Patients’ experience in Hong Kong hospitals: A comparison between south Asian and Chinese people

Patient experience in hospital is positively associated with both self-rated and objectively measured health outcomes. In many countries ethnic minority patients have more negative experience and bear a disproportionate burden of disease than their majority counterparts. However, hospital experience of ethnic minority patients in Asia is still unexplored. We aimed to explore the hospital experience of South Asian ethnic minority and compare that with local Chinese patients’ experience in Hong Kong. A cross-sectional study sample comprised of 783 participants (388 South Asian and 395 Chinese). Picker Patient Experience-15 (PPE-15) questionnaire was used for data collection. Simple and multiple regressions were used to compare South Asian and Chinese participants’ in-hospital stays. The regression analyses were done before and after adjusting for demographics and after Propensity Score Weighting (PSW). All estimates were accompanied by a 95% confidence interval. Two-sided tests were conducted with a significance concluded by a p-value. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Trust as a mediator in the relationship between childhood sexual abuse and IL-6 level in adulthood

Childhood sexual abuse (CSA) has been shown to predict the coupling of depression and inflammation in adulthood. Trust within intimate relationships, a core element in marital relations, has been shown to predict positive physical and mental health outcomes, but the mediating role of trust in partners in the association between CSA and inflammation in adulthood requires further study. The present study aimed to examine the impact of CSA on inflammatory biomarkers (IL-6 and IL-1β) in adults with depression and the mediating role of trust. A cross-sectional survey data set of adults presenting with mood and sleep disturbance was used in the analysis. CSA demonstrated a significant negative correlation with IL-6 level (r = -0.28, p<0. 01) in adults with clinically significant depression, while trust showed a significant positive correlation with IL-6 level (r = 0.36, p < .01). Sobel test and bootstrapping revealed a significant mediating role for trust between CSA and IL-6 level. CSA and trust in partners were revealed to have significant associations with IL-6 level in adulthood. Counterintuitively, the directions of association were not those expected. Trust played a mediating role between CSA and adulthood levels of IL-6. Plausible explanations for these counterintuitive findings are discussed

Regulation of caspase activation in axotomized retinal ganglion cells

Transection of the optic nerve initiates massive death of retinal ganglion cells (RGCs). Interestingly, despite the severity of the injury, RGC loss was not observed until several days after axotomy. The mechanisms responsible for this initial lack of RGC death remained unknown. In the current study, immunohistochemical analysis revealed that caspases-3 and -9 activation in the RGCs were not detected until day 3 post-axotomy, coinciding with the onset of axotomy-induced RGC loss. Interestingly, elevated Akt phosphorylation was observed in axotomized retinas during the absence of caspase activation. Inhibiting the increase in Akt phosphorylation by intravitreal injection of wortmannin and LY294002, inhibitors of PI3K, resulted in premature nuclear fragmentation, caspases-3 and -9 activation in the RGCs were not detected until day 3 post-axotomy, coinciding with the onset of axotomy-induced RGC loss. Interestingly, elevated Akt phosphorylation was observed in axotomized retinas during the absence of caspase activation. Inhibiting the increase in Akt phosphorylation by intravitreal injection of wortmannin and LY294002, inhibitors of PI3K, resulted in premature nuclear fragmentation, caspasess-3 and -9 activation in the ganglion cell layer. Our findings thus indicate that the PI3K/Akt pathway may serve as an endogenous regulator of caspase activation in axotomized RGCs, thereby, contributing to the late onset of RGC death following axotomy

A randomized controlled study to evaluate the effects of lifestyle intervention program for patients with severe mental illness taking Second Generation Antipsychotics (SGAs) in body weight management and monitoring their Body Mass Index (BMI)

Background: Second generation antipsychotics (SGAs) are strongly associated with accelerated body weightgain resulting in overweight and obesity in patients with severe mental illness (SMI). Evidence found that lifestyleinterventions used behavioral techniques to improve dietary habits and increase physical activity can reduce the increasein patients’ body weight and BMI. Methods: Randomized Controlled Trial (RCT) on 54 patients with severe mental illnesswere randomized with 27 patients joined in the Lifestyle Intervention group (LIP) and 27 patients in treatment as usual group(TAU) from September/2018 to October/2019. The intervention group attended the educational talks on medication, dietcontrol and physical exercise and use of a daily record. Result: After twelve months, the LIP presented a decrease of 1.25kg(CI 95% -0.73 to 3.24) and treatment as usual TAU presented with a significant increase of 1.65kg CI 95% -2.84 to -0.45)(p=0.009). The BMI of the LIP showed a decrease of 0.51kg/m2 (CI 95% -0.29 to 1.33) and the TAU presented an increaseof 0.66kg/m2. Conclusion: The TAU shows a significant increase of body weight while the LIP group had a decrease inbody weight under the Life Intervention program. This study was not intended for patients to reduce body weight, rather toprevent their body weight to increase and enhance their quality of life through understanding physical health, exercise anddietary habit

A randomized controlled study to evaluate the effects of lifestyle intervention program for patients with severe mental illness taking Second Generation Antipsychotics (SGAs) in body weight management and monitoring their Body Mass Index (BMI)

Background: Second generation antipsychotics (SGAs) are strongly associated with accelerated body weightgain resulting in overweight and obesity in patients with severe mental illness (SMI). Evidence found that lifestyleinterventions used behavioral techniques to improve dietary habits and increase physical activity can reduce the increasein patients’ body weight and BMI. Methods: Randomized Controlled Trial (RCT) on 54 patients with severe mental illnesswere randomized with 27 patients joined in the Lifestyle Intervention group (LIP) and 27 patients in treatment as usual group(TAU) from September/2018 to October/2019. The intervention group attended the educational talks on medication, dietcontrol and physical exercise and use of a daily record. Result: After twelve months, the LIP presented a decrease of 1.25kg(CI 95% -0.73 to 3.24) and treatment as usual TAU presented with a significant increase of 1.65kg CI 95% -2.84 to -0.45)(p=0.009). The BMI of the LIP showed a decrease of 0.51kg/m2 (CI 95% -0.29 to 1.33) and the TAU presented an increaseof 0.66kg/m2. Conclusion: The TAU shows a significant increase of body weight while the LIP group had a decrease inbody weight under the Life Intervention program. This study was not intended for patients to reduce body weight, rather toprevent their body weight to increase and enhance their quality of life through understanding physical health, exercise anddietary habit

Enhancement of in vitro and in vivo anticancer activities of polysaccharide peptide from Grifola frondosa by chemical modifications

Context: Grifola frondosa (Polyporaceae), maitake, is a widely consumed edible mushroom in some Asian countries. The fruit bodies and mycelia of maitake have shown different bioactive compounds with anticancer and other therapeutic properties. Objective: This study evaluated three chemically modified maitake polysaccharide-peptides’ (MPSP) adjuvant effect (in vivo) and anticancer activity (in vitro growth inhibitory effect) compared with crude MPSP from G. frondosa. Materials and Methods: We investigated the possibility of enhancing the adjuvant effect and anticancer effect of crude MPSP by using simple chemical modification methods to convert crude MPSP to phosphorylated, acetylated or esterified MPSPs. The adjuvant effect and growth inhibitory effect were evaluated by C6 cell inoculated rat model with cyclophosphamide (CPA) treatment and in vitro cell viability assay, respectively. Results: All four tested MPSPs showed significant adjuvant effect to CPA treatment on rats inoculated with C6 cancer cells. In addition, an obvious growth inhibitory effect was observed in C6 cancer cells but not in normal brain cells treated with various forms of MPSPs. Only phosphorylation could significantly (p \u3c 0.05) improve the adjuvant effect (in vivo) and growth inhibitory effect. A same rank order (phosphorylated MPSP \u3e esterified MPSP ≥ acetylated MPSP ≥ crude MPSP) of efficacy was observed in both the in vivo and in vitro assays. Discussion and Conclusion: This study showed chemical phosphorylation could markedly enhance both adjuvant effects and growth inhibitory effects. This study demonstrated the feasibility of enhancing the efficacy of MPSP by using a simple chemical modification method, and this provides a foundation for future study in this area

Safety and Immunogenicity of a Booster Vaccination by CoronaVac or BNT162b2 in Previously Two-Dose Inactivated Virus Vaccinated Individuals with Negative Neutralizing Antibody

COVID-19 has swept across the globe since 2019 and repeated waves of infection have been caused by different variants of the original SARS-CoV-2 (wild type), with the Omicron and Delta variants having dominated recently. Vaccination is among the most important measures in the absence of widespread use of antivirals for prevention of morbidity and mortality. Inactivated virus vaccine has been abundantly used in many countries as the primary two-dose regimen. We aim to study the safety and immunogenicity of CoronaVac (three-dose inactivated virus vaccine) and the BNT162b2 (two-dose inactivated virus vaccine followed by an mRNA vaccine) booster. Both CoronaVac and BNT162b2 boosters are generally safe and have good immunogenicity against the wild type SARS-CoV-2 and the Delta variant with the majority having neutralizing antibodies (NAb) on day 30 and day 90. However, the BNT162b2 booster is associated with a much higher proportion of positive NAb against the Omicron variant. Only 8% of day 30 and day 90 samples post CoronaVac booster have NAb against the Omicron variant. In addition, more BNT162b2 booster recipients are having positive T-cell responses using interferon gamma release assay. In places using inactivated virus vaccine as the primary two-dose scheme, the heterologous mRNA vaccine booster is safe and more immunogenic against the Omicron variant and should be considered as a preferred option during the current outbreak