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Although there is a growing volume of research on violence against women, violence against older women has received little attention to date. Little is known about the experience of elder abuse, discrimination, loneliness, and health among older women, in particular in the era of COVID-19 when our lives have been changed drastically. Using two waves of survey data ( N = 1,498), this study compared the estimates of elder abuse and age discrimination before and during the COVID-19 pandemic, examined their associations with physical and mental health, and explored the mediating effects of loneliness on the associations in two independent samples of older women in Hong Kong. Reductions in some forms of abuse and discrimination against older women during the pandemic were observed. Findings from regression analyses show that elder abuse and age discrimination were associated with poorer health, and these associations were mediated by loneliness.

Background The establishment of mental health facilities in the community has been hindered by opposition from local residents in Hong Kong. Through a comparative review, this study aimed to compare the issues related to the process of establishment of community-based mental health facilities between Hong Kong and selected overseas countries and regions. It will better inform the strategies and best practices that can be adopted for the establishment of mental health facilities in Hong Kong. Methods Three electronic databases (PubMed, Scopus, and PsycINFO) were used to examine literature on nine jurisdictions in Asia and western societies from 2005 to 2019. In addition, we conducted a number of in-depth interviews with overseas experts to gain in-depth insights and clarify information that was unavailable or unclear. A total of 19,248 articles were identified through the initial search. 71 of them met the inclusion criteria. In addition, 20 articles about the establishment of other types of community facilities or sensitive facilities were identified from supplementary sources. Results Most Western countries and Singapore have adopted regulations or laws to reduce public discrimination against particular groups, giving them corresponding human rights and legislating to demarcate the use of land in the community. Regions close to Hong Kong emphasize communication with community leaders to obtain support for sensitive services or facilities. Conclusions Hong Kong may consider strengthening the land zoning ordinance in relation to community sensitive facilities, as well as increasing communication with the community and considering the possibility of locating facilities in government buildings.

Background: Cultural competence training plays an effective role in improving cultural competence for healthcare professionals, but cultural competence training was found to be insufficient in Hong Kong. Aim: This study aims to explore receptivity and readiness of Hong Kong healthcare professionals (nurses, occupational therapists (OTs), and physiotherapists (PTs)) towards cultural competence training. Methods: Twenty-three semi-structured interviews were conducted with 7 educators/trainers from tertiary institutions, 2 representatives of professional groups, and 14 managerial and frontline workers. Data were analysed using theoretical thematic analysis. Findings: Results show that nurses and PTs have lower levels of cultural competence than OTs owing to insufficient in-depth training and the nature of professional practice, and they expressed lower willingness to receive the training than OTs. However, the staff in these three professions encounter various challenges in serving ethnoculturally diverse groups. Therefore, barriers in receiving cultural competence training and best practice for providing cultural competence training were identified and discussed for these three professions.

This study focuses on older participants' experiences of and views on a lifelong learning program at the Hong Kong Polytechnic University in Hong Kong. As many third age adults tend not to have the opportunity to receive tertiary education when they were young, this program aims to fulfil their dream of studying at a university and boost their self-esteem and self-confidence. Using qualitative research methods, this research was conducted after the MiniU program (supported by the Institute of Active Aging of the Hong Kong Polytechnic University). Semi-structured interviews were conducted with 32 participants after the program. While participants had acquired knowledge and experience of university life from the Mini-U program, they also reported concerns and difficulties with participation including difficulties in memorizing course content and financial difficulties. The program has offered a unique opportunity for enhancing participants' interpersonal relationships and wellbeing. The research also further informs the development of creative lifelong learning programs aimed at improving the well-being of older people.

This research explores the possibility of providing a general guideline for the use of LEGO® SERIOUS PLAY® (LSP) in youth work and examining the experiences of the frontline youth workers in Hong Kong who have adopted LSP to engage youngsters, who have been experiencing enormous socioeconomic challenges in different aspects. A 12-session workshop applied into social training for special educational needs (SEN) secondary students was held with the major objective of enhancing their communication skills. All sessions were divided into three parts: introduction, utilization, and expression. Most participants' abilities in oral description and word usage improved upon completion of the workshop, and they have more motivation and initiation in communicating with others in the group. LSP could thus be proven as a useful method in the SEN workshop in terms of establishing rapport and relationships, expressing the participants' thoughts, as it has provided an alternative for trainers to support the kids concern. Apart from LSP, this research has also found that other approaches such as snorkeling, adventured-based counseling, and cognitive behavioural therapy (CBT) could also be effective approaches adopted by practitioners to support young people.

This qualitative evaluation study examined the impact of unstructured intervention on people with depression in a community mental health centre in Hong Kong. In the intervention, service users initiated groups and designed group activities by themselves, with social workers as facilitators. Semi-structured interviews were conducted with service users enrolled in unstructured intervention, their family members, and service providers in 2019. Overall, 32 participants were recruited through purposive sampling. The results revealed that peer interactions helped participants to feel accepted and understood. Participants also acquired experience with emotional coping strategies and practised their interpersonal skills, and by learning new skills from peers, they were able to rebuild their self-esteem and improve their relationships with friends and family. To cater to clients' different needs and concerns, unstructured activities should be diversified. Family and social functioning should also be emphasised in the development of unstructured intervention because the generic skills and knowledge acquired from unstructured activities with peers could help to enhance family relationships, self-confidence, and the ability to manage issues related to working and socialising.

The establishment of mental health facilities in the community has been hindered by opposition from local residents in Hong Kong. Through a comparative review, this study aimed to compare the issues related to the process of establishment of community-based mental health facilities between Hong Kong and selected overseas countries and regions. It will better inform the strategies and best practices that can be adopted for the establishment of mental health facilities in Hong Kong.Three electronic databases (PubMed, Scopus, and PsycINFO) were used to examine literature on nine jurisdictions in Asia and western societies from 2005 to 2019. In addition, we conducted a number of in-depth interviews with overseas experts to gain in-depth insights and clarify information that was unavailable or unclear. A total of 19,248 articles were identified through the initial search. 71 of them met the inclusion criteria. In addition, 20 articles about the establishment of other types of community facilities or sensitive facilities were identified from supplementary sources.Most Western countries and Singapore have adopted regulations or laws to reduce public discrimination against particular groups, giving them corresponding human rights and legislating to demarcate the use of land in the community. Regions close to Hong Kong emphasize communication with community leaders to obtain support for sensitive services or facilities.Hong Kong may consider strengthening the land zoning ordinance in relation to community sensitive facilities, as well as increasing communication with the community and considering the possibility of locating facilities in government buildings.

This study examines the effect of community service arrangements on secondary school students in Hong Kong under the Other Learning Experiences (OLE) component of the New Senior Secondary (NSS) Cur...

This paper examines how family atmosphere, parental self-efficacy, parenting methods and children’s patterns of mobile device use result in negative outcomes for children’s use of mobile devices. The hierarchical multiple regression analysis found that a stressful and conflictive family atmosphere and higher dependence on mobile devices promote negative outcomes. The self-efficacy of parents in helping their children to avoid the negative outcomes was also found to be positive associated the actual negative outcomes that their children had experienced in using mobile devices. Data were collected from a sample of 1561 students from 39 secondary schools in Hong Kong, including students studying at the Form one to Form five levels (equivalent to the seventh to eighth grade) and 1233 of their parents. Hierarchical linear regression analysis was applied to examine the magnitude of the associations between these variables. The paper highlights the importance of avoiding a tense atmosphere and conflicts between parents and children. For service providers, this paper provides a comprehensive reference to understand how parents and children think about family dynamics and relationships under the impact of technological development on individual families. Also, parents would be more advantageous if they were more efficacious about themselves in helping children to avoid the negative outcomes. This study can help service providers determine which intervention approaches can effectively support families in managing parent–child conflicts, developing cohesiveness, and facilitating children’s proper use of new technologies.

This research examined understandings of cultural competence of social workers in Hong Kong, their needs and challenges in serving culturally diverse groups, and their willingness and receptivity to receive cultural competence training by using constructivist grounded theory. Individual qualitative interviews were conducted with thirteen frontline and managerial practitioners and educators in training institutions in the social work profession. Data were analysed by identifying major themes. The findings show that social workers in Hong Kong tend to encounter language barriers and various forms of cultural shocks in serving ethnoculturally diverse clients. The professional code of practice is not sufficient in promoting culturally competent practice and there are institutional barriers to the enhancement of cultural competence of the social services. Mainstream social work units are generally not well prepared to provide services to non-Chinese communities. In response to these obstacles, professional training should provide future Hong Kong social workers with opportunities to interact with ethnoculturally diverse communities through service-learning. To tackle institutional racism, leaders should have cultural awareness and promote culturally inclusive practices. Inclusion of staff members from diverse cultural backgrounds would increase the capacity of the organisations to better serve clients of diverse needs. Anti-racism training should be made as an essential professional development component for social work students, practicum students, practitioners and managers.

Background The social unrest in the second half of 2019 in Hong Kong came with conflicts, confrontations, and violence which affected almost everyone in the city. The destruction and disruption of the urban facilities have undoubtedly had a significant impact on the lives and mental well-being of the public, and the older people are even more vulnerable. This study examined the impacts of the social unrest on the wellbeing of older people, an area that was seldomly addressed in the public discourse and literature. Methods Narrative interviews were conducted to capture older people’s lived experiences and ways of making sense of the unrest in Hong Kong. A total of 63 participants aged 60 and above was recruited through personal networks of the research team, and referrals by participants who took part in the interviews. Qualitative semi-structure interviews was conducted one on one via telephone. Results Thirty-three male and 30 female participants took part in the interview. The number of participants from different risk zones affected by political unrest was comparable. Three themes were generated. Participants experienced challenges during the social unrest, including disturbance to family and social life, reduced incomes which affect quality of life, and difficulties in socializing with friends and accessing medical services. The social unrest caused emotional disturbance, giving rise to feelings of panic, fear, insomnia, depression, annoyance, and anger. Participants reported different coping strategies, ranging from moving to other places, to avoiding going to risky areas and watching news. Conclusion Social unrest brings emotional distress to older people. In many cases, older people cope with challenges in different ways, whether active or passive. Social workers and other professionals should give more support to older people to encourage them to overcome their difficulties. The stakeholders’ awareness of the problem and mental health promotion is required to alleviate the multiple layers of negative impacts.

A heightened interest in online gaming has emerged during COVID-19, and people have become increasingly vulnerable to internet gaming disorder (IGD). However, playing video games can also have a positive effect; gaming has been recognized as an efficient coping strategy. Currently, relatively little is understood about how online gaming can turn from an efficient coping strategy into an addiction disorder. This study investigated the mediating roles of social cynicism, escape and coping motives on the association between daily disruption during COVID-19 and IGD, seeking to reveal the underlying mechanism that influences the effects of gaming. A total of 203 participants in Hong Kong who reported having played electronic games during COVID-19 were surveyed. We conducted three hierarchical multiple regressions, then tested a serial mediation model using path analysis with structural equation modeling. The results revealed that escape motives significantly mediated the relationship between daily disruption related to COVID-19 and IGD, but no such effect was found for coping motives. Social cynicism alone was not a significant mediator, but social cynicism and escape motives in series mediated the relationship between daily disruption and IGD. These difference outcomes suggested different underlying mechanisms of escape and coping motives.

Background Integrated Community Centres for Mental Wellness (ICCMWs) provide district-based community support services for patients discharged from mental health facilities and other residents in Hong Kong. However, selecting locations for these community centres is challenging primarily because of community opposition, which has introduced barriers to responses to service users’ interests and the operations of individual centres. This study examines public preferences for conflict resolution options, evaluates the feasibility of different consultation approaches, identifies effective methods for reducing public opposition and recommends possible approaches to public consultation and location selection. Methods A total of 74 individual interviews were conducted with key informants, including government personnel, service operators, politicians, resident representatives, community activists and service users. These interviewees were asked about their knowledge, experiences and perspectives of centre location selection processes. Results Interviews revealed that neighbourhood consultations for establishing community centres for mental wellness are time-consuming and did not yield a consensus of support from residents. In some instances, the government may decide to delay or withdraw location selection plans because of strong public opposition mainly because of bias and misunderstanding towards service users. However, the role of local politicians in mediating neighbourhood opinions and the government’s determination in planning location selection are essential for successfully selecting ICCMW locations. Conclusion Government departments should develop stronger collaboration to study target neighbourhoods and lobby stakeholders at earlier stages. Such investigations should involve identifying key stakeholders, the political and social dynamics of controversies and community demographics. A protocol specifying a time frame should be implemented to facilitate smooth and effective public consultation and community mental health service location selection processes.

ObjectivesTo examine the physical, psychological and pandemic fatigue during the COVID-19 pandemic, and to explore the correlates of fatigue using a representative, population-based, community sample of Chinese adults in Hong Kong.DesignCross-sectional study.SettingTelephone surveys in Hong Kong from December 2020 to January 2021 (during the fourth wave of COVID-19 outbreak).Participants1255 adults living in Hong Kong aged 18 years or older sampled using a multistage approach (53% women).Main outcome measuresPhysical and psychological fatigue: The Fatigue Assessment Scale (with a cut-off score of 22). Pandemic fatigue: Adherence to six disease prevention measures (DPM) recommended by the government.ResultsAbout 25.7% of the participants were feeling fatigued physically and psychologically. Physical and psychological fatigue was not directly associated with pandemic fatigue, and their association was fully mediated by self-perceived disruptions of COVID-19-related restrictions in daily life. Results from the hierarchical regression analysis showed that higher levels of fatigue were associated with economically inactive status (B=0.18, SE=0.04, pConclusionsFatigue affected many individuals during the pandemic. Disruptions of DPM in daily life may serve as a mediator in the association between pandemic fatigue and physical and psychological fatigue, reflecting the need of effective interventions to reduce self-perceived disruptions of COVID-19-related restrictions in the general population. Resources should be allocated to provide sufficient services to individuals vulnerable to fatigue during the prolonged pandemic.

People with opioid use disorders are overrepresented in correctional facilities, and are at high risk of opioid overdose. Despite the fact that buprenorphine/naloxone is the first line treatment for people with opioid use disorder, there are often institutional, clinical, and logistical barriers to buprenorphine/naloxone initiation in correctional facilities. Guided by the knowledge-to-action framework, this knowledge translation project focused on synthesizing knowledge and developing a tool for buprenorphine/naloxone initiation that was tailored to correctional facilities, including jails. This information and tool can be used to support buprenorphine/naloxone access for people in correctional facilities, in parallel with other efforts to address barriers to treatment initiation in correctional facilities.

Vaccination is one of the most effective ways to stop the spread of COVID-19. Understanding factors associated with intention to receive COVID-19 vaccines is the key to a successful vaccination programme. This cross-sectional study explored the rate of vaccination intention and identified its predictors using the health belief model (HBM) in the general population in Hong Kong during the pandemic. Data were collected between December 2020 and January 2021 via telephone surveys. Hierarchical logistic regression analysis was used to identify factors associated with intention to receive COVID-19 vaccines. A total of 1255 adults (>18 years, 53% female) completed the telephone survey. Overall, 42% indicated an intention to vaccinate, 31.5% showed vaccine hesitancy, and 26.5% reported refusal to receive any COVID-19 vaccines. Individuals who were men, older in age, working, with past experiences of other pandemics, less concerned with the vaccine safety, with poorer knowledge about COVID-19, and having greater levels of perceived susceptibility, self-efficacy, cues to action, and acceptance of governmental preventive measures related to COVID-19 were significantly more likely to report an intention to vaccinate. The low intention among the Hong Kong population reflects the importance of developing effective vaccination promotion campaigns with the predictors identified in this study.

Objectives: To effectively control the spread of COVID-19, the public’s adherence to relevant disease preventive measures (DPM) is critical. This study examined individuals’ adherence to various DPM and identified facilitators and barriers to adherence in a community sample in Hong Kong. Methods: In this cross-sectional study, telephone surveys were conducted over December 2020 and January 2021. Participants provided responses on their adherence to DPM as well as other psychosocial and cognitive factors via the phone. Results: Of the sample of 1255 Chinese adults (aged >18 years, 53% women), 94.4% wore face masks in public areas; 88.4% avoided touching their eyes, nose, and mouth; 82.1% performed hand hygiene practices; 81.5% used alcohol-based hand rubs; 74.6% abided by social distancing; and 39.7% tested for COVID-19 on a voluntary basis. Perceived benefits, perceived barriers, self-efficacy, cues to action, perceived acceptability, and disruptions to daily life related to COVID-19 were associated with individuals’ adherence to DPM. Conclusions: Adherence to DPM was strong in Hong Kong, and the adherence level could be predicted by various factors. It is vital to consider these factors in order to improve the public’s adherence.

Grandparenting and intergenerational relationship play important roles in some older adults‘ later life, especially older people of Chinese culture. This study investigated the relationship between grandparenting activities, intergenerational relationship, and psychosocial well-being of Hong Kong Chinese older adults. A representative sample of 507 grandparents (aged 55+) were telephone surveyed in June to July 2019. Level of involvement in grandparenting activities was measured. Resilience and happiness were measured by Connor-Davidson Resilience Scale and Subjective Happiness Scale. Two single-item instruments were adapted to capture the relationships between older adults and adult children, and between grandparents and grandchildren, respectively. A series of linear regressions and mediation tests with bootstrap approach were performed to examine the relationships between grandparenting activities, intergenerational relationship, and resilience and happiness. After controlling for socio-demographics, the frequency of grandparenting activities correlated positively with resilience and happiness. The relationship was partially mediated by inter-generational relationships including the relationships with adult children and grandchildren. The findings have concluded that grandparenting involvement and satisfactory intergenerational relationship are protective factors of health and wellbeing. Future healthy aging policy-making or programming should expand the scope from focusing on individual older adults to strategies of achieving the family-friendly goal so that intergenerational relationships could be better nurtured, benefiting not just the family as a functional unit but also the older adults’ healthy aging.

This article examines the issue of parental self-efficacy in guiding and supervising children to use mobile devices in Hong Kong. Data were collected from a sample of 1,561 students and 1,233 of their parents. Multiple hierarchical regression analyses showed that the frequency with which parents adopted involvement as a parenting method and the frequency of minor parent–child conflicts triggered by parental supervision were significantly associated with parental self-efficacy in supervising children to use mobile devices. Findings suggest that support for parents to adopt involvement methods more frequently and better manage parent–child conflicts are crucial in enhancing their self-efficacy.

As Hong Kong is undergoing rapid population ageing over the past few decades, and this trend is expected to persist due to low fertility rates and extended life expectancy. This trend has significant implications for Hong Kong’s labor market and workforce. This study aims to gain a better understanding of the experiences, needs, and definitions of older workers in Hong Kong. It helps to draw attention to issues of occupational safety and health (OSH) risks and help identifying and promoting strategies and interventions for effectively supporting the ageing workforce in the workplace. The major objective of this research is to identify the OSH problems and challenges perceived by the older workers, employers and other stakeholders. Both quantitative and qualitative research methods are applied. A qualitative study with focus groups and individual in-depth interviews have been conducted with a representative sample of 70 stakeholders, including employees, employers, representative of labour unions, policymakers, NGO representatives and researchers in the related disciplines. We obtained their views on age-related changes within the older workforce and how such changes would affect their work ability, the OSH issues facing the older workers in different industries, and the facilitators and barriers associated with remaining in or joining the labour force. Feasible intervention strategies for effectively supporting the ageing workforce in the workplace are also being identified.

Happiness is essential to one’s well-being and impact on every aspect of our lives. Happier people are living longer, they are healthier. Happier people are more likely to be physically active and enjoy better sleep habits and practices. While few existing research studies had examined the determinants of happiness of older people, especially in Chinese society. Understanding happiness in the context of social unrest and political instability is thus limited. This study tested the correlates of happiness at interpersonal, psychological and environmental levels at a time when there were extended scale of violence, destructions, and clashes in the community between police and protesters in late 2019 during the anti-extradition campaign. In social unrest, older people, due to their function and mobility, could be emotionally and physically vulnerable. A total of 1,209 older persons aged 55 and above from Hong Kong answered the questionnaire by stratified random sampling. Our findings show that their overall resilience was strongly and positively associated with levels of happiness. Due to the recent political instability Hong Kong, their satisfaction toward social and political situation of Hong Kong also correlated positively to levels of happiness. We suggest that future interventions and policy initiatives should put extra emotional and tangible support to older adults, particularly during social unrests and unstable political conditions, in addition to strategies for the enhancement of resilience and mental capital.

Background:Multidisciplinary team (MDT) discussion between rheumatology and radiology is vital in diagnostic and prognostic management of patients’ outcome. Nevertheless, discrepancies of the radiology report and clinical history cause unnecessary confusion and distresses to clinicians and patients. This could potentially affect subsequent clinical management.Objectives:This survey was aimed to evaluate outcomes of rheumatology / radiology MDT discussion and to identify any discrepancies between original reports of the radiology images and amended reports following MDT. We also looked for potential reasons for the discrepancies and their impact on patient and health care resources due to erroneous original reporting.Methods:We looked at all types of images which were discussed in rheumatology/ radiology MDT of University Hospital Plymouth from October 2016 to April 2019. A total of 154 images were randomly selected and their reports were analyzed. The original reports were compared with the addendum made after the MDT and on the rheumatology electronic records. Clinical letters were also looked at to identify changes in follow up and treatment plans after the MDT.Results:The majority of discussed images were X-rays (88). This is followed by 56 MRIs, 8 Ultrasounds and 2 others including CT.After MDT review 38/88 X-rays (43%), 9/56 MRIs (16%) and 1/ 8 USS (13%) reports were amended. 31/38 amended X-ray (82%) and 5/9 amended MRIs (56%) were externally reported originally. In addition, 4 X-rays and 1 MRI reported by Radiology trainees were also amended.Following the MDT outcome, the management plan was changed in 18/38 (47%) amended X-ray reports and 6/ 9 (67%) in amended MRI reports.There were 17 rheumatology referrals by GP that were based on erroneous X-rays reporting and 3 of them were rejected after the MDT. The others were brought to the MDT after the first clinic visit and were discharged subsequently.Conclusion:Joint rheumatology/ radiology MDT discussion makes significant outcome to patient care by minimizing unnecessary investigations and treatment based on erroneous or unclear reporting. Question is raised about efficacy of outsourcing of radiology reporting and need for intensive training for radiology trainees in reporting muscululoskeletal(MSK) images. Since significant numbers of GP referrals were based on erroneous reports, reporting done by MSK radiologists would have reduced unnecessary burden and waste of outpatient rheumatology resources.The images submitted for MDT were selected largely by consultant rheumatologists based on their review of the images and reliance on the original report. Therefore, clinical impact is underestimated in this survey as there were potentially other images not reviewed in MDT that had ended in unnecessary clinical consultation. This survey emphasizes the need and importance of incorporating formal musculoskeletal radiology training into routine rheumatology training program.Disclosure of Interests:None declared

Background/objectives Among older adults, intergenerational support can help to improve well-being. This study examines the correlation between intergenerational relationships and the subjective well-being among older Chinese immigrants in the United States. Design Hierarchical multiple regression analyses were applied to test the association between intergenerational relationships and self-rated well-being. The mediating effects of sense of control and the moderation effects of support from friends were also tested. Sample A cross-sectional sample of 2717 older Chinese immigrants, aged 60 years and older, with children and grandchildren was drawn from the Population Study of Chinese Elderly. Measurements Study measures included four items concerning intergenerational relationships: the Pearlin Mastery Scale, two items on seeking support from friends, and single items measuring self-rated health status and quality of life. Results Only the feeling of closeness with children was positively linked with subjective well-being, while coresidence and frequency of talking were not. Support from friends moderated the association with self-rated health status, while sense of control partially mediated the association between feeling of closeness and both self-rated health status and quality of life. Conclusion A stronger sense of closeness with children correlates to self-rated health status and quality of life among older Chinese immigrants. The effects of sociocultural changes affecting Chinese American families, and potential implications for older adults' health, could be addressed through strategies to develop emotional closeness with their families and to support sense of control and well-being among older Chinese adults. J Am Geriatr Soc 67:S557-S563, 2019.

BACKGROUND/ OBJECTIVES Prior research has shown that social engagement is beneficial to older adults' health and well-being. This study examined the association between environmental factors and social engagement of older Chinese immigrants in the United States. SAMPLE A cross-sectional data set of Chinese immigrants in the greater Chicago, IL, area (Population Study of Chinese Elderly; n = 3159), was used in this study. DESIGN Multiple regression models were used to test the associations between older adults' engagement in cognitive and social activities and environmental factors, including financial difficulties, social support, neighborhood cohesion, neighborhood disorder, and sense of community. MEASUREMENT Eight questions measuring participants' engagement in cognitive and social activities, a single-item question measuring financial difficulties, a 12-item social support measurement, an eight-item neighborhood cohesion measurement, and a six-item neighborhood disorder and sense of community scale. RESULTS Having fewer financial difficulties and a cohesive neighborhood is related to a higher level of engagement in both cognitive and social activities. More social support from family and friends and a sense of community are associated with higher levels of social activities engagement, but not cognitive activity engagement. Neighborhood cohesion has a stronger association with social engagement than other environmental factors and most individual-level factors. Surprisingly, neighborhood disorder is positively related to social activity engagement, which needs further examination. The associations between environmental factors and social engagement showed no significant difference between healthy and unhealthy older adults. CONCLUSION This study highlights the need for policies and programs to promote an active lifestyle among older immigrants by creating facilitative social and physical environments. J Am Geriatr Soc 67:S571-S576, 2019.

The purpose of this study is to optimise the settings of the Retinal Image Analysis Laboratory (RIALAB), a semi-automatic drusen quantification software, in planning for high-throughput quantification of drusen in clinical studies of age-related macular degeneration (AMD).A comparison of five different settings in RIALAB was made on 67 images from the Rotterdam eye study (population-based study) and 56 images from the fellow eye of patients with active neovascular AMD in King's College Hospital, London (hospital-based study).The 'Few Outer' setting was the best setting, with it being most appropriate for 52 (77.6%) of the Rotterdam cohort and 47 (83.9%) for the London cohort. Pearson's χ(2)-test revealed both results to be statistically significant (P0.0001).RIALAB is a viable algorithm and software package that can detect, quantify, and analyse drusen efficiently in both population-based and hospital-based studies. We have shown that the 'Few Outer' drusen setting can be employed as the default setting, with fine-tuning only needed in a minority of cases, thus helping to speed up workflow.

Hepatic steatosis is associated with increased insulin resistance and tricarboxylic acid (TCA) cycle flux, but decreased ketogenesis and pyruvate dehydrogenase complex (PDC) flux. This study examined whether hepatic PDC activation by inhibition of pyruvate dehydrogenase kinase 2 (PDK2) ameliorates these metabolic abnormalities. Wild-type mice fed a high-fat diet exhibited hepatic steatosis, insulin resistance, and increased levels of pyruvate, TCA cycle intermediates, and malonyl-CoA but reduced ketogenesis and PDC activity due to PDK2 induction. Hepatic PDC activation by PDK2 inhibition attenuated hepatic steatosis, improved hepatic insulin sensitivity, reduced hepatic glucose production, increased capacity for β-oxidation and ketogenesis, and decreased the capacity for lipogenesis. These results were attributed to altered enzymatic capacities and a reduction in TCA anaplerosis that limited the availability of oxaloacetate for the TCA cycle, which promoted ketogenesis. The current study reports that increasing hepatic PDC activity by inhibition of PDK2 ameliorates hepatic steatosis and insulin sensitivity by regulating TCA cycle anaplerosis and ketogenesis. The findings suggest PDK2 is a potential therapeutic target for nonalcoholic fatty liver disease.

We recently suggested that alveolar interstitial fibroblast-to-myofibroblast transdifferentiation may be a key mechanism underlying in utero nicotine-induced lung injury. However, the effects of in utero nicotine exposure on fetal alveolar type II (ATII) cells have not been fully determined. Placebo, nicotine (1 mg/kg), or nicotine (1 mg/kg) + the peroxisome proliferator-activated receptor (PPAR)-γ agonist prostaglandin J2 (PGJ2, 0.3 mg/kg) was administered intraperitoneally once daily to time-mated pregnant Sprague-Dawley rats from embryonic day 6 until their death on embryonic day 20. Fetal ATII cells were isolated, and ATII cell proliferation, differentiation (surfactant synthesis), and metabolism (metabolic profiling with the stable isotope [1,2-13C2]-d-glucose) were determined after nicotine exposure in utero or in vitro. In utero nicotine exposure significantly stimulated ATII cell proliferation, differentiation, and metabolism. Although the effects on ATII cell proliferation and metabolism were almost completely prevented by concomitant treatment with PGJ2, the effects on surfactant synthesis were not. On the basis of in utero and in vitro data, we conclude that surfactant synthesis is stimulated by nicotine's direct effect on ATII cells, whereas cell proliferation and metabolism are affected via a paracrine mechanism(s) secondary to its effects on the adepithelial fibroblasts. These data provide evidence for direct and indirect effects of in utero nicotine exposure on fetal ATII cells that could permanently alter the “developmental program” of the developing lung. More importantly, concomitant administration of PPAR-γ agonists can effectively attenuate many of the effects of in utero exposure to nicotine on ATII cells.

Iron impurities in bulk silicon are found to getter efficiently at the polysilicon layer by an electric field during isothermal annealing. Experimental results show that iron concentration at the polysilicon layer increases to the level that becomes detectable by total reflection x-ray fluorescence (TXRF) spectroscopy. The improved gettering efficiency for iron is attributed mainly to the directional drift of ionic iron interstitials toward the polysilicon gettering sites, under the influence of the applied potential gradient, thus presenting a more effective method for reducing the iron content in silicon.

Temperature-dependent direct current (dc) and microwave (mw) conductivity, σdc and σmw, electron paramagnetic resonance (EPR), and mechanical properties of sulfonated polyaniline/poly(p-phenylene terephthalamide) (SPAN/PPD-T) composite fibers are presented. Tenacity and modulus are in the range of 15 and 270 g/denier (gpd), respectively, for 30 wt % (weight percent prior to sulfonation) SPAN composite fiber. Room-temperature dc conductivity σRT varies from 7.8 × 10-5 to 1.5 × 10-1 S/cm, increasing with increasing wt % polyaniline (PAn) and spin stretch factor (SSF). The temperature-dependent conductivity follows the quasi-one-dimensional variable range hopping (Q1D VRH) model: σdc(T) = σ0 exp [−(T0/T)γ], where γ ∼ 0.5 and σ0 is a constant. T0 is 4.3 × 104 to 2.9 × 104 K, respectively, for 10 and 30 wt % PAn. The σmw of the fiber with the same SSF 7.0 but a 30/70 PAn/PPD-T ratio shows a typical temperature dependence for materials for which the hopping conduction mechanism is dominant. There is a larger d...

Highly conducting polymers such as polyaniline and polypyrrole in a dielectrical state have unusually strong temperature of dependence of dynamic conductivity. We argue that this strong temperature dependence is due to the low dimensionality of charge transport in the polymers. The hopping network is formed by fast one-dimensional diffusion along the chains and rare interchain hops. Depending on the chain morphology the network is modeled by a quasi-one-dimensional system of randomly linked chains or by a quasi-one-dimensional chain fractal with dimensionality 1+s, where s≪1. We point out the experimental data for dielectric constant and ac-conductivity that supports these two models.

Phase transitions on the electron-doped side of the Ca{sub 1-x}Bi{sub x}MnO{sub 3} system (x{ =}x{ge}0.03, is characterized by the absence of charge and orbital ordering, a canted G-type antiferromagnetic spin structure, and delocalized electron transport. The second phase, observed from 0.25{>=}x{ge}0.12 (single phase at x=0.18), is characterized by pronounced orbital ordering, a C-type antiferromagnetic spin structure, and insulating behavior. The third low-temperature phase, observed for x{>=}0.20, is characterized by orbital and magnetic ordering similar to the Wigner crystal structure previously observed for Ca{sub 0.67}La{sub 0.33}MnO{sub 3}, but with a 4axbx2c unit cell. The most striking feature of the phase diagram is the wide compositional range over which low-temperature phase separation is observed. Only those samples with x

We report that LiCl dopes the emeraldine base (EB) form of polyaniline and produces polyaniline with unusual properties—polyaniline with doping-induced charge localization. Our assignment of Li+ doping is based upon the observation of electronic states in the bandgap and associated spins for EB processed with LiCl. However, even at the maximum doping level, LiCl-doped polyaniline is a strongly localized charged insulator based on the observation of low DC conductivity, low dielectric constant, rapid decrease of the oscillator strength to zero in the infrared, low magnetic susceptibility dominated by a weak Curie component, broad EPR linewidth and predominantly Gaussian lineshape of the EPR signal. Finally, we attribute these properties to the formation of bipolarons or antiferromagnetically coupled polaron pairs in LiCl-doped EB.

A mathematical model is presented to explain the effect of ultraviolet (UV) irradiation on the minority carrier recombination lifetime (LT) and surface barrier observed in thermally oxidized, RCA cleaned, and contaminated silicon wafers. The proposed model assumes that UV photons (4.9 eV) modify the density of two interface traps and the oxide charge density. It considers the conversion between the two species of traps with energy levels E1 and E2, relative to the intrinsic Fermi level (Ei). These modifications directly affect the surface recombination velocity and hence the effective LT. The changes in the effective lifetime and the surface barrier as a result of UV irradiation as simulated by the model was found to be in good agreement with experimental data.

The minority carrier recombination lifetimes of ultraviolet-irradiated silicon wafers were studied using the laser-microwave photoconductance method. These wafers were intentionally surface contaminated with metals. With ultraviolet irradiation, the effective minority carrier recombination lifetimes of these samples are enhanced. The lifetime enhancement occurs at a faster rate for contaminated wafers. These lifetime enhancements are not permanent; with cessation of the ultraviolet radiation, the preirradiation levels can be restored.

The results of the temperature dependence of dc conductivity, microwave dielectric constant, X-ray diffraction, EPR, and NMR experiments are reported for chemically synthesized polypyrrole films soluble in organic solvents. The temperature dependence of dc conductivity of these systems follows the three-dimensional variable range hopping model. The slope of the temperature dependence of dc conductivity varies with dopants and solvents used. Room temperature dc conductivities are in the range of ∼0.2−0.01 S/cm, and the localization lengths are estimated as ≤10 A, which indicates a relatively strong localization of charge. The results of microwave dielectric constant experiments support the strong localization behavior. The X-ray diffraction studies show that soluble polypyrroles are amorphous. From electron paramagnetic resonance experiments, the density of states of polypyrrole doped with naphthalenesulfonic acid in m-cresol solvent is estimated as ∼0.107 states/(eV ring). We obtain the result that the sy...

Testosterone-induced nitrogen retention in castrated male animals and sex-related differences in the size of the muscles in male and female animals have been cited as evidence that testosterone has anabolic effects. However, the effects of testosterone on body composition and muscle size have not been rigorously studied. The objective of this study was to determine the effects of replacement doses of testosterone on fat-free mass and muscle size in healthy hypogonadal men in the setting of controlled nutritional intake and exercise level. Seven hypogonadal men, 19-47 yr of age, after at least a 12-week washout from previous androgen therapy, were treated for 10 weeks with testosterone enanthate (100 mg/week) by im injections. Body weight, fat-free mass measured by underwater weighing and deuterated water dilution, and muscle size measured by magnetic resonance imaging were assessed before and after treatment. Energy and protein intake were standardized at 35 Cal/kg.day and 1.5 g/kg.day, respectively. Body weight increased significantly from 79.2 +/- 5.6 to 83.7 +/- 5.7 kg after 10 weeks of testosterone replacement therapy (weight gain, 4.5 +/- 0.6 kg; P = 0.0064). Fat-free mass, measured by underwater weighing, increased from 56.0 +/- 2.5 to 60.9 +/- 2.2 kg (change, +5.0 +/- 0.7 kg; P = 0.0004), but percent fat did not significantly change. Similar increases in fat-free mass were observed with the deuterated water method. The cross-sectional area of the triceps arm muscle increased from 2421 +/- 317 to 2721 +/- 239 mm2 (P = 0.045), and that of the quadriceps leg muscle increased from 7173 +/- 464 to 7720 +/- 454 mm2 (P = 0.0427), measured by magnetic resonance imaging. Muscle strength, assessed by one repetition maximum of weight-lifting exercises increased significantly after testosterone treatment. L-[1-13C]Leucine turnover, leucine oxidation, and nonoxidative disappearance of leucine did not significantly change after 10 weeks of treatment. There was no significant change in hemoglobin, hematocrit, creatinine, and transaminase levels. Replacement doses of testosterone increase fat-free mass and muscle size and strength in hypogonadal men. Whether androgen replacement in wasting states characterized by low testosterone levels will have similar anabolic effects remains to be studied.

We have previously established Adriamycin-resistant HOB1 cell lines showing the multidrug resistance (MDR) phenotype. For further study, we analyzed the free-radical scavengers glutathione S-transferase (GST) and glutathione peroxidase (GPX) by enzyme assays and Northern blots. Three cell lines, HOB1/ADR0.1, HOB1/ADR1.0, and HOB1/ADR5.0, represented HOB1 cells resistant to 0.1, 1.0, and 5.0 microM Adriamycin, respectively. The mdr1 transcript was overexpressed in HOB1/ADR0.1 cells, and the amount of its expression reached a maximum between HOB1/ADR1.0 and HOB1/ADR5.0 cell lines. The increases in GST activity and GST-pi expression were observed only in high-level-resistant cell line (HOB1/ADR1.0 and HOB1/ADR5.0), which also showed increased GPX activity and expression. For investigation of the cytotoxic effect of Adriamycin on HOB1 cells prior to the mdr1 overexpression, an appropriate number of parental HOB1 cells were treated with 0.1 microM Adriamycin for 7 days, and the viable cells (HOB1/ADR) were isolated and subjected to analyses for mdr1, GST-pi, and GPX expression and for GST and GPX activity. In comparison with HOB1/ADR0.1 cells, HOB1/ADR cells did not show mdr1 overexpression but had significant increases in the activity and expression of GST and GPX. The current study suggests that in the early phase of Adriamycin treatment, GST and GPX are more important than P-glycoprotein for the development in HOB1 cells of resistance against Adriamycin.

We have shown that unesterified, unsaturated long-chain fatty acids inhibit angiotensin II (AII) binding to receptors in adrenal glomerulosa cells. In this report, we show that oleic and arachidonic acids are specific inhibitors of the AT1 subtype of angiotensin receptor, and exert no effect on receptors of the AT2 subtype. By contrast, decanoic acid is a weak inhibitor of the AT2 subtype only. Our previous work on a post-receptor locus of inhibition by fatty acids of aldosterone biosynthesis showed that the 18-oxidase step is uniquely sensitive. In brief, the first and last steps involved in angiotensin-stimulated aldosterone secretion are particularly sensitive to inhibition by fatty acids. These results suggest a specific role for unesterified fatty acids in regulation of salt and water metabolism.

Mild skin rejection is a common observation in reconstructive transplantation. To enlighten the role of this inflammatory reaction we investigated markers for cellular and antibody mediated rejection, adhesion molecules and tolerance markers. Forty-seven skin biopsies (rejection grade I) of human hand allografts were investigated by immunohistochemistry (CD3, CD4, CD8, CD20, CD68, C4d, LFA-1, ICAM-1, E-selectin, P-selectin, VE-cadherin, HLA-DR, IDO, and Foxp3). Expression was read with respect to time after transplant. The infiltrate was mainly comprised of CD3+T-lymphocytes. Among these, CD8+cells were more prominent than CD4+cells. CD20+B-lymphocytes were sparse and CD68+macrophages were found in some, but not all samples (approximately 10% of the infiltrate). The CD4/CD8-ratio was increased after the first year. C4d staining was mainly positive in samples at time-points later than 1 year. Adhesion molecules LFA-1, ICAM-1, E-selectin, P-selectin, and VE-cadherin were found upregulated, and for P-selectin, expression increased with time after transplant. IDO expression was strongest at 3 months-1 year post-transplant and a tendency toward more Foxp3+ cells at later time points was observed. Mild skin rejection after hand transplantation presents with a T-cell dominated dermal cell infiltrate and upregulation of adhesion molecules. The role of C4d expression after year one remains to be elucidated.

BACKGROUND: Combat wounds have unique features including significant devitalization due to high-energy blast, deep contamination, complex/composite tissue loss, and multiple coexisting injuries. In this regard, Composite Tissue Allotransplantation (CTA) is an innovative reconstructive modality that can provide functional restoration after complex musculoskeletal trauma. CTA is now a clinical reality with numerous upper extremity and face transplants performed worldwide thus providing new hope for service members suffering from catastrophic combat trauma and devastating tissue defects. Broader clinical application of CTA, however, continues to be hampered by requirement for long-term multi-drug immunosuppression to prevent graft rejection. This study for the first time proposes a novel cell-based therapy utilizing Mesenchymal Stem Cells (MSC) that augments nerve regeneration while minimizing the need for immunosuppression. METHODS: Sciatic nerve transections and repairs were performed on Lewis rats in control and experimental groups with local and systemic (intravenous) MSC injection (n=8 per group). Syngeneic (Lewis-Lewis) and Allogeneic (Lewis-Brown Norway) hind limb transplants were performed to analyze neuroregenerative effects of MSC with and without allo-immune response (n=4 per group). RESULTS: Compound Muscle Action Potential (CMAP) amplitudes significantly improved for systemic MSC injection groups relative to controls after sciatic nerve transection and repair. However, no significant differences were observed between groups in functional gait analysis. In addition, histomorphometry and gastrocnemius weight data did not indicate any significant differences among groups. However, the number and density of axons observed between 6 and 16 weeks increased by approximately 35% and 30%, respectively. Syngeneic hind limb transplants that received local or systemic MSC injections showed significant enhancement of functional recovery following MSC therapy.

Neutrino-electron elastic scattering was observed with a 15-ton fine-grained tracking calorimeter exposed to electron neutrinos from muon decay at rest. The measured ${\ensuremath{\nu}}_{e}{e}^{\ensuremath{-}}\ensuremath{\rightarrow}{\ensuremath{\nu}}_{e}{e}^{\ensuremath{-}}$ elastic scattering rate of 236\ifmmode\pm\else\textpm\fi{}35 events yields the total elastic scattering cross section $10.0\ifmmode\pm\else\textpm\fi{}1.5(\mathrm{stat})\ifmmode\pm\else\textpm\fi{}0.9(\mathrm{syst})\ifmmode\times\else\texttimes\fi{}{10}^{\ensuremath{-}45} \mathrm{c}{\mathrm{m}}^{2}\ifmmode\times\else\texttimes\fi{}[{E}_{\ensuremath{\nu}} (\mathrm{MeV})]$, and a model-independent measurement of the strength of the destructive interference between the charged and neutral currents, $I=\ensuremath{-}1.07\ifmmode\pm\else\textpm\fi{}0.21$, that agrees well with the standard model (SM) prediction $I=\ensuremath{-}1.08$. The agreement between the measured electroweak parameters and SM expectations is used to place limits on neutrino properties, such as neutrino flavor-changing neutral currents and neutrino electromagnetic moments. Limits are placed on the masses of new bosons that interact with leptons: for a neutral tensor boson, ${M}_{T}g105$ GeV; for a neutral (pseudo)scalar boson, ${M}_{P,S}g47$ GeV; for a charged Higgs boson, ${M}_{{\ensuremath{\chi}}^{+}}g87$ GeV; and for a purely left-handed charged (neutral) vector boson, ${M}_{x}g239 (119)$ GeV.