2,431 research outputs found

    Attributing variance in supportive care needs during cancer: Culture-service, and individual differences, before clinical factors

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    Background Studies using the Supportive Care Needs Survey (SCNS) report high levels of unmet supportive care needs (SCNs) in psychological and less-so physical & daily living domains, interpreted as reflecting disease/treatment-coping deficits. However, service and culture differences may account for unmet SCNs variability. We explored if service and culture differences better account for observed SCNs patterns. Methods Hong Kong (n = 180), Taiwanese (n = 263) and Japanese (n = 109) CRC patients’ top 10 ranked SCNS-34 items were contrasted. Mean SCNS-34 domain scores were compared by sample and treatment status, then adjusted for sample composition, disease stage and treatment status using multivariate hierarchical regression. Results All samples were assessed at comparable time-points. SCNs were most prevalent among Japanese and least among Taiwanese patients. Japanese patients emphasized Psychological (domain mean = 40.73) and Health systems and information (HSI) (38.61) SCN domains, whereas Taiwanese and Hong Kong patients emphasized HSI (27.41; 32.92) and Patient care & support (PCS) (19.70; 18.38) SCN domains. Mean Psychological domain scores differed: Hong Kong = 9.72, Taiwan = 17.84 and Japan = 40.73 (p<0.03–0.001, Bonferroni). Other SCN domains differed only between Chinese and Japanese samples (all p<0.001). Treatment status differentiated Taiwanese more starkly than Hong Kong patients. After adjustment, sample origin accounted for most variance in SCN domain scores (p<0.001), followed by age (p = 0.01–0.001) and employment status (p = 0.01–0.001). Treatment status and Disease stage, though retained, accounted for least variance. Overall accounted variance remained low. Conclusions Health service and/or cultural influences, age and occupation differences, and less so clinical factors, differentially account for significant variation in published studies of SCNs.published_or_final_versio

    Residential Assessment Instrument 2.0 in care planning for residents in nursing homes

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    The Role of the Mucus Barrier in Digestion

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    Mucus forms a protective layer across a variety of epithelial surfaces. In the gastrointestinal (GI) tract, the barrier has to permit the uptake of nutrients, while excluding potential hazards, such as pathogenic bacteria. In this short review article, we look at recent literature on the structure, location, and properties of the mammalian intestinal secreted mucins and the mucus layer they form over a wide range of length scales. In particular, we look at the structure of the gel-forming glycoprotein MUC2, the primary intestinal secreted mucin, and the influence this has on the properties of the mucus layer. We show that, even at the level of the protein backbone, MUC2 is highly heterogeneous and that this is reflected in the networks it forms. It is evident that a combination of charge and pore size determines what can diffuse through the layer to the underlying gut epithelium. This information is important for the targeted delivery of bioactive molecules, including nutrients and pharmaceuticals, and for understanding how GI health is maintained

    Experience of South and Southeast Asian minority women in Hong Kong during COVID-19 pandemic: a qualitative study

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    BACKGROUND: Hong Kong has a relatively low incidence rate of COVID-19 across the globe. Nevertheless, ethnic minorities in Hong Kong, especially South Asians (SAs) and Southeast Asians (SEAs), face numerous physical, mental, social, economic, cultural and religious challenges during the pandemic. This study explores the experiences of SA and SEA women in a predominantly Chinese metropolitan city. METHODS: Ten SA and SEA women were recruited and face-to-face interviews were conducted. Questions about participants’ daily life experience, physical and mental health conditions, economic situation and social interaction amid COVID-19 pandemic were asked to assess the impact of COVID-19. RESULTS: SAs and SEAs have a distinctive family culture, and women experienced significant physical and mental impact of COVID-19 due to their unique gender role in the family. In addition to taking care of their family in Hong Kong, SA and SEA women also had to mentally and financially support family members residing in their home countries. Access to COVID-related information was restricted due to language barrier. Public health measures including social distancing imposed extra burden on ethnic minorities with limited social and religious support. CONCLUSIONS: Even when COVID-19 incidence rate is relatively low in Hong Kong, the pandemic made life even more challenging for SAs and SEAs, which is a community already struggling with language barriers, financial woes, and discrimination. This in turn could have led to greater health inequalities. Government and civil organizations should take the social determinants of health inequalities into account when implementing COVID-19-related public health policies and strategies

    Comparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study

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    Aim: To investigate the optimal strategy to treat dyspeptic patients in primary care. Methods: Dyspeptic patients presenting to primary care outpatient clinics were randomly assigned to: (1) empirical endoscopy, (2) H pylori test-and-treat, and (3) empirical prokinetic treatment with cisapride. Early endoscopy was arranged if patients remained symptomatic after 2 wk. Symptom severity, quality-of-life (SF-36) as well as patient preference and satisfaction were assessed. All patients underwent endoscopy by wk 6. Patients were followed up for one year. Results: Two hundred and thirty four patients were recruited (163 female, mean age 49). 46% were H pylori positive. 26% of H pylori tested and 25% of empirical prokinetic patients showed no improvement at wk 2 follow-up and needed early endoscopy. 15% of patients receiving empirical cisapride responded well to treatment but peptic ulcer was the final diagnosis. Symptom resolution and quality-of-life were similar among the groups. Costs for the three strategies were HK4343,4343, 1771 and $1750 per patient. 66% of the patients preferred to have early endoscopy. Conclusion: The three strategies are equally effective. Empirical prokinetic treatment was the least expensive but peptic ulcers may be missed with this treatment. The H pylori test-and-treat was the most cost-effective option. © 2006 The WJG Press. All rights reserved.published_or_final_versio

    Determination and Distribution Study of Pogostone in Rat Tissues by Ultra-Fast Liquid Chromatography

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    Purpose: To develop and validate a rapid, sensitive and reliable ultra-fast liquid chromatography (UFLC) method with photodiode array (PDA) detection for the determination of pogostone (PO) in rat tissues using honokiol as internal standard (IS).Methods: Rats were randomly divided into two groups (intravenous administration group and oral administration group) and given of a single dose of 10 mg/kg PO by intravenous administration and oral administration, respectively. After intravenous injection, the rats were sacrificed at 15, 60 and 360 min, while rats, after oral administration, were euthanasized at 30, 90 and 360 min, respectively. For the analysis of the preparation, optimal chromatographic conditions were determined using Acquity UPLC BEH C18 column with acetonitrile-water containing 0.1 % formic acid (55:45, v/v) as the mobile phase, at a flow rate of 400 μL/min. UV detection wavelength was set at 310 nm with temperature maintained at 30 °C.Results: Good linear relationship of calibration curve (r &gt; 0.9984) was achieved over the range of 0.1 - 40 μg/mL for all the tissue samples. The limit of quantification (LOQ) and limit of detection (LOD) were 0.1 and 0.05 μg/mL, respectively. This method proved to have good precision, accuracy, stability, extraction recovery and matrix effect for tissue distribution studies of PO in rats.Conclusion: The developed method is suitable for tissue distribution studies in rats following intravenous and oral administration of PO at a dose of 10 mg/kg.Keywords: Ultra-fast liquid chromatography, Tissue distribution, Pogostone, Honokiol, Rat

    Stability of Mine Car Motion in Curves of Invariable and Variable Radii

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    We discuss our experiences adapting three recent algorithms for maximum common (connected) subgraph problems to exploit multi-core parallelism. These algorithms do not easily lend themselves to parallel search, as the search trees are extremely irregular, making balanced work distribution hard, and runtimes are very sensitive to value-ordering heuristic behaviour. Nonetheless, our results show that each algorithm can be parallelised successfully, with the threaded algorithms we create being clearly better than the sequential ones. We then look in more detail at the results, and discuss how speedups should be measured for this kind of algorithm. Because of the difficulty in quantifying an average speedup when so-called anomalous speedups (superlinear and sublinear) are common, we propose a new measure called aggregate speedup

    A qualitative study of community pharmacists' opinions on the provision of osteoporosis disease state management services in Malaysia

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    Background: Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. Methods: Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. Results: Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care. Conclusions: The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration
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