Thesis (M. Phil.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

The outbreak of severe acute respiratory disease (SARS) in Taiwan on April, 2003 caused the life of Taiwanese out of order and panic. The health-care workers feel anxious and panic. The downside emotion even caused escape and mass resignations in hospitals. SARS tested how good every individual and the leadership of every hospital, area, and nation can handle crisis. Can hospitals offer enough support and a safe working environment to their health-care workers? Does the working attitude and willing of the health-care workers relate to how much awareness of the support from the hospitals? The purpose of the research is to find out during SARS, the working stress for anesthetists, the relation of support from the hospitals and the working attitude and willing to take care of patients from the anesthetists. Hope this can be a reference to management level in medical care organization The conclusion of this research: 1.The management level in hospitals should apply different HR strategies to different health-care workers as every health-care worker has different personality. The difference makes his commitment to organization, profession and willing to take care of patients different. 2.During SARS, the awareness from anesthetists to organization support includes four sides. They are safe support, emotional support, fair support and respect support. The four sides have different affects on anesthetists¡¦ working attitude. To organization commitment, the most important is safe support and then ¡K. Support, fair support and respect support. 3. If health-care workers can feel enough support from the organization, they will feedback their commitment to the organization and profession. Therefore, except giving the assistance to reduce working stress, the management level should provide enough safe support, emotional support, fair support and respect support. 4. Working stress affects health-care workers¡¦ willing to stay on duty and take care of SARS patients. Therefore, to assist health-care workers in reducing fear and uncertainty of SARS, increasing the ability to adjust stress by training of SARS can reduce the intention of quit and job changing. The assistance can encourage the health-care workers to be more aggressive on taking care of SARS patients.

SARS(Severe Acute Respiratory Syndrome)which caused a serious epidemic situation in Taiwan was a never known virus last year. People were fear of going out, and avoided entering to the public place, like theater, department store, bus¡Ketc. in case to be infected with SARS. Under the completed network infrastructure and the changing environment, people seemed to intend shopping on line more than ever To know the effect of SARS on electronic commerce of Taiwan, we tried to investigate the online behavior of users, such as the spending time on surfing, the products by online shopping, and the intention of online shopping. We found that SARS had a positive effect on electronic commerce. Besides, this research uses Maslow¡¦s need theory for the research framework, including the physiological needs, the safety needs, the belongingness and love needs, the esteem needs, the self actualization needs, the desires to know and to understand, the aesthetic needs and the entertainments needs which were derived form the need theory. Basing on the above needs, we investigated what kind of needs would be increasing and what kind of needs would be not during SARS. Moreover we also investigated the degree that products could satisfy the eight needs. Combined with the result of survey, we develop a fitting model to forecast the intention of online shopping and also fit with the result of MIC survey.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Severe lymphopenia is a clinical feature of Severe Acute Respiratory Syndrome (SARS) patients. However, lymphocytes do not express receptor for SARS-CoV, neither the widely accepted viral receptor angiotensin converting enzyme 2 (ACE2) nor the putative receptors Dendritic Cell- and Liver/lymph-Specific Intercellular adhesion molecule-3-Grabbing Non-integrin (DC-SIGN and L-SIGN). Our group previously showed in vitro that, SARS-CoV Spike pseudotyped particles (SARSCoVpp) could infect human B cells only when inoculated in presence of anti-SARSCoV Spike immune serum. Such observations raised concerns about the possible occurrence of antibody-dependent enhancement (ADE) of infection, a phenomenon during which a virus bounded by antibodies could gain entry into cells through mechanisms involving complement receptors or Fc receptors. Recently, we have demonstrated the participation of the human Fc gamma receptor II (hFcγRII) molecules in granting SARS-CoV an opportunity to infect human immune cells. The aim of this study was to decipher the molecular mechanism leading to antibodymediated, FcγRII-dependent infection of immune cells by SARS-CoV. By using transduction experiment, I highlighted that different members of the hFcγRII family (namely hFcγRIIA, hFcγRIIB1 and hFcγRIIB2) could confer susceptibility to ADE of SARS-CoVpp infection. I further demonstrated that purified anti-viral immunoglobulin G, but not other soluble factor(s) from heat-inactivated immune serum, was the determinant for occurrence of ADE infection. Additionally, with the development of a cell-cell fusion assay, I illustrated that in contrast to the ACE2- dependent pathway, ADE infection did not occur at the plasma membrane, but rather require internalization of virus/antibodies immune complexes by the target cells. In line with this hypothesis, my results using a panel of FcγRII-expressing mutants demonstrated that binding of immune complexes to cell surface FcγRII was a prerequisite but was not sufficient to trigger ADE infection. In these experiments, only FcγRII signaling-competent constructions conferred susceptibility to ADE of SARS-CoVpp infection. Altogether my results point toward a role of the anti-SARS-CoV Spike IgG in vitro in granting SARS-CoV an opportunity to infect cells bearing signaling-competent FcγRII receptors. If further confirmed, such observations could have implications for understanding SARS-CoV tropism and SARS pathogenesis, as well as warrant for careful design of SARS vaccines and immunotherapy based on anti-viral antibodies. / published_or_final_version / Microbiology / Master / Master of Philosophy

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

This thesis explores how the 2003 epidemic of Severe Acute Respiratory Syndrome, or SARS, threw into relief the myriad historical, political and economic factors that shape understandings of and responses to a new disease. The author traces how the historic "othering" of Chinese immigrants and their descendents in the United States was combined with dominant discourses of risk and blame to understand SARS and the potential for a domestic epidemic. Narratives from community members of Manhattan's Chinatown are used to investigate the local impacts of the production of these discourses during the SARS epidemic. Finally, the author explores how these dominant discourses were applied locally within Chinatown understand local and personal risk.

A significant challenge of the 21st century is the growing health threat stemming from drug-resistant infectious diseases. There is an undeniable need to discover new, safe and effective drugs with novel mechanisms of action to combat this threat. A study of drugs currently on the market showed that natural products account for approximately 75% of new anti-infective drugs, either as new agents or analogs based upon their structure. Unfortunately, major pharmaceutical companies have cut back tremendously in natural products research in part due to the frustrating obstacle of frequent rediscovery of compounds. Fungi in particular are difficult to work with in that they do not always produce the same variety and quantities of secondary metabolites under laboratory conditions. One of the groundbreaking discoveries evolving from genomics research is the observation that many fungi possess more gene clusters encoding for the production of secondary metabolites than the reported number of natural products isolated from those organisms. Simple epigenetic modifications such as DNA methlytransferase or histone deacetylase inhibition can activate silenced genes leading to the genesis of novel chemistry from the fungus. The work presented herein is a study of the isolation and characterization of anti-infective compounds from Floridian mangrove endophytes. In addition, epigenetic modifications were explored in order to increase the production of secondary metabolites as well as for the purpose of generating new analogs not found in the controls. Finally, structure activity relationship studies were performed in order to maximize the anti-malarial and antibiotic activity of cytosporone E.

Severe acute respiratory syndrome (SARS) was defined as an invasive respiratory disease in 2002, which originally came from China and rapidly spread all over the globe. Acute pneumonia and lower respiratory tract involvement most affected the middle aged individuals and elderly with a mortality rate of 11%. While SARS Corona virus (SARS-CoV) has maintained its potential capacity to reemerge, clinical study of the immune system of SARS patients, as well as controlled studies may lead to application of new treatment strategies in future. Throughout this work, I have focused on early immune responses to SARS-CoV in humans and in ferrets. CXCL0 has been associated with alterations in the clinical course of several infectious diseases, including SARS and influenza. Here I have cloned ferret CXCL10 gene and have expressed its recombinant protein. I demonstrate that the CXCL10 plasma level in SARS patients is associated with the severity of disease. I also show that endogenous ferret CXCL10 exhibits similar mRNA expression patterns in the lungs of deceased SARS patients and ferrets experimentally infected with SARS-CoV. Type I interferons (IFNs) are indispensable parts of the innate immunity during early stages of infection. A clear distinction between genes upregulated by direct virus-cell interactions and genes upregulated by secondary IFN production has not been made yet. Here, I have investigated differential gene regulation in ferrets upon subcutaneous administration of IFN-a2b and during SARS-CoV infection. In vivo experiments revealed that IFN-a2b causes upregulation of abundant IFN response genes (IRGs), chemokine receptors, and other genes that participate in phagocytosis and leukocyte migration. SARS-CoV infection of ferrets leads to upregulation of varieties of IRGs and a broad range of genes involved in cell migration and inflammation. This work allowed dissection of several molecular signatures present during SARS-CoV infection, which are part of a robust IFN antiviral response. Since localization of CD8+ Tcells may contribute to tissue injury, I have characterized ferret CD8 gene and have generated reagents that can be used in future studies with the aim of evaluating CD8+ T cells localization in the ferret lung during infection with SARS-CoV.