Understanding the experience of inpatient rehabilitation: insights into patient-centred care from patients and family members

The aim of the study was describe the experiences, needs and preferences of recent inpatients of a rehabilitation centre, and the needs of their families. Data were collected in four focus groups, two with patients (n = 13) who had recently completed inpatient rehabilitation following an illness, injury or elective surgery, and two with family members (n = 11). During the focus groups, two researchers facilitated discussion on any topic that participants considered important to the experience of inpatient rehabilitation; participants were encouraged to describe their care, needs and preferences. The focus group discussions were audio-taped and transcribed verbatim. Field notes were hand recorded. Data were analysed and collated into themes. Six key themes emerged. Participants wanted: interactions with friendly, empathetic staff; regular contact with senior staff and all staff to introduce themselves by name and profession; timely communication of accurate information; and rehabilitation services seven days a week. The physical environment had both positive and negative effects on patient well-being. Patients with complex or atypical circumstances required special attention to ensure their needs were met. In conclusion, patients and families identified six important issues that need to be considered during inpatient rehabilitation.

The Supportive Role of the Family in Solving Real and Projected Problems of Everyday Life

In this research the supportive role of the family in coping with everyday problems was studied using two large data sets. The results show the importance of the structural aspect of social support. Mapping individual preferences to support referents showed the crucial role of spouse and parents in solving everyday problems. The individual choices of particular support referents could be fairly accurately predicted from knowledge of the composition of the family, in both categorical regression and logit models. The far lower predictability of the criterion variable was shown using a wide range of socioeconomic, social and demographic indicators. Residence in small cities and indicators of extreme occupational strata were particularly predictive of the choice of support referent. The supportive role of the family was also traced in the personal projects of young adults, which were seen as ecological, natural and dynamic middle-level units of analysis of personality. Different aspects of personal projects, including reliance on social support referents, turned out to be highly interrelated. One the one hand, expectations of support were determined by the content of the project, and on the other, expected social support also influences the content of the project. Sivuha sees this as one of the ways others can enter self-structures.

Reference Values and Factors Associated With Renal Resistive Index in a Family-Based Population Study

Increased renal resistive index (RRI) has been recently associated with target organ damage and cardiovascular or renal outcomes in patients with hypertension and diabetes mellitus. However, reference values in the general population and information on familial aggregation are largely lacking. We determined the distribution of RRI, associated factors, and heritability in a population-based study. Families of European ancestry were randomly selected in 3 Swiss cities. Anthropometric parameters and cardiovascular risk factors were assessed. A renal Doppler ultrasound was performed, and RRI was measured in 3 segmental arteries of both kidneys. We used multilevel linear regression analysis to explore the factors associated with RRI, adjusting for center and family relationships. Sex-specific reference values for RRI were generated according to age. Heritability was estimated by variance components using the ASSOC program (SAGE software). Four hundred women (mean age±SD, 44.9±16.7 years) and 326 men (42.1±16.8 years) with normal renal ultrasound had mean RRI of 0.64±0.05 and 0.62±0.05, respectively (P<0.001). In multivariable analyses, RRI was positively associated with female sex, age, systolic blood pressure, and body mass index. We observed an inverse correlation with diastolic blood pressure and heart rate. Age had a nonlinear association with RRI. We found no independent association of RRI with diabetes mellitus, hypertension treatment, smoking, cholesterol levels, or estimated glomerular filtration rate. The adjusted heritability estimate was 42±8% (P<0.001). In a population-based sample with normal renal ultrasound, RRI normal values depend on sex, age, blood pressure, heart rate, and body mass index. The significant heritability of RRI suggests that genes influence this phenotype.

Letter from William Tudor to his family,

Four letters written from Tudor to his family while he was traveling in France in 1800 and 1802. In two letters, he describes in detail his capture by a French privateer aboard the ship Minerva in the spring of 1800. He also discusses the business activities of "Mr. C" (John Codman), his employer. Tudor additionally describes the French countryside and the impact of the French Revolutionary Wars on the cities.

The Providence plantations for two hundred and fifty years : an historical review of the foundation, rise, and progress of the city of Prividence ... Also, sketches of the cities of New Port and Pawtucket, and other towns of the state, for which Providence is the commercial centre, together with an account of the celebration of the two hundred and fiftieth anniversary of the settlement of Providence. Being an historical souvenir of this occasion /

Mode of access: Internet.

Skid row in American cities.

Mode of access: Internet.

The memoirs of Charles-Lewis, Baron de Pollnitz. Being the observations he made in his late travels from Prussia thro' Germany, Italy, France, Flanders, Holland, England, &c. In letters to his friend, discovering not only the present state of the chief cities and towns; but the characters of the principal persons at the several courts.

"Account of the electoral family of Saxony, translated from the Bron's State of it": v. 1, p. 99-155.

Family expenditures for medical care, five regions,

Made-up set; supplied title.

Family expenditures for automobile and other transportation : five regions /

"This volume presents a description of the automobile and other transportation expenditures of families at different income levels in the small cities, villages, and farm counties survey by the Bureau of Home Economics as a part of the consumer purchases study. Other reports deal with family income, with the pattern of family consumption as a whole, and with expenditures for major family budget categories, such as food, clothing, and housing."--Foreword.

Family expenditures for personal care, gifts, selected taxes, and miscellaneous items : five regions /

Cover title.

Screening for physical activity in family practice - Evaluation of two brief assessment tools

Background: Physical activity (PA) is relevant to the prevention and management of many health conditions in family practice. There is a need for an efficient, reliable, and valid assessment tool to identify patients in need of PA interventions. Methods: Twenty-eight family physicians in three Australian cities assessed the PA of their adult patients during 2004 using either a two- (2Q) or three-question (3Q) assessment. This was administered again approximately 3 days later to evaluate test-retest reliability. Concurrent validity was evaluated by measuring agreement with the Active Australia Questionnaire, and criterion validity by comparison with 7-day Computer Science Applications, Inc. (CSA) accelerometer counts. Results: A total of 509 patients participated, with 428 (84%) completing a repeat assessment, and 415 (82%) accelerometer monitoring. The brief assessments had moderate test-retest reliability (2Q k = 58.0%, 95% confidence interval [CI] = 47.2-68.8%; 3Q k = 55.6%, 95% CI = 43.8-67.4%); fair to moderate concurrent validity (2Q k = 46.7%, 95% CI = 35.657.9%; 3Q k = 38.7%, 95% CI = 26.4-51.1%); and poor to fair criterion validity (2Q k = 18.2%, 95% CI = 3.9-32.6%; 3Q k = 24.3%, 95% CI = 11.6-36.9%) for identifying patients as sufficiently active. A four-level scale of PA derived from the PA assessments was significantly correlated with accelerometer minutes (2Q rho = 0.39, 95% CI = 0.28-0.49; 3Q rho = 0.31, 95% CI = 0.18-0.43). Physicians reported that the assessments took I to 2 minutes to complete. Conclusions: Both PA assessments were feasible to use in family practice, and were suitable for identifying the least active patients. The 2Q assessment was preferred by clinicians and may be most appropriate for dissemination.

Undue influence and the family home

This book provides a comprehensive analysis of the doctrine of undue influence in the context of the family home and fully incorporates the recent House of Lords ruling in Royal Bank of Scotland v Etridge (No 2) (2001). It is aimed predominantly at the legal practitioner, but will also act as a useful source of reference for academics and students of contract, land law and equity and trusts. Emphasis is placed on claims brought by spouses (usually the wife) seeking to set aside a charge over the matrimonial home made in favour of a lending institution. The role of lenders in this context is also examined in depth, as is the part played by the solicitor acting on behalf of the parties. Apart from providing an exposition of the doctrine and its key elements, the book also gives a broader outlook by examining the Commonwealth experience (notably in Australia, Canada and New Zealand) and suggesting an underlying concept of unconscionability as governing undue influence claims. There is also a separate chapter on remedies, as well as an appendix containing a number of draft pleadings for use by the legal practitioner. In the foreword, the Honourable Mr Justice Neuberger writes: 'Pawlowski and Brown are to be congratulated for having produced a book ...as comprehensive and user-friendly as this volume. Not only have they considered the effect of the authorities in a clear and logical way, but they have also highlighted problems which have yet to be resolved and questions which have yet to be answered ...one of the hallmarks of a good legal book.'

Of Marx and Makers: an Historical Perspective on Generative Justice

In Marxist frameworks “distributive justice” depends on extracting value through a centralized state. Many new social movements—peer to peer economy, maker activism, community agriculture, queer ecology, etc.—take the opposite approach, keeping value in its unalienated form and allowing it to freely circulate from the bottom up. Unlike Marxism, there is no general theory for bottom-up, unalienated value circulation. This paper examines the concept of “generative justice” through an historical contrast between Marx’s writings and the indigenous cultures that he drew upon. Marx erroneously concluded that while indigenous cultures had unalienated forms of production, only centralized value extraction could allow the productivity needed for a high quality of life. To the contrary, indigenous cultures now provide a robust model for the “gift economy” that underpins open source technological production, agroecology, and restorative approaches to civil rights. Expanding Marx’s concept of unalienated labor value to include unalienated ecological (nonhuman) value, as well as the domain of freedom in speech, sexual orientation, spirituality and other forms of “expressive” value, we arrive at an historically informed perspective for generative justice. 

Resident perceptions of natural resources between cities and across scales in the Pacific Northwest

As the global population becomes increasingly urban, research is needed to explore how local culture, land use, and policy will influence urban natural resource management. We used a broad-scale comparative approach and survey of residents within the Portland (Oregon)-Vancouver (Washington) metropolitan areas, USA, two states with similar geographical and ecological characteristics, but different approaches to land-use planning, to explore resident perceptions about natural resources at three scales of analysis: property level (“at or near my house”), neighborhood (“within a 20-minute walk from my house”), and metro level (“across the metro area”). At the metro-level scale, nonmetric multidimensional scaling revealed that the two cities were quite similar. However, affinity for particular landscape characteristics existed within each city with the greatest difference generally at the property-level scale. Portland respondents expressed affinity for large mature trees, tree-lined streets, public transportation, and proximity to stores and services. Vancouver respondents expressed affinity for plentiful accessible parking. We suggest three explanations that likely are not mutually exclusive. First, respondents are segmented based on preferences for particular amenities, such as convenience versus commuter needs. Second, historical land-use and tax policy legacies may influence individual decisions. Third, more environmentally attuned worldviews may influence an individual’s desire to produce environmentally friendly outcomes. Our findings highlight the importance of acknowledging variations in residents’ affinities for landscape characteristics across different scales and locations because these differences may influence future land-use policies about urban natural resources.

Genetic diversity of Cryptosporidium identified in clinical samples from cities in Brazil and Argentina

The identification and characterisation of Cryptosporidium genotypes and subtypes are fundamental to the study of cryptosporidiosis epidemiology, aiding in prevention and control strategies. The objective was to determine the genetic diversity of Cryptosporidium in samples obtained from hospitals of Rio de Janeiro, Brazil, and Buenos Aires, Argentina. Samples were analysed by microscopy and TaqMan polymerase chain reaction (PCR) assays for Cryptosporidium detection, genotyped by nested-PCR-restriction fragment length polymorphism (RFLP) analysis of the 18S rRNA gene and subtyped by DNA sequencing of the gp60 gene. Among the 89 samples from Rio de Janeiro, Cryptosporidium spp were detected in 26 by microscopy/TaqMan PCR. In samples from Buenos Aires, Cryptosporidium was diagnosed in 15 patients of the 132 studied. The TaqMan PCR and the nested-PCR-RFLP detected Cryptosporidium parvum , Cryptosporidium hominis , and co-infections of both species. In Brazilian samples, the subtypes IbA10G2 and IIcA5G3 were observed. The subtypes found in Argentinean samples were IbA10G2, IaA10G1R4, IaA11G1R4, and IeA11G3T3, and mixed subtypes of Ia and IIa families were detected in the co-infections. C. hominis was the species more frequently detected, and subtype family Ib was reported in both countries. Subtype diversity was higher in Buenos Aires than in Rio de Janeiro and two new subtypes were described for the first time.