Self-management of coronary heart disease in angina patients after percutaneous coronary intervention: A mixed methods study.

After having elective percutaneous coronary intervention (PCI) patients are expected to self-manage their coronary heart disease (CHD) by modifying their risk factors, adhering to medication and effectively managing any recurring angina symptoms but that may be ineffective. Objective: Explore how patients self-manage their coronary heart disease (CHD) after elective PCI and identify any factors that may infl uence that. Design and method: This mixed methods study recruited a convenience sample of patients (n=93) approximately three months after elective PCI. Quantitative data were collected using a survey and were subject to univariate, bivariate and multi-variate analysis. Qualitative data from participant interviews was analysed using thematic analysis. Findings: After PCI, 74% of participants managed their angina symptoms inappropriately. Younger participants and those with threatening perceptions of their CHD were more likely to know how to effectively manage their angina symptoms. Few patients adopted a healthier lifestyle after PCI. Qualitative analysis revealed that intentional non-adherence to some medicines was an issue. Some participants felt unsupported by healthcare providers and social networks in relation to their self-management. Participants reported strong emotional responses to CHD and this had a detrimental effect on their self-management. Few patients accessed cardiac rehabilitation.

An examination of the techniques used to capture mangrove crabs, Ucides cordatus, in the Mamanguape River estuary, Northeastern Brazil, with implications for management.

The present research, undertaken in a mangrove swamp in northeastern Brazil (Mamanguape River Estuary), examined the factors that led to the overwhelming acceptance of the tangle-netting technique by crab harvesters in detriment to the now illegal tamping technique. Both techniques are the only ones currently used at our study site and in many other areas in Brazil, despite being prohibited by law. Data were collected through direct observations to determine capture efficiency, productivity, daily production, selectivity, and harvesting effort, and through interviews with crab harvesters, focusing on their perceptions of the capture techniques, the conditions of crab stocks and the sales price of a dozen crabs. Our results indicated that the two capture techniques did not significantly differ in terms of their efficiency or productivity, but daily production rates differed significantly, being greater using tangle-netting. The tangle-netting permits a greater harvesting effort (6 hours and 34 min) compared to tamping (4 hours and 19 min). Tangle-netting is also less selective than tamping indicated by the larger number of captured smaller specimens, including females. This results in a lower average sales price for a dozen crabs caught by tangle-netting (US$ 0.95) compared to tamping (US$ 1.02). The greater daily production of crab harvesters using the tangle-netting technique nevertheless increased their net gain, explaining their preference for this method, Given that tangle-netting results in greater harvesting pressure but lower selectivity compared to tamping, it may potentially be less sustainable. All of the crab harvesters interviewed having more than 20 years of experience (n = 34) stated they perceived that stocks of U. cordatus had become reduced over the last 20 years, together with average crab sizes. It is now important to examine the structure of the local U. cordatus population and to assess its fishery to allow evaluating whether the illegal, but prominent tangle-netting and tamping mangrove crab capture techniques are sustainable or not. We further suggest improving the dialogue between decision makers and fishermen, which barely exists to date, to initiate a discussion about possible ways of resolving the current situation of illegality of the fishermen. This will be key to achieving effective sustainable co-management of this important natural mangrove forest resource.