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Difficulties in regulating affect are core characteristics of a wide range of mental health conditions and are associated with deficits in cognitive control, particularly in affective contexts, affective control. The current study explored how affective control relates to mental health over the course of adolescence. We developed an Affective Control Task, which was administered to young adolescents (11–14 years; n = 29); mid-adolescents (15–18 years; n = 31), and adults (22–30 years; n = 31). The task required individuals to sort cards according to continuously changing rules: color, number, or item type. There was a neutral condition in which items were shapes, and an affective condition, in which items were emotional facial expressions. Better affective control was associated with fewer mental health difficulties (p < .001, R2 = .15). Affective control partially accounted for the association between age group and mental health problems, z = 2.61, p = .009, Akaike information criterion = 484, with the association being strongest in young adolescents, r (27) = −.44, p = .018. Affective control further accounted for variance in the association between self-reported (but not experimental) emotion regulation and mental health (z = −3.44, p < .001, Akaike information criterion = 440). Poor affective control, especially in young adolescents, is associated with more mental health problems and higher levels of emotion regulation difficulties. Improving affective control therefore may constitute a promising target for prevention.
This study aimed to examine the relationships between socio-economic status, health-promoting lifestyles, and quality of life among Chinese nursing students.
Nursing students will be future health promoters, but they may not always adopt the recommended healthy lifestyle. Currently, there are insufficient studies examining the health-promoting lifestyles of Chinese nursing students, and the impact of socio-economic status and health-promoting lifestyle on their health.
This was a cross-sectional survey. Data were collected from nursing students studying in pre-registration nursing programs of a university in Hong Kong. The survey was conducted through a self-administered questionnaire that solicited information regarding their socio-economic status, health-promoting lifestyle, quality of life, and perceptions of the barriers to adopting a health-promoting lifestyle.
A total of 538 students returned completed questionnaires for analysis. Among the health-promoting lifestyle subscales, the participants performed best in interpersonal relations and worst in physical activity, and the vast majority of them did not actively engage in health-risk behaviors. Hierarchical regression analyses revealed that only 5% of the variance in quality of life was explained by socio-economic variables, whereas a total of 24% of the variance was explained when health-promoting lifestyle variables were added. In particular, health responsibility, physical activity, spiritual growth, and stress management were statistically significant predictors of quality of life.
Early concerns about how prepared nurses are to take on the role of promoting health still apply today. School administrators should plan the nursing curriculum to include activities that encourage student nurses to participate in health-promoting lifestyles. Future studies are needed to explore the barriers that prevent students from practicing health-promoting behavior.
The correlation between objective and subjective nasal obstruction is poor, and dissatisfaction rates after surgery for nasal obstruction are high. Accordingly, novel assessment techniques may be required. This survey aimed to determine patient experience and preferences for the measurement of nasal obstruction.
Prospective survey of rhinology patients.
Of 72 questionnaires distributed, 60 were completed (response rate of 83 per cent). Obstruction duration (more than one year) (χ2 = 13.5, p = 0.00024), but not obstruction severity, affected willingness to spend more time being assessed. Questionnaires (48 per cent) and nasal inspiratory peak flow measurement (53 per cent) are the most commonly used assessment techniques. Forty-nine per cent of participants found their assessment unhelpful in understanding their obstruction. Eighty-two per cent agreed or strongly agreed that a visual and numerical aid would help them understand their blockage.
Many patients are dissatisfied with current assessment techniques; a novel device with visual or numerical results may help. Obstruction duration determines willingness to undergo longer assessment.
Multidrug-resistant organisms (MDROs) are increasingly reported in residential care homes for the elderly (RCHEs). We assessed whether implementation of directly observed hand hygiene (DOHH) by hand hygiene ambassadors can reduce environmental contamination with MDROs.
From July to August 2017, a cluster-randomized controlled study was conducted at 10 RCHEs (5 intervention versus 5 nonintervention controls), where DOHH was performed at two-hourly intervals during daytime, before meals and medication rounds by a one trained nurse in each intervention RCHE. Environmental contamination by MRDOs, such as methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum β-lactamse (ESBL)–producing Enterobacteriaceae, was evaluated using specimens collected from communal areas at baseline, then twice weekly. The volume of alcohol-based hand rub (ABHR) consumed per resident per week was measured.
The overall environmental contamination of communal areas was culture-positive for MRSA in 33 of 100 specimens (33%), CRA in 26 of 100 specimens (26%), and ESBL-producing Enterobacteriaceae in 3 of 100 specimens (3%) in intervention and nonintervention RCHEs at baseline. Serial monitoring of environmental specimens revealed a significant reduction in MRSA (79 of 600 [13.2%] vs 197 of 600 [32.8%]; P<.001) and CRA (56 of 600 [9.3%] vs 94 of 600 [15.7%]; P=.001) contamination in the intervention arm compared with the nonintervention arm during the study period. The volume of ABHR consumed per resident per week was 3 times higher in the intervention arm compared with the baseline (59.3±12.9 mL vs 19.7±12.6 mL; P<.001) and was significantly higher than the nonintervention arm (59.3±12.9 mL vs 23.3±17.2 mL; P=.006).
The direct observation of hand hygiene of residents could reduce environmental contamination by MDROs in RCHEs.
Nasal obstruction is a common ENT complaint; however, decisions on its management are challenging, with high rates of dissatisfaction following surgery. This study investigated the practice of UK clinicians in the evaluation of nasal patency.
Seventy-eight UK-based rhinologists were surveyed at the 2015 British Academic Conference in Otolaryngology.
Clinical history and examination are almost universally used to evaluate nasal blockage. The most commonly used test was the nasal misting pattern (73 per cent), followed by peak nasal inspiratory flow (19 per cent). The Sino-Nasal Outcome Test 22 or 23 was utilised by 29 per cent of respondents. Sixty-three per cent of respondents reported that a lack of equipment was the principle reason for not using objective measures, followed by time constraints and a lack of correlation with symptom scores.
British clinicians rely on clinical skills to evaluate nasal blockage. There is a desire for a simple, non-invasive device that objectively measures airflow for nasal breathing during physiological resting and correlates with subjective symptom scores.
Mycobacterium marinum, a bacterium found in freshwater and saltwater, can infect persons with direct exposure to fish or aquariums. During December 2013, the New York City Department of Health and Mental Hygiene learned of four suspected or confirmed M. marinum skin or soft tissue infections (SSTIs) among persons who purchased whole fish from Chinese markets. Ninety-eight case-patients with non-tuberculous mycobacteria (NTM) SSTIs were identified with onset June 2013–March 2014. Of these, 77 (79%) were female. The median age was 62 years (range 30–91). Whole genome sequencing of clinical isolates revealed two main clusters and marked genetic diversity. Environmental samples from distributors yielded NTM though not M. marinum. We compared 56 case-patients with 185 control subjects who shopped in Chinese markets, frequency-matched by age group and sex. Risk factors for infection included skin injury to the finger or hand (odds ratio [OR]: 15·5; 95% confidence interval [CI]: 6·9–37·3), hand injury while preparing fish or seafood (OR 8·3; 95% CI 3·8–19·1), and purchasing tilapia (OR 3·6; 95% CI 1·1–13·9) or whiting (OR 2·7; 95% CI 1·1–6·6). A definitive environmental outbreak source was not identified.
Introduction: Sepsis protocols call for the acquisition of blood cultures in septic emergency department (ED) patients.However, the criteria for blood cultures are vague, they are costly, only positive 8-12% of the time, with up to half of these being false positives. The objective of this study was to establish if positive blood cultures could be excluded in low-risk sepsis patients with levels of CRP below 20 ml/L. Methods: This was a multicenter prospective cohort study of 765 ED patients at St Paul’s and Mount St Joseph’s hospitals in Vancouver with sepsis (2 or more SIRS criteria and infection) and none of: immuncompromised, injection drug use, indwelling vascular device or septic shock (SBP<90 mmhg). Consecutive patients with sepsis had CRP and blood cultures obtained at the same time.OUTCOMES. True positive blood cultures, false positive blood cultures, positive blood cultures that changed patient management. True and false positive blood cultures were based on Infectious Disease Society of America Guidelines, and change in management was defined as change in type or length of antibiotic therapy and was blindly adjudicated by a medical microbiologist. Results: 765 ED patients with sepsis met inclusion criteria. Mean age was 48.3 years and 57% were male. Blood cultures were positive in 99/765 (12.9%) subjects, of which 19 were false positive (19.2%). CRP was >20 mg/L in 595/765 (77.8%) of patients. Of 170 subjects with a CRP<20 mg/L, 3 had a positive blood culture (1.8%; 95% CI 0.1%- 5%). Management was not changed in any patient with a positive blood culture and CRP level<20 mg/L. Of 19 subjects with a false positive blood culture, CRP was <20 mg/L for 6 (31.6%). Conclusion: In this cohort of low-risk sepsis patients, based on a CRP of <20 mg/L, acquisition of blood cultures could be safely avoided in 22.2% of patients, at significant savings to the health care system.
Offline computation is an essential component in most multiscale model reduction techniques. However, there are multiscale problems in which offline procedure is insufficient to give accurate representations of solutions, due to the fact that offline computations are typically performed locally and global information is missing in these offline information. To tackle this difficulty, we develop an online local adaptivity technique for local multiscale model reduction problems. We design new online basis functions within Discontinuous Galerkin method based on local residuals and some optimally estimates. The resulting basis functions are able to capture the solution efficiently and accurately, and are added to the approximation iteratively. Moreover, we show that the iterative procedure is convergent with a rate independent of physical scales if the initial space is chosen carefully. Our analysis also gives a guideline on how to choose the initial space. We present some numerical examples to show the performance of the proposed method.
Some studies demonstrated that physical activity may have beneficial effect on cognitive function. The objective of the study was to estimate the association between physical activity and cognitive function in community-dwelling elderly Chinese in Hong Kong (HK) and Guangzhou (GZ).
In the neighborhood of HK and GZ, a convenience sample of 557 (260 in HK and 297 in GZ) older persons without dementia aged over 60 years (73.4 ± 6.5) was recruited. Physical activity was measured using a checklist. Information on physical activity participation, cognitive function, and other variables were collected. Multivariate linear regression analyses were performed to evaluate the association between physical activity and cognitive function.
Total number of physical activities showed significant association with the delayed recall test (p < 0.01) and category verbal fluency test (CVFT) (p < 0.01). However, with further adjustment for participation in intellectual activity, the coefficients were no longer statistically significant (p > 0.05)
Physical activity may not be associated with better cognitive function among elderly Chinese independently of other factors.
With the proportion of older adults in Hong Kong projected to double in size in the next 30 years, it is important to develop measures for detecting individuals in the earliest stage of Alzheimer's disease (AD, 0.5 in Clinical Dementia Rating, CDR). We tested the utility of a non-verbal prospective memory task (PM, ability to remember what one has to do when a specific event occurs in the future) as an early marker for AD in Hong Kong Chinese.
A large community dwelling sample of older adults who are healthy controls (CDR 0, N = 125), in the earliest stage of AD (CDR 0.5, N = 125), or with mild AD (CDR 1, N = 30) participated in this study. Their reaction time/accuracy data were analyzed by mixed-factor analyses of variance to compare the performance of the three CDR groups. Logistic regression analyses were performed to test the discriminative power of these measures for CDR 0 versus 0.5 participants.
Prospective memory performance declined as a function of AD severity: CDR 0 > CDR 0.5 > CDR 1, suggesting the effects of early-stage AD and AD progression on PM. After partialling out the variance explained by psychometric measures (e.g., ADAS-Cog), reaction time/accuracy measures that reflected the PM still significantly discriminated between CDR 0 versus 0.5 participants in most of the cases.
The effectiveness of PM measures in discriminating individuals in the earliest stage of AD from healthy older adults suggests that these measures should be further developed as tools for early-stage AD discrimination.
Reported rates of child sexual abuse in China fall at the lower end of the range found in Western studies. However, most of the studies were conducted in only one city or province and thus their results may not be generalisable. Acknowledging the infeasibility of recruiting a truly representative sample, we conducted a survey during 2009–10 using a probability sampling procedure to obtain a large and diverse sample of school-aged adolescents from six regions in China. About one in every 13 children had had experience of sexual abuse. Routine screening in medical and social settings is urged. Efforts should be made to ensure wide awareness of this issue.
In this paper, we present an efficient computational methodology for diffusion and convection-diffusion problems in highly heterogeneous media as well as convection-dominated diffusion problem. It is well known that the numerical computation for these problems requires a significant amount of computer memory and time. Nevertheless, the solutions to these problems typically contain a coarse component, which is usually the quantity of interest and can be represented with a small number of degrees of freedom. There are many methods that aim at the computation of the coarse component without resolving the full details of the solution. Our proposed method falls into the framework of interior penalty discontinuous Galerkin method, which is proved to be an effective and accurate class of methods for numerical solutions of partial differential equations. A distinctive feature of our method is that the solution space contains two components, namely a coarse space that gives a polynomial approximation to the coarse component in the traditional way and a multiscale space which contains sub-grid structures of the solution and is essential to the computation of the coarse component. In addition, stability of the method is proved. The numerical results indicate that the method can accurately capture the coarse behavior of the solution for problems in highly heterogeneous media as well as boundary and internal layers for convection-dominated problems.
The epidemiology of varicella is believed to differ between temperate and tropical countries. We conducted a varicella seroprevalence study in elementary and college students in the US territory of American Samoa before introduction of a routine varicella vaccination programme. Sera from 515 elementary and 208 college students were tested for the presence of varicella-zoster virus (VZV) IgG antibodies. VZV seroprevalence increased with age from 76·0% in the 4–6 years group to 97·7% in those aged ⩾23 years. Reported history of varicella disease for elementary students was significantly associated with VZV seropositivity. The positive and negative predictive values of varicella disease history were 93·4% and 36·4%, respectively, in elementary students and 97·6% and 3·0%, respectively, in college students. VZV seroprevalence in this Pacific island appears to be similar to that in temperate countries and suggests endemic VZV circulation.
Background: This study evaluates which cognitive measure is best for predicting incident dementia in a population-based random sample of Chinese older adults without dementia over a five-year period.
Methods: A total of 787 community-dwelling Chinese older adults without dementia in Hong Kong were assessed at baseline (T0), at two years (T1), and at five years (T2).
Results: The annual conversion rate to dementia was 1.6% and 6.3% for baseline normal participants and baseline mild cognitive impairment (MCI) participants, respectively. The Cantonese version of Mini-mental State Examination (CMMSE) scores declined significantly over time. In participants who progressed to dementia, Category Verbal Fluency Test (CVFT) scores dropped significantly from T0 to T1. A 1-SD drop of either CMMSE or CVFT in two years predicted dementia at five years with 91.5% sensitivity and 62.0% specificity. A stable CMMSE and CVFT at two years predicted a 91% chance of not progressing to clinical dementia at five years.
Conclusion: In this community sample of Chinese older adults, a decline in cognitive screening tests in short term (two years) offered useful information in predicting dementia conversion over a longer period.
We examined the impact of the neonatal hepatitis B immunization programme, first provided to all neonates born to mothers screened positive for hepatitis B surface antigen (HBsAg) in late 1983, on the age-specific prevalence of HBsAg carriage in teenage mothers managed in 1998–2008. HBsAg carriage was found in 2·5%, 2·7%, 8·8% and 8·0% of mothers aged ⩽16, 17, 18, and 19 years, respectively (P = 0·004), which was also correlated with advancing age (P = 0·011). While neither difference nor correlation with age was found in mothers born before 1984, the prevalence of 1·2%, 1·5%, 7·1% and 8·3%, respectively, was significantly different among (P = 0·008) and correlated with (P = 0·002) age in mothers born 1984 onwards. Regression analysis indicated there was a significantly higher incidence of HBsAg carriage from age 17 onwards (adjusted odds ratio 2·55, 95% confidence interval 1·07–6·10, P = 0·035), suggesting that the protective effect of the vaccine declined in late adolescence.
Fluid flow through a two-dimensional fracture network has been simulated using a discrete fracture model. The computed field-scale permeabilities were then compared to those obtained using an equivalent continuum approach in which the permeability of each grid block is first obtained by performing fine-scale simulations of flow through the fracture network within that region. In the equivalent continuum simulations, different grid-sizes were used, corresponding to N by N grids with N = 10, 40, 100 and 400. The field-scale permeabilities found from the equivalent continuum simulations were generally within 10% of the values found from the discrete fracture simulations. The discrepancies between the two approaches seemed to be randomly related to the grid size, as no convergence was observed as N increased. An interesting finding was that the equivalent continuum approach gave accurate results in cases where the grid block size was clearly smaller than the 'representative elementary volume'.