines were equilibrated with a 50% helium atmosphere and analysed by crushing in vacuo followed by melting, and yield a minimum olivine–melt partition coefficient of 0.0025 0.0005 (s.d.) and a maximum of 0.0060 0.0007 (s.d.). The results indicate that helium might be more compatible than uranium and thorium during mantle melting and that high 3He/4He ratios can be preserved in depleted residues of melting. A depleted source for high 3He/4He ocean island basalts would resolve the apparent discrepancy7 in the relative helium concentrations of ocean island and mid-ocean-ridge basalts

Cryptic striations in the upper mantle revealed by hafnium isotopes in southeast Indian ridge basalts

The Earth's mantle is isotopically heterogeneous on length scales ranging from centimetres to more than 104 kilometres1, 2. This heterogeneity originates from partial melt extraction and plate tectonic recycling, whereas stirring during mantle convection tends to reduce it. Here we show that mid-ocean ridge basalts from 2,000 km along the southeast Indian ridge (SEIR) display a bimodal hafnium isotopic distribution. This bimodality reveals the presence of ancient compositional striations (streaks) in the Indian Ocean upper mantle. The number density of the streaks is described by a Poisson distribution, with an average thickness of approx40 km. Such a distribution is anticipated for a well-stirred upper mantle, in which heterogeneity is continually introduced by plate tectonic recycling, and redistributed by viscous stretching and convective refolding