Legal Aspects of the Care of Older People in Hong Kong and Nurse's Role in it

Legal system provide different means of protection to older people in Hong Kong in terms of life ending decision making, elder abuse, financial and housing affairs. Nurses often plays an important role in it such as begin an advocator and providing professional views and knowledge for helping the older people to plan their life

The Most Effective Treatment or Intervention for Treating Chinese Elderly Depression: a Literature Review

Background: There is an increase in the percentage of Chinese elderly population with depression globally which may be contributed by financial stain, poor living conditions, and poor social support with friends and relatives, absence of carer and precipitating poor health condition and different therapy had been used for them.Objectives: This literature review was conducted to evaluate different treatment and interventions that had been used on Chinese elderly population with depression.Methodology: A systematic searching process from January, 2013 to June, 2013. Key word used is elder, geriatric, senile, old age, aged 60 or above, depress, depression, depressive symptoms and Chinese.Results: 84 studies were retrieved and it shows that Tai Chi is most effective in treating depression symptoms, Qigong is most effective in treating the associated factors of depressive symptoms and lastly Qigong is also the most effective therapy in treating the general well-being of the outcomes of depression

Non-invasive ventilation during paediatric retrieval: a systematised review

Background: In hospital critical-care and emergency settings, non-Invasive ventilation (NIV) is increasingly used in neonatal and paediatric patients as an alternative to invasive positive pressure ventilation (IPPV). Critically ill children and babies may need transfer to higher levels of care, but the emergency transport setting is lagging behind the hospital sector in terms of availability of NIV. Aim and objectives: The goal of this study was to assess the evidence on the safety and effectiveness of NIV in children during transportation. Safety outcome measures were intubation or escalation of ventilation mode (during and soon after transport) and adverse event (AE) occurrence during transport. Effectiveness outcome measures related to improvement in clinical parameters during transfer. Methods: A systematised review of the literature was conducted, based on searches of MEDLINE via PubMed, EMBASE (via Scopus), Cochrane Central Register of Controlled Trials (CENTRAL), African Index Medicus, Web of Science Citation Index and the World Health Organisation Trials Registry (ICTRP). Two reviewers independently reviewed all identified studies for eligibility, with an initial screening round followed by a full-text review of potentially relevant articles. The quality of studies meeting inclusion criteria was evaluated using an adapted quality assessment tool developed for this study. Results: A total of 1287 records were identified; of these, 12 studies met inclusion criteria. Following quality assessment, eight studies were included and four studies were excluded. There were no randomised controlled trials, quasi-randomised controlled trials or non-randomised studies of intervention, to answer the research question. The included studies were all observational in design: seven studies (n= 708) evaluated in-transport use of continuous positive airway pressure (CPAP) and one study (n=150) reported on use of high-flow nasal cannula (HFNC) in children during transport. During transport on NIV, 3/858 (0.4%) patients required either intubation (1/708; 0.1%; CPAP studies) or escalation of mode of ventilation (2/150; 1%; HFNC study). In the 24 hours following transfer, 63/650 (13%) of children transferred on NIV, were intubated. The odds of intubation within 24 hours were significantly higher for CPAP transfer 60/500 (12%) compared with HFNC 3/150(2%): OR (95% CI) 6.68 (2.40 - 18.63), p=0.00003. Adverse events, where reported, were found to occur in 2-4% of NIV transports, with use of BVM in 8/334 (2%), desaturation episodes in 9/290 (3%), apnoea in 11/290(4%) and administration of CPR in 0/290 (0%) cases being described. There was insufficient reporting of change in vital signs or clinical condition during transport for meaningful analysis. Conclusion: This study is the first systematised review indicating that NIV use in children during transport is likely to be safe. From the low-reliability evidence available, it was calculated that NIV use in children during transport would result in a 0.4% rate of intubation or escalation during transport and an in-transport adverse event rate of 2-4%. There was insufficient evidence to comment on clinical effectiveness of NIV during transfer. Following NIV transfer, 13% of patients were intubated within 24 hours, with significantly higher odds of intubation in children transported on CPAP compared with HFNC. Recommendations: Further research is needed in order to make firm recommendations regarding the safety and effectiveness of NIV during transport of children. A recommended minimum data set, for the standardised reporting of observational studies of paediatric NIV use during transport, is suggested. It is recommended that transport databases and registries are expanded to include NIV details as well as information regarding the presence or absence of pre-specified adverse events during transport

Engineering and Characterization of Human β-defensin-3 and Its Analogues and Microcin J25 Peptides Against \u3cem\u3eMannheimia haemolytica\u3c/em\u3e and Bovine Neutrophils

Mannheimia haemolytica-induced bovine respiratory disease causes loss of millions of dollars to Canadian cattle industry. Current antimicrobials are proving to be ineffective and leave residues in meat. Antimicrobial peptides (AMPs) may be effective against M. haemolytica while minimizing the risk of drug residues. Cationic AMPs can kill bacteria through interactions with the anionic bacterial membrane. Human β-Defensin 3 (HBD3) and microcin J25 (MccJ25) are AMPs with potent activity against many Gram-negative bacteria. We tested the microbicidal activity of wild-type HBD3, three HBD3 peptide analogues (28 amino acid, 20AA, and 10AA) derived from the sequence of natural HBD3, and MccJ25 in vitro against M. haemolytica. Three C-terminal analogues of HBD3 with all cysteines replaced with valines were manually synthesized using solid phase peptide synthesis. Since AMPs can act as chemoattractant we tested the chemotactic effect of HBD3, 28AA, 20AA, and 10AA peptides on bovine neutrophils in Boyden chamber. Minimum bactericidal concentration (MBC) assay showed that M. haemolytica was intermediately sensitive to HBD3, 28AA and 20AA analogues with an MBC of 50 µg/mL. The 10AA analogue had MBC 6.3 µg/mL which is likely a result of lower final inoculum size. MccJ25 didn’t have significant bactericidal effect below an MBC \u3c 100 µg/mL. Bovine neutrophils showed chemotaxis towards HBD3 and 20AA peptides (P \u3c 0.05) but not towards 28AA analogue. Co-incubation of neutrophils with any of the peptides did not affect their chemotaxis towards N-formyl-l-methionyl-l-leucyl-phenylalanine (fMLP). The data show that these peptides are effective against M. haemolytica and are chemotactic for neutrophils in vitro

To study prescription behavior of physician in regard to brand and generic name

Background: Drugs are the chemical substances used for diagnosis, prevention and treatment of a disease. They are prescribed either by using generic name or brand name. The objective of this study was study the preference of registered medical practitioners towards prescribing of drugs by generic name or brand name and to know the reasons for the same.Methods: The questionnaire based observational study was done on 300 registered medical practitioners after satisfying inclusion and exclusion criteria. The data collected was evaluated and the response recorded in percentage.Results: Out of 300 practitioners 92% admitted prescribing drug by brand name for fear of substitution by substandard product and did not allow pharmacist to substitute the same, rest 8% prescribe by generic names. 78% considered generic drugs to be less efficacious and 3% had the view that they have more side effects. 83% doctors consider patient affordability while prescribing however only 60% of them informed patients about the cost of prescribed drugs. Other factors influencing prescription behaviour were health care administration policy (10%) and company representative (7%).Conclusions: Majority of physicians prescribe drugs by brand names due to its assured efficacy and they are reluctant to prescribe generic names because of their view of substitution by less efficacious, substandard and counterfeit products. The regulating agencies have to assure the efficacy of generic products. The spurious and substandard drugs available in the market have to be checked and strict action should be taken in order to maintain the quality of these products. This will boost the confidence of the physicians in prescribing the generic drugs resulting in decreased health care cost

HOW CAN WE MAKE THE CURRENT UK PSYCHIATRIC TRAINING SCHEME TRULY TRAINEE CENTRED?

Introduction. UK Psychiatric training is popular worldwide and IMG from throughout the world come to UK. Psychiatric training has undergone significant changes but this has not reflected in the outcomes. There is a need to refocus on trainee centred teaching principles. Current Psychiatric Training: Current training scheme started in 2007 as run-through programme spanning six years. Till 2005, examinations decided the progression of trainees through the training scheme with development of Work Place Based Assessments. Following Tooke’s report,training was uncoupled and examinations regained importance in deciding the progress of trainees to higher training. Factors affecting psychiatric training: EWTD, budget cuts, service priorities lead to a sense of lack of importance among trainees. Surveys focussing on clinical supervision pointed to the inadequacy and poor quality of supervision. Training has lost trainee centeredness. It is important to make the training maximally effective to deliver safer services. Trainees are major work forces and the future consultants who lead and manage services. Conclusion: Student centred teaching is a highly skilled educational process. Adapting these principles into psychiatric training could help trainees learn successfully

RGD-tagged helical rosette nanotubes aggravate acute lipopolysaccharide-induced lung inflammation

Rosette nanotubes (RNT) are a novel class of self-assembled biocompatible nanotubes that offer a built-in strategy for engineering structure and function through covalent tagging of synthetic self-assembling modules (G∧C motif). In this report, the G∧C motif was tagged with peptide Arg-Gly-Asp-Ser-Lys (RGDSK-G∧C) and amino acid Lys (K-G∧C) which, upon co-assembly, generate RNTs featuring RGDSK and K on their surface in predefined molar ratios. These hybrid RNTs, referred to as Kx/RGDSKy-RNT, where x and y refer to the molar ratios of K-G∧C and RGDSK–G∧C, were designed to target neutrophil integrins. A mouse model was used to investigate the effects of intravenous Kx/RGDSKy-RNT on acute lipopolysaccharide (LPS)-induced lung inflammation. Healthy male C57BL/6 mice were treated intranasally with Escherichia coli LPS 80 μg and/or intravenously with K90/RGDSK10-RNT. Here we provide the first evidence that intravenous administration of K90/RGDSK10-RNT aggravates the proinflammatory effect of LPS in the mouse. LPS and K90/RGDSK10-RNT treatment groups showed significantly increased infiltration of polymorphonuclear cells in bronchoalveolar lavage fluid at all time points compared with the saline control. The combined effect of LPS and K90/RGDSK10-RNT was more pronounced than LPS alone, as shown by a significant increase in the expression of interleukin-1β, MCP-1, MIP-1, and KC-1 in the bronchoalveolar lavage fluid and myeloperoxidase activity in the lung tissues. We conclude that K90/RGDSK10-RNT promotes acute lung inflammation, and when used along with LPS, leads to exaggerated immune response in the lung

Thermostable xylanases from thermophilic fungi and bacteria: current perspective

Thermostable xylanases from thermophilic fungi and bacteria have a wide commercial acceptability in feed, food, paper and pulp and bioconversion of lignocellulosics with an estimated annual market of USD 500 Million. The genome wide analysis of thermophilic fungi clearly shows the presence of elaborate genetic information coding for multiple xylanases primarily coding for GH10, GH11 in addition to GH7 and GH30 xylanases. The transcriptomics and proteome profiling has given insight into the differential expression of these xylanases in some of the thermophilic fungi. Bioprospecting has resulted in identification of novel thermophilic xylanases that have been endorsed by the industrial houses for heterologous over- expression and formulations. The future use of xylanases is expected to increase exponentially for their role in biorefineries. The discovery of new and improvement of existing xylanases using molecular tools such as directed evolution is expected to be the mainstay to meet increasing demand of thermostable xylanases