Comparing mask fit and usability of traditional and nanofibre N95 filtering facepiece respirators before and after nursing procedures.

BACKGROUND: The reliability of N95 filtering facepiece respirators (FFRs) depends on correct fitting. The perceived usability of FFRs is equally important because discomfort during usage may affect compliance. Body movements during nursing procedures may also increase the risk of face seal leakage. AIM: To evaluate the mask fit and usability of the best-fitting 3M N95 FFR and the nanofibre N95 FFR before and after nursing procedures. The physical properties of these FFRs were also examined. METHODS: This experimental study had a one-group multiple comparison design. In total, 104 nursing students participated, and performed nursing procedures for 10 min when wearing the best-fitting 3M FFR and the nanofibre FFR. Mask fit and perceived usability of the FFRs were evaluated. FINDINGS: More participants failed to obtain a fit factor ≥100 when using the best-fitting 3M FFR than when wearing the nanofibre FFR (33.7% vs 21.2%) after the procedures (P=0.417). The nanofibre FFR also demonstrated higher usability than the 3M FFRs in terms of facial heat, breathability, facial pressure, speech intelligibility, itchiness, difficulty of maintaining the mask in place, and comfort level (P<0.001). The nanofibre FFR was also lighter, thinner and had slightly higher bacterial filtration efficiency than the 3M FFRs. CONCLUSION: The nanofibre FFR demonstrated significantly better usability than the 3M FFRs. None of the respirators were able to provide consistent protection for the wearer, as detected by face seal leakage after performing nursing procedures. Further improvement in the prototype design is needed to increase compliance and ensure the respiratory protection of users.

Knowledge, attitudes and commitment toward organ donation among nursing students in Hong Kong.

BACKGROUND: Organ donation is the major component for transplant programs; however, the rate of organ donation is relatively low in Asia. Therefore, understanding the attitude and knowledge of individuals that affect their willingness to commit as an organ donor is crucial to develop effective educational programs that raise public awareness and commitment toward organ donation. The current study aims to identify the knowledge level, attitude, and commitment toward organ donation among nursing students in a local university. METHODS: A questionnaire was developed and distributed to all full-time nursing students of undergraduate and master programs in a university at Hong Kong. RESULTS: A total of 362 students completed the questionnaire, including 87 males and 257 females. The mean age of the students was 22.6 years. A total of 147 students (40.6%) had registered for organ donation. Students on average could correctly answer 23.7 out of 33 questions (71.8%) regarding their knowledge on organ donation and transplantation. With regard to attitude toward organ donation, students obtained a mean score of 70.2. Univariate analysis revealed that year of study, religion, and attitude were significantly associated with commitment toward organ donation. In logistic regression analysis, year of study (odds ratio [OR] for year 2, 1.961, 95% confidence interval [CI], 1.006-3.824; OR for year 3, 6.915, 95% CI, 2.835-16.868; and OR for year 4, 4.845, 95% CI, 2.071-11.334) and attitude (OR, 1.087, 95% CI, 1.049-1.126) were significantly associated with commitment toward donation after adjusting the age, gender, and study program. CONCLUSION: Attitude and year of study were strongly correlated with commitment toward organ donation; therefore, educational or promotional materials should be provided to improve the attitude of students toward organ donation.

Auricular acupuncture for insomnia: a systematic review.

OBJECTIVE: Auricular acupuncture (AA) is a therapeutic method by which specific points on the auricle are stimulated to treat various conditions. AA is often recommended as treatment for insomnia. The aim of this systematic review was to evaluate data from randomised, placebo-controlled clinical trials testing the effectiveness of AA for treating insomnia. METHODS: We searched the literature using 18 databases from their inception to April 2008 without language restrictions. All prospective randomised clinical trials (RCTs) of AA for subjects with insomnia were considered. Methodological quality was assessed using the Jadad score. RESULTS: We identified 433 possible relevant articles, in which include 10 acceptable RCTs. The methodological quality of the trials was generally poor. Magnetic pellets AA was compared with placebo AA in three of the studies. The results suggested beneficial effects on sleep efficiency compared with placebo AA. One RCT tested needle AA compared with placebo AA and failed to show the effectiveness of AA. Four RCTs compared Semen Vaccariae or magnetic pellet AA with conventional drugs (estazolam or diazepam). Favourable effects for AA were found. Two RCTs tested thumbtack needle AA vs. no treatment suggested beneficial effects of AA on a sleep score. CONCLUSION: We conclude that, because of the paucity and of the poor quality of the data, the evidence for the effectiveness of AA for the symptomatic treatment of insomnia is limited. Further, rigorously designed trials are warranted to confirm these results.

The long-term effects of auricular therapy using magnetic pearls on elderly with insomnia.

OBJECTIVE: To examine the long-term effect of auricular therapy using magnetic pearls administered for the elderly suffering from insomnia. DESIGN: A follow-up study after a randomized controlled trial. SETTINGS: Four hostels for the elderly in Hong Kong. INTERVENTIONS: This paper focuses on reporting the long-term effect of auricular therapy using magnetic pearls in the experimental group of a randomized controlled study. Fifteen volunteer participants were followed up at 1-, 3-, and 6-month intervals after a 3-week treatment course. OUTCOME MEASURES: Objective sleep parameters using actigraphic monitoring were collected at different intervals of time after the therapy. RESULTS: Results of RANOVA demonstrate that there was a significant difference of nocturnal sleep time (F(2.30,29.90)=3.63, P<0.05) and marginally differences of sleep efficiency (F(4,52)=2.52, P=0.05) at baseline, immediately after the therapy, and at the three time intervals at 1, 3 and 6 months. The results illustrate that the mean nocturnal sleep time (F=4.95, P=0.30, R(2)=0.91) and the mean sleep efficiency (F=13.50, P=0.19, R(2)=0.96) also remained constant over the 6-month follow up period. The results of least square polynomial regression analysis also illustrate that the mean NST (F=4.95, P=0.30, R(2)=0.91) and the mean sleep efficiency (F=13.50, P=0.19, R(2)=0.96) remained constant over the 6-month follow up period. CONCLUSION: The results of this follow up study indicate that auricular therapy using magnetic pearls could have a long-term effect, at least within the observed period of time, on improving the quality as well as the quantity of sleep among the elderly.

Students' perceptions of the effectiveness of mentors in an undergraduate nursing programme in Hong Kong.

AIM OF THE PAPER: This paper reports the results of a multiple-phase study on a mentoring scheme for nursing students in one of the universities in Hong Kong. Using a qualitative approach, students' perceptions of the various roles of mentors were collected, and this information was used as the basis to design a tool for subsequent evaluation of the mentoring scheme. BACKGROUND: The nursing department in one of the universities in Hong Kong initiated and developed the idea of an 'Honorary Clinical Instructors' scheme (HCI scheme) for the supervision of the pre-registration nurses. The scheme was examined in a local context, where the Chinese culture dominated, so that a standardized protocol that takes into account the potential cultural dimensions could be established. DESIGN: The mentoring roles outlined by the English National Board (ENB) for Nursing, Midwifery, Health Visiting were used as a framework to identify undergraduate nursing students' perception of the effectiveness of mentors. Information gathered from interviews with Year 2 students (n=12) and Year 3 students (n=10) was used as the basis to design a questionnaire for subsequent programme evaluation. An evaluation questionnaire based on the interviewing results was developed for further evaluation of the mentoring scheme. FINDINGS: After the mentoring scheme was evaluated in semester one, a series of strategies were designed to improve the preparation of mentors and the implementation of the scheme. The strategies were identified as effective by the significant differences in the perceptions students had towards the mentoring scheme in semester one and semester two (t189=-4.80, P < 0.001), with semester two (n=81) having a mean score difference of 8.69 higher than in semester one (n=110). CONCLUSIONS: It was concluded that the questionnaire developed in the project could be adopted as a useful instrument to evaluate the effectiveness of mentoring programmes for nursing courses, and that the results of this study may also stimulate more research interest in this area to improve the quality of clinical teaching in the pre-registration nursing education programmes in the future.

Clinical staff as mentors in pre-registration undergraduate nursing education: students' perceptions of the mentors' roles and responsibilities.

This paper reports part of a multiple-phase action research initiated by a university nursing department in Hong Kong. Local hospitals were invited to collaborate in a joint mentoring programme which recruited clinical staff to mentor pre-registration nursing students during clinical placement. Interviews based on the five roles -assisting, befriending, guiding, advising and counselling, as outlined by the English National Board, were conducted to explore students' views of the mentor's roles. Findings showed that students in general agreed that the five roles depicted were necessary roles of the mentors. They saw the roles of assisting and guiding as most crucial, while the befriending role was useful to facilitate their settling into the ward. The advising and counselling roles were seen as less important. It was concluded that students tended to be more instrumental in viewing their mentor's behaviours; activities that have a direct effect on their learning are considered as more important, while other factors which have a less immediate or less direct effect on their learning, are seen as of lower priority.

Is there a place for auricular therapy in the realm of nursing?

Several theories, such as the 'homuncular reflex theory' 'delta reflex theory', and 'meridian theory' point to the fact that the ear is related to all parts of the human body and internal organs. Being one of the approaches in traditional Chinese medicine, auricular therapy is a therapeutic method by which specific points on the auricle are punctured or pressed. Auricular therapy can activate meridians and collaterals, regulate the Qi and blood, help to achieve the balance between Yin and Yang status of internal organs, and is therefore suitable for treating many disorders of the body. Successful examples of previous studies using this therapy including insomnia, weight reduction, hypertension, treatment of addiction, and pain reduction. However, inconsistency in the treatment protocol among studies, or the use of combined therapies, makes it impossible to draw a strong causal relationship between this therapy and the treatment effect. More appropriate clinical trials are therefore necessary to understand in depth the therapeutic effect of auricular therapy. Ideally, these trials can take place in the context of nursing practice so as to explore the application of this therapy in the realm of nursing, and to enable nurses to make a more effective contribution to primary health care.

Occupation and risk of hip fracture.

BACKGROUND: Physical activity in old age probably protects against hip fracture. However, very little is known about the impact of occupation during working life, in terms of its physical activity level and the socio-economic status (SES) it indicates, on the risk of hip fracture in later life. METHOD: A population-based case-control study was conducted on 416 subjects to investigate relationships between risk of hip fracture and occupational physical activity and occupation-related SES. Occupational physical activity was coded according to the proportion of the working day at ages 20 and 50 years that the subjects were likely to have spent sitting. The Australian Classification of Standard Occupations (ASCO) was used as the basis for the coding of SES, indicated by job titles. RESULTS: Compared with those in the intermediate category, women with a sedentary job at age 50 years (odds ratio (OR) 7.2, 95 per cent confidence interval (CI) 1.2-41.9) or a mainly weight-bearing job (OR 5.1, 95 per cent CI 1.1-23.2) had an increased risk of hip fracture. A decreasing hip fracture risk with increasing SES of the longest held job was also observed. CONCLUSION: The finding of a J-shaped relationship in women between occupational physical activity and risk of hip fracture supports the need for research into the most effective types of exercise for maintenance of bone strength. Furthermore, the protective effect of SES demonstrated in this study still need to be corroborated in other studies before establishing evidence of a causal relationship.