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.

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.

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.

A cost-effectiveness analysis of teledietetics in short-, intermediate-, and long-term weight reduction

Introduction

To evaluate the effectiveness of teledietetics in weight loss for 24 weeks and the cost-effectiveness of weight loss between face-to-face and teledietetics services.

Methods

The study was conducted at a community health center and a community dietetics clinic. The study was a quasiexperimental design. Fifty adults aged 20–50 with a BMI ≥23 participated in the study. The face-to-face (FD) group received 12 dietary counselling sessions and recorded their diet in a log book. The teledietetics (TD) group attended three group nutrition seminars and recorded their diet on a Web-based platform. Changes in variables were compared using an independent t-test. Direct and indirect costs were applied to compute cost-effectiveness ratios.

Results

At week 6, the FD group showed greater reductions in all variables than did the TD group. At week 12, the effects reversed. At week 24, the accumulated reductions in weight and fat in the TD group were significantly higher than those in the FD group (all at p < 0.0001). The observed direct costs for 1% weight loss and 1% fat loss were USD 28.24 and USD17.09, respectively.

Discussion

A dietetic service delivered as a teledietetics model is more cost-effective than the face-to-face dietetics model in weight reduction.

Electronic dietary recording system improves nutrition knowledge, eating attitudes and habitual physical activity: a randomised controlled trial

OBJECTIVE

This study's objective was to investigate whether use of an electronic dietary recording system improves nutrition knowledge, eating attitudes and habitual physical activity levels compared to use of a food diary and no self-monitoring.

METHODS

Sixty adults aged 20-60 with a body mass index ≥25 were recruited and randomly assigned to one of three groups: a group using an electronic system (EG), a group using a food diary (FD) and a control group using nothing (CG) to record food intake. All participants took part in three 60-90 nutrition seminars and completed three questionnaires on general nutrition knowledge, habitual physical activity levels and eating attitudes at the beginning and end of the 12-week study. The pre- and post-test scores for each questionnaire were analysed using a paired sample t-test.

RESULTS

Significant improvements in the domain of 'dietary recommendations' were found in the EG (p=0.009) and FD groups (p=0.046). Great improvements were found in 'sources of nutrients', 'choosing everyday foods' and 'diet-disease relationships' in EG and FD groups. EG group showed greater improvement in the work index and sport index.

CONCLUSION

An electronic dietary recording system may improve eating and exercise behaviour in a self-monitoring process.

Effectiveness of a food education program in improving appetite and nutritional status of elderly adults living at home

OBJECTIVE

To evaluate a 3-week program comprising cooking demonstrations with free food samples in motivating elderly adults to cook more and improve their nutritional status.

DESIGN

An experimental pre-post study.

SETTING

Three districts in Hong Kong.

PARTICIPANTS

Sixty aged 59-95 home-living adults.

INTERVENTION

Group A (one 1-day food sample given free weekly) and Group B (three 1-day food samples given free weekly).

MAIN OUTCOME MEASURE

Satisfaction questionnaires were conducted every week. Mini Nutritional Assessment (MNA) scores were assessed at baseline and 6 months after the program's completion.

ANALYSIS

Nutritional status was assessed before and after intervention. Repeated analysis of variance measures of compliance, appetite, easiness of program at 3-week time-points were calculated to differentiate a more frequent (Group B) and a less frequent (Group A) provision of food sample reinforced their cooking skills to a greater extent.

RESULTS

The compliance rate of Group B was higher than that of Group A. More than 60% of the participants intended to continue cooking and a third of the participants expressed satisfaction with the program. The MNA scores had improved 6 months later (combined data from both groups).

CONCLUSIONS

Nutrition education through cooking demonstrations and the community-based distribution of food ingredients can improve the nutrition status of the elderly population.

Teledietetics improves weight reduction by modifying eating behavior: a randomized controlled trial

BACKGROUND

Weight reduction without behavioral modification is not sustainable. However, with a technology application such as teledietetics, the recording process could be a cognitive cue for individuals to change their eating behavior. This study tested obese participants to determine whether teledietetics shows better results in weight reduction.

STUDY DESIGN AND METHODS

We conducted a double-blinded randomized controlled trial. The participants in the food diary (FD) and electronic diary (ED) groups recorded their dietary intakes in logbooks and on an electronic diary system, respectively. The participants in the control group (CG) did nothing. Subjects were adults 20-60 years of age with a body mass index (BMI) of ≥25 kg/m(2). The ED and FD groups were the intervention groups and were compared with the CG group. The participants' body weights, BMIs, fat percentages, waist-to-hip ratios (WHRs), and mean arterial pressures (MAPs) were measured before the study, at Week 6, and at Week 12. Demographic data were collected using self-administered questionnaires. A chi-squared test and descriptive statistics were used to describe the demographic and biomeasurement data. Repeated-measures analysis of variance was used to evaluate the effectiveness of the three groups over time.

RESULTS

Significant decreases in body weight (F1.705,86.950=20.508, p<0.001) and BMI (F1.657, 84.486=21.256, p<0.001) and insignificant decreases in fat percentage (F2,94=0.547, p=0.581), WHR (F1.785,91.052=2.888, p=0.067), and MAP (F2,94=7.542, p=0.0001) were observed among the three measurement times.

CONCLUSIONS

Electronic dietary records were better than food diaries in terms of fat percentage reduction in our trials, indicating that teledietetics increases healthy-eating awareness.

The effects of caffeine abstinence on sleep: a pilot study

AIM

The aim of this study was to examine whether caffeine abstinence in the evening could improve the sleep quality of those who habitually consume coffee.

DESIGN

A double-blind control group design (caffeine and caffeine-free groups).

SETTING

A university.

SUBJECTS

A convenience sampling of 10 students (mean age 21.4 years).

METHODS

It was a 14-day experiment. For the first 7 days, all participants consumed caffeinated coffee. In the following 7 days, subjects consumed caffeinated or decaffeinated coffee according to their assigned group.

MEASURES

Sleep-wake parameters, self-reported sleep quality and level of refreshment.

RESULTS

There were no significant differences (p>.05) among the data of the two groups identified. No significant changes (p>.05) were found in the sleep quality of either group during the study.

CONCLUSION

This study confirms that caffeine abstinence in the evening might not be helpful in sleep promotion. It highlights the need to implement evidence-based practice in health promotion.

Study on the effectiveness of disinfection with wipes against methicillin-resistant Staphylococcus aureus and implications for hospital hygiene

BACKGROUND

Environmental contamination with methicillin-resistant Staphylococcus aureus (MRSA) poses a significant risk in the epidemiology of infection. This study aimed to assess the effectiveness of disinfection in clinical areas by assessment of the wipe-rinse method to MRSA in the immediate patient environment, on both the bed rails and the cleaning wipes.

METHODS

The environmental disinfection procedures of 8 MRSA-positive hospitalized patients in 2 orthopedic wards were evaluated. A total of 56 pre- and postdisinfection samples from the bed rails as well as pre- and postuse wipes samples were collected.

RESULTS

The average MRSA loads on the bed rails before and after disinfections were 4.4 colony-forming units (cfu)/cm(2) and 0.4 cfu/cm(2), respectively, the process reducing MRSA survival from a mean of -0.70 log to -1.65 log. The mean difference of MRSA survival detected on the wipes after each wiping ranged from 0.13 to 0.42 log.

CONCLUSION

The presence of MRSA in the proximity of the patient, ie, the bed rails as well as the cleaning tool (the wipe), was demonstrated in this study. If thorough rinsing was not conducted between wiping, bacteria accumulated on the wipes, which can result in cross transmission.

Importance of a balanced diet on the physical fitness level of schoolchildren aged 6-12

Previous studies have focused on a single nutrient's relationship with disease and thus are unable to strongly support the health claims of a balanced diet. This article explores the integrated effect of nine nutrients on an individual's physical fitness level. Two-day dietary records and physical fitness assessments were collected in three primary schools. Cluster analysis allowed compliance with nutrient recommendations to be compared among groups of primary school students with different characteristics. Two clusters were identified statistically. Cluster B, which comprised more schoolchildren at the 'Good' and 'Pass' levels and fewer at the 'Excellent' level, had significantly more participants who met the guidelines for total fat, saturated fat, sodium and cholesterol, compared with Cluster A. This finding reveals the benefits of a balanced diet, with physical fitness level as the outcome measure. The results also have implications for approaching health problems from the diet-fitness perspective rather than the obesity-disease perspective.

BiliCheck transcutaneous bilirubinometer: a screening tool for neonatal jaundice in the Chinese population

OBJECTIVE

To verify the usefulness of the BiliCheck transcutaneous bilirubin meter as a screening device for neonatal jaundice in a Chinese population compared with the Minolta bilirubin meter.

DESIGN

A prospective correlation study that compared transcutaneous bilirubin measurements with serum bilirubin levels.

SETTING

Obstetric ward and a neonatal unit of a regional hospital in Hong Kong.

PATIENTS

Neonates with gestation above 32 weeks with neonatal jaundice who were admitted between April 2001 and February 2002.

MAIN OUTCOME MEASURES

Transcutaneous measurements of serum bilirubin obtained from the forehead and the sternum with two instruments: BiliCheck and Minolta Airshields JM 102.

RESULTS

A total of 77 term and six near-term babies (gestation, 32-37 weeks) were recruited. The mean age at the time of data collection was 3.96 days (range, 2-9 days). The correlations between serum bilirubin and transcutaneous bilirubin measurements of the two devices at the two sites were high, with a coefficient of 0.718 (95% confidence interval, 0.610-0.800; n=100) for forehead measurements, and 0.814 (95% confidence interval, 0.740-0.870; n=99) for sternum using the Minolta Airshields JM 102; and a coefficient of 0.757 (95% confidence interval, 0.657-0.827; n=98) for forehead measurements, and 0.794 (95% confidence interval, 0.700-0.862; n=92) for sternum using the BiliCheck. For BiliCheck, a cut-off point of 250 micromol/L at the forehead and 260 micromol/L at the sternum had a specificity of 61.9% and 70.0%, respectively with a sensitivity of 100% for the detection of serum bilirubin concentrations of 250 micromol/L or higher. This level is commonly used as the level for initiation of treatment such as phototherapy.

CONCLUSION

BiliCheck is a useful screening tool for neonatal jaundice in the Chinese population and is comparable with the Minolta Airshields JM 102.

SARS: caring for patients in Hong Kong

AIM AND OBJECTIVE

To explore in depth the experiences of nurses' caring for SARS patients in Hong Kong.

BACKGROUND

Severe Acute Respiratory Syndrome (SARS) dramatically demonstrates the global havoc that can be wreaked by a newly emerging infectious disease. The current literature either has a predominantly biomedical focus or deals with the psychological impact on healthcare workers. Published studies on the lived experience of nurses caring for SARS patients are currently lacking.

DESIGN

A phenomenological design.

METHODS

Using methods consistent with Husserl's philosophy, eight Registered Nurses working in three regional hospitals in Hong Kong were invited to participate in sharing their lived experience of caring for SARS patients and data were analysed using Colaizzi's approach.

RESULTS

The three major themes explicated were: the various emotions experienced in caring for SARS patients, the concept of uncertainty and revisiting the 'taken for granted' features of nursing.

CONCLUSION

These themes, when taken together, describe the essence of the voyage undertaken by nurses who cared for SARS patients during the outbreak. The findings of this study indicate that extensive and ongoing support is needed to prepare and enable nurses to care for SARS patients during a crisis and make it easier for nurses to deal with the various uncertainties.

RELEVANCE TO CLINICAL PRACTICE

The essence of caring for SARS patients is highlighted in this study. The experience of caring for SARS patients prompts nurses to find meaning in their experience(s), and to develop knowledge and attitudes on how best to care for patients and prepare for a new crisis in the future. This paper considers a more in-depth understanding of the lived experience of nurses during the crisis and the relevance of this perspective for education and support of nurses.

The psychometric properties of Chinese pain intensity verbal rating scale

BACKGROUND

This study investigates the validity and reliability of the Chinese pain intensity verbal rating scale (C-PIVRS).

METHODS

This is a correlational comparative study. Fifty Chinese adults were recruited by convenience. A pain source generator (precision pain source, PPS-3) was used to produce four levels of mechanical pain stimuli (350, 550, 750 and 950 g). The pain stimuli were applied to subjects' interphalangeal joints in random sequences to stimulate sensation of pain. The subjects then rated their pain intensity using both the C-PIVRS and the visual analog scale (VAS) for each stimulus. The pain scores obtained from the C-PIVRS were compared with the VAS for satisfactory level of reliability and validity. Test and re-test were applied to verify consistency between the two pain scales.

RESULTS

The test/re-test correlation coefficients between the two pain scales were r = 0.92 (P < 0.001) and r = 0.91 (P < 0.001), respectively. This showed a good positive correlation. The intra-class correlation (ICC) ranged from 0.78 to 0.90, which indicated good reliability. In the factor analysis, a single factor emerged in each analysis. The first eigen values of each matrix were 3.42, 3.24, 3.17 and 3.29 for each level of pain stimulation. This indicated that both pain scales were assessing the same pain dimension.

CONCLUSIONS

The two pain scales have a comparable level of reliability and validity for assessing pain intensity in Chinese adults.