Abstract Over the past several decades, palliative care has seen tremendous development in Western countries, but there is still inadequate access to palliative care among non-dominant ethnocultural groups. The Chinese have been the largest immigrant group in New Zealand since the 19th century(1). They have unique beliefs and practices around illness, death, dying and filial piety(2). These differ greatly from those in Western cultures and have notable implications for hospice palliative care planning and provision. However, immigrant Chinese community remains a relatively marginalised and under-researched group in palliative care(3-5). This results in limited knowledge about its culture and people among health professionals, as well as the lack of experience in providing terminal care to Chinese immigrants. Through the introduction of New Zealand Palliative Care Strategy and the analysis of Chinese immigrants’ difficulties and preferences for palliative care, this aims to increase understanding of how cultural values of Chinese affect their acceptance and decision-making with respect to palliative care so that for efficiently providing palliative care to this ethnic minority group in New Zealand.

Resumen En las últimas décadas, los cuidados paliativos han experimentado un enorme desarrollo en los países occidentales, pero el acceso a los mismos sigue siendo insuficiente entre los grupos etnoculturales no dominantes. Los chinos son el mayor grupo de inmigrantes en Nueva Zelanda desde el siglo XIX(1). Tienen creencias y prácticas únicas en torno a la enfermedad, la muerte, el morir y la piedad filial(2). Éstas difieren en gran medida de las de las culturas occidentales y tienen notables implicaciones para la planificación y prestación de cuidados paliativos en los hospicios. Sin embargo, la comunidad china inmigrante sigue siendo un grupo relativamente marginado y poco investigado en el ámbito de los cuidados paliativos(3-5). Esto se traduce en un conocimiento limitado sobre su cultura y su población entre los profesionales sanitarios, así como en la falta de experiencia en la prestación de cuidados terminales a los inmigrantes chinos. A través de la introducción de la Estrategia de Cuidados Paliativos de Nueva Zelanda y el análisis de las dificultades y preferencias de los inmigrantes chinos en materia de cuidados paliativos, este ensayo pretende aumentar la comprensión de cómo los valores culturales de los chinos afectan a su aceptación y la toma de decisiones con respecto a los cuidados paliativos para que para proporcionar de manera eficiente los cuidados paliativos a este grupo étnico minoritario en Nueva Zelanda.

Resumo Nas últimas décadas, os cuidados paliativos tem experimentado um enorme desenvolvimento nos países ocidentais mas ainda há acesso inadequado a cuidados paliativos entre grupos étnico-culturais não dominantes. Os chineses tem sido o maior grupo de imigrantes na Nova Zelândia desde o século XIX(1). Eles tem crenças e práticas singulares em torno de doença, morte, morrer e devoção filial(2). Isso difere grandemente das culturas ocidentais e tem implicações notáveis no planejamento e fornecimento de cuidados paliativos em lares de idosos. Entretanto, a comunidade de imigrantes chineses permanece sendo um grupo relativamente marginalizado e sub-investigado no que diz respeito a cuidados paliativos(3-5). Isso resulta em conhecimento limitado sobre sua cultura e povo entre profissionais da saúde, bem como na falta de experiência em fornecer cuidados terminais a imigrantes chineses. Através da introdução da Estratégia de Cuidados Paliativos da Nova Zelândia e a análise das dificuldades e preferências de imigrantes chineses para cuidados paliativos, esse estudo tente aumentar a compreensão de como valores culturais de chineses afetam sua aceitação e tomada de decisão a respeito de cuidados paliativos, de maneira a eficientemente fornecer cuidados paliativos a esse grupo étnico minoritário na Nova Zelândia.

ABSTRACT Purpose Shen-fu injection (SFI) was used to intervene in the resuscitation of porcine hemorrhagic shock (HS) model to study its protective effects on acute kidney injury. Methods After 60 min of HS, 28 animals were randomly assigned into four groups. The groups were as follows: hemorrhagic shock group (HS); HS resuscitation with shed-blood group (HSR); HS resuscitation with shed-blood and SFI (1 mL·kg–1) group (HSR-SFI); and the sham operation group (Sham). The bloods were analyzed for serum creatinine (sCr), cystatin C (CysC) and neutrophil gelatinase-associated lipocalin (NGAL). BAX, Bcl-2, and caspase-3 protein expressions by Western blot analysis and immunohistochemical staining. The renal tissues were removed and pathologic changes were observed. Results Mean aortic pressure (MAP) in HSR-SFI groups were higher than that in HSR groups after shock. At the 6th hour after shock, the urine volume per hour in the HSR-SFI groups was more than that in the HSR groups. The sCr, NGAL, CysC and cytokine levels of HSR-SFI groups were lower. The Bcl-2 expression was increased in the HSR-SFI groups. The BAX and caspase-3 expressions were reduced. The histopathologic score in the HSR-SFI was lower. Conclusions SFI may reduce the risk of acute kidney injury (AKI) following hemorrhagic shock by attenuating systemic inflammatory responses, and regulating the expression of apoptosis-related proteins.

Abstract Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded. The bloods were analyzed for serum creatinine (sCr), CysC and NGAL. The kidney was surgically removed observe pathologic changes under a light microscope. Results: The sCr increased in both TH and NH groups after ROSC, compared to baseline. Between two groups, the sCr and creatinine clearance (Cc) showed lower level in the TH group. The urine volume per hour in the TH group were higher during cooling. After resuscitation, NGAL and CysC in the NH group were higher than in the TH group. Under the light microscope, compared with the TH group, the renal injury was prominent in the NH group. Conclusion: Mild hypothermia had a protection to renal ischemia reperfusion injury after resuscitation.