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Developmental origins of health and disease research have cemented relationships between the early-life environment and later risk of non-communicable diseases (NCDs). However, there is limited translation of this knowledge in developing-economy nations, such as the Cook Islands, that carry exceptionally high NCD burdens. Considering the evidence, Cook Islands leaders identified a need for increased community awareness of the importance of early-life nutrition. Using a community-based participatory research approach, this study aimed to engage Cook Islands community representatives in the co-construction of a contextually relevant early-life nutrition resource. A booklet distributed to mothers in Australia and New Zealand was used as a starting point. Ten semi-structured focus groups (n = 60) explored views regarding the existing resource and options for contextual adaptation. Three core themes were identified: knowledge of the importance of early-life nutrition, recognition of the need for an early-life nutrition resource and the importance of resources being context specific. A draft booklet was created based on these discussions. Participants were invited to give feedback via a second round of focus groups. This confirmed that the voice of the community was represented in the draft booklet. Suggestions for additional material not included in the original resource were also identified. We report on the process and outcomes of the co-construction with community representatives of a resource that has the potential to be used to stimulate community-level discussion about the importance of early-life nutrition. It is crucial that communities have an active voice in research and in making decisions about interventions for their population.
This work proposes and analyzes a family of spatially inhomogeneous epidemic models. This is our first effort to use stochastic partial differential equations (SPDEs) to model epidemic dynamics with spatial variations and environmental noise. After setting up the problem, the existence and uniqueness of solutions of the underlying SPDEs are examined. Then, definitions of permanence and extinction are given, and certain sufficient conditions are provided for permanence and extinction. Our hope is that this paper will open up windows for investigation of epidemic models from a new angle.
Antibiotic overuse and misuse is a common problem in nursing homes. Antibiotic time-out (ATO) interventions have led to improvements in antibiotic uses in hospitals, but their impact in nursing homes remain understudied.
To evaluate the impact of a stewardship intervention, promoting use of ATOs on the frequency and types of antibiotic change events (ACEs) in nursing homes.
Controlled before-and-after intervention study.
Nursing homes in Wisconsin and Pennsylvania.
Data on antibiotic prescriptions in 11 nursing homes were collected for 25 months. We categorized ACEs as (1) early discontinuation, (2) class modification, or (3) administration modification. Class modification ACEs were further classified based on whether the change narrowed, expanded, or had no effect on bacterial spectrum coverage. Analyses were performed using a difference-in-difference (DiD) approach.
Of 2,647 antibiotic events initiated in study nursing homes, 376 (14.2%) were associated with an ACE. The overall proportion of ACEs did not significantly differ between intervention and control nursing homes. Early discontinuation ACEs increased in intervention nursing homes (DiD, 2.5%; P = .01), primarily affecting residents initiated on broad-spectrum antibiotics (DiD, 2.9%; P < .01). Class modification ACEs decreased in intervention nursing homes but remained unchanged in control nursing homes.
The impact of an ATO intervention in study nursing homes was mixed with increases in early discontinuation ACEs offset by reductions in class modification ACEs. More research on the potential value of ATO interventions in nursing homes is warranted.
The catechol-O-methyltransferase (COMT) gene is related to dopamine degradation and has been suggested to be involved in the pathogenesis of major depressive disorder (MDD). However, how this gene affects brain function properties in MDD is still unclear.
Fifty patients with MDD and 35 cognitively normal participants underwent a resting-state functional magnetic resonance imaging scan. A voxelwise and data-drive global functional connectivity density (gFCD) analysis was used to investigate the main effects and the interactions of disease states and COMT rs4680 gene polymorphism on brain function.
We found significant group differences of the gFCD in bilateral fusiform area (FFA), post-central and pre-central cortex, left superior temporal gyrus (STG), rectal and superior temporal gyrus and right ventrolateral prefrontal cortex (vlPFC); abnormal gFCDs in left STG were positively correlated with severity of depression in MDD group. Significant disease × COMT interaction effects were found in the bilateral calcarine gyrus, right vlPFC, hippocampus and thalamus, and left SFG and FFA. Further post-hoc tests showed a nonlinear modulation effect of COMT on gFCD in the development of MDD. Interestingly, an inverted U-shaped modulation was found in the prefrontal cortex (control system) but U-shaped modulations were found in the hippocampus, thalamus and occipital cortex (processing system).
Our study demonstrated nonlinear modulation of the interaction between COMT and depression on brain function. These findings expand our understanding of the COMT effect underlying the pathophysiology of MDD.
Cadmium (Cd) is a toxic heavy metal that poses a threat to the health of humans and animals. It can cause serious damage to the small intestine, which is the main absorption site of Cd and the primary target organ after oral administration. Our previous study found that zinc chelate of hydroxy analogue of methionine (Zn-HMTB), a new type of feed additive, decreased Cd accumulation in the liver and kidneys. The aim of this study was to investigate the effect of Zn-HMTB on Cd absorption and Cd-induced toxicity in the small intestine of piglets. Twenty-four piglets (Landrace × Large White, 13.22 ± 0.58 kg BW) were randomly divided into four dietary treatment groups: basal diet, and diets containing 30 mg/kg Cd from CdCl2 and 0, 100 or 200 mg/kg Zn from Zn-HMTB. The experiment lasted 27 days. The feed intake and final BW of each piglet were recorded at the end of the experiment. Gastrointestinal (GI) tract tissue and samples of liver, kidney, spleen, heart, lung and longissimus muscle tissue and faeces were collected. The concentrations of Cd and metal trace elements in the GI tract and organs were analysed, as was the relative messenger RNA (mRNA) expression of inflammatory cytokines and metal element transporters in the small intestine, and epithelial apoptosis in the small intestine. The results showed that, compared with Cd-treated piglets, piglets in the Zn-HMTB and Cd cotreatment groups had less Cd deposition in the stomach, ileum, caecum, colon, liver, kidneys, spleen, lungs, heart and muscles (P < 0.05), and lower Cd concentrations in faeces (P < 0.05), suggesting that Zn-HMTB increased Cd absorption and the excretion of Cd in other forms (possibly urine). Zinc chelate of hydroxy analogue of methionine increased Zn deposition in the jejunum and the relative mRNA expression of divalent metal transporters 1 and zinc transporter 5 in the duodenum (P < 0.05), indicating that Zn-HMTB may promote the absorption and transportation of Cd and Zn together by upregulating metal element transporters. Competition between Zn and Cd may be responsible for accelerating Cd excretion. Furthermore, Zn-HMTB reduced Cd-induced apoptosis of enterocytes and inflammatory stimuli in the small intestine, suggesting that Zn-HMTB reduced Cd-induced toxicity to the small intestine. These results suggest that Zn-HMTB can be helpful in decreasing Cd accumulation in the GI tract and organs of piglets and relieving Cd-induced toxicity to the small intestine but cannot reduce the absorption of Cd.
Previous chapters in this book have focused on domestic (or municipal) law within Hong Kong. This chapter examines the interface between Hong Kong law and international law and Chinese law (PRC law). It looks at the distinct international legal personality that Hong Kong possesses, Hong Kong’s engagement with international entities and the application of international law in Hong Kong. Previous chapters have discussed certain aspects of the interface between Hong Kong and the PRC legal system, and this chapter builds on this by focusing on mutual legal assistance between the two legal systems, access to the Mainland market for legal services from Hong Kong and cross-border crime.
With the increasing popularity of alternative methods of resolving disputes to lessen the burden on courts, a separate chapter must be dedicated to this topic. One may not typically think of alternative methods of resolving disputes as part of the legal system, but this chapter shows otherwise. Particularly with the Civil Justice Reform, alternative dispute resolution has played and will continue to play an even larger role in solving legal disputes in Hong Kong. The two main methods of alternative dispute resolution, namely mediation and arbitration, are examined.
This chapter looks at law at an abstract level and the fundamental questions of ‘What is law?’ and ‘Why have laws?’ are explored by discussing the functions and concepts of law. This chapter examines the macro and micro functions of law, as well as the major perspectives of law including natural law, legal positivism, sociology of law and critical legal theory. It concludes by exploring various classifications of legal systems and the way in which the law is divided within them, such as the difference between the common law and civil law systems, national and international law, substantive and procedural law, and public and private law.
While legislation is enacted by the Legislative Council (or under its authority), the courts have a role in the interpretation of legislation. This chapter discusses the various common law approaches to statutory interpretation that are likely to be adopted by Hong Kong courts. Moreover, this chapter goes through the aids to interpretation within an ordinance, external aids to interpretation, presumptions which protect basic values, interpretation of the Basic Law and resolving conflicts found in bilingual legislation. A case study is used to illustrate how the courts balance different interpretive considerations. Recognising how judges interpret laws will help hone the skills of legal reasoning (thinking like a judge).
Where do lawyers look to when they wish to ascertain what the law is on a particular matter? This chapter goes over the various sources of law in Hong Kong. It starts at the top with the Basic Law, which is sometimes referred to as the ‘mini-constitution’ of Hong Kong. It covers the five interpretations of the Basic Law by the Standing Committee of National People’s Congress (NPCSC). It then takes readers through legislation, including primary and secondary legislation, and through the different parts of a statue. Case law is then examined, along with the different parts of a reported case, highlighting the parts of a judgment that constitute law. Lastly, Chinese customary law and national laws of the People’s Republic of China that are applied in Hong Kong are discussed.
This chapter outlines the system and structure of the courts in Hong Kong and discusses the concept of judicial precedent. It leads readers through the hierarchical structure of the courts and its historical development during the pre- and post-1997 periods. The different levels of the courts are examined including the Court of Final Appeal (CFA), the High Court, the District Court and Magistrates’ Courts. Different tribunals that exercise judicial power are also reviewed. The second section of this chapter deals with judicial precedents, an essential feature of the common law. The doctrine of precedent as it applies in Hong Kong is detailed, taking readers through vertical and horizontal stare decisis for each level of the courts. The status of English and overseas decisions, including Privy Council decisions in present-day Hong Kong, is discussed.
This chapter provides a general picture of the criminal justice system in Hong Kong. It highlights the roles and powers of key criminal justice agencies including the Hong Kong Police Force (HKPF), the Independent Commission Against Corruption (ICAC) and the prosecution. It includes discussion of police powers and prosecutorial decision-making. This chapter also goes through the criminal procedure, drawing attention to key decision points such as bail, court venue, the plea and the standard of proof. It concludes by looking at the various sentencing options at the court’s disposal.
This chapter provides an overview of the system of governance in the Hong Kong Special Administrative Region (HKSAR). It introduces readers to the fundamental concepts of ‘one country, two systems’ and ‘high degree of autonomy’ under the Basic Law, which provide the framework for the allocation and exercise of responsibilities over Hong Kong by the central authorities and the Hong Kong government. Within the sphere of Hong Kong’s autonomy, the Basic Law provides for the exercise of governmental powers by three arms of government: the executive, the legislature and the judiciary. The powers and functions of these three arms are outlined in this chapter, together with discussion of the doctrine of ‘separation of powers’.
This chapter discusses how laws are made in Hong Kong by studying the process of legislation. Issues are discussed surrounding how the Basic Law limits the scope of certain legislation and who has the authority to create legislation. Readers are taken through the step-by-step process of lawmaking in Hong Kong from the proposal to how a bill achieves status as law in Hong Kong. Both the passage of primary legislation and secondary legislation are illustrated. The interactions and balance between branches of government and between governments (the HKSAR and the PRC) are exemplified in the process of legislation.
The first chapter outlines the aims of the book, which is to provide an introduction to the Hong Kong legal system especially for first-year law students, but also for students of other disciplines, and practitioners and scholars from other jurisdictions who are looking for a comprehensive and user-friendly overview of Hong Kong’s legal system. It also highlights the key elements of that system, discussing its rules and principles, namely the rule of law, separation of powers and the independence of the judiciary, as well as legal institutions and legal personnel. This chapter traces the historical development of Hong Kong’s legal system, from the acquisition of Hong Kong by the British and the importation of English law (including common law) into colonial Hong Kong to the transfer of sovereignty of Hong Kong to the People’s Republic of China (PRC) in 1997 and the present-day legal framework under ‘one country, two systems’.