An exploratory study on utilisation pattern and costs of aged care in Hong Kong: implications for formal care in the community

SUMMARY: This paper explores the aged care utilisation patterns among elderly people in Hong Kong, and the relationship between the cost of aged care and the health of respondents. 450 persons aged 65 and above residing in public housing estates in the Southem District of Hong Kong Island were interviewed using a structured questionnaire. In the preceding six months, community-dwelling elderly had a higher rate of utilising medical/health services than community support services. Using the standard cost of each service supplied by the relevant departments, the average cost for those who used both medical/health and community support services was higher compared to those who used medical/health services only or community support services only. Using ADLs and self-rated health to indicate the level of health of the respondents, non-linear relationships were observed between the health of respondents and the average cost of care services. The number and nature of diseases reported, other than cultural explanations and individuals’ help-seeking behaviour, may explain this ‘unconventional’ situation. To conclude, affordable and accessible formal care enables many elderly people to live independently in the community. Preventive intervention may enhance the well-being of elderly people, rendering them less dependent on expensive medical/health care. Although there are limitations to this study, the study provides a premise forfurther discussion on assessing the cost of aged care and the health of elderly people in Hong Kong.published_or_final_versio

Validity and normative data for thirty-second chair stand test in elderly community-dwelling Hong Kong Chinese

It is important to establish valid field measures of lower body strength in the elderly, and to provide representative normative values that are culturally specific in order to help health professionals in the risk assessment of this group. A sample of 1,038 elderly Hong Kong Chinese undertook a 30-sec chair stand test (30CST), with a subsample of 143 completing isometric measures of maximal hip flexion and knee extension, plus a habitual physical activity questionnaire. The 30CST was significantly, yet only weakly, correlated with the isometric strength measures (r ∼ 0.3-0.4), but accurately discriminated between levels of habitual physical activity and across ages in decades. The normative values generated provide useful data for health screening in this elderly Hong Kong population, but do not compare well with their healthier US counterparts. © 2006 Wiley-Liss, Inc.postprin

Patterns of physical exercise and contributing factors among Hong Kong older adults

Key Messages 1. Studies suggest that regular physical activity and exercise offer a significant opportunity to enhance years of active independent life for older individuals. However, the majority of local respondents have a relatively sedentary lifestyle and were not getting adequate physical activity and exercise, though many recognised the health benefits of being active. 2. Compared with their relatively active American counterparts, in terms of strength, flexibility and agility, the respondents of this study fared unfavourably, with mean values in the 20-30 percentile score or lower. 3. More than 80% of elderly adults regularly participated in sports activities, the majority of whom engaged in only a low-to-moderate level of physical exercise mainly due to limited choices and time allocation for such activity. Nearly 17% of the respondents engaged in walking as a leisure activity; a substantial proportion included completion of their household activities (shopping, visiting friends) in what they termed ‘walking’. As walking confers many health benefits, its promotion in the immediate environments of the elderly is practical and undoubtedly health enhancing. 4. Findings suggested that cognitive-perceptual factors, ie perceived ‘pros’ and ‘cons’ of doing exercise, selfefficacy of exercise, stages of change and perceived barriers to exercise were all influential variables contributing to engagement in sports activity. Longitudinal studies are needed to understand the causal and temporal relations between these variables. 5. Health promotion programmes to educate older adults about the benefits of engaging in physical activity with respect to their self-efficacy are crucial. Education can enhance individual’s knowledge and/or awareness concerning the health benefits of physical activity and exercise. Those who are deprived and less educated should receive more attention from policymakers and service providers.published_or_final_versio

Commentary on the Regulation of Viral Proteins in Autophagy Process

The ability to subvert intracellular antiviral defenses is necessary for virus to survive as its replication occurs only in the host cells. Viruses have to modulate cellular processes and antiviral mechanisms to their own advantage during the entire virus life cycle. Autophagy plays important roles in cell regulation. Its function is not only to catabolize aggregate proteins and damaged organelles for recycling but also to serve as innate immunity to remove intracellular pathogenic elements such as viruses. Nevertheless, some viruses have evolved to negatively regulate autophagy by inhibiting its formation. Even more, some viruses have employed autophagy to benefit their replication. To date, there are more and more growing evidences uncovering the functions of many viral proteins to regulate autophagy through different cellular pathways. In this review, we will discuss the relationship between viruses and autophagy and summarize the current knowledge on the functions of viral proteins contributing to affect autophagy process

VI-Band Follow-Up Observations of Ultra-Long-Period Cepheid Candidates in M31

The ultra-long period Cepheids (ULPCs) are classical Cepheids with pulsation periods exceeding $\approx 80$ days. The intrinsic brightness of ULPCs are ~1 to ~3 mag brighter than their shorter period counterparts. This makes them attractive in future distance scale work to derive distances beyond the limit set by the shorter period Cepheids. We have initiated a program to search for ULPCs in M31, using the single-band data taken from the Palomar Transient Factory, and identified eight possible candidates. In this work, we presented the VI-band follow-up observations of these eight candidates. Based on our VI-band light curves of these candidates and their locations in the color-magnitude diagram and the Period-Wesenheit diagram, we verify two candidates as being truly ULPCs. The six other candidates are most likely other kinds of long-period variables. With the two confirmed M31 ULPCs, we tested the applicability of ULPCs in distance scale work by deriving the distance modulus of M31. It was found to be $\mu_{M31,ULPC}=24.30\pm0.76$ mag. The large error in the derived distance modulus, together with the large intrinsic dispersion of the Period-Wesenheit (PW) relation and the small number of ULPCs in a given host galaxy, means that the question of the suitability of ULPCs as standard candles is still open. Further work is needed to enlarge the sample of calibrating ULPCs and reduce the intrinsic dispersion of the PW relation before re-considering ULPCs as suitable distance indicators.Comment: 13 pages, with 14 Figures and 4 Tables (one online table). AJ accepte

Cognitive Load Theory: An Empirical Study of Anxiety and Task Performance in Language Learning

Abstract Introduction. This study explores the relationship among three variables-cognitive load

The effects of postintubation hypertension in severe traumatic brain injury

Introduction. The effect of post-intubation hypertension in severe traumatic brain injury (TBI) patients remains uncertain. We aimed to determine the relationship between post-intubation hypertension (mean arterial pressure (MAP) > 110mmHg) and outcomes in severe TBI. Methods. In this retrospective cohort study, adults who presented with isolated TBI and a MAP 70mmHg were assessed. Data were retrieved from our institutional trauma registry and the admission list of our neurosurgical intensive care unit (ICU). Results. We enrolled 126 patients, 81 of whom had a MAP 110 mmHg after intubation and were assigned to group 1; 45 patients who had a MAP > 110 mmHg were assigned to group 2. Only age (P = 0.008), heart rate (HR; P = 0.036), and MAP before intubation (P 110 mmHg, P < 0.034, OR 3.119, 95% CI 1.087–8.953). Conclusion. Post-intubation hypertension was associated with longer ventilator-dependent and ICU stays in patients with severe TBI

Crystallization of Adenylylsulfate Reductase from Desulfovibrio gigas: A Strategy Based on Controlled Protein Oligomerization

Adenylylsulfate reductase (adenosine 5′-phosphosulfate reductase, APS reductase or APSR, E.C.1.8.99.2) catalyzes the conversion of APS to sulfite in dissimilatory sulfate reduction. APSR was isolated and purified directly from massive anaerobically grown Desulfovibrio gigas, a strict anaerobe, for structure and function investigation. Oligomerization of APSR to form dimers–α_2β_2, tetramers–α_4β_4, hexamers–α_6β_6, and larger oligomers was observed during purification of the protein. Dynamic light scattering and ultracentrifugation revealed that the addition of adenosine monophosphate (AMP) or adenosine 5′-phosphosulfate (APS) disrupts the oligomerization, indicating that AMP or APS binding to the APSR dissociates the inactive hexamers into functional dimers. Treatment of APSR with β-mercaptoethanol decreased the enzyme size from a hexamer to a dimer, probably by disrupting the disulfide Cys156—Cys162 toward the C-terminus of the β-subunit. Alignment of the APSR sequences from D. gigas and A. fulgidus revealed the largest differences in this region of the β-subunit, with the D. gigas APSR containing 16 additional amino acids with the Cys156—Cys162 disulfide. Studies in a pH gradient showed that the diameter of the APSR decreased progressively with acidic pH. To crystallize the APSR for structure determination, we optimized conditions to generate a homogeneous and stable form of APSR by combining dynamic light scattering, ultracentrifugation, and electron paramagnetic resonance methods to analyze the various oligomeric states of the enzyme in varied environments