A New Flavonol from Athrixia phylicoides (Bush Tea)

Athrixia phylicoides (bush tea), belonging to the Asteraceae family, is a popular beverage used as a herbal tea and for medicinal purposes. The processed leaves of bush tea contain 5-hydroxy-6,7,8,3’,4’,5’-hexamethoxyflavon-3-ol as major flavonoid.KEYWORDS: Athrixia philicoides, bush tea, flavonoids, health beverage, phenols

Considering how athletic identity assists adjustment to spinal cord injury: a qualitative study

Objectives: To establish how sport, and access to an athletic identity, has been used when adjusting to a spinal cord injury. Design: Qualitative study using semi-structured interviews. Setting: Private athletic club. Participants: Eight (six males and two females) athletes from a wheelchair badminton club participated in the study. The individuals had finished rehabilitation, and were aged between 20 and 50 years. Main outcome measures: A single semi-structured interview was undertaken with each participant. Results: Following the thematic analysis, two final themes were presented: (1) adjustment and paradox of chronic illness; and (2) the role and value of an athletic identity. Conclusions: Badminton provided participants with an opportunity to continue and develop a positive athletic identity. Identity may be used as a factor that can promote recovery, and is considered as a way to encourage and maintain positive long-term adjustment to disability

The Psychosocial Consequences of Sports Participation for Individuals with Severe Mental Illness: A Metasynthesis Review

The purpose of the current metasynthesis review was to explore the psychosocial benefits of sport and psychosocial factors which impact on sports participation for individuals with severe mental illness. AMED, CINAHL Plus, Medline, EMBASE, ProQuest Nursing & Allied Health Source, and Science Citation Index were searched from inception until January 2014. Articles included use qualitative methods to examine the psychosocial effects of sports participation in people with severe mental illness. Methodological quality was assessed using the Consolidated Criteria for Reporting Qualitative Studies and a case study tool. Included studies were analysed within a metasynthesis approach. Eight articles involving 56 patients met the inclusion criteria. The results identified the broader and direct psychosocial benefits of sport. Sport provided a ?normal? environment and interactions that were not associated with an individual?s mental illness. Sport provided individuals with a sense of meaning, purpose, belonging, identity, and achievement. Other findings are discussed. Direct psychosocial benefits are a consequence of sports participation for the vast majority of individuals with severe mental illness. Further to this, sports participation was associated with a reduction in social isolation and an increase in social confidence, autonomy, and independence

A pragmatic randomised controlled trial of healing therapy in a gastroenterology outpatient setting

Introduction: To determine the benefits of healing therapy (spiritual healing) as an adjunct to conventional management in irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Methods: 200 outpatients with IBS or IBD were randomised to either conventional treatment (control) or conventional plus five sessions of healing therapy (intervention). After 12 weeks controls also had healing therapy. Outcomes used were, the Measure Yourself Medical Outcomes Profile (MYMOP). IBS-QOL, IBDQ, and symptom measures. Results: There was a significant improvement in the MYMOP score at week 6 (p < 0.001) which was maintained to week 12 (p < 0.001) and 24 (p < 0.001). Improvements in MYMOP were significantly greater in the intervention group at both 6 (p < 0.001) and 12 weeks (p < 0.001) with effect sizes of 0.7 (95% CI: 0.4–1.1) and 0.8 (95% CI: 0.4–1.2). Condition-specific data for IBS showed that most QoL dimensions had a significant minimum 10-point score improvement at 6 and 12 weeks. The overall score improvement was 12.9 units at week 6 (p < 0.001), 12.4 units at week 12 (p < 0.001) and 13.8 units at week 24 (p < 0.001). In IBD there was also similar score improvement, but only up to week 12 were there associations of improved social and bowel functions (p < 0.001, respectively). Between group differences were identified for QoL scores in IBS at both week 6 (p < 0.001) and 12 (p < 0.001) but only for week 12 (p < 0.001) in the IBD group. Conclusions: The addition of healing therapy to conventional treatment was associated with improvement in symptoms and QoL in IBS, and to a lesser extent in IBD

Patient journey following lumbar spinal fusion surgery (LSFS): protocol for a multicentre qualitative analysis of the patient rehabilitation experience (FuJourn)

INTRODUCTION: There has been a 65% increase in lumbar spinal fusion surgery (LSFS) worldwide over the last 13 years, with costs of £26 million to the UK National Health Service annually. Patient dissatisfaction with outcome and persistent pain and disability incurs further costs. Three trials provide low-quality evidence for the role of physiotherapy. Our UK surveys investigating physiotherapy/surgeon practice concluded rehabilitation should be tailored to the individual patient owing to considerable clinical heterogeneity. This study will explore the perceptions of patients who undergo LSFS to inform precision rehabilitation. METHODS AND ANALYSIS: A qualitative study, using interpretive phenomenological analysis, will recruit a purposive sample (n=40) to ensure patterns of similarity and difference in their journeys can be explored. In-depth semistructured interviews will be undertaken following discharge from hospital and at 12 months postsurgery. Patients' preoperative and postoperative experiences, underlying attitudes and beliefs towards the surgical intervention, facilitators and barriers to recovery, adherence to advice and physiotherapy, experiences of rehabilitation and return to normal function/activity/work will be explored. A 12-month patient diary will provide real time access to patient data, capturing a weekly record of life as lived, including symptoms, medication, experiences of stages of recovery, rehabilitation adherence, healthcare professional appointments, attitudes, their feelings and experiences throughout their journey. Data will be analysed in a number of stages in accordance with interpretive phenomenological analysis, supported using NVivo software. Analysis of the first interviews and patient diaries will afford a rich density of data to build an overall understanding of the patients' lived experiences, informing the 12-month interview. Strategies (eg, reflexivity) will ensure trustworthiness. ETHICS AND DISSEMINATION: The study has ethical approval (IRAS 223283). Findings will ensure that patient-driven data inform precision rehabilitation by understanding the patient journey. Findings will be disseminated through peer-reviewed journals and conferences

Are older adults with chronic musculoskeletal pain less active than older adults without pain? A systematic review and meta-analysis.

Objective: To compare the overall levels of physical activity of older adults with chronic musculoskeletal pain and asymptomatic controls. Review Methods: A systematic review of the literature was conducted using a Cochrane methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Major electronic databases were searched from inception until December 2012, including the Cochrane Library, CINAHL, EBSCO, EMBASE, Medline, PubMed, PsycINFO, and the international prospective register of systematic reviews. In addition, citation chasing was undertaken, and key authors were contacted. Eligibility criteria were established around participants used and outcome measures focusing on daily physical activity. A meta-analysis was conducted on appropriate studies. Results: Eight studies met the eligibility criteria, four of these reported a statistically lower level of physical activity in the older adult sampl e with chronic pain compared with the asymptomatic group. It was possible to perform a non-heterogeneous meta-analysis on five studies. This established that 1,159 older adults with chronic pain had a significantly lower level of physical activity (−0.20, confidence interval 95% = −0.34 to −0.06, p = 0.004) compared with 576 without chronic pain. Conclusion: Older adults with chronic pain appear to be less active than asymptomatic controls. Although this difference was small, it is likely to be clinically meaningful. It is imperative that clinicians encourage older people with chronic pain to remain active as physical activity is a central non-pharmacological strategy in the management of chronic pain and is integral for healthy aging. Future research should prioritize the use of objective measurement of physical activity

The effects and determinants of exercise participation in first-episode psychosis: A qualitative study

© 2016 Firth et al. Background: Previous qualitative studies have found that exercise may facilitate symptomatic and functional recovery in people with long-term schizophrenia. This study examined the perceived effects of exercise as experienced by people in the early stages of psychosis, and explored which aspects of an exercise intervention facilitated or hindered their engagement. Methods: Nineteen semi-structured interviews were conducted with early intervention service users who had participated in a 10-week exercise intervention. Interviews discussed people's incentives and barriers to exercise, short- and long-term effects, and opinions on optimal interventions. A thematic analysis was applied to determine the prevailing themes. Results: The intervention was perceived as beneficial and engaging for participants. The main themes were (a) exercise alleviating psychiatric symptoms, (b) improved self-perceptions following exercise, and (c) factors determining exercise participation, with three respective sub-themes for each. Conclusions: Participants explained how exercise had improved their mental health, improved their confidence and given them a sense of achievement. Autonomy and social support were identified as critical factors for effectively engaging people with first-episode psychosis in moderate-to-vigorous exercise. Implementing such programs in early intervention services may lead to better physical health, symptom management and social functioning among service users. Trial registration: Current Controlled Trials ISRCTN09150095. Registered 10 December 2013

Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention

Purpose: Policy is increasingly focused on implementing a recovery-orientation within mental health services, yet the subjective experience of individuals receiving a pro-recovery intervention is under-studied. The aim of this study was to explore the service user experience of receiving a complex, pro-recovery intervention (REFOCUS), which aimed to encourage the use of recovery-supporting tools and support recovery-promoting relationships. Methods: Interviews (n=24) and two focus groups (n=13) were conducted as part of a process evaluation and included purposive sample of service users who received the complex, pro-recovery intervention within the REFOCUS randomised controlled trial (ISRCTN02507940). Thematic analysis was used to analyse the data. Results: Participants reported that the intervention supported the development of an open and collaborative relationship with staff, with new conversations around values, strengths and goals. This was experienced as hope-inspiring and empowering. However, others described how the recovery tools were used without context, meaning participants were unclear of their purpose and did not see their benefit. During the interviews, some individuals struggled to report any new tasks or conversations occurring during the intervention. Conclusion: Recovery-supporting tools can support the development of a recovery-promoting relationship, which can contribute to positive outcomes for individuals. The tools should be used, in a collaborative and flexible manner. Information exchanged around values, strengths and goals should be used in care-planning. As some service users struggled to report their experience of the intervention, alternative evaluation approaches need to be considered if the service user experience is to be fully captured

Using motivational techniques to reduce cardiometabolic risk factors in long term psychiatric inpatients: A naturalistic interventional study

Background People with severe mental illness have markedly reduced life expectancy; cardiometabolic disease is a major cause. Psychiatric hospital inpatients have elevated levels of cardiometabolic risk factors and are to a high degree dependent of the routines and facilities of the institutions. Studies of lifestyle interventions to reduce cardiometabolic risk in psychiatric inpatients are few. The current study aimed at assessing the feasibility and effects of a lifestyle intervention including Motivational Interviewing (MI) on physical activity levels, cardiometabolic risk status and mental health status in psychotic disorder inpatients. Methods Prospective naturalistic intervention study of 83 patients at long term inpatient psychosis treatment wards in South-Eastern Norway. Patients were assessed 3–6 months prior to, at start and 6 months after a life-style intervention program including training of staff in MI, simple changes in routines and improvements of facilities for physical exercise. Assessments were done by clinical staff and included level of physical activity, motivation, life satisfaction, symptom levels (MADRS, AES-C, PANSS, and GAF) as well as anthropometric and biochemical markers of cardiometabolic risk. A mixed model was applied to analyze change over time. Results A total of 88% of patients received MI interventions, with a mean of 2.5 MI interventions per week per patient. The physical activity level was not increased, but activity level was positively associated with motivation and negatively associated with positive symptoms. Triglyceride levels and number of smokers were significantly reduced and a significant decrease in symptom levels was observed. Conclusions The current results suggest that a simple, low cost life-style intervention program focusing on motivational change is feasible and may reduce symptoms and improve lifestyle habits in psychosis patients in long term treatment facilities. Similar programs may easily be implemented in other psychiatric hospitals.submittedVersio

Correlates of physical activity among community-dwelling adults aged 50 or over in six low- and middle-income countries

Background: Considering that physical activity is associated with healthy ageing and helps to delay, prevent, or manage a plethora of non-communicable diseases in older adults, there is a need to investigate the factors that influence physical activity participation in this population. Thus, we investigated physical activity correlates among community-dwelling older adults (aged ≥50 years) in six low- and middle-income countries. Methods: Cross-sectional data were analyzed from the World Health Organization’s Study on Global Ageing and Adult Health. Physical activity was assessed by the Global Physical Activity Questionnaire. Participants were dichotomized into low (i.e., not meeting 150 minutes of moderate physical activity per week) and moderate-to-high physically active groups. Associations between physical activity and a range of correlates were examined using multivariable logistic regressions. Results: The overall prevalence (95%CI) of people not meeting recommended physical activity levels in 34,129 participants (mean age 62.4 years, 52.1% female) was 23.5% (22.3%-24.8%). In the multivariable analysis, older age and unemployment were significant sociodemographic correlates of low physical activity. Individuals with low body mass index (<18.5kg/m2), bodily pain, asthma, chronic back pain, chronic obstructive pulmonary disease, hearing problems, stroke, visual impairment, slow gait, and weak grip strength were less likely to meet physical activity targets in the overall sample (P<0.05). The associations varied widely between countries. Conclusion: Our data illustrates that a multitude of factors influence physical activity target achievement in older adults, which can inform future interventions across low- and middle-income countries to assist people of this age group to engage in regular physical activity. Future prospective cohort studies are also required to investigate the directionality and mediators of the relationships observed