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

Aqueous Extract of Oldenlandia diffusa Suppresses LPS-Induced iNOS, COX-2 and TNF-α Expression in RAW 264.7 Cells via the NF-κB Activity

Purpose: To elucidate the anti-inflammatory mechanisms of aqueous extract of Oldenlandia diffusa (AEOD) in LPS-stimulated RAW 264.7 cells.Methods: We evaluated the mRNA and protein expression of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2) and tumor necrosis factor (TNF)-α using RT-PCR and Western blot analyses. Expressions of IκBα, phospho-IκBα and p65 were analyzed by Western blot analysis. The level of nitric oxide (NO) production was analyzed using Griess reaction. The release of prostaglandin E2 (PGE2) and tumor necrosis factor (TNF)-α was determined using sandwich ELISA.Results: AEOD significantly suppressed nitric oxide (NO) production in LPS-stimulated RAW 264.7 cells without direct cytotoxicity. AEOD decreased the production of prostaglandin E2 (PGE2) and TNF-α in LPS-stimulated RAW 264.7 cells. LPS-induced mRNA and protein expression of iNOS, COX-2 and TNF-α were attenuated by treatment with AEOD. These data imply that AEOD tightly regulates the expression of these inflammatory mediators at the transcriptional level. Therefore, we determined the effects of AEOD on nuclear factor-κB (NF-κB) activity, which has been considered to be a potential transcriptional factor for regulating the expression of iNOS, COX-2 and TNF-α. As expected, AEOD suppressed the LPS-induced degradation and phosphorylation of IκBα and sustained the expression of p65 in the cytosol. Furthermore, AEOD substantially inhibited the LPS-induced DNA binding activity of NF-κB. These data show that AEOD may control NO, PGE2 and TNF-α production via the suppression of NF-κB activity.Conclusion: Our results suggest that AEOD has a high potential activity for regulating LPS-induced inflammation.Keywords: Oldenlandia diffusa, NO, iNOS, COX-2, PGE2, TNF-α, NF-κ

Influence of ambient water intrusion on coral reef acidification in the Chuuk lagoon, located in the coral-rich western Pacific Ocean

Weekly carbonate chemistry condition data recorded between 2008 and 2014 in the Chuuk lagoon (7.3 degrees N and 151.5 degrees E) of the Federated States of Micronesia, located in the western Pacific Ocean, were analyzed. The results showed that, during periods of weak intrusion of ambient seawater from the surrounding open ocean, two internal biological processes (calcification and respiration) reinforced each other and together lowered the pH of the reef water for extended periods, ranging from a few to several months. The analysis indicated that reduced intrusion of ambient water is associated with periods of low wind speeds. Such conditions increase the residence time of reef water, thus promoting acidification by respiration and calcification. This phenomenon likely affects many other areas of the coral-rich western Pacific Ocean, which contains 50% of global coral reefs and in which the degree of ambient water intrusion into the atolls has been shown to be closely associated with the El Nino-Southern Oscillation-induced wind speed change.1111Ysciescopu

Predictors of betel quid chewing behavior and cessation patterns in Taiwan aborigines

BACKGROUND: Betel quid, chewed by about 600 million people worldwide, is one of the most widely used addictive substances. Cessation factors in betel quid chewers are unknown. The present study explores prevalence and the quit rate of betel quid chewing in Taiwan aborigines. Our goal was to delineate potential predictors of chewing cessation. METHODS: A stratified random community-based survey was designed for the entire aborigines communities in Taiwan. A total of 7144 participants were included between June 2003 and May 2004 in this study. Information on sociodemographic characteristics, such as gender, age, obesity, education years, marital status, ethnicity, and habits of betel quid chewing, smoking and drinking was collected by trained interviewers. RESULTS: The prevalence of betel quid chewers was 46.1%. Betel quid chewing was closely associated with obesity (OR = 1.61; 95% CI: 1.40–1.85). Betel quid chewers were most likely to use alcohol and cigarettes together. Quit rate of betel quid chewers was 7.6%. Betel quid chewers who did not drink alcohol were more likely to quit (OR = 1.89; 95% CI: 1.43–2.50). Alcohol use is a significant factor related to cessation of betel quid chewing, but smoking is not. CONCLUSION: Taiwan aborigines have a high prevalence of betel quid chewers and a low quit rate. Alcohol use is strongly association with betel quid chewing. Efforts to reduce habitual alcohol consumption might be of benefit in cessation of betel quid chewing

Architectural Growth of Cu Nanoparticles Through Electrodeposition

Cu particles with different architectures such as pyramid, cube, and multipod have been successfully fabricated on the surface of Au films, which is the polycrystalline Au substrate with (111) domains, using the electrodeposition technique in the presence of the surface-capping reagents of dodecylbenzene sulfonic acid and poly(vinylpyrrolidone). Further, the growth evolution of pyramidal Cu nanoparticles was observed for the first time. We believe that our method might open new possibilities for fabricating nanomaterials of non-noble transition metals with various novel architectures, which can then potentially be utilized in applications such as biosensors, catalysis, photovoltaic cells, and electronic nanodevices

Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective

Abstract Background Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents. Method Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders. Results Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68). Conclusions The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries

Comparing factors affecting commencement and cessation of betel quid chewing behavior in Taiwanese adults

<p>Abstract</p> <p>Background</p> <p>Betel quid is the fourth most common used substance in the world after tobacco, alcohol and caffeine. Although factors related to betel quid chewing or cessation of behaviors were reported previously, few studies simultaneously compared both behaviors in the same population. In addition, it is essential to consider time-to-event concept, since the chance of developing or stopping habit may vary over time. The purpose of this study was to compare the risk factors for commencement and cessation of betel quid chewing behaviors in a time-to-event setting.</p> <p>Methods</p> <p>A stratified multi-stage cluster sampling with selection probabilities proportional to size (PPS) was designed for Taiwanese adults with aged 18 years old and above. Kaplan-Meier estimates and Cox proportional hazard regression models were used to compare and calculate the hazard rate ratios for related factors to commencement or cessation of chewing habits.</p> <p>Results</p> <p>In Taiwan, men had a higher betel quid chewing rate (M: 20.9%, W: 1.2%), but woman chewers had a lower cessation rate (M: 27.5%, W: 12.7%). The hazard rate ratio (HRR) of having chewing habit changed from 4.22 (men vs women) univariately to 1.38 multivariablely, which indicated gender differences were confounded by other factors. In multivariable analysis, the risk factors of gender, education and ethnicity were significantly associated with both starting and cessation of betel quid chewing behavior. The factors of occupation, cigarette smoking and alcohol drinking were only associated with starting habit.</p> <p>Conclusion</p> <p>Commencement or cessation of chewing behavior involves a scenario of time, hence it is preferable to use a time-to-event approach for the comparison. The cessation rates of betel quid chewing were decreasingly associated with the daily consumption of betel quid. Hence, reducing of daily amount in betel quid cessation program may be associated with future stopping habit.</p

The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan

In areas where the practise of betel quid chewing is widespread and the chewers also often smoke and drink alcohol, the relation between oral precancerous lesion and condition to the three habits is probably complex. To explore such association and their attributable effect on oral leukoplakia (OL) and oral submucous fibrosis (OSF), a gender–age-matched case–control study was conducted at Kaohsiung, southern Taiwan. This study included 219 patients with newly diagnosed and histologically confirmed OL or OSF, and 876 randomly selected community controls. All information was collected by a structured questionnaire through in-person interviews. A preponderance of younger patients had OSF, while a predominance of older patients had OL. Betel quid chewing was strongly associated with both these oral diseases, the attributable fraction of OL being 73.2% and of OSF 85.4%. While the heterogeneity in risk for areca nut chewing across the two diseases was not apparent, betel quid chewing patients with OSF experienced a higher risk at each exposure level of chewing duration, quantity and cumulative measure than those who had OL. Alcohol intake did not appear to be a risk factor. However, cigarette smoking had a significant contribution to the risk of OL, and modified the effect of chewing based on an additive interaction model. For the two oral premalignant diseases combined, 86.5% was attributable to chewing and smoking. Our results suggested that, although betel quid chewing was a major cause for both OL and OSF, its effect might be difference between the two diseases. Cigarette smoking has a modifying effect in the development of oral leukoplakia