Objective Depression is a major public health problem. There is some evidence supporting the effectiveness of needle acupuncture in its treatment. Laser stimulation, regarded here as a modality of acupuncture, is non-invasive and therefore free of infection risk; and it is acceptable to patients with needle phobia. The technique is relatively easily learned by community-based general practitioners. It is also amenable to sham control and therefore double-blinding in clinical trials. A double-blind randomised controlled trial was conducted to test the efficacy of low level laser acupuncture in mild to moderate depression. Methods Thirty patients with depression were randomised to receive either active or inactive laser treatment. The laser unit could be switched to one of two settings. One switch position delivered active laser acupuncture and the other was inactive (sham). In the active mode, 0.5J was delivered to each of six to eight individually tailored acupuncture sites per visit. All patients were treated twice weekly for four weeks then weekly for a further four weeks. The patients and the acupuncturist were both blinded to conditions. Outcome was assessed using the Beck Depression Inventory at baseline, weeks four and eight during treatment, and at 4 and 12 weeks following the treatment. Results At the end of the treatment period, Beck Depression Inventory scores fell from baseline by 16.1 points in the intervention group and by 6.8 points in the sham control group (P<0.001). The difference showed only a trend four weeks later, but was again significant after 12 weeks (P=0.007). Laser acupuncture was well tolerated with transient fatigue as the most common adverse effect. Conclusion Laser acupuncture may be worth further investigation as a treatment for mild to moderate depression in primary care.

This report describes a patient with schizophrenia who developed episodes of ocular dystonia as a delayed side effect of neuroleptic medication. Each episode was preceded and accompanied by marked agitation, stereotypic behaviour and exacerbation of hallucinations. Both the psychotic and dystonic symptoms responded to anticholinergic medication. The theoretical and practical implications of this observation are discussed.

Background:The escalating rate of private hospital nurses leaving their workplace raised serious concern among the stakeholders. Past studies had found that nursing practice environment was the key influence on nurses' leaving intention, but studies examining the quality of nursing practice environment of private hospital settings was scarce and therefore warrant investigation to provide direction for interventions in addressing nursing turnover.Objectives: To determine nurses' perceptions towards nursing practice environment and whether there is any significant associations with nurses' demographic variables.Methods: Cross-sectional inferential survey study was conducted at four private hospitals in the Peninsular Malaysia using the Practice Environment Scale of the Nursing Work Index (PES-NWI) and 885 nurses participated in the study.Results: Nurses rated their practice environment as favourable. However, items stated in "staffing and resource adequacy" subscale warrant serious attention because nurses rated poorly on item related to "enough staff to get the work done" (M = 2.37, SD = .81) and "enough registered nurses to provide quality patient care" (M = 2.41, SD = .82). Furthermore, t-test analyses found that nurses with educational sponsorship bond (p < .001), higher educational qualifications (p < .05), and have been working in the hospital since graduation (p < .001) were more likely to rate their practice environment lower. Conclusion:Hospital administrators play significant role in sustaining and creating positive nursing practice environment in order to ensure steady supply of nurses to meet the challenging healthcare needs.

Background: Many nurses are leaving for various destinations and leaving intention was found to be the immediate precursor for actual turnover, but studies examining the different forms of leaving intention (unit, hospital, country, and profession) and exit destinations are scarce.Objectives: To determine the different forms of nurses' leaving intention (i.e., leaving the unit, hospital, country, and profession), exit destinations and associations of demographic variables on the different forms of leaving intention and exit destinations. Methods:The study design was a cross-sectional survey. Private hospital nurses in the Peninsular Malaysia were the study population and a total of 942 (73% response rate) nurses participated in the study. A self-reported questionnaire was used for data collection. Results:The results revealed that intention of leaving the organisation (M = 2.81, SD = 1.33) was the highest and followed by intention of leaving the unit (M = 2.54, SD = 1.31). In terms of exit destinations, advancing nursing qualification (M = 2.95, SD = 1.31) and practising nursing in another country (M = 2.55, SD = 1.31) were the most preferred exit destinations among the nurses. Conclusions:Nursing managers play a significant role in retaining nurses within the units and organisations. The findings on nurses' exit destinations are crucial because they serve as the direction for nurses' retention strategies which include professional development opportunities through training, education and staff mobility.

Background: Positive physician-nurse collaborative relationship is the key determinant for patients' outcomes.Objective: The purpose of the study was to investigate registered nurses' attitude towards physician-nurse collaboration and its association with demographic characteristics. Methodology:The study was descriptive and crosssectional. The data of the study was collected using the "Jefferson Scale of Attitudes toward Physician-Nurse Collaboration". The sample size of the study was 127 registered nurses recruited using convenience sampling. Descriptive statistics and inferential statistics t-test were used for data analysis. Results:The results showed that nurses' attitude towards physician-nurse collaboration was positive (M=3.25, SD±0.29). The attitude of the participants was highly positive towards "shares education and collaboration" (M=3.42, SD±0.36), "nurse's autonomy" (M=3.42, SD±0.44), and "caring vs. curing" subscales (M=3.41, SD±0.41). However, the participants rated lowest for "physician's authority" subscale (M=2.12, SD±0.83) and particularly on the item "doctors should be dominant authority in all health care matters" (M=2.11, SD±0.99). Furthermore, t-test analysis revealed no significant association between nurses' attitude towards physiciannurse collaboration and demographic characteristics such as age, gender, and educational level (p > 0.05). Conclusion:The results of the study provided some crucial evidences on nurses' attitude towards physiciannurse collaboration. The evidences are useful for the relevant stakeholders to initiate relevant strategies to improve and strengthen the relationship gap between physicians and nurses.