A feasibility study of mindfulness-based interventions for children.

BACKGROUND: Children's overall psychological well-being is a concern for parents and adults worldwide. Mindfulness appears to be a promising intervention for enhancing children's psychological well-being, and its effectiveness has been well-documented. However, there is a paucity of data on the feasibility and acceptability of implementing mindfulness-based interventions (MBIs) for children; this is a crucial factor in determining whether MBIs can be utilized to benefit children. The aim of this study was to determine the feasibility and acceptability of implementing MBIs among Hong Kong children. METHODS: Seventy-eight children (mean age = 9.06, SD = .375) were recruited from a primary school in Hong Kong and received MBIs in a single session that lasted about 2 h. The intervention's feasibility was determined in terms of retention rates, while acceptability was based on qualitative feedback from the children. RESULTS: The results show that there were high retention rates (96%). Qualitative analyses of children's feedback revealed that they experienced enhanced well-being, and enjoyed and benefited from the interventions. CONCLUSIONS: This study shows the high feasibility of MBIs in children, supporting the conduct of an efficacy trial to examine the effects of MBIs among children. Support from school teachers and measures to raise and maintain children's interest in mindfulness could facilitate the conduct of a study.

Effects of posture on heart rate variability in non-frail and prefrail individuals: a cross-sectional study.

BACKGROUND: Frailty is an aging-related syndrome leading to high mortality in older adults. Without effective assessment and prevention of frailty, the incidence of frailty and relevant adverse outcomes will increase by 2050 as worldwide populations age. Although evidence suggested heart rate variability (HRV) is a potential measure of frailty, the role of HRV in frailty assessment remains unclear because of controversial findings. This study examined the effects of posture on HRV parameters in non-frail and prefrail individuals to understand the role of HRV in assessing frailty. METHODS: Forty-six participants aged ≥ 50 years were recruited between April and August 2022. Frailty was defined using Fried's criteria. HRV was measured in standing, sitting, and lying postures, respectively, using a Polar Watch, and analyzed using Kubios HRV Standard 3.5.0 (Kubios). The five most commonly used parameters were examined, including standard deviations of all normal-to-normal intervals (SDNN), root mean square of the successive differences (RMSSD), low frequency (LF), high frequency (HF), and LF/HF. Independent t-tests and Mann-Whitney tests were used for inter-group comparisons. Friedman tests were used for intra-group comparisons across postures. RESULTS: The non-frail group showed significant differences in HRV parameters across postures (all p < 0.05), whereas the prefrail group did not demonstrate any difference (all p > 0.05). The differences in the non-frail group included higher RMSSD and HF in the lying posture compared to those in the standing posture (29.54 vs 21.99 p = 0.003, 210.34 vs 96.34 p = 0.001, respectively), and higher LF and LF/HF in the sitting posture compared to those in the lying posture (248.40 vs 136.29 P = 0.024, 1.26 vs 0.77 p = 0.011, respectively). CONCLUSIONS: The effects of posture on HRV were blunted in the prefrail group, which suggests an impaired cardiac autonomic functioning. Measuring the effects of posture on HRV parameters may contribute to frailty assessment. However, further evidence from larger cohorts and including additional HRV parameters is needed.

The effectiveness of mindfulness yoga on patients with major depressive disorder: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Mindfulness yoga is a type of exercise that emphasizes the integration of mindfulness or meditation into yoga. The aim of this study was to determine the effectiveness of mindfulness yoga intervention on major depressive disorder (MDD) patients. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching nine databases, including PubMed, EMBASE, Web of Science, The Cochrane Library, MEDLINE, China National Knowledge Infrastructure (CNKI), Wanfang Data knowledge service platform, Chinese Biomedical Literature Database (CBM), and China Science and Technology Journal Database (VIP) from inception to April 2023. Primary outcomes included the severity of depression. Secondary outcomes included anxiety and rumination. RESULTS: Nine RCTs met our inclusion criteria (n = 581). The meta-analysis showed that mindfulness yoga significantly has a significant effect on depression (SMD = -0.53; 95%CI = -0.96 to -0.11; P < 0.05) among MDD patients. The only two RCTs involved also showed that mindfulness yoga could alleviate the anxiety level of MDD patients after intervention (SMD = -1.08; 95%CI = -1.64 to -0.52; P < 0.05). Meta-analysis did not reveal positive effects of the mindfulness yoga groups on rumination after intervention based on three RCTs (SMD = -0.33; 95%CI = -0.89 to 0.23; P > 0.05), but found a significant difference in the follow-up period based on two RCTs (MD = -7.42; 95%CI = -11.27 to -3.56; P < 0.05), compared with the control groups. CONCLUSION: Although we were unable to provide conclusive evidence to support the effectiveness of mindfulness yoga in improving symptoms in MDD patients, we found the literature included in this study indicated that mindfulness yoga might have a potential benefit for MDD patients and should be a feasible, acceptable, and promising intervention.

Exploring the impact of a compassion-oriented training program on personal care workers in a nursing home: A mixed-methods pilot study.

This pilot study aimed to explore the impact of a compassion-oriented training program on Personal Care Workers (PCWs) in a nursing home. A mixed-methods approach was used, including pre- and post-questionnaire surveys to measure changes in compassion, and in-depth interviews and daily diaries to explore PCWs' perceptions and experiences. A convenience sample of five female PCWs from a nursing home in Hong Kong participated in the study. The quantitative results showed that the PCWs experienced a decline in compassion after participating in the program. The qualitative data analysis identified three themes: (1) the multifaceted nature of compassion, (2) barriers and threats to compassion, and (3) transfer of skills at the workplace. Overall, These findings highlighted the complexity of implementing effective compassion training programs in nursing home, and emphasized the importance of recognizing the multifaceted nature of compassion and addressing barriers and threats to compassion in the workplace.

Polylactic Acid-Based Biomaterials in Wound Healing: A Systematic Review.

OBJECTIVE: To examine (1) the effectiveness of polylactic acid (PLA)-based biomaterials in wound healing, (2) their effects on wound infection prevention, and (3) their safety compared with existing biomaterials. DATA SOURCES: Data sources included PubMed, MEDLINE, Cochrane Library, CINAHL (Cumulative Index to Nursing and Allied Health Literature), CNKI (China National Knowledge Infrastructure), WEIPU, and WANFANG databases. STUDY SELECTION: Investigators included 14 studies discussing the effects of PLA-based biomaterials in cutaneous wound healing published from 2000 to 2021. DATA EXTRACTION: Authors extracted the following information from the selected studies: general information, study type, type of wound, PLA-based biomaterials and techniques, study period, outcome measures, and results. DATA SYNTHESIS: Polylactic acid-based biomaterials may promote wound healing through wound area repair, collagen deposition, angiogenesis, and cell activities, which are related to the good biocompatibility, biodegradability, and moisture management properties of PLA. A proper product structure may also help. Both the native PLA materials and PLA blends seem to be antibacterial, although more evidence is needed for the native PLA products. Because there was no severe adverse event or obvious cytotoxicity observed in the included studies, PLA-based biomaterials are likely safe. CONCLUSIONS: Polylactic acid-based biomaterials may be good wound dressing materials, although more evidence is needed to support their broader application in wound care.

Development of an integrative learning program for community dwelling old people with dementia.

OBJECTIVE: to develop an integrative learning program for people with dementia. METHOD: a methodological study was conducted using Delphi technique to develop the learning program, followed by a feasibility test. An expert panel was invited to develop the integrative learning program based on the neuroplasticity and learning framework. A feasibility test was conducted to evaluate the implementation of the program in two centers after the training of personnel who run the program. Verbatim transcripts of case conferences were coded, analyzed, and collapsed into themes and sub-themes by consensus. RESULTS: there was no indication for content modification during the period of program implementation. Qualitatively, the participating older adults showed improvement in communications, emotions, connectedness with self and others, and well-being. CONCLUSION: the integrative learning program was uneventfully implemented with promising results. The program is ready for full-scale research on its efficacy in multiple centers to obtain more robust evidence.

Development of an integrative learning program for community dwelling old people with dementia / Desarrollo de un programa de aprendizaje integrador para personas de edad avanzada con demencia que viven en la comunidad / Desenvolvimento de um programa de aprendizagem integrativa para idosos com demência residentes na comunidade

Objective: to develop an integrative learning program for people with dementia. Method: a methodological study was conducted using Delphi technique to develop the learning program, followed by a feasibility test. An expert panel was invited to develop the integrative learning program based on the neuroplasticity and learning framework. A feasibility test was conducted to evaluate the implementation of the program in two centers after the training of personnel who run the program. Verbatim transcripts of case conferences were coded, analyzed, and collapsed into themes and sub-themes by consensus. Results: there was no indication for content modification during the period of program implementation. Qualitatively, the participating older adults showed improvement in communications, emotions, connectedness with self and others, and well-being. Conclusion: the integrative learning program was uneventfully implemented with promising results. The program is ready for full-scale research on its efficacy in multiple centers to obtain more robust evidence.

Objetivo: desarrollar un programa de aprendizaje integrador para personas con demencia. Método: se realizó un estudio metodológico empleando la técnica Delphi para desarrollar el programa de aprendizaje, seguida de una prueba de viabilidad. Se invitó a un panel de expertos a que desarrollara el programa de aprendizaje integrador sobre la base del marco de la neuroplasticidad y el aprendizaje. Se realizó una prueba de viabilidad para evaluar la implementación del programa en dos centros después de haber capacitado al personal que dirige el programa. Las transcripciones literales de los debates de casos se codificaron, analizaron y resumieron en temas y subtemas por medio de consenso. Resultados: no hubo ninguna indicación para modificar el contenido durante el período de implementación del programa. En forma cualitativa, los adultos mayores que participaron del programa evidenciaron mejoras en la comunicación, las emociones, la capacidad de conexión con ellos mismos y con los demás y el bienestar. Conclusión: el programa de aprendizaje integrador se implementó sin inconvenientes con resultados prometedores. El programa es apto para ser sometido a una investigación a gran escala con respecto a su eficacia en varios centros para obtener evidencia más sólida.

Objetivo: desenvolver um programa de aprendizagem integrativa para pessoas com demência. Método: foi realizado um estudo metodológico com a técnica Delphi para desenvolver o programa de aprendizagem, seguido de um teste de viabilidade. Um grupo de especialistas foi convidado para desenvolver o programa de aprendizagem integrativa com base no framework da neuroplasticidade e da aprendizagem. Um teste de viabilidade foi realizado para avaliar a implementação do programa em dois centros após treinamento do pessoal que dirige o programa. Transcrições literais de conferências de casos foram codificadas, analisadas e agrupadas em temas e subtemas por consenso. Resultados: não houve indicação de modificação de conteúdo durante o período de implementação do programa. Qualitativamente, os idosos participantes apresentaram melhora nas comunicações, emoções, conexão consigo e com os outros e bem-estar. Conclusão: o programa de aprendizagem integrativa foi implementado sem intercorrências com resultados promissores. O programa está adequado para ser submetido a pesquisas em grande escala relacionadas com sua eficácia em vários centros a fim de obter evidências mais robustas.

The effects of health literacy in influenza vaccination competencies among community-dwelling older adults in Hong Kong.

BACKGROUND: Poor health literacy was found to be one of the key barriers in older adults' disease prevention practice. However, it has still been unclear how different processes in health literacy play a role in older adult's vaccination-related competencies. By adopting the European Health Literacy Survey (HLS-EU), the current study aimed to examine older adults' competences in accessing, understanding, evaluating and applying health information, as well as how they are related to perceived difficulties in vaccination-related practices. . METHODS: With a cross-sectional design, a quantitative exploratory study was conducted using structured questionnaires. Four-hundred and 86 community-dwelling older adults aged 65 and above were recruited from non-government organizations in Hong Kong. Health literacy was measured by the Chinese version of 47-item HLS-EU (HLS-Asia-Q), which assesses the competences in accessing, understanding, evaluating and applying health information across the domains of health care, disease prevention, and health promotion. Linear regression was performed to test the association between different aspects of health literacy and vaccination-related information processing. RESULTS: The findings showed that the health literacy of Hong Kong older adults has been limited, particularly in information appraisal. Poorer competences in accessing and appraising health information were associated with greater difficulties in making vaccination decision. CONCLUSIONS: By identifying the health literacy processes associated with vaccination, our findings suggested that health-promotion programs strengthening the appraisal and comparison of vaccination information should be provided for the general public. Meanwhile, health professionals and mass media should reduce the complexity when delivering the health messages, and make it easier for older adults to access and comprehend, thus increasing the inclination to take vaccine and preventing the spread of communicable diseases.

To investigate the association between the health literacy and hand hygiene practices of the older adults to help them fight against infectious diseases in Hong Kong.

BACKGROUND: Proper hand hygiene helps prevent infectious diseases, while health literacy plays a critical role in preventive health behaviors. It remains unclear as to why proper hand hygiene practices cannot be sustained and what role health literacy plays in older adults fight against infectious diseases. METHODS: A convenience sample of 433 old adults aged 65 and above was recruited. Their hygiene practices and health literacy were evaluated using a structured questionnaire adopted from the Centre for Health Protection and the Chinese version of the HLS-Asia-Q questionnaire. RESULTS: The percentage distribution of the hand hygiene performance, from always to never, was 18%-10%. A majority 63.28% (274) of them were classified as having inadequate health literacy (0-25), while a meager 1.62% (7) of them as having excellent health literacy (42.01-50). The Spearman correlation showed a significant positive relationship (P < 0.05) between the participants' health literacy and their hand hygiene practices. CONCLUSIONS: Health literacy and hand hygiene are positively related in helping the older adults fight against infectious diseases. To sustain proper hand hygiene practices is to provide frequent hand hygiene training to the older adults.

Can Flu-Like Absenteeism in Kindergartens Be Reduced Through Hand Hygiene Training for Both Parents and Their Kindergarteners?

Background: Hand hygiene has been found as an effective method to prevent the spread of infectious diseases. Parents, however, were found to have inadequate knowledge, reporting skills, and parenting practices related to seasonal influenza. The aim of our study was to investigate if there was any correlation between the flu infection among parents and their kindergarteners and ascertain the effectiveness of using hand hygiene interventions in kindergartens to lower kindergarteners' absenteeism attributable to seasonal flu. Methods: This study was a quasi-experimental study with a pretest-posttest design. Fifteen kindergartens were randomly selected from the kindergarten lists in different districts displayed on the Hong Kong government website. From these 15 kindergartens, parents and their kindergarteners were then randomly selected to participate in our hand hygiene program. To support the validity of the program, the WHO hand hygiene checklist was used to ensure sufficient coverage of the objectives. All kindergarteners attended 45-minute session for 4 weeks, while their parents attended a separate session lasting 1 hour. Parents monitored their kindergartners on a daily basis for any flu symptoms and kindergartens monitored their school attendance. Results: The study results showed that kindergarteners with strong parenting and proper hand hygiene compliance had fewer recorded signs and symptoms of flu-like illnesses. Our findings also showed that the kindergarteners' absence rates in all participating kindergartens owing to flu decreased from 21.5% to 12% of the study period in 3 months. Conclusion: It was found that the flu infection rates of the parents and their kindergarteners were significantly correlated with P = .005. The awareness and personal hygiene skills of the parents and kindergarteners were both raised after the program. The findings in this study supported that positive parenting on hand hygiene can help reduce kindergarteners' flu-like absenteeism.

Building Healthy Eating Knowledge and Behavior: An Evaluation of Nutrition Education in a Skill Training Course for Construction Apprentices.

BACKGROUND: Prior research has found poor health among construction workers is related to poor nutrition and low fruit and vegetable consumption. Promoting nutrition knowledge can improve dietary behaviors, but nutrition education among construction workers is limited. We evaluated the effectiveness of nutrition education on fruit and vegetable consumption among construction apprentices. In this pilot evaluative study, 36 construction apprentices enrolled in skill training programs received two 1.5-hour nutrition classes. Twelve questions addressing healthy eating knowledge and behavior were administered at baseline, after intervention, and at three months follow-up. After intervention, daily fruit consumption improved from baseline (mean (s.d.) =1.42 (0.55)) to post intervention (mean (s.d.) =1.72 (0.70)) (p < 0.05) and to three months follow-up (mean(s.d.) =1.94 (0.83)) (p > 0.05). After intervention, daily vegetable consumption improved from baseline (mean (s.d.) =1.67 (0.59)) to post intervention (mean (s.d.) =1.97 (0.74)) (p < 0.05) and to three months follow-up (mean (s.d.) = 2.19 (0.82)) (p > 0.05). Younger construction apprentices showed better healthy eating knowledge at post intervention and three months follow-up (p > 0.05). Working in normal hours showed better healthy eating knowledge at post intervention but not at three months follow up (p > 0.05). Both age groups and working hours did not show significant differences on healthy eating behaviour. Nutrition education implemented as a three-hour session within skill courses may possibly promote fruit and vegetable consumption among construction apprentices. Further research with control group is required to support the findings in this study.

Chinese adults' nutrition label literacy in Hong Kong: Implications for nurses.

The study aimed to investigate Chinese adults' nutrition label literacy in Hong Kong. It employed a web-based survey with structured questions. A total of 368 Chinese adults aged 18-59 participated in the survey and their nutrition label literacy was measured by the Newest Vital Sign (NVS). About two-thirds (68%) of the participants had limited nutrition literacy skills. Although they were able to identify correctly the calorie and sugar content of food products, 44% and 48% of them had difficulty in determining the consumption of calories and serving food sizes respectively. Another finding from the survey was that those with lower education level and of older age had significantly lower mean nutrition label literacy scores, which indicated that they were at higher risk for food insecurity. The findings showed that the nutrition label literacy level of Hong Kong's general public is quite low. This study can provide insights for nurses and healthcare professionals on how to educate people with lower education level and/or of advanced age to use nutrition labels more effectively and to further nutrition label literacy study and research, particularly in Hong Kong.

Cardiovascular Health of Construction Workers in Hong Kong: A Cross-Sectional Study.

BACKGROUND: Given a shortage of construction workers, it is important to develop strategies to avoid early retirement caused by cardiovascular diseases in Hong Kong. OBJECTIVES: (1) to describe the cardiovascular health of construction workers in Hong Kong, (2) to examine the demographic differences in cardiovascular health, and (3) to examine the association between health behaviors and cardiovascular health factors. METHODS: 626 registered construction workers were included in the analysis. Blood chemistry, blood pressure, weight, and height were measured. Face-to-face questionnaire interviews for health behaviors were conducted. RESULTS: Approximately two-thirds of the construction workers achieved only three out of the seven “ideal” cardiovascular health metrics. The younger, more educated, and female subjects had better cardiovascular health scores than the older, less educated, and male counterparts. Fish and seafood consumption was associated with (1) ideal weight status and (2) ideal cholesterol level, whereas less soft drink consumption was associated with ideal cholesterol level. CONCLUSIONS: The findings highlighted the importance of promoting cardiovascular health in the construction industry. This study provided some insights for future interventions, which should include increasing fish and seafood intake, decreasing soft drink consumption, and enhancing the health literacy amongst older, less educated, and male construction workers.

Effect of music intervention on apathy in nursing home residents with dementia.

This study examined the effectiveness of group music intervention in the treatment of nursing home residents with apathy. Apathy can clinically defined with a score of 40 or above on the apathy evaluation scale (AES). Seventy-seven residents were randomly assigned to the intervention or control group. The intervention group was given a music intervention programme, which included listening to traditional music, including nostalgic songs, and playing musical instruments three times a week, for a total of twelve weeks. Results demonstrated a decrease in apathy scores in the intervention group (z = 4.667, P <0.01), but not in the control group (z = -1.810, P > 0.05). Cognitive function, as assessed by Mini Mental State Examination (MMSE) score, was stable in the intervention group (t = 1.720, P > 0.05), but declined in the control group (t = -1.973, P <0.05). We conclude that music intervention has the potential to be an effective therapy for the treatment of apathy in the early stages of dementia.

A Pilot Randomized, Controlled Study of Nanocrystalline Silver, Manuka Honey, and Conventional Dressing in Healing Diabetic Foot Ulcer.

Nanocrystalline silver (nAg) and Manuka honey (MH) dressing have increasing popularity for treating diabetic foot ulcer (DFU). This study was an open-label randomized controlled trial with three parallel groups' design in examining the preliminary effectiveness of nAg against MH and conventional dressing in healing DFU in terms of ulcer healing, ulcer infection, and inflammation. 31 participants (11 in the nAg group, 10 in the MH group, and 10 in the convention group) diagnosed with type 2 diabetes were enrolled. Wound cleaning, debridement, and topical dressing application were performed according to the group allocation in each visit at weeks 1, 2, 3, 4, 6, 8, 10, and 12. The results found that the proportions of complete ulcer healing were 81.8%, 50%, and 40% in the nAg, MH, and conventional groups, respectively. The ulcer size reduction rate was potentially higher in the nAg group (97.45%) than the MH group (86.21%) and the conventional group (75.17%). In bacteriology, nAg showed a greater rate of microorganism reduction although it was not significant. To conclude, nAg alginate was potentially superior to MH and conventional dressing in healing diabetic foot ulcer in terms of ulcer size reduction rate.

Effects of Praise Dance on the Quality of Life of Chinese Women.

OBJECTIVE: Religion, spirituality, and health are inseparable in human history. Yet, the effects of religion and spirituality on health are controversial. The objective of this study was to investigate the effects of praise dance on the quality of life (QoL) of women with or without medically diagnosed diseases. METHOD: This was a pretest-posttest study with one convenience sample that took place at Praise Dance Association Hong Kong (PDA) centers. Two hundred and fifty-six Chinese adult females participated. They were aged ≥45 years and had joined the PDA centers within 4 weeks of the commencement of this study. The intervention lasted for 12 weeks, and the subjects practiced praise dance three times a week in a group with a coach in the first four weeks and subsequently on their own or with the same group at least once a week. Each dancing session lasted for 30 min. The subjects completed the World Health Organization Quality of Life (WHOQOL)-BREF (HK) questionnaire before and after the intervention of the praise dance. RESULTS: The findings showed significant improvement in the psychological well-being of the participants, regardless of their religious background. The improvement in their physical domain was statistically marginal. CONCLUSION: This is the first empirical study to test the benefit of praise dance on QoL. Promoting praise dance could be beneficial to the psychological well-being of women, regardless of their religious backgrounds. The effect of religion or spirituality on QoL warrants further investigation.

Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services.

OBJECTIVES: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. METHOD: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. RESULTS: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. CONCLUSION: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services / Conhecimento dos enfermeiros sobre a cobertura universal de saúde para serviços inclusivos e sustentáveis de cuidados a idosos / El conocimiento de las enfermeras sobre la cobertura universal de salud en servicios inclusivos y sostenibles para el cuidado de adultos mayores

Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

Objetivos: explorar o conhecimento dos enfermeiros sobre a cobertura universal de saúde (CUS) para o desenvolvimento inclusivo e sustentável de serviços de saúde a idosos. Método: estudo transversal. Foi recrutada uma amostra de conveniência de 326 enrolled nurses (EN) ou registered nurses (RN). Os entrevistados responderam a um questionário com base nas estratégias de implementação preconizadas pelo Fórum Global da OMS para Governmental Chief Nursing Officers and Midwives (GCNOMs). As perguntas abordavam iniciativas do governo, políticas de financiamento da saúde, políticas de recursos humanos e percepção dos entrevistados sobre a importância e contribuição do enfermeiro no alcance da CUS em serviços de cuidados a idosos. Resultado: o conhecimento de enfermeiros sobre a CUS em serviço de atenção ao idoso foi razoavelmente satisfatório. Enfermeiros tanto da prática clínica como da gestão perceberam-se contribuindo mais e tendo mais importância do que aqueles que trabalham na educação. Eles eram relativamente indiferentes à política de saúde e à política. Conclusão: a pesquisa revelou uma lacuna de conhecimento considerável no conhecimento da CUS pelos enfermeiros nos serviços de cuidados a idosos e evidenciou a necessidade de enfermeiros terem mais sintonia com a política de saúde. O currículo de formação para preparar os enfermeiros deve ser reforçado para incluir estudos em política pública e advocacia. Os enfermeiros podem fazer a diferença por meio de sua participação no desenvolvimento e implementação da CUS nos serviços de saúde.

Objetivos: explorar los conocimientos que tienen las enfermeras sobre la cobertura universal de salud (CUS) para el desarrollo inclusivo y sostenible de servicios para el cuidado de adultos mayores. Método: se utilizó una encuesta transversal. Se formó una muestra de conveniencia de 326 enrolled nurses (EN) o registered nurses (RN) que actualmente estuvieran ejerciendo. Los encuestados respondieron a un cuestionario basado en las estrategias de implementación apoyadas por el WHO Global Forum for Government Chief Nursing and Midwifery Officers (WGFGCNO). Las preguntas abarcaban la iniciativa del gobierno, políticas de financiamiento de la salud, las políticas de recursos humanos y la percepción de los encuestados sobre la importancia y la contribución de las enfermeras en el logro de la CUS en los servicios de cuidado para adultos mayores. Resultados: el conocimiento de las enfermeras sobre CUS en el servicio de cuidado para los adultos mayores fue bastante satisfactorio. Tanto las enfermeras de práctica clínica y como las de gestión perciben tener un mayor aporte e importancia que las de que están en educación. Tenían un punto de vista relativamente indiferente a la política sanitaria y la política. Conclusión: la encuesta descubrió una considerable brecha en el conocimiento de las enfermeras sobre CUS en los servicios de cuidado para adultos mayores y puso de manifiesto la necesidad de que las enfermeras estén más en sintonía con la política sanitaria. El plan de estudios para la preparación de las enfermeras debe fortalecerse para incluir estudios en las políticas públicas y promoción. Las enfermeras pueden hacer una diferencia a través de su participación en el desarrollo e implementación de CUS en los servicios de salud.

The Anti-Inflammatory and Antibacterial Action of Nanocrystalline Silver and Manuka Honey on the Molecular Alternation of Diabetic Foot Ulcer: A Comprehensive Literature Review.

Honey and silver have been used since ancient times for treating wounds. Their widespread clinical application has attracted attention in light of the increasing prevalence of antibiotic-resistant bacteria. While there have been a number of studies exploring the anti-inflammatory and antibacterial effects of manuka honey and nanocrystalline silver, their advantages and limitations with regard to the treatment of chronic wounds remain a subject of debate. The aim of this paper is to examine the evidence on the use of nanocrystalline silver and manuka honey for treating diabetic foot ulcers through a critical and comprehensive review of in vitro studies, animal studies, and in vivo studies. The findings from the in vitro and animal studies suggest that both agents have effective antibacterial actions. Their anti-inflammatory action and related impact on wound healing are unclear. Besides, there is no evidence to suggest that any topical agent is more effective for use in treating diabetic foot ulcer. Overall, high-quality, clinical human studies supported by findings from the molecular science on the use of manuka honey or nanocrystalline silver are lacking. There is a need for rigorously designed human clinical studies on the subject to fill this knowledge gap and guide clinical practice.

Comparing the physiological and perceptual responses of construction workers (bar benders and bar fixers) in a hot environment.

This study aimed to (1) quantify the respective physical workloads of bar bending and fixing; and (2) compare the physiological and perceptual responses between bar benders and bar fixers. Field studies were conducted during the summer in Hong Kong from July 2011 to August 2011 over six construction sites. Synchronized physiological, perceptual, and environmental parameters were measured from construction rebar workers. The average duration of the 39 field measurements was 151.1 ± 22.4 min under hot environment (WBGT = 31.4 ± 2.2 °C), during which physiological, perceptual and environmental parameters were synchronized. Energy expenditure of overall rebar work, bar bending, and bar fixing were 2.57, 2.26 and 2.67 Kcal/min (179, 158 and 186 W), respectively. Bar fixing induced significantly higher physiological responses in heart rate (113.6 vs. 102.3 beat/min, p < 0.05), oxygen consumption (9.53 vs. 7.14 ml/min/kg, p < 0.05), and energy expenditure (2.67 vs. 2.26 Kcal/min, p < 0.05) (186 vs. 158 W, p < 0.05) as compared to bar bending. Perceptual response was higher in bar fixing but such difference was not statistically significant. Findings of this study enable the calculation of daily energy expenditure of rebar work.