The place and promotion of well-being in mental health services: a qualitative investigation.

The study investigated the place and promotion of well-being from the perspectives of services users and mental health professionals. * Data from focus groups and interviews were analysed and found that well-being promotion was available, for example weight management groups in mental health services. However, they also found that there were some contradictions between the groups of people interviewed about what was available and what to promote in the future. * The study concludes suggesting partnerships with local communities to further develop well-being services, such as opportunities for physical activity, for people with mental health problems. Abstract This study explored service users' and mental health professionals' understandings, experiences and opinions of well-being and its promotion within mental health services. A qualitative case study methodology included nine participants (five adult service users, three mental health professionals, one senior manager) who were purposively sampled from a Mental Health Trust in England. Service users participated in a focus group, while individual semi-structured interviews were held with the mental health professionals and senior manager. Interpretative phenomenological analysis of the data revealed five main themes including well-being as a holistic concept; well-being promotion; the place, promotion and position of well-being; role of mental health services in well-being promotion; and areas for further improvement. Findings revealed evidence of well-being promotion; however, there were contradictions regarding what was known between the groups of participants and what could be provided in the future. Implications for practice include the need to establish more effective partnership working between mental health services and local communities, especially in light of financial constraints within health services at large. This could assist the increased provision of therapeutic services for well-being promotion.

Stability of psychometric questionnaires.

In 1999, Wilson and Batterham proposed a new approach to assessing the test-retest stability of psychometric questionnaires. They recommended assessing the proportion of agreement - that is, the proportion of participants that record the same response to an item - using a test-retest design. They went on to use a bootstrapping technique to estimate the uncertainty of the proportion of agreement. The aims of this short communication are (1) to demonstrate that the sampling distribution of the proportion of agreement is well known (the binomial distribution), making the technique of 'bootstrapping' redundant, and (2) to suggest a much simpler, more sensitive method of assessing the stability of a psychometric questionnaire, based on the test-retest differences (within-individuals) for each item. Adopting methods similar to Wilson and Batterham, 97 sport students completed the Social Physique Anxiety Scale on two occasions. Test-retest differences were calculated for each item. Our results show that the proportion of agreement ignores the nature of disagreement. Items 4 and 11 showed similar agreement (44.3% and 43.3% respectively), but 89 of the participants (91.8%) differed by just +/-1 point when responding to item 4, indicating a relatively stable item. In contrast, only 78 of the participants (80.4%) recorded a difference within +/- 1 point when responding to item 11, suggesting quite contrasting stability for the two items. We recommend that, when assessing the stability of self-report questionnaires using a 5-point scale, most participants (90%) should record test-retest differences within a reference value of +/- 1.

Two new sheep haemoglobins, one of which is replaced by haemoglobin C in anaemia.

Two new haemoglobin variants, provisionally named Hb G and Hb H, were found during a survey of 295 Welsh Mountain cross-bred sheep. Both haemoglobins appear to be beta chain variants controlled by genes allelic to those for the common forms Hb A and Hb B. Studies on an anaemic Hb AH and an Hb AG type sheep showed that Hb G, like Hb A, is replaced by Hb C in anaemia whereas Hb H, like Hb B, is not replaced.

Blood genetic marker studies of a sheep-goat hybrid and its back-cross offspring.

Blood samples from a female sheep-goat hybrid and its back-cross male offspring were tested for electrophoretic variants of plasma albumin, transferrin and esterase, and of red cell carbonic anhydrase, nucleoside phosphorylase, NADH-diaphorase, 'X'-protein, superoxide dismutase, malic enzyme and haemoglobin. Red cells were also tested for blood group antigens. Both animals showed variants that could not be attributed to either sheep or goat alone, thus confirming previous chromosomal data that the female was a genuine sheep-goat hybrid.

L-antigen and active potassium transport in HK and LK red cells of Barbary sheep (Ammotragus lervia).

1. The potassium concentration in red cells of 21 Barbary sheep showed a bimodal distribution, with five animals of LK type (K+ conc. 30-45 mM) and 16 of HK type (K+ conc. 80-95 mM). 2. Evidence is presented that both Lp and Ll antigens are present on LK Barbary sheep red cells. 3. Active K+ transport in LK Barbary sheep red cells was stimulated 3-5 fold by sheep and goat anti-L. 4. Active K+ transport in HK Barbary sheep red cells was higher than in LK red cells. Five out of six HK animals tested showed no stimulation of active K+ transport with anti-L. One HK animal (2BA2) showed some stimulation of active K+ transport, and also absorbed some anti-L from antisera, suggesting that Lp antigen is present on these red cells. 5. Ouabain-sensitive ATPase in membranes from HK and LK Barbary sheep red cells showed kinetics characteristic of HK and LK membranes of domestic goats and sheep; the ATPase of LK Barbary sheep membranes sensitized with anti-L was stimulated 2-fold due to an alteration in the internal sodium and potassium affinities in favour of sodium.

Monoclonal antibodies to bovine blood group antigens.

Hybridomas were made by fusing mouse myeloma cells with spleen cells from mice immunized with bovine red cells. Sixteen cloned lines which secreted haemolytic monoclonal antibodies reacting with antigens in the A, B, F, Z and S blood group systems were established; one of the antibodies identified a new factor in the B system. Extensive tests on red cells from 1000 animals indicated that several of the antibodies are suitable for use in routine blood typing; others are of potential use for genetic studies of the bovine blood group systems.

Abnormal gamma-glutamylcysteine synthetase activities in sheep red blood cells.

Red blood cell gamma-glutamylcysteine synthetase (GC-S) activities and glutathione (GSH) concentrations were investigated in pure-bred Finnish Landrace, Tasmanian Merino, and Finnish Landrace X Tasmanian Merino sheep. Previous studies were confirmed that a dominant gene (L) at the GSH locus leads to partial GC-S and GSH deficiency, while a recessive gene (h) at the Tr locus codes for defective red cell amino acid transport, concomitant GSH deficiency, and significantly elevated levels of GC-S. In addition, new results are presented which suggest that there is a dominant gene (A) at another locus distinct from GSH and Tr (provisionally designated GC-S) which has a marked epistatic enhancing effect on measured GC-S activities.

Genetic control of amino acid transport in sheep erythrocytes.

An inherited amino acid transport deficiency results in low concentrations of glutathione (GSH) in the erythrocytes of certain sheep. Earlier studies based on phenotyping according to GSH concentrations indicated that the gene TrH, which controls normal levels of GSH, behaves as if dominant or incompletely dominant to the allele Trh, which controls the GSH deficiency. The present papers shows that when sheep are classified according to amino acid transport activity, the TrH gene behaves as if codominant to Trh. Erythrocytes from sheep homozygous for the TrH gene exhibit rapid saturable L-alanine influx (apparent Km, 21.6 mM; Vmax, 22.4 mmol/liter cells/hr.). Cells from sheep homozygous for the Trh gene exhibit slow nonsaturable L-alanine uptake (0.55 mmol/liter cells/hr at 50mM extracellular L-alanine). Cells from heterozygous sheep show saturable L-alanine uptake with a diminished Vmax (apparent Km, 19.1 mM; Vmax, 12.7 mmol/liter cells/hr). These erythrocytes have a significantly lower GSH concentration than cells from TrH, TrH sheep but similar intracellular levels of dibasic amino acids.

Close linkage between the C blood group locus and the locus controlling amino acid transport in sheep erythrocytes.

Data from 838 Finnish Landrace or Finnish Landrace crossbred sheep showed a highly significant correlation between phenotypes of the C blood group system and erythrocyte amino acid transport variants. Erythrocytes with normal amino acid transport properties (GSH high, Ly- type) were Cb-positive or Cb-negative. Erythrocytes with the amino acid transport lesion (GSH low, Ly +) were never Cb-negative. Sheep erythrocytes homozygous for Cb showed stronger lysis reactions with anti-Cb than heterozygous cells. Ly + sheep were nearly always homozygous for Cb, whereas most Ly- sheep were heterozygous for Cb-negative. Inheritance studies provided strong evidence that this association is due to close genetic linkage.

Properties of a goat anti-L antibody: further evidence for heterogeneity of the L antigen.

The preparation and properties of an antibody (anti-L) against low potassium type (LK) goat red cells raised in a high potassium type (HK) goat are described. This reagent stimulated active potassium transport, but showed only weak serological activity against low potassium type (LK) sheep and goat red cells. The results are discussed in relation to the hypothesis that anti-L antibody has two specificities--a sodium pump-stimulating activity (anti-Lp) and a serological activity (anti-L1y).