Case study analysis of end of life care development in the Chinese cultural context of Macao:A social movement perspective

Abstract Background The modern hospice movement is often recognised as a social movement. However, such understanding is primarily based on historic reflection and this approach has lacked theoretical exploration. There is a lack of systematic examination of the modern hospice movement by way of social movement theories. Aim Focusing on the Chinese socio-cultural context of Macao, this study aimed to understand the EoLC movement by applying the social movement theory, the Framing Perspective, as proposed by Snow and Benford in 1988. Methods A case study approach was conducted. Semi-structured interviews were held between 2012 and 2013, with pioneers (n = 11) of the EoLC in Macao. Thematic analysis was adopted to analyse the interviews. Results The Framing Perspective analysis illuminated that there was both growth and stagnation of the EoLC movement. Three themes emerged: 1) the suffering of people at the end of their lives was considered as a social problem needed to be addressed urgently, 2) the incoherent EoLC strategies developed by pioneers indicated the lack of internal ideological cohesion within the movement, 3) external constraints contributed to the stagnation of the movement. Conclusions The EoLC development in Macao can be understood as a social movement. The Framing Perspective provided a theoretical way to understand the emergence of EoLC; offering a novel perspective to conceptualise the modern hospice movement. This sociological and theoretical lens opened up new ways for future research to study the emergence of EoLC in different socio-cultural contexts

Environmental Factors Influencing Arab Qatari Women’s Breast Cancer Screening: Health Care Practitioners’ Perspective

Breast cancer, the most common cancer among Arab women in Qatar, significantly affects the morbidity and mortality of Arab women largely because of delayed diagnosis related to low participation rates in breast cancer screening (BCS). To understand the reasons for the low participation rates, a critical ethnographic study was conducted with 15 health care practitioners in Qatar. Thematic analysis of the interview data resulted in identification of environmental factors influencing participation in BCS: (a) gender friendly health care services, (b) lack of a national BCS protocol, (c) time constraints, (d) deficiencies in the patient health records system, (e) cost for mammograms, and (f) transportation. A recurring theme across the factors was that, from the perspective of health care practitioners, Arab women’s health cannot be understood in isolation from the environment in which they live. Interventions that promote BCS practices must address the contextual factors that impact health of the population.&nbsp

Mood-congruent free recall bias in anxiety

The present study evaluated the status of mood-congruent free recall bias in anxious individuals following incidental encoding of target words. In the first experiment, high trait anxiety individuals showed increased recall of threat-related information after an orienting task promoting lexical processing of target words. In a second experiment, both lexical and semantic orienting tasks were performed at study. In this experiment, anxious individuals displayed a mood-congruent recall bias only for target information processed at a lexical level. Theoretical and practical implications of these findings are discussed

An integrated approach of building information modelling and life cycle assessment (BIM-LCA) for gas and solar water heating systems

Buildings are responsible for the energetic consumption and potential greenhouse gas emissions during their life cycle. Water heating system contribute to a building’s energetic consumption, mainly in residential units, throughout the building’s operational phase. Variability in energy sources, reservation and distribution systems of hot water along with the types of construction materials used in these building systems are key decisions to make in the initial design phases of a building project. Often, the definition of the most appropriate water heating system for a building is made via a technical-economic decision. However, the decision is rarely based on natural resource consumption and environmental impact generation throughout the life-cycle of the heating systems and of buildings as a whole. This study presents an application of a specific environmental management tool, based on an integrated Building Information Modelling (BIM) and Life-Cycle Analysis (LCA) method for selection of hot water systems, during the early design building phase. The proposed approach is implemented in the pre-operational phase, in order to enable decision makers to appreciate the resulting environmental performance of water heating systems in buildings. The applicability of the framework is tested via a comparative study of solar heating water systems and natural gas heating water systems for a residential multifamily building to be constructed in Rio de Janeiro, Brazil. For the indicators damage to human health and damage to ecosystem, results indicate that the greatest impact on global warming comes from the natural gas heating system, while for solar heating, free particulate matter was the highest negative contribution. The operation phase for the natural gas system was highest for climate change while for solar heating system, it was the fresh water that was impacted the most during the pre-operational phase of the system’s use

The use of smart phones and their mobile applications among older adults in Hong Kong: An exploratory study

The purpose of this study was to explore social participation using smart phones by the older population in Hong Kong. The present study was conducted from 10-June-2013 to 16-August-2013. It was a cross-sectional survey study, and data were collected from street interviews. Potential participants were approached and invited to respond to a questionnaire. The locations for collecting data were evenly distributed on Hong Kong Island, Kowloon, and the New Territories. The size of the samples for Hong Kong Island, Kowloon, and the New Territories were calculated based on their respective proportion of the Hong Kong population in 2011. The estimated time to complete the questionnaire was approximately 10 minutes. The questionnaire included questions on demographic data and the use of smart phones and their related features. A total of 982 participants were interviewed, 46% of whom were male and 54% female. The participants were divided into the following two groups: the young-old (age 50-69) and the old-old (age 70 or above). The mean age was 67.93±10.386. The findings showed that, in comparison with the young-old group (age 50 to 69), a smaller percentage of the old-old group (70 and over) used smart phones and mobile messaging applications to communicate with others. There were no differences in patterns with regard to the type and frequency of the mobile applications being used. However, a smaller percentage of the old-old group had installed the mobile app by themselves and introduced the mobile app to others. This study reveals the behavioral patterns of the young-old and the old-old groups in the use of mobile devices to communicate. The young-old and old-old groups exhibited the same patterns in terms of the types and frequency of the mobile apps used; however, a smaller percentage of the old-old group used mobile apps to communicate. Different educational programs on the importance of social support should be established, and the promotional strategies for these programs need to be tailored to older adults

Conducting clinical trials in sub-Saharan Africa: challenges and lessons learned from the Malawi Cryptosporidium study

Background An effective drug to treat cryptosporidial diarrhea in HIV-infected individuals is a global health priority. Promising drugs need to be evaluated in endemic areas which may be challenged by both lack of resources and experience to conduct International Committee of Harmonisation-Good Clinical Practice (ICH-GCP)-compliant clinical trials. Methods We present the challenges and lessons learned in implementing a phase 2A, randomized, double-blind, placebo-controlled trial of clofazimine, in treatment of cryptosporidiosis among HIV-infected adults at a single site in Malawi. Results Primary challenges are grouped under study initiation, study population, study implementation, and cultural issues. The lessons learned primarily deal with regulatory system and operational barriers, and recommendations can be applied to other human experimental trials in low- and middle-income countries, specifically in sub-Saharan Africa. Conclusion This study demonstrated that initiating and implementing human experimental trials in sub-Saharan Africa can be challenging. However, solutions exist and successful execution requires careful planning, ongoing evaluation, responsiveness to new developments, and oversight of all trial operations

Rare and Low Frequency Genomic Variants Impacting Neuronal Functions Modify the Dup7q11.23 Phenotype

© 2021, The Author(s). Background: 7q11.23 duplication (Dup7) is one of the most frequent recurrent copy number variants (CNVs) in individuals with autism spectrum disorder (ASD), but based on gold-standard assessments, only 19% of Dup7 carriers have ASD, suggesting that additional genetic factors are necessary to manifest the ASD phenotype. To assess the contribution of additional genetic variants to the Dup7 phenotype, we conducted whole-genome sequencing analysis of 20 Dup7 carriers: nine with ASD (Dup7-ASD) and 11 without ASD (Dup7-non-ASD). Results: We identified three rare variants of potential clinical relevance for ASD: a 1q21.1 microdeletion (Dup7-non-ASD) and two deletions which disrupted IMMP2L (one Dup7-ASD, one Dup7-non-ASD). There were no significant differences in gene-set or pathway variant burden between the Dup7-ASD and Dup7-non-ASD groups. However, overall intellectual ability negatively correlated with the number of rare loss-of-function variants present in nervous system development and membrane component pathways, and adaptive behaviour standard scores negatively correlated with the number of low-frequency likely-damaging missense variants found in genes expressed in the prenatal human brain. ASD severity positively correlated with the number of low frequency loss-of-function variants impacting genes expressed at low levels in the brain, and genes with a low level of intolerance. Conclusions: Our study suggests that in the presence of the same pathogenic Dup7 variant, rare and low frequency genetic variants act additively to contribute to components of the overall Dup7 phenotype