Background:Spiritual distress is prevalent in advanced disease, but often neglected, resulting in unnecessary suffering. Evidence to inform spiritual care practices in palliative care is limited.Aim:To explore spiritual care needs, experiences, preferences and research priorities in an international sample of patients with life-limiting disease and family caregivers.Design:Focus group study.Setting/participants:Separate patient and caregiver focus groups were conducted at 11 sites in South Africa, Kenya, South Korea, the United States, Canada, the United Kingdom, Belgium, Finland and Poland. Discussions were transcribed, translated into English and analysed thematically.Results:A total of 74 patients participated: median age 62 years; 53 had cancer; 48 were women. In total, 71 caregivers participated: median age 61 years; 56 were women. Two-thirds of participants were Christian. Five themes are described: patients’ and caregivers’ spiritual concerns, understanding of spirituality and its role in illness, views and experiences of spiritual care, preferences regarding spiritual care, and research priorities. Participants reported wide-ranging spiritual concerns spanning existential, psychological, religious and social domains. Spirituality supported coping, but could also result in framing illness as punishment. Participants emphasised the need for staff competence in spiritual care. Spiritual care was reportedly lacking, primarily due to staff members’ de-prioritisation and lack of time. Patients’ research priorities included understanding the qualities of human connectedness and fostering these skills in staff. Caregivers’ priorities included staff training, assessment, studying impact, and caregiver’s spiritual care needs.Conclusion:To meet patient and caregiver preferences, healthcare providers should be able to address their spiritual concerns. Findings should inform patient- and caregiver-centred spiritual care provision, education and research.

Nordic Walking may improve exercise capacity, lower body endurance and coordination of movements in patients with good exercise tolerance participating in early, short-term rehabilitation after an acute coronary syndrome.

The aim of this study was to investigate the effect of Rhodiola rosea supplementation on the balance of oxidants and antioxidants in the serum and erythrocytes of competitive rowers. This double-blinded study included 22 members of the Polish Rowing Team who were participating in a preparatory camp. Participants were randomly assigned to the supplemented group (n = 11), who received 100 mg of R. rosea extract twice daily for 4 wk, or the placebo group (n = 11). At the beginning and end of the study, participants performed a 2,000-m maximum test on a rowing ergometer. Blood samples were taken from the antecubital vein before each exercise test, 1 min after completing the test, and after a 24-hr restitution period. The following redox parameters were assessed in erythrocytes: superoxide dismutase activity, glutathione peroxidase activity, and thiobarbituric-acid-reactive substances concentrations. In addition, creatine kinase activity and total antioxidant capacity were measured in plasma samples, lactate levels were determined in capillary blood samples, and uric acid concentrations were measured in serum. After supplementation, the total plasma antioxidant capacity was significantly higher (p = .0002) in the supplemented group than in the placebo group, and superoxide dismutase activity in erythrocytes directly after and 24 hr after the ergometry was significantly (p = .0461) lower in athletes receiving R. rosea extracts than in the placebo group. In conclusion, supplementation with R. rosea increased antioxidant levels in the plasma of professional rowers but had no effect on oxidative damage induced by exhaustive exercise.

High-intensity physical exercise decreases intracellular antioxidant potential. An enhanced antioxidant defense system is desirable in people subjected to exhaustive exercise. The aim of this study was to investigate the influence of supplementation with artichoke-leaf extract on parameters describing balance between oxidants and antioxidants in competitive rowers. This double-blinded study was carried out in 22 members of the Polish rowing team who were randomly assigned to a supplemented group (n = 12), receiving 1 gelatin capsule containing 400 mg of artichoke-leaf extract 3 times a day for 5 wk, or a placebo group (n = 10). At the beginning and end of the study participants performed a 2,000-m maximal test on a rowing ergometer. Before each exercise test, 1 min after the test completion, and after a 24-hr restitution period blood samples were taken from antecubital vein. The following redox parameters were assessed in red blood cells: superoxide dismutase activity, glutathione peroxidase activity, glutathione reductase activity, reduced glutathione levels, and thiobarbituric-acid-reactive-substances concentrations. Creatine kinase activity and total antioxidant capacity (TAC) were measured in plasma samples, lactate levels were determined in capillary blood samples, and serum lipid profiles were assessed. During restitution, plasma TAC was significantly higher (p < .05) in the supplemented group than in the placebo group. Serum total cholesterol levels at the end of the study were significantly (p < .05) lower in the supplemented group than in the placebo group. In conclusion, consuming artichoke-leaf extract, a natural vegetable preparation of high antioxidant potential, resulted in higher plasma TAC than placebo but did not limit oxidative damage to erythrocytes in competitive rowers subjected to strenuous training.

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