This study examined test-retest reliabilities of self-reported human immunodeficiency virus (HIV) sexual and drug injection behaviors among 246 prior drug users admitted to either of two residential drug treatment programs in Westborough, Massachusetts, and Providence, Rhode Island, between June 1990 and September 1992. Participants, selected by their date of admission, were administered admission and reliability questionnaires pertaining to HIV risk behaviors, the latter at approximately 2 weeks after admission. Estimated reliabilities (kappa coefficients) of the sexual behaviors ranged from 0.72 to 0.91; those for the drug injection variables ranged from 0.63 to 0.98. These results were consistent across groups defined by sex and injection of drugs. The consistently good reliabilities are significant to the design of independent studies of drug treatment populations utilizing self-report measures of sexual and drug behaviors.

Probability of partial necrosis occurring in reverse sural artery flap significantly increase when top-edge of the flap locates in the upper 1/9 of the calf, when LWR of the flap is 5:1 or more, or when width is 8 cm or more. The flap with top-edge locating lower 7/9 of the calf is safe and reliable.

In the absence of pain management outcome reports representing mainland China, the purposes of this study were to describe the outcome of postoperative pain management and the relationship between patient satisfaction and clinical outcomes in an indigenous Chinese population. From a sample of 388 second-day-postoperative inpatients, 304 (78%) reported pain in the past 24 hours and were enrolled in the study. Mean ratings for pain were moderate to severe. Patients reported mild to moderate pain-related interference with mood and physical activities. There were significant differences on worst pain intensity and pain interference with daily activity in the past 24 hours for different types of surgery. Top-ranked nonpharmacologic methods for managing pain were tolerating pain, changing positions, and family support. As measured by the Pain Management Index, 60.2% of patients were inadequately treated for pain, yet patients reported high satisfaction with pain management. Patient satisfaction, however, was inversely and significantly correlated with pain intensity. Study results indicate a need for standardized policies and guidelines about pain management and education among providers and for patients and families to overcome the suboptimal pain outcomes among this Chinese population.

Nursing managers should implement measures to improve nurses' knowledge and attitudes regarding major immobility complications to reduce the incidence of these complications in bedridden patients.

No abstract

Distally based sural fasciocutaneous flap is traditionally raised by the retrograde method. This article introduces the anterograde-retrograde method for harvest of the flap and describes our experience on altering the flap plan. A total of 159 flaps in 154 patients were elevated by the anterograde-retrograde approach that harvest of the flap began with exploring the peroneal artery perforators nearby the pivot point before the upper and bilateral edges of the flap were incised. Partial necrosis occurred in 16 (10.1%) flaps, and marginal necrosis developed in 10 flaps. Nine flaps were redesigned with adjusted pivot point and skin island. The anterograde-retrograde approach for harvest of the flap can accurately locate the perforator, readily adjust both the pivot point and skin island if necessary, and thus improve reliability of the flap. This approach is particularly applicable for elevation of the flap without preoperative localization of the perforators by means of the Doppler.

Family members of people with severe mental illness are subjected to stigmatization, and a better understanding of their experience of stigma is important for developing anti‐stigma interventions to reduce the related adverse consequences. This review aimed to systematically identify, evaluate, and synthesize existing findings from qualitative studies regarding the experience of stigma among family members of people with severe mental illness. A systematic literature search for primary studies was conducted in PubMed, EMBASE, Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, ProQuest Dissertations and Theses (PQDT), SinoMed (China), Chinese Citation Database (CNKI), and Wanfang Data (China) until March 2019. Findings from the included qualitative studies were extracted and aggregated using meta‐synthesis, guided by the Joanna Briggs Methodology for Qualitative Systematic Reviews. The results revealed that family members experienced stigma and suffered from various negative consequences related to it. Five major categories were identified in 20 studies: ‘negative public images of mental illness’, ‘structural discrimination against mental illness’, ‘stigma encountered in everyday life’, ‘psychological distress associated with stigmatization’, and ‘coping with stigma’. The study contributes to our understanding of the stigma experienced by family members of people with severe mental illness. It is suggested that culturally appropriate multi‐level interventions targeting the general public, health professionals, communities, and family members need to be developed to reduce the harmful influence of associated family stigma.

Antidepressant non-adherence among people with depressive disorder is a major, ongoing public health issue, yet few studies have focused on older adults and their medication adherence. Although treatment adherence is determined by multiple factors, one of the important and modifiable predictors are patients' attitudes and beliefs about medication. We explored a sample of 135 older Chinese people with major depression, and the relationship between beliefs about antidepressants and medication adherence. Sociodemographic and illness variables were also examined. In all, high antidepressant adherence was reported in 37.8%, moderate adherence in 39.2%, and low adherence in 23%. Ordinal regression analysis showed perceived necessity (P < 0.01) and concern (P < 0.01) about antidepressants were significant influencing factors. Other variables with a positive association with higher adherence were lower average income (P < 0.05), fewer number of prior episodes of depression (P < 0.01), and comorbid anxiety (P < 0.05). The present study highlights low adherence in a sample of older depressed Chinese people, and highlights how beliefs about medication affect adherence. Therefore, more attention should be focused on non-adherence in older patients, and there is a need to establish accessible and systematic education programmes to correct misconceptions to improve their adherence.