Family support and cardiac rehabilitation: A comparative study of the experiences of South Asian and White-European patients and their carer's living in the United Kingdom

Background: Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change. Aims: To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification. Methods: Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina. Results: The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes. Conclusions: Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a person's relationship with service support and when it does not. (C) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved

The extremophilic pharmacy:drug discovery at the limits of life

[No abstract

Social inclusion and valued roles : a supportive framework

The aim of this paper is to examine the concepts of social exclusion, social inclusion and their relevance to health, well-being and valued social roles. The article presents a framework, based on Social Role Valorization (SRV), which was developed initially to support and sustain socially valued roles for those who are, or are at risk of, being devalued within our society. The framework incorporates these principles and can be used by health professionals across a range of practice, as a legitimate starting point from which to support the acquisition of socially valued roles which are integral to inclusio

The extremophilic pharmacy:drug discovery at the limits of life

[No abstract

The Catalytic Mechanism of a Natural Diels-Alderase Revealed in Molecular Detail

The Diels-Alder reaction, a [4 + 2] cycloaddition of a conjugated diene to a dienophile, is one of the most powerful reactions in synthetic chemistry. Biocatalysts capable of unlocking new and efficient Diels-Alder reactions would have major impact. Here we present a molecular-level description of the reaction mechanism of the spirotetronate cyclase AbyU, an enzyme shown here to be a bona fide natural Diels-Alderase. Using enzyme assays, X-ray crystal structures, and simulations of the reaction in the enzyme, we reveal how linear substrate chains are contorted within the AbyU active site to facilitate a transannular pericyclic reaction. This study provides compelling evidence for the existence of a natural enzyme evolved to catalyze a Diels-Alder reaction and shows how catalysis is achieved

Search for Sub-TeV Gamma Rays Coincident with BATSE Gamma Ray Bursts

Project GRAND is a 100m x 100m air shower array of proportional wire chambers (PWCs). There are 64 stations each with eight 1.29 m^2 PWC planes arranged in four orthogonal pairs placed vertically above one another to geometrically measure the angles of charged secondaries. A steel plate above the bottom pair of PWCs differentiates muons (which pass undeflected through the steel) from non-penetrating particles. FLUKA Monte Carlo studies show that a TeV gamma ray striking the atmosphere at normal incidence produces 0.23 muons which reach ground level where their angles and identities are measured. Thus, paradoxically, secondary muons are used as a signature for gamma ray primaries. The data are examined for possible angular and time coincidences with eight gamma ray bursts (GRBs) detected by BATSE. Seven of the GRBs were selected because of their good acceptance by GRAND and high BATSE Fluence. The eighth GRB was added due to its possible coincident detection by Milagrito. For each of the eight candidate GRBs, the number of excess counts during the BATSE T90 time interval and within plus or minus five degrees of BATSE's direction was obtained. The highest statistical significance reported in this paper (2.7 sigma) is for the event that was predicted to be the most likely to be observed (GRB 971110).Comment: To be presented at the XXVIII International Cosmic Ray Conference, Tsukuba, Japa