BACKGROUND: Current European Association of Urology (EAU) guidelines support adjuvant intravesical Bacillus Calmette-Guérin (BCG) treatment after Transurethral Resection of Bladder Tumor (TURB) for intermediate- or high-risk Non-Muscle-Invasive Bladder Cancer (NMIBC) patients, aiming to reduce the risk of tumor recurrence. The quality of data, however, does not allow definitive conclusions on whether different strains and dosages of BCG have different efficacies on long-term survival outcomes. OBJECTIVE: To evaluate the long-term survival outcomes of different strains and dosages of BCG in patients with NMIBC. DESIGN, SETTING, AND PARTICIPANTS: All NMIBC patients treated with intravesical BCG therapy from 2001 to 2020 were identified using a territory-wide database in Hong Kong. INTERVENTION: BCG strains and dosages (Connaught strain 81 mg, Connaught strain 27 mg, Tokyo strain 80 mg, and Danish strain 30 mg) were retrieved from medical records. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall Survival (OS), Cancer-Specific Survival (CSS), Recurrence-Free Survival (RFS), and Progression-Free Survival (PFS) were analyzed using the Kaplan-Meier method. A multivariable Cox regression analysis was used to adjust potential confounding factors, and to estimate Hazard Ratio (HR) and 95% confidence interval (CI) of different BCG strains. A further subgroup analysis on adequate versus inadequate BCG treatment was performed. RESULTS AND LIMITATIONS: A total of 2602 NMIBC patients treated with intravesical BCG were identified. Among them, 1291 (49.6%) received Connaught strain 81 mg, 199 (7.6%) received Connaught strain 27 mg, 1014 (39.0%) received Tokyo strain, and 98 (3.8%) received Danish strain. The median follow-up was 11.0 years. No statistically significant differences in OS, CSS, RFS, and PFS were detected among the different groups. At the multivariable analysis, the Connaught strain 27 mg group was inferior to the Connaught strain 81 mg group in terms of OS (HR: 1.26, 95% CI: 1.05-1.51), CSS (HR: 1.69, 95% CI: 1.08-2.66), and PFS (HR: 1.86, 95% CI: 1.20-2.88). Adequate BCG treatment was associated with improved OS (HR: 0.82, 95% CI: 0.73-0.92), CSS (HR: 0.64, 95% CI: 0.47-0.86), RFS (HR: 0.80, 95% CI: 0.70-0.92), and PFS (HR: 0.52, 95% CI: 0.39-0.68). Among patients treated with adequate BCG, at the multivariable analysis the Connaught strain 27 mg group showed worse results than the Connaught strain 81 mg group in terms of CSS (HR: 1.93, 95% CI: 1.07-3.51). Compared with the Connaught strain 81 mg group, both Tokyo and Danish strains had similar survival outcomes in the whole cohort and the adequate BCG treatment subgroup. CONCLUSIONS: Our findings suggest that adequate BCG remains the most important factor in optimizing survival outcomes in patients with intermediate- and high-risk NMIBC. No significant differences in survival outcomes were observed between full-dose Connaught, Tokyo, and Danish strains. Reduced-dose Connaught strain was associated with the worst survival outcomes. PATIENT SUMMARY: We evaluated the efficacy of different strains and dosages of bacillus Calmette-Guérin (BCG) in patients with intermediate- or high-risk non-muscle-invasive bladder cancer in the past two decades in Hong Kong. We conclude no significant differences in long-term survival outcomes in terms of full-dose Connaught, Tokyo, and Danish strains, while reduced-dose Connaught strain was inferior to the full-dose group. Adequate BCG treatment benefits long-term survival.
- MeSH
- adjuvancia imunologická terapeutické užití aplikace a dávkování MeSH
- aplikace intravezikální MeSH
- BCG vakcína * terapeutické užití aplikace a dávkování MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory močového měchýře neinvadující svalovinu * mortalita terapie MeSH
- nádory močového měchýře * mortalita terapie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Hongkong MeSH
BACKGROUND: Evidence-based nursing practice (EBNP) has been regarded core competencies in nursing practice and education. Defining evidence-based nursing practice and translating evidence into nursing practice by nursing students who are green to clinical practice in their education journey remain unclear. AIM: To explore how pre-registered nursing students define and characterize evidence-based nursing practice as they participate in their clinical practicum. DESIGN: This study used an interpretive phenomenological qualitative study design. SETTINGS AND PARTICIPANTS: Twenty nursing students were interviewed for their clinical practicum experience from four universities, one nursing college and one hospital-based nursing school in Hong Kong. METHODS: Data was generated through semi-structured in-depth interview and analyzed following interpretative phenomenological analysis guidelines, using a cyclical coding process. RESULTS: Four themes emerged regarding nursing students' definition of EBNP, highlighting that EBNP is 'identifying a reliable learning source', by which they can 'rationalize their nursing practice', and enabling them to 'establish care standard through critical thinking', and eventual 'fostering their professionalism' to improve health outcomes and reduce potential harms. CONCLUSION: Nursing students defined and characterized evidence-based nursing practice as core competencies in accompany their practicum that enables them to learn and grow professionally with a universal desire to be qualified, cope with doubt, and improve patient outcome. They recognized the challenges in identifying evidence and emphasized conservative approach to validate the evidence to avoid patient harm. Students expressed doubt towards their instructors EBNP when observing procedures untaught at school, which requires the curriculum model to foster students' skills in applying and appraising evidence and instructors' capacity to rationalize and role model EBNP.
- MeSH
- dospělí MeSH
- klinické kompetence * normy MeSH
- kvalitativní výzkum * MeSH
- lidé MeSH
- ošetřovatelství založené na důkazech * MeSH
- rozhovory jako téma metody MeSH
- studenti ošetřovatelství * psychologie MeSH
- studium ošetřovatelství bakalářské * normy metody MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Hongkong MeSH
OBJECTIVES: Higgs and Gilleard (2015) have uniquely theorized the fourth age as a "social imaginary" of deep old age that blends notions of frailty, abjection, and the moral relations of care. This report evaluates the coherence and reach of the fourth-age imaginary among older adults in relative good health. METHODS: In a qualitative design and within samples at 5 sites (in Czechia, Germany, Hong Kong, Taiwan, and the United States), 138 adults aged 70+ and still living independently discussed what it would mean to be "not independent" in later life. Replies referenced other people in general, specific people, and one's own actual or potential experience. RESULTS: Pooled across sites, the views of our participants confirm the theorized features of the social imaginary. Participants spoke readily of gateway infirmities heralding frailty and of frailty's abjection; expressed dread and abhorrence of dependence, some saying that death would be preferable; and were anxious about nursing homes and about burdening others with an obligation to care for them. DISCUSSION: The bleak but formidable reputation of the fourth age impinges on those living in the third. The consonant expression of fourth-age features among older adults on 3 continents supports Gilleard and Higgs's claim that the fourth-age imaginary "contains a universal ontological quality" owing to human corporeality and the senescence to which it is subject. Fourth-age studies that document the lived experience of frailty and dependence have the potential to undermine the imaginary and furnish new narratives for facing the future.
Various mHealth/eHealth services play an increasingly important role in healthcare systems and personal lifestyle management. Yet, the relative popularity of these services among the young population of the Czech Republic was not known. Therefore, we carried out an on-line survey with a convenience sample (n = 299) of young adults aged 18-29 and living in the Czech Republic. To this end, we adapted the survey instrument which was previously used in a similar study conducted in a different cultural context (Hong Kong). In our study, we found out that health tutorial activities (i.e., acquiring information on diet, exercise, fitness) were the most common among our respondents (M = 2.81, SD = 1.14). These were followed by health information seeking activities (i.e., acquiring information on medical problems) (M = 2.63, SD = 0.89) and medical services (i.e., the eHealth/mHealth services that provide infrastructural support, such as ePrescription and doctor appointment organizers) (M = 2.18, SD = 0.97). Based on the grouping according to gender and existing health condition, pairwise comparisons showed statistically significant differences. We also briefly analyzed the influence of the COVID-19 pandemic on the examined activities. Based on their relative popularity, we suggest leveraging the potential of health tutorial activities to improve public health.
- MeSH
- COVID-19 * MeSH
- lidé MeSH
- mladý dospělý MeSH
- pandemie MeSH
- průzkumy a dotazníky MeSH
- SARS-CoV-2 MeSH
- telemedicína * MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Hongkong MeSH
INTRODUCTION: Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese). METHODS AND ANALYSIS: The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status. ETHICS AND DISSEMINATION: Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.
- MeSH
- charakteristiky bydlení MeSH
- chůze * MeSH
- cvičení * MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- vytvořené prostředí * MeSH
- životní prostředí - projekt MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Austrálie MeSH
- Bangladéš MeSH
- Belgie MeSH
- Brazílie MeSH
- Česká republika MeSH
- Hongkong MeSH
- Indie MeSH
- Izrael MeSH
- Malajsie MeSH
- Nigérie MeSH
- Nový Zéland MeSH
- Portugalsko MeSH
- Španělsko MeSH
Objectives: Reminiscence is considered an important aspect of successful ageing. Prominent reminiscence functions in old age are to pass on important experiences (Teach/Inform) and to prepare for death (Death Preparation). These reminiscence functions were hypothesized to be associated with generative behavior which in turn was hypothesized to be associated with meaning in life. Thus, we tested an indirect effect of reminiscence functions on meaning in life mediated by generative behavior.Method: Elderly participants provided information on reminiscence functions, generative behavior, and meaning in life. Participants were recruited in Cameroon, China (Hong Kong), the Czech Republic, and Germany, to test the generalizability of findings.Results: The assumed indirect effect was identified: Reminiscence functions were associated with meaning in life via generative behavior. This pattern was found for all cultural samples.Conclusion: Albeit results have to be interpreted with caution as they are based on cross-sectional data, findings suggest that these reminiscence functions motivate generative behavior and thus indirectly affect meaning in life in elderlies from all four cultural contexts. In future studies, this effect needs to be replicated with a broader age range and a more fine-grained measure of generative behavior to account for potential differences in culturally appropriate generative outlets.
OBJECTIVES: This retrospective study aimed to analyze the trend of mortality due to thoracic aortic ruptures caused by deceleration injuries that occurred within the catchment area of Hradec Kralove University Hospital. MATERIALS AND METHODS: The study sample comprised 175 patients who had sustained thoracic aortic ruptures caused by deceleration injuries and were transported to Hradec Kralove University Hospital in 2009-2014. The small proportion of patients enrolled in this retrospective study were diagnosed and treated at the emergency department (ED). However, the overwhelming majority of the sample comprised of patients who died at the accident scene and later underwent an autopsy at the Institute of Forensic Medicine in our hospital. RESULTS: Of 175 patients, 150 underwent an autopsy. Of these, 139 individuals (79%) died at the incident scene, and 11 (6%) were transported to the ED and later died of their injuries. A total of 36 patients were admitted to the hospital; 29 were admitted primary (11 later died), and 7 were transferred. No deaths occurred in the group of secondary admissions. Thus, 31% of all patients hospitalized died following transport to the hospital. Of 175 patients, 15% (or 69% of all hospitalized patients) survived their injuries. Among patients who died as a result of thoracic aortic injury, no unexpected deaths were recorded (i.e., no deaths among patients with survival probability more than 50% = PS > 0.5). CONCLUSION: Our results suggested that the lethality of thoracic aortic injuries might be minimized by transporting triage-positive patients directly to trauma centers. Accurate diagnoses and treatments were supported by admission chest X-rays, a massive transfusion protocol, and particularly, CT angiography, which is not routinely included in primary surveys. An additional prognostic parameter was clinical collaboration between an experienced trauma surgeon, an interventional radiologist, and a vascular or thoracic surgeon.
- MeSH
- aorta thoracica diagnostické zobrazování zranění MeSH
- dopravní nehody mortalita statistika a číselné údaje MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- rentgendiagnostika MeSH
- retrospektivní studie MeSH
- ruptura aorty diagnostické zobrazování epidemiologie etiologie mortalita MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- traumatologická centra statistika a číselné údaje MeSH
- zpomalení škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Hongkong MeSH
The present study examines the association between various facets of generativity, that is, cultural demand for generativity, generative concern, and generative action, with the satisfaction of the needs for relatedness, competence, and autonomy in samples of elderly from Cameroon, China (Hong Kong), the Czech Republic, and Germany. Participants provided information on self-transcendence values (internalized cultural demand), generative concern and action, and need satisfaction. Results suggest, first, that internalized cultural demand affects generative action indirectly through generative concern, second, that generative concern has a positive direct effect on need satisfaction, but that, third, there is also an indirect effect of generative concern on need satisfaction through generative action, which, fourth, is positive for the needs for relatedness and competence but negative for the need for autonomy. These findings were culture-invariant in our study, suggesting generalizability to other cultures. They are discussed with respect to the role of values in generativity and a possible trade-off of generative action for the satisfaction of needs at least in the elderly.
- MeSH
- kulturní charakteristiky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- osobní uspokojení * MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- stárnutí MeSH
- vztahy mezi generacemi * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Hongkong MeSH
- Kamerun MeSH
- Německo MeSH
The aim of this survey study is to define the group of the working poor within the Czech Republic and in the selected countries. Comparison of this group can be a benefit for future research and improvement of the quality of life of the working poor. This survey study is based on articles in the SCOPUS, EBSCO and Google Scholar databases. The data have been processed through the method of the text analysis of documents. The working poor are currently an inexplicitly defined group of people. Researches show that there are two indicators for evaluation of the working poor. One of them is the so-called poverty level that is set by a certain percentage from the median of income of the particular state (mostly 50% or 60%). The second indicator is a minimum wage. The working poor are often people who work only part-time and whose wages are in the amount of about a minimum wage. Unfortunately, even people working full time often get wages at the poverty level. However, despite this fact, people still more often choose a less stable job with a minimum wage rather than being unemployed. A job provides them with a certain barrier against falling into social exclusion. Of course, the poverty level as well as the minimum wage differ in particular countries. The number of people living under the poverty level also differs. At present, the only country that explicitly defines this group are the United States of America. Approximately 14% of the population work below the poverty level there. In the whole of Asia it is about 29.5% of the population, and Asia is in one of the top positions among the countries with the biggest level of poverty in the world. The researches done in Europe show similar numbers. In the Czech Republic, the amount of the working poor is about 4% of the population. In Poland the number is about 7%, and in the UK about 8% of the population work below the poverty level. The researches from Eurostat, which have been done within Europe, look more favourable for the Czech Republic than for many other states. In 2014 the Czech Republic was a country that has one of the least dangers of poverty for those who are working.
- MeSH
- lidé MeSH
- pracující chudí ekonomika statistika a číselné údaje MeSH
- příjem statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Geografické názvy
- Asie MeSH
- Česká republika MeSH
- Evropa MeSH
- Hongkong MeSH
- Polsko MeSH
- Slovenská republika MeSH
- Spojené království MeSH
- Spojené státy americké MeSH
- východní Evropa MeSH
Generativity has been argued to be an important indicator of successful aging. Indeed, generative concern has been found to be associated with meaning in life. In the present study, this relationship is argued to be partly explained through generative goals. Moreover, the path between generative goals and meaning in life is hypothesized to be conditional on belief in the species (assessed through Machiavellianism as a proxy variable). This moderated mediation model is tested with data from 4 cultural samples: 856 Cameroonian, Czech, German, and Hong Kong Chinese participants aged at least 60 years provided information on their generative concern, generative goals, meaning in life, and Machiavellianism. Controlling for effects of relationship, level of education, everyday competence, and cognitive functioning on meaning in life, analyses confirmed the moderated mediation model in all cultural samples. That is, generative concern is partly associated with meaning in life because it leads to generative goals. In turn, these provide individuals with meaning in life. This association, however, depends on belief in the species in that meaning in life does not increase when Machiavellian attitudes compete with generative goals.
- MeSH
- cíle MeSH
- kognice fyziologie MeSH
- kulturní charakteristiky * MeSH
- kulturní různorodost MeSH
- lidé středního věku MeSH
- lidé MeSH
- osobní uspokojení * MeSH
- postoj * MeSH
- psychologické modely MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sociální chování * MeSH
- stárnutí psychologie MeSH
- stupeň vzdělání MeSH
- vyjednávání MeSH
- život * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Hongkong MeSH
- Kamerun MeSH
- Německo MeSH
