Communication in Hong Kong accident and emergency departments: The clinicians’ perspectives

© The Author(s) 2015. In this article, we report findings from the first qualitatively driven study of patient–clinician communication in Hong Kong Accident and Emergency Departments (AEDs). In light of the Hong Kong Hospital Authority’s policy emphasis on patientcentered care and communication in the public hospitals it oversees, we analyze clinicians’ perceptions of the role and relevance of patient-centered communication strategies in emergency care. Although aware of the importance of effective communication in emergency care, participants discussed how this was frequently jeopardized by chronic understaffing, patient loads, and time pressures. This was raised in relation to the absence of spoken interdisciplinary handovers, the tendency to downgrade interpersonal communication with patients, and the decline in staff attendance at communication training courses. Participants’ frequent descriptions of patient-centered communication as dispensable from, and timeburdensome in, AEDs highlight a discrepancy between the stated Hong Kong Hospital Authority policy of patient-centered care and the reality of contemporary Hong Kong emergency practice

Benthic phosphorus cycling within the Eurasian marginal sea ice zone

The Arctic Ocean region is currently undergoing dramatic changes, which will likely alter the nutrient cycles that underpin Arctic marine ecosystems. Phosphate is a key limiting nutrient for marine life but gaps in our understanding of the Arctic phosphorus (P) cycle persist. In this study, we investigate the benthic burial and recycling of phosphorus using sediments and pore waters from the Eurasian Arctic margin, including the Barents Sea slope and the Yermak Plateau. Our results highlight that P is generally lost from sediments with depth during organic matter respiration. On the Yermak Plateau, remobilization of P results in a diffusive flux of P to the seafloor of between 96 and 261 µmol m−2 yr−1. On the Barents Sea slope, diffusive fluxes of P are much larger (1736–2449 µmol m−2 yr−1), but these fluxes are into near-surface sediments rather than to the bottom waters. The difference in cycling on the Barents Sea slope is controlled by higher fluxes of fresh organic matter and active iron cycling. As changes in primary productivity, ocean circulation and glacial melt continue, benthic P cycling is likely to be altered with implications for P imported into the Arctic Ocean Basin

Convective Fingering of an Autocatalytic Reaction Front

We report experimental observations of the convection-driven fingering instability of an iodate-arsenous acid chemical reaction front. The front propagated upward in a vertical slab; the thickness of the slab was varied to control the degree of instability. We observed the onset and subsequent nonlinear evolution of the fingers, which were made visible by a {\it p}H indicator. We measured the spacing of the fingers during their initial stages and compared this to the wavelength of the fastest growing linear mode predicted by the stability analysis of Huang {\it et. al.} [{\it Phys. Rev. E}, {\bf 48}, 4378 (1993), and unpublished]. We find agreement with the thickness dependence predicted by the theory.Comment: 11 pages, RevTex with 3 eps figures. To be published in Phys Rev E, [email protected], [email protected], [email protected]

Preoperative systemic inflammation predicts postoperative infectious complications in patients undergoing curative resection for colorectal cancer

The presence of systemic inflammation before surgery, as evidenced by the glasgow prognostic score (mGPS), predicts poor long-term survival in colorectal cancer. The aim was to examine the relationship between the preoperative mGPS and the development of postoperative complications in patients undergoing potentially curative resection for colorectal cancer. Patients (n=455) who underwent potentially curative resections between 2003 and 2007 were assessed consecutively, and details were recorded in a database. The majority of patients presented for elective surgery (85%) were over the age of 65 years (70%), were male (58%), were deprived (53%), and had TNM stage I/II disease (61%), had preoperative haemoglobin (56%), white cell count (87%) and mGPS 0 (58%) in the normal range. After surgery, 86 (19%) patients developed a postoperative complication; 70 (81%) of which were infectious complications. On multivariate analysis, peritoneal soiling (P<0.01), elevated preoperative white cell count (P<0.05) and mGPS (P<0.01) were independently associated with increased risk of developing a postoperative infection. In elective patients, only the mGPS (OR=1.75, 95% CI=1.17-2.63, P=0.007) was significantly associated with increased risk of developing a postoperative infection. Preoperative elevated mGPS predicts increased postoperative infectious complications in patients undergoing potentially curative resection for colorectal cancer

Comparison of estimated energy intake in children using a Web-based Dietary Assessment Software with accelerometer-estimated energy expenditure in children

Background: The OPUS (Optimal well-being, development and health for Danish children through a healthy New Nordic Diet) project carried out a school meal study to assess the impact of a New Nordic Diet (NND). The random controlled trial involved 834 children aged 8–11 in nine local authority schools in Denmark. Dietary assessment was carried out using a program known as WebDASC (Web-based Dietary Assessment Software for Children) to collect data from the children. Objective: To compare the energy intake (EI) of schoolchildren aged 8–11 estimated using the WebDASC system against the total energy expenditure (TEE) as derived from accelerometers worn by the children during the same period. A second objective was to evaluate the WebDASC's usability. Design: Eighty-one schoolchildren took part in what was the pilot study for the OPUS project, and they recorded their total diet using WebDASC and wore an accelerometer for two periods of seven consecutive days: at baseline, when they ate their usual packed lunches and at intervention when they were served the NND. EI was estimated using WebDASC, and TEE was calculated from accelerometer-derived activity energy expenditure, basal metabolic rate, and diet-induced thermogenesis. WebDASC's usability was assessed using a questionnaire. Parents could help their children record their diet and answer the questionnaire. Results: Evaluated against TEE as derived from the accelerometers worn at the same time, the WebDASC performed just as well as other traditional methods of collecting dietary data and proved both effective and acceptable with children aged 8–11, even with perhaps less familiar foods of the NND. Conclusions: WebDASC is a useful method that provided a reasonably accurate measure of EI at group level when compared to TEE derived from accelerometer-determined physical activity in children. WebDASC will benefit future research in this area