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Men who have sex with men (MSM) who use dating applications (apps) have higher rates of engaging in condomless anal sex than those who do not. Therefore, we conducted a two-arm randomized controlled trial to evaluate the effectiveness of an interactive web-based intervention in promoting safer sex among this population. The intervention was guided by the Theory of Planned Behavior and co-designed by researchers, healthcare providers, and MSM participants. The primary outcome was the frequency of condomless anal sex in past three months. Secondary outcomes included five other behavioral outcomes and two psychological outcomes. This trial was registered on ISRCTN (ISRCTN16681863) on 2020/04/28. A total of 480 MSM were enrolled and randomly assigned to the intervention or control group. Our findings indicate that the intervention significantly reduced condomless anal sex behaviors by enhancing self-efficacy and attitudes toward condom use among MSM dating app users, with the effects sustained at both three and six months. [ABSTRACT FROM AUTHOR]

Background: Many individuals consider nocturia a significant nuisance, leading to a reduced health-related quality of life (HRQOL). However, there has been a lack of psychometrically sound patient-reported outcome measures to assess the impact of nocturia on patients in Chinese contexts. This study aimed to translate, culturally adapt, and validate the International Consultation on Incontinence Questionnaire Nocturia Quality of Life Module (ICIQ-NQOL) for use among primary care patients in Hong Kong, China. Additionally, it sought to investigate the mechanisms that link nocturia and sleep quality with HRQOL by employing moderated mediation analysis. Methods: The traditional Chinese version of the ICIQ-NQOL was developed through iterative translations, cognitive debriefing interviews, and panel reviews. The psychometric evaluation included assessments of factor structure, convergent validity, concurrent validity, known-group validity, internal consistency, test-retest reliability and responsiveness. Study instruments included the ICIQ-NQOL, International Prostate Symptom Score (IPSS), Pittsburgh Sleep Quality Index (PSQI), and a modified Incontinence Impact Questionnaire-Short Form (IIQ-7). Results: A total of 419 primary care patients were recruited from general outpatient clinics, among whom 228 experiencing an average of two or more nocturia episodes per night over the past four weeks. Confirmatory factor analysis supported the two-factor structure of the ICIQ-NQOL. Concurrent validity was confirmed by moderate correlations between the IIQ-7 total score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.43 to 0.49, all p < 0.001). The ICIQ-NQOL also had moderate correlations with the IPSS total symptom score (r ranging from 0.40 to 0.48, all p < 0.001). Convergent validity was supported by moderate correlations between the global PSQI score and the total score as well as two domain scores of the ICIQ-NQOL (r ranging from 0.42 to 0.52, all p < 0.001). Known-group comparisons showed that the ICIQ-NQOL could differentiate between patients with and without nocturia in terms of sleep/energy domain score (p < 0.001), bother/concern domain score (p < 0.001), and total score (p < 0.001), each demonstrating a moderate Cohen's d effect size. Item-total correlations corrected for overlap exceeded 0.4, and Cronbach's alpha coefficients were greater than 0.7. Test-retest reliability was confirmed with intraclass correlation coefficients exceeding 0.7 among patients reporting no change in their nocturia symptoms at a 2-week follow-up. Regarding responsiveness, the Cohen's d effect sizes for differences in domain and total scores between the baseline and 2-week follow-up assessments were greater than 0.3 among patients showing improvement in nocturia. Our moderated mediation analysis indicated that sleep quality significantly moderated the impact of nocturia on HRQOL, with a notably stronger indirect effect among females compared to males. Conclusions: The ICIQ-NQOL is a reliable and valid instrument for assessing the HRQOL in primary care patients suffering from nocturia. The findings advocate for gender-specific approaches in the management and treatment of nocturia to optimize HRQOL. [ABSTRACT FROM AUTHOR]

Understanding metabolic and immune functional genes in the gut microbiota of sentinel species, such as spotted seals (Phoca largha), is essential for assessing the health of marine mammals and improving conservation strategies. Information on the gut microbiome is essential for improving conditions in captive species thus aiding in pinniped population restoration, however, it remains poorly understood. In this study, the microbiota in feces from wild and captive P. largha obtained from Liaodong Bay and an aquarium in China were analyzed using metagenomic sequencing. The results showed significant differences in the diversity, composition, and function of gut microbiota between wild and captive P. largha. The bacteria responsible for rapid absorption of energy to product body fat, Firmicutes, were more abundant in the gut microbiota of wild P. largha than in captives. Stronger biosynthesis abilities of nutrients and innate immune factors were observed in the gut microbiota of wild P. largha compared to captive samples. Regarding biomolecules (volatile fatty acids, amino acids vitamins, and several innate immune factors), only the biosynthesis of vitamin B1, secondary bile acids, and a few amino acids were significantly higher in the gut microbiota of the captive P. largha. E. coli, and genera of Bradyrhizobium, Bacteroides, and Rhodanobacter were the dominant biosynthesis functional bacteria in wild P. largha. Overall, these findings showed that wild P. largha had better health status compared to captive species; more importantly, they provide critical data for the development of effective strategies to enhance the growth and health of pinnipeds in captive environments. [ABSTRACT FROM AUTHOR]

Up to 92 percent of Chinese women of reproductive age have pre-menstrual syndrome (PMS). The severe form of PMS (i.e. pre-menstrual dysphoric disorder [PMDD]) negatively affects women's everyday functioning and reproductive health. This study examined the relationships between menstrual, psychosocial characteristics and the risk of PMDD among young Chinese women. A cross-sectional online survey was conducted among Chinese university students in Hong Kong. Logistic regression was used to compute adjusted odds ratio (aOR) for the association of high-risk PMDD with menstrual and psychosocial characteristics. A total of 541 Chinese university students were recruited. Approximately 53 percent of female students were at high risk of developing PMDD. The high-risk PMDD group was significantly associated with a heavy volume of menstrual flow (aOR = 2.17, 95 percent CI 1.06–4.45), irregular menstrual cycle (1.72, 1.17–2.52), high dysmenorrhea (2.80, 1.95–4.04) and older ages of menarche (0.67, 0.45–0.98) in the menstrual characteristics. In the psychosocial characteristics, high-risk PMDD was significantly associated with symptoms of anxiety (2.19, 1.48–3.32) and depression (2.22, 1.48–3.32), high loneliness (1.94, 1.34–2.79) and low resilience (2.21, 1.52–3.23) levels. Additionally, resilience had a potential moderating effect on the associations between the high risk of PMDD and anxiety, depression and loneliness. The development and delivery of interventions that can enhance resilience and manage psychological distress would be beneficial for young Chinese women's reproductive health. [ABSTRACT FROM AUTHOR]

Background: Existing research on sexual satisfaction has been carried out primarily in Western samples, lacking insights from less sexually permissive cultures such as China, particularly in the case of heterosexual and sexual minority women. Aim: This study aimed to culturally adapt and validate the New Sexual Satisfaction Scale–Short Form (NSSS-S) in a sample of Chinese women with diverse sexual identities. Methods: The standard forward-backward translation procedure and cognitive debriefing were conducted to translate the NSSS-S into Mandarin Chinese (NSSS-SC). The psychometric properties of the NSSS-SC were assessed in this cross-sectional survey. Outcomes: The primary outcome measure was the NSSS-S. The World Health Organization Quality of Life–Abbreviated Form, the Positive Sexuality Scale, the Female Sexual Function Index, and a single-item measure of sexual satisfaction were used to test the measure's validity. Results: A total of 336 Chinese women were recruited, with an average age of 26.82 years (SD, 6.03; range, 18-56). The 1-dimensional model had a good fit to the data and was invariant across 2 sexual identity groups (cisgender heterosexual and sexual minority women) and age. The NSSS-SC had good reliability; no significant floor and ceiling effects were observed. We found moderate to strong correlations between the NSSS-SC scores and the sexual satisfaction, sexual function, positive sexuality, and quality-of-life indicators. On average, cisgender heterosexual women were characterized by higher sexual satisfaction scores when compared with sexual minority women. Clinical Translation: The NSSS-SC can be used as a reliable and culturally appropriate measure of sexual satisfaction in women of different ages and sexual identities, which could be used in future sex-related surveys. Strengths and Limitations: This study is the first to translate the NSSS-S into Chinese and validate the NSSS-SC in a sample of Chinese women with varied sexual identities. However, this study recruited only female participants; future studies should also validate the NSSS-SC in Chinese men. Conclusion: The NSSS-SC is linguistically equivalent to the original scale and has solid psychometric properties, which can be used to assess sexual satisfaction levels in diverse samples of Chinese women. [ABSTRACT FROM AUTHOR]

This study explores the changing professional identities of teachers and their emotional experiences during curriculum reform in Shenzhen in the southern part of China. A qualitative approach to research was adopted. Findings reveal that the informants display several teaching behaviours and diverse emotions ranging from pain and helplessness, fulfilment and anxiety, and other mixed emotions. The three types of influential factors that influence teachers' professional identities are also discussed in this study.

BACKGROUND: Next-generation sequencing comprehensive genomic panels (NGS CGPs) have enabled the delivery of tailor-made therapeutic approaches to improve survival outcomes in patients with cancer. Within the China Greater Bay Area (GBA), territorial differences in clinical practices and health care systems and strengthening collaboration warrant a regional consensus to consolidate the development and integration of precision oncology (PO). Therefore, the Precision Oncology Working Group (POWG) formulated standardized principles for the clinical application of molecular profiling, interpretation of genomic alterations, and alignment of actionable mutations with sequence-directed therapy to deliver clinical services of excellence and evidence-based care to patients with cancer in the China GBA. METHODS: Thirty experts used a modified Delphi method. The evidence extracted to support the statements was graded according to the GRADE system and reported according to the Revised Standards for Quality Improvement Reporting Excellence guidelines, version 2.0. RESULTS: The POWG reached consensus in six key statements: harmonization of reporting and quality assurance of NGS; molecular tumor board and clinical decision support systems for PO; education and training; research and real-world data collection, patient engagement, regulations, and financial reimbursement of PO treatment strategies; and clinical recommendations and implementation of PO in clinical practice. CONCLUSION: POWG consensus statements standardize the clinical application of NGS CGPs, streamline the interpretation of clinically significant genomic alterations, and align actionable mutations with sequence-directed therapies. The POWG consensus statements may harmonize the utility and delivery of PO in China's GBA. POWG consensus statements standardize genomic-based cancer care in the China GBA, enabling evidence-based practice and improved patient outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: The NCCN Clinical Practice Guidelines are testing criteria used to identify high-risk individuals associated with an increased risk of breast, ovarian, pancreatic, and prostate cancer. The testing criteria have been recently modified in early 2023. In this study, we provided a real-world application of the updated criteria and their effect on germline mutation rates in Chinese high-risk breast cancer patients. An additional 6.4% (242/3797) of the patients were included after the revision; the mutation rates in these newly included patients were 2.1% and 2.5% for BRCA1/2 and all six high-penetrance genes (BRCA1, BRCA2, CDH1, PALB2, PTEN, and TP53), respectively. Applying the updated criteria for genetic investigation would increase the number of positive detection, leading to potentially more patients. However, the balance between the resource and benefits requires further consideration. Background: The National Comprehensive Cancer Network (NCCN) testing criteria for the high-penetrance breast cancer susceptibility genes, specifically BRCA1, BRCA2, CDH1, PALB2, PTEN, and TP53, have been recently modified in 2023 to 2023 v.1. The following criteria have been changed: (1) from a person diagnosed with breast cancer at ≤45 to ≤50; (2) from aged 45–50 of personal breast diagnosis to any age of diagnosis with multiple breast cancers; and (3) from aged ≥51 of personal breast diagnosis to any age of diagnosis with family history listed in NCCN 2022 v.2. Methods: High-risk breast cancer patients (n = 3797) were recruited from the Hong Kong Hereditary Breast Cancer Family Registry between 2007 and 2022. Patients were grouped according to NCCN testing criteria 2023 v.1 and 2022 v.2. A 30-gene panel for hereditary breast cancer was performed. The mutation rates on high-penetrance breast cancer susceptibility genes were compared. Results: About 91.2% of the patients met the 2022 v.2 criteria, while 97.5% of the patients met the 2023 v.1 criteria. An extra 6.4% of the patients were included after the revision of the criteria, and 2.5% of the patients did not meet both testing criteria. The germline BRCA1/2 mutation rates for patients meeting the 2022 v.2 and 2023 v.1 criteria were 10.1% and 9.6%, respectively. The germline mutation rates of all 6 high-penetrance genes in these two groups were 12.2% and 11.6%, respectively. Among the additional 242 patients who were included using the new selection criteria, the mutation rates were 2.1% and 2.5% for BRCA1/2 and all 6 high-penetrance genes, respectively. Patients who did not meet both testing criteria were those with multiple personal cancers, a strong family history of cancers not listed in the NCCN, unclear pathology information, or the patient's voluntary intention to be tested. The mutation rates of BRCA1/2 and the 6 high-penetrance genes in these patients were 5.3% and 6.4%, respectively. Conclusion: This study provided a real-world application of the revision of NCCN guidelines and its effect on the germline mutation rate in the Chinese population. Applying the updated criteria for further genetic investigation would increase the positive detection rate, and potentially more patients would benefit. The balance between the resource and outcome requires careful consideration. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to understand the perceptions and experiences of sexual violence among Chinese men who have sex with men (MSM) in Hong Kong. Design: The study adopted a qualitative descriptive design with thematic analysis. Methods: Thirty‐one Chinese MSM were recruited in Hong Kong from May to June 2019 using purposive sampling. Individual semi‐structured interviews were conducted with the participants. The interview data were transcribed verbatim from the recordings and analysed using Braun and Clarke's thematic analysis approach. Results: Four themes were identified: (1) different forms of sexual violence, from physical to virtual; (2) inner struggles with fears and worry; (3) low awareness and perceived risk of sexual violence – 'it has nothing to do with me' and (4) dilemma towards sexual violence prevention. Conclusion: The study provided qualitative evidence regarding the experiences and perceptions of sexual violence among Chinese MSM in Hong Kong. Physical and image‐based forms of sexual violence were identified, which led the participants to experience psychological distress, fear of contracting human immunodeficiency virus/other sexually transmitted infections, notoriety within the gay community, and discrimination and stigmatization within their family and workplace. To reduce the risk of sexual violence, some participants were cautious about the venue in which they engaged in sex and the habit of sharing sexually explicit photos with others. However, some participants had low awareness and perceived risk of sexual violence. Impacts: This study was the first to fill the research gap on sexual violence issues among Chinese MSM using dating apps in Hong Kong. The qualitative findings enhanced the scholarly understanding of Chinese MSM's perceptions and experiences of sexual violence. The study findings can help nursing staff and other healthcare professionals to develop tailored primary, secondary and tertiary sexual violence prevention programmes for MSM or beyond. [ABSTRACT FROM AUTHOR]

This study examined the associations of change in unmet needs for assistance with Activities of Daily Living (ADLs) with the self-rated health and life satisfaction of community-dwelling Chinese older adults. Using national longitudinal data from the Chinese Longitudinal Healthy Longevity Study, we examined the associations of change in unmet ADL needs with self-rated health and life satisfaction from baseline (T1) to a 3-year follow-up (T2) among 1,914 ADL-limited older adults. Change in unmet ADL needs was categorized into 'Persistently Unmet,' 'Unmet at T1 Only,' 'Unmet at T2 Only,' and 'Never Unmet.' Self-rated health and life satisfaction were rated by 5-point Likert scales. Linear mixed models were performed to examine the associations, controlling for sociodemographics, health conditions, and social support. Older adults whose ADL needs were 'Persistently Unmet,' 'Unmet at T2 Only,' or 'Never Unmet,' showed a significant decline in self-rated health, but those whose ADL needs were 'Unmet at T1 Only' exhibited a significant rise at follow-up. While life satisfaction was stable among older adults with 'Persistently Unmet' or 'Never Unmet' ADL needs, it significantly decreased among those with 'Unmet at T2 Only' ADL needs and increased among those with 'Unmet at T1 Only' ADL needs. Unmet needs may play an even more significant role in negatively impacting life satisfaction than the ADL limitation itself. Unmet ADL needs' effects on self-rated health and life satisfaction appeared to be short-term rather than long-term. Thus, it is never too late to adequately meet older adults' ADL needs. Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2022.2045563 [ABSTRACT FROM AUTHOR]

Background: Hong Kong lacks comprehensive school-based sexuality education. Recent public health concerns have brought the inadequacies of sex education in Hong Kong to the forefront. The aim of the proposed study is to develop and evaluate the effectiveness of a comprehensive school-based sexuality education program in Hong Kong.Methods: The proposed study is a prospective longitudinal study implemented in six secondary schools in Hong Kong over two academic years. The study adopts an ecological approach providing informational workshops for students, teachers and school management, social workers and guidance counsellors and parents. Study outcomes will be evaluated through pre- and post-tests.Results: Key outcomes of interest among students include sexual health knowledge, awareness of values motivating healthy sexual decisions, understanding and efficacy of sexual communication and intention to use contraception. Among school employees and parents key outcomes include self-efficacy to engage in sexual health discussions with students/children, sexual health knowledge and awareness of Hong Kong community sexual health resources.Conclusions: The proposed study will result in the development of a tested school-based culturally relevant comprehensive sexual health education program. Ultimately, this program aims to not only empower adolescents and their trusted adults in building a supportive environment for sexual health promotion but also construct a learning network to generate longitudinal evidence for the effectiveness of comprehensive sexuality education in improving sexual health outcomes. The program has the potential for expansion through widespread adoption in Hong Kong schools to benefit more adolescents and reduce the medical and societal burdens related to crisis pregnancy, sexually transmitted infections and sexual abuse. [ABSTRACT FROM AUTHOR]

Objective: To explore factors associated with depression and COVID‐19 related fear among pregnant women and new mothers. Design: A cross‐sectional survey was conducted in China from July 2020 to July 2021. Sample: A total of 3027 pregnant and new mothers were recruited. Measurement: Sociodemographic characteristics and the perceptions of the COVID‐19 pandemic were collected. The Patient Health Questionnaire‐9 (PHQ‐9) and the Fear Scale was used to assess the depressive and fear level towards the COVID‐19 pandemic, respectively. Results: Approximately 17.2% of the participants had depression (PHQ‐9 ≥10). In Hong Kong, participants who perceived that they have increased knowledge to prevent infection were less likely to have depression (adjusted odds ratio [aOR] = 0.83; 95% confidence interval [CI] = 0.74–0.94). There was no association between perceived severity if infected and severity of spread and the depression level in our sample. An inverse relationship was found between the COVID‐19 related fear level and perceived knowledge to prevent infection (Beta‐coefficient [β] = ‐0.20; 95% CI = ‐0.38 to ‐0.02). Conclusion: Public health nurses need to promote accurate and up to date COVID‐19 related information at clinical and community settings and implement effective screening for depression and fear symptoms to identify these high‐risk groups to improve women's psychological well‐being. [ABSTRACT FROM AUTHOR]

Objective: To extend analyses of nutrition transition in developed countries to China within the framework of the 3Vs rule considering degree of processing starting with plant/animal calorie ratio (Rule 1), industrially processed foods (IPFs, Rule 2), and food diversity through nutrient intakes (Rule 3). Design: Total and main food group (n 13) calorie intakes, percentages of animal and IPF calories, adequacy of the Dietary Reference Intake (DRI) and prevalence of chronic diseases were retrieved from scientific literature and international databases. Setting: China, 1990–2019. Participants: Overall population. Results: The total calorie intake decreased by 9 % over 30 years while the prevalence of chronic diseases substantially increased. Percentages of IPFs (Rule 1) and animal (Rule 2) calorie intake shifted from 9 to 30 % and 2 to 30 %, respectively. Meanwhile, the overall DRI adequacy (Rule 3) did not improve, with calcium and retinol deficiencies in 2019, and, although remaining above DRI, iron, copper, magnesium, and vitamins E, C and B1–B9 intakes regularly decreased. Notably, the prevalence of obesity increased five-fold, paralleling the exponential increase in IPF calorie intake. Both sources of calories were highly correlated with prevalence of main chronic diseases. Conclusions: Despite a slight decreased of total calorie consumption and small variations of adequacy with DRI, the farther the Chinese population moved away from the 3Vs rule during the 1990–2019 period, the more the prevalence of chronic diseases increased. Further analyses on foods' transitions will be better assessed when advocating sources/quality of calories (Rules 1/2), rather than only nutrient composition (Rule 3). [ABSTRACT FROM AUTHOR]

Intimate partner sexual violence (IPSV) among emerging adults, including heterosexuals and sexual minorities in the Chinese population, is poorly understood. Focusing on college students, the objectives of the present study were to estimate the prevalence of IPSV among Chinese emerging adults, examine the association between sexual orientation and IPSV, and evaluate the mental health and quality of life of survivors of IPSV. Data were collected from four university campuses in Hong Kong. A total of 1,015 participants were included in the data analysis. The prevalence of IPSV as identified by Conflict Tactics Scale (CTS)-2 was 12.1%. There was no gender difference in the prevalence of IPSV. Multiple logistic regression found that being older; having experienced childhood sexual abuse and having a smoking habit; and belonging to a sexual minority were factors associated with IPSV. Multiple linear regression found that IPSV survivors were more likely to have higher levels of anxiety and depression, more severe psychosomatic symptoms, and poorer quality of life in three domains: psychological, social relationships, and environment when compared with those without IPSV experience. The documented factors underscored the importance of awareness that men and sexual minorities might incur IPSV, which should receive more attention in IPSV prevention programs. Also, interventions for IPSV survivors should be targeted at improving their mental health and quality of life and sex education should place more emphasis on sexual consent and sexual health in dating relationships. [ABSTRACT FROM AUTHOR]

This article explored the long-run relationship between financial development and income inequality at the provincial level. In contrast with the intuitive hypothesis that financial deepening helps reduce the inequality, the provincial data reveal that financial deepening cannot improve the inequality. Instead, it makes the inequality worse. Since this result implies that financial development can increase GDP per capita and also increase income inequality, China is not passing the turning point of the inverted U-shaped curve yet. This is consistent to the fact that China is a developing country. [ABSTRACT FROM AUTHOR]

Rapid urbanisation and economic growth in developing Asian countries have exacerbated their exposure to flood hazards, particularly evident in low-lying urban cities that are currently facing increasing risks from extreme precipitations, likely made worse by the impending climate change. We present a set of simplified indices representative of the characteristics of rainfall-run-off process for evaluating pluvial flood hazard using the fuzzy comprehensive evaluation method. The highly urbanised Pearl River Delta (PRD) region in southern China is studied as an example of mapping the regional pluvial flood hazard and assessing the socio-economic exposure at risk. The developed hazard map captures the broad patterns of high flood hazard zones when compared with reported surface water flooding hotspots and the PRD riverine flood map from the 2015 Global Assessment Report. Further analysis on the regional socio-economic profiles suggests that most PRD cities are faced with large flood loss potential, with estimates of approximate 23 million people and 2.4 trillion RMB gross domestic product exposed to high flood hazard. Mega cities Guangzhou and Shenzhen top the ranking with over 20–40% of their dense urban settlements in the high flood hazard zone. This highlights the impact of human activities on the natural surface run-off process, and the need for robust flood hazard assessment for better understanding and design of holistic solutions towards more adequate flood mitigation systems for continuous urbanisation and future climate conditions. [ABSTRACT FROM AUTHOR]

Background: Alertness is an important part of attention which is different from the opposite of sleepiness. This study aimed to translate and assess the measurement properties of the Toronto Hospital Alertness Test (THAT) in Hong Kong Chinese population. Methods: The standard forward-backward translation procedure and cognitive debriefing were conducted to obtain the Chinese THAT. One hundred Chinese adults completed the Chinese THAT, the Center for Epidemiological Studies Depression Scale (CES-D), the Pittsburgh Sleep Quality Index (PSQI), and the Athens Insomnia Scale (AIS) by telephone interviews. Results: The factorial validity was assessed by confirmatory factor analysis, and the internal reliability was examined by coefficient omega. The two negatively worded items of the THAT had low factor loadings and were removed. One more item was removed based on the modification indices of the eight-item model. The remaining seven-item THAT showed satisfactory unidimensionality with root mean square error of approximation (RMSEA) = 0.06, standardized root mean square residual (SRMR) = 0.08, and comparative fit index (CFI) = 1.00. The coefficient omega of the seven-item Chinese THAT was 0.80 (95% CI: 0.74–0.86). Convergent validity was demonstrated with THAT moderately associated with CES-D (r = − 0.45, P < 0.01), PSQI (r = − 0.40, P < 0.01), and AIS (r = − 0.45, P < 0.01). Conclusions: The Chinese version of THAT demonstrated acceptable reliability and validity in a Chinese population. [ABSTRACT FROM AUTHOR]

Aims: To estimate the prevalence of self-reported symptoms associated with temporomandibular disorders (TMD) and treatment-seeking in adult Chinese in Hong Kong. Methods: A telephone survey technique was used to identify 1,526 randomly selected Cantonese-speaking individuals aged 18 years or over. Standard questions were asked about joint and jaw muscle pain, jaw opening, and joint sounds. In addition, questions on tooth grinding and clenching, sleep patterns, and treatment-seeking behavior were posed. Results: Jaw pain was reported by 33% of the population. Only 5% of them had frequent pain, with two thirds of this subgroup having moderate to severe symptoms. The prevalence of frequent problems with jaw opening and joint clicking was 0.3% and 1.8%, respectively. There were no gender-related differences in the reporting of TMD symptoms or related conditions. Conclusion: One percent of the Hong Kong Chinese population had TMD-related jaw pain that was of moderate or severe intensity and occurred frequently; 0.6% of the population had sought treatment for jaw pain, impaired jaw opening, or joint clicking that occurred often in the previous year. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to evaluate the mental health and health-related quality of life (HRQOL) of Chinese college students who were the victims of dating violence.Methods: Six hundred and fifty-two subjects were included in the data analysis. Subjects completed a structured questionnaire containing the Woman Abuse Screening tool, the Hospital Anxiety and Depression Scale, the 10-item version of the Perceived Stress Scale (PSS-10) and the World Health Organization Quality of Life-BREF Instrument (WHOQOL-BREF).Results: Analysis by independent t test suggested that victims of dating violence had more severe depressive, anxiety and stress symptoms and poorer HRQOL than non-victims. Multiple linear regression models found that more severe dating violence victimization was associated with more severe depressive, anxiety and stress symptoms. The mediation analysis found that after simultaneously controlling for the degree of depressive, anxiety and stress symptoms, the direct effect between dating violence severity and HRQOL, as measured by overall HRQOL and the global health, physical and environment domains of the WHOQOL-BREF, was statistically insignificant, supporting a full-mediation model. The relationship between dating violence severity and the social domain of HRQOL was partially mediated by the degree of depressive, anxiety and stress symptoms.Conclusion: Victims of dating violence had poorer mental health and HRQOL than non-victims. The study findings affirm the importance of assessing depressive, anxiety and stress symptoms in victims and the need to improve their depressive, anxiety and stress symptoms to diminish the negative effects of dating violence, which are apparent in their HRQOL. [ABSTRACT FROM AUTHOR]

Purpose: Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health.Methods: The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression).Results: After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate -2.82, 95 % confidence interval (CI) -4.77 to -0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64-3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13-2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05-1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit.Conclusion: Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health. [ABSTRACT FROM AUTHOR]

Nearshore environments are a critical transitional zone that connects the marine and terrestrial/freshwater ecosystems. The release of anthropogenic chemicals into nearshore ecosystems pose a human and environmental health risk. We investigated the microbial diversity, abundance and function in metal-contaminated sediments collected from the Rongjiang, Hanjiang and Lianjiang River estuaries and adjacent coastal areas using high throughput sequencing. The concentration of nutrients (NO 3 -N, NO 2 -N, NH 4 -N, PO 4 -P) and metal (Cu, Zn, Cd, Pb, As, Hg) contaminants were higher at the mouth of the rivers compared to the coastal lines, and this was confirmed using cluster analysis. Estimates obtained using geoaccumulation index showed that about 38.9% of the sites were contaminated with Pb and the pollution load index showed that sediment from the mouth of Hanjiang River Estuary was moderately polluted with metals. In the nearshore sediment samples collected, Proteobacteria, Bacteroidetes, Planctomycetes, Chloroflexi, Acidobacteria were the dominant phylum with relative abundances of 46.6%, 8.05%, 6.47%, 5.26%, and 4.59%, respectively. There was no significant correlation between environmental variables and microbial abundance and diversity except for total organic carbon (TOC) (diversity; r = 0.569, p < 0.05) and Cr (diversity; r = 0.581, p < 0.05). At phyla level, Nitrospirae had a significant negative correlation with all metals except Cr, while OD1 had a significant positive correlation with all the metals. Overall, changes in nearshore sediment microbial communities by environmental factors were observed, and these may affect biogeochemical cycling. Image 1 • Richness and diversity were higher on Lianjiang and Rongjiang River mouths. • Proteobacteria and Gammaproteobacteria were the most abundant phyla and class. • About 39% of the nearshore sediments in eastern Guangdong were contaminated. • Nitrospirae and OD1 had significant correlation with all metals except Cr. • Planctomycetes and Verrucomicrobia maybe playing key roles in carbon biogeochemical. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare the health-related quality of life (HRQOL) of Chinese patients with prostate cancer against the general population and patients with colorectal cancer, breast cancer, nasopharyngeal cancer, and leukemia.Methods: Chinese male patients (n = 291) with a confirmed diagnosis of prostate cancer were recruited from a urological specialist outpatient clinic in Hong Kong. HRQOL was measured by a condition-specific Functional Assessment of Cancer Therapy-Prostate (FACT-P) and a generic Chinese (HK) SF-12 Health Survey Version 2 (SF-12v2) questionnaire. Mean HRQOL scores of condition-specific and generic questionnaires were compared to available scores derived from other cancers and age-matched male general population, respectively.Results: Chinese patients with prostate cancer had lower general health and vitality domains and lower mental component summary scores than the age-matched Hong Kong normative population. Patients with prostate cancer reported better condition-specific HRQOL (physical well-being, emotional well-being and function well-being) when compared to general cancer population, patients with breast cancer, colorectal cancer, nasopharyngeal cancer, and leukemia in Hong Kong.Conclusions: Patients with prostate cancer substantially perceived their HRQOL to be better, compared to patients with other cancers, with overall health, energy, and mental health below of Hong Kong general population. Interventions should target at these domains in order to improve the HRQOL of patients with prostate cancer. It is reassuring to find that prostate cancer had less negative impact on HRQOL than other cancer types did. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the validity and reliability of a newly-translated Thyroid-specific Patient-Reported Outcome short-form (ThyPRO-39) instrument for ethnic-Chinese patients suffering from benign thyroid diseases.Methods: The translation and cross-cultural adaptation of the English ThyPRO-39 were performed using the double forward translation, reconciliation, single backward translation, and cognitive debriefing, followed by a panel review. Cross-sectional data of 308 patients with benign thyroid diseases were utilized for this psychometric evaluation of ThyPRO-39 instrument. Convergent validity between similar construct in the ThyPRO-39, SF-6D, and SF-12v2 was assessed using Spearman correlations. The internal construct validity was assessed by corrected item-total correlations. Sensitivity of the ThyPRO-39 domain scores was determined by performing known group comparisons by independent t test. The internal consistency reliability was assessed by Cronbach's alpha coefficient.Results: Significant floor effects were observed in 9 out of 13 domains of the ThyPRO-39. The hypothesized correlations between similar constructs in the ThyPRO-39 and the SF-12v2 and SF-6D were generally observed, supporting convergent validity. The internal construct validity was supported in most items, except eight items in six scales. Scale score of hyperthyroid symptoms of the ThyPRO-39 was significantly higher in the group with Graves' disease or hyperthyroid disease than the group without Graves' disease nor hyperthyroid disease. Scale scores of eye symptoms and impaired daily life were significantly higher in the incidental group than the non-incidental group. For six domains (hyperthyroid symptoms, hypothyroid symptoms, eye symptoms, tiredness, depressivity, and emotional susceptibility), Cronbach's alpha did not reach the recommended standard of 0.7.Conclusions: This was the first psychometric study to translate and adapt the ThyPRO-39 instrument for non-Caucasian patients, and report its validity and reliability for use in Chinese patients with benign thyroid diseases. Given the low item-total correlations in eight items and low internal consistency reliability in respective scales of the ThyPRO-39, we suggest that the improvement of those eight items should produce a more valid and reliable ThyPRO-39 instrument. [ABSTRACT FROM AUTHOR]

Purpose: Evidence regarding the onset of depressive symptoms in primary care is rarely available but can help inform policy development, service planning, and clinical decision making. The objective of this study was to estimate the 12-month cumulative incidence and predictors of a positive screen for depressive symptoms on the 9-item Patient Health Questionnare-9 (PHQ-9) among primary care patients with no history of physician-diagnosed depression.Methods: We monitored a cohort of 2,929 adult primary care patients with no past history of physician-diagnosed depression and with baseline PHQ-9 scores of 9 or lower by telephone interview at 3, 6, and 12 months. A generalized linear mixed effects Poisson Model was used to explore factors associated with the incidence of PHQ-positive symptoms.Results: The cumulative incidence of positive screening on the PHQ-9 over 12 months was 5.23% (95% CI, 3.83%-6.64%). Positive predictors included being female, coming from a lower-income household, being a smoker, having at least 2 comorbidities, having a family history of depression, and having consulted a physician at least twice in the past 4 weeks. Consulting a physician with qualifications in both family medicine and psychological medicine was a negative predictor.Conclusions: The cumulative incidence of PHQ-9-screened depressive symptoms in this study population was higher than those reported for depressive disorders in earlier systematic reviews. Groups who may warrant greater treatment attention include women, patients with multimorbidity, smokers, patients with recent high rates of medical consultations, and those who are from lower-income households or who have a family history of depression. Greater physician training may have a protective effect. [ABSTRACT FROM AUTHOR]

Sporting events have become the focus of government interest in Hong Kong in recent years. The Hong Kong Games (HKG) in particular is aimed at promoting sports participation and community cohesion within the 18 districts. Since the debut of the HKG in 2007, no academic research has been conducted to explore the actual impact of the Games on sustainable sports participation in Hong Kong. This paper addresses the underexplored issue of the links between hosting the HKG and the perceptions of the social and economic impact of such events within the framework of social exchange theory. A total of 532 questionnaires were collected from sports students undertaking tertiary education in Hong Kong. The statistical results clearly indicated a lack of community support for the HKG. Hence, this paper makes recommendations on the integration of the ‘sports-for-all’ concept in the wider community. [ABSTRACT FROM PUBLISHER]

Background: Qualifying the relationship between multi-morbidity, health-related quality of life (HRQOL) and depressive symptoms in primary care can help to inform the development of appropriate interventions and services which can help to enhance HRQOL in patients with chronic disease.Objective: The objective of this study was to determine whether the physical aspect of HRQOL mediates the relationship between chronic disease multi-morbidity and depressive symptoms in Chinese primary care patients.Methods: A cross-sectional survey was conducted on patients recruited from the waiting rooms of 59 primary care clinics distributed across Hong Kong. About 9259 subjects were included for the mediation model analysis. The primary outcome was level of depressive symptoms as measured by the Patient Health Questionniare 9. The mediation model was tested using a bootstrapping method.Results: The prevalence of chronic disease was 50.4%, with 25.4% having two or more co-morbidities. The relationship between multi-morbidity and depressive symptoms was found to be mediated by the Physical Component Summary score of the SF-12 v2. Further analysis found the general health (GH) and role physical domains of the SF-12 were the strongest mediators, followed by bodily pain and physical functioning (PF).Conclusion: To enhance the functional capacity of primary care patients with co-existing chronic disease and depressive symptoms, health care interventions should be directed at improving the physical aspects of HRQOL, in particular enhancing patients' GH perception, role functioning and PF, and to better manage chronic pain. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the mental health of Chinese primary care patients with lower urinary tract symptoms (LUTS). This was a cross-sectional observational study. Five hundred and nineteen subjects with LUTS completed a structured questionnaire containing the Depression, Anxiety, and Stress Scale-Short Form, the International Prostate Symptom Score, the adapted International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and questions about socio-demographics. Overall, 17.7% of subjects reported depressive symptoms, 24.3% anxiety symptoms and 9.6% stress symptoms. In males, demographic factors associated with poorer mental health included being not married; clinical factors included higher LUTS severity, weak stream, straining and mixed urinary incontinence. In females, demographic factors associated with poorer mental health included being younger, not married and lower household income; clinical factors included higher LUTS severity, incomplete bladder emptying, urgency and weak stream. Chinese primary care patients with LUTS appear to be an at-risk group for poorer mental health with increased prevalence of anxiety and depressive symptoms and may require routine screening to identify those who may require more tailored interventions to address both their urinary symptoms and psychological distress. [ABSTRACT FROM PUBLISHER]

Background: In Hong Kong, people aged 50-64 years were added as a recommended priority group (recommended group) for influenza vaccination by the Department of Health (DH) starting from 2011/12 onwards. The coverage rate of influenza vaccination for this age group was suboptimal at 8.5 % in 2012/13. This study investigates the factors associated with the uptake of influenza vaccination among adults in Hong Kong aged 50-64 years. Methods: A case-control study was conducted in communities by street intercept interviews from 17 July to 15 August 2013. Cases were adults aged 50-64 years who had received the influenza vaccine in 2011/12 or 2012/13, while controls were the same as the cases, except they had not received the influenza vaccine in 2011/12 or 2012/13. Multiple logistic regression analysis was performed on the data to explore the associations between vaccination status and the variables. Results: Six hundred and four respondents in total were interviewed and included in the analysis. There were 193 cases (vaccinated) and 411 controls (non-vaccinated), with a case-to-control ratio of 1:2.1. The following were strongly associated with vaccination compared to other factors: 'eligible for free government vaccine' (OR6.38, 95 % CI, 3.43-11.87, p < 0.001); 'willing to receive flu vaccination for free' (OR4.84, 95 % CI, 2.13-11.03, p < 0.001); 'perceived having severe or moderate symptoms when contracting flu' (OR2.90, 95 % CI, 1.21-6.97, p = 0.02), and 'convenient to reach a vaccination location' (OR2.87, 95 % CI, 1.06-7.74, p = 0.04). The majority of the cases (80.8 %) and controls (93.9 %) were not aware that they belonged to a recommended group for influenza vaccination and most (>80 %) were willing to be vaccinated if it was free. Conclusions: Factors related to free and convenient vaccination, the perception of the severity of symptoms when contracting influenza had a comparatively strong association with influenza vaccination uptake amongst 50-64 year olds, compared to other factors. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients' quality of life and outcomes. There is currently little data on the health related quality of life (HRQOL) of Chinese ESRD patients undergoing HD and this study sought to examine the patterns of HRQOL and its associated factors within this population, as well as in comparison with the general local population. Methods: A cross-sectional study of 244 ESRD patients receiving HD in the hospital and in the community in Hong Kong was conducted using the Short Form-12 Health Survey version 2 (SF-12v2). All study subjects were one-to-one matched with subjects in a Hong Kong general population database by sex and exact age. Independent t-tests were performed to compare the mean SF-12v2 scores between HD patients and the general population, followed by one-way analysis of variance with post hoc Tukey's HSD tests to compare community-based haemodialysis, hospital-based haemodialysis and the general population. Multiple linear regressions were used to identify the factors (socio-demographic, clinical characteristics and comorbidities) associated with the HRQOL scores of ESRD patients receiving HD. Results: The SF-12v2 Physical Functioning, Role Physical, Bodily Pain, General Health and Physical Component Summary scores of HD patients were significantly lower than the age-sex adjusted general population. However, the SF-12v2 Mental Health and Mental Component Summary scores of HD patients were significantly higher than the corresponding general population. Poorer HRQOL was associated with being female, smoking, unemployment and hospital-based haemodialysis. Conclusions: HD patients had substantially poorer physical HRQOL but better mental HRQOL than the age-sex adjusted general population. Patients receiving HD in the community setting had better HRQOL. Reasons for these observations will need to be further investigated. Those patients who are female, smokers and unemployed may warrant more attention as their poorer HRQOL may be associated with poorer outcomes. [ABSTRACT FROM AUTHOR]

With development of e-waste related legislation in China, formal recycling activities are designated in some areas while informal ones are illegally transferred to emerging areas to avoid supervision. However, the resulting environmental impact and ecological risks are not clear. Here, we investigated the discharge of polychlorinated biphenyls (PCBs) to soil and aquatic environments by e-waste recycling activities in the Lian River Basin, China. The study area included a designated industrial park in the traditional e-waste recycling area (Guiyu, known as the world's largest e-waste center), several emerging informal recycling zones, and their surrounding areas and coastal area. A total of 27 PCBs were analyzed, and the highest concentration was found in an emerging site for soil (354 ng g−1) and in a traditional site for sediment (1350 ng g‐−1) respectively. The pollution levels were significantly higher in both the traditional and emerging recycling areas than in their respective upstream countryside areas (p = 0.0356 and 0.0179, respectively). Source analysis revealed that the traditional and emerging areas had similar PCB sources mainly associated with three PCB technical mixtures manufactured in Japan (KC600) and the USA (Aroclor 1260 and Aroclor 1262). The PCB pollution in their downstream areas including the coastal area was evidently affected by the formal and informal recycling activities through river runoff. The ecological risk assessments showed that PCBs in soils and sediments in the Lian River Basin could cause adverse ecotoxicological consequences to humans and aquatic organisms. [Display omitted] • PCB level was comparable in the traditional and emerging e-waste recycling areas. • PCB level in sediments was higher than in soils across the Lian River Basin. • HCA and PCA linked the sources to PCB technical mixtures imported from abroad. • PCB pollution in marine sediment was affected by the river runoff. • Habitat-based risk assessment showed marine sediments posed risk to cetaceans. [ABSTRACT FROM AUTHOR]

This article reports the findings of a study conducted in an elementary school in 2007–2008. The design-based study, which is a replication of another study conducted in 2003–2005, analysed the influence of different leadership styles on teacher communication networks. Two curriculum development teams, namely English and General Studies teams, were set up to help in curriculum innovation, design and implementation in classrooms. Participating teachers conducted reflection meetings to evaluate the effectiveness of the implemented curriculum and discuss measures for improvement. Teacher interviews were conducted before and after each cycle of curriculum innovation. Meetings were videotaped. This study analyses the videotaped meetings through quantitative and qualitative approaches, and aims to show the effects of leadership styles and power on communication networking systems of the two teams. Results show that two modes of communication networking systems are prevalent in the videotaped meetings: restricted and extended modes. These two modes have different effects on space for teacher learning. The extended mode allows more space for teacher participation and reflection, whereas the restricted mode restricts teacher access to active participation. An effective leadership programme enhances the capacities of participants, creates conditions that allow the emergence of extended mode in meetings and provides guidance towards the realization of innovations. [ABSTRACT FROM PUBLISHER]

Background The Female Sexual Function Index (FSFI) remains the most widely used scale for assessing female sexual function. However, while an adapted version of the FSFI has been proven to be suitable for Western sexual minority women, it has yet to be used in China. Aim This study aimed to validate the Mandarin Chinese version of the adapted FSFI among Chinese cisgender heterosexual women and sexual and gender minority women, and evaluate its psychometric properties. Methods A cross-sectional online survey was conducted. The modified scoring method related to zero responses was examined, and structural validity, internal consistency, internal reliability, convergent validity, and known-group validity were evaluated. Outcomes The primary measure was the adapted FSFI, and the Positive Sexuality Scale and the New Sexual Satisfaction Scale–Short Form were used to test convergent validity. Results A total of 431 Chinese adult women were recruited, including 193 cisgender heterosexual women and 238 sexual and gender minority women. Confirmatory factor analysis using the original scores supported the original 6-factor model. Using both Cronbach's α and McDonald's ω, the results showed that the values of the total scale and 6 subscales were in the 0.76 to 0.98 and 0.83 to 0.98 ranges, respectively, indicating satisfactory reliability. Moderate-to-strong correlations among the total FSFI scores and positive sexuality and sexual satisfaction were found (r  = 0.32-0.71), supporting good convergent validity. Clinical Implications The adapted FSFI facilitates the use of more inclusive language in the clinical setting, allowing for a more comprehensive and unbiased assessment of sexual function in all women. Strengths and Limitations This study recruited both cisgender women of varied sexual orientations and gender minorities who were assigned female at birth, demonstrating that the adapted FSFI could be suitably applied to sexual minority populations. However, from a fully inclusive perspective of sex and gender, there is no research on how to accurately evaluate transgender women with female external genitalia or appropriately assess those with a female reproductive system but who do not self-identify as female. Therefore, more in-depth research is needed to further revise the FSFI for better use in the wider female population. Conclusion This Chinese version of the adapted FSFI has good psychometric properties and is a reliable and valid instrument to assess female sexual function. Furthermore, the modified scoring method could be an effective alternative among samples of sexually inactive women. [ABSTRACT FROM AUTHOR]

Abstract: This study aims to determine an optimal recovery time after a participant has exercised to exhaustion in a controlled climatic condition. Ten males and four females volunteers were examined under hot (30°C) and humid (75% relative humidity) environment in a climatic chamber to simulate typical summer outdoor working conditions of construction workers in Hong Kong. The participants (age 31.3 ± 9.3 years; height 168.5 ± 9.8 cm; weight 62.5 ± 7.1 kg; and percentage body fat 22.9 ± 7.2%) performed graded upper body exercise at a target cadence of 70 rotation per minute (RPM) until exhaustion and were recovered inside the climatic chamber until their physiological conditions returned to the pre-exercise level or lower. Physiological Strain Index (PSI) was used as a yardstick to determine the rate of recovery. The physiological conditions of the participants were monitored by recording their ear temperature (to estimate core temperature), heart rate, oxygen consumption, respiratory exchange ratio and Ratings of Perceived Exertion (RPE). It was found that on average a participant could achieve 97% energetic recovery in 40 min; 90% in 35 min; 82% in 30 min; 75% in 25 min; 68% in 20 min; 60% in 15 min; 53% in 10 min; and 46% in 5 min. Linear regression results showed that recovery time is a significant independent variable to determine the rate of recovery (R 2 = 0.95, P < 0.05). Depending on the level of recovery, an optimal recovery time after exhaustion in a hot and humid environment can be determined based on these findings. [Copyright &y& Elsevier]

Background: Ethnic variations in breast cancer epidemiology and genetics have necessitated investigation of the spectra of BRCA1 and BRCA2 mutations in different populations. Knowledge of BRCA mutations in Chinese populations is still largely unknown. We conducted a multi-center study to characterize the spectra of BRCA mutations in Chinese breast and ovarian cancer patients from Southern China. Methodology/Principal Findings: A total of 651 clinically high-risk breast and/or ovarian cancer patients were recruited from the Hong Kong Hereditary Breast Cancer Family Registry from 2007 to 2011. Comprehensive BRCA1 and BRCA2 mutation screening was performed using bi-directional sequencing of all coding exons of BRCA1 and BRCA2. Sequencing results were confirmed by in-house developed full high resolution DNA melting (HRM) analysis. Among the 451 probands analyzed, 69 (15.3%) deleterious BRCA mutations were identified, comprising 29 in BRCA1 and 40 in BRCA2. The four recurrent BRCA1 mutations (c.470&lowbar;471delCT, c.3342&lowbar;3345delAGAA, c.5406+1&lowbar;5406+3delGTA and c.981&lowbar;982delAT) accounted for 34.5% (10/29) of all BRCA1 mutations in this cohort. The four recurrent BRCA2 mutations (c.2808&lowbar;2811delACAA, c.3109C>T, c.7436&lowbar;7805del370 and c.9097&lowbar;9098insA) accounted for 40% (16/40) of all BRCA2 mutations. Haplotype analysis was performed to confirm 1 BRCA1 and 3 BRCA2 mutations are putative founder mutations. Rapid HRM mutation screening for a panel of the founder mutations were developed and validated. Conclusion: In this study, our findings suggest that BRCA mutations account for a substantial proportion of hereditary breast/ovarian cancer in Southern Chinese population. Knowing the spectrum and frequency of the founder mutations in this population will assist in the development of a cost-effective rapid screening assay, which in turn facilitates genetic counseling and testing for the purpose of cancer risk assessment. [ABSTRACT FROM AUTHOR]

Objectives: A sentinel surveillance system (SSS) was set up in Hong Kong to monitor hand, foot and mouth disease (HFMD) trends. This evaluation assessed the performance of the SSS from 2001 to 2009, and aimed to identify areas for improvement. Study design: A retrospective review using structured guidelines for evaluating public health surveillance systems published by the US Centers for Disease Control and Prevention. Methods: The effectiveness of the SSS was evaluated using routine service statistics, laboratory surveillance data, and results of an acceptability survey conducted among the sentinel doctors. This information was used to assess various attributes of the SSS including simplicity, flexibility, data quality, usefulness, sensitivity, specificity, positive predictive value (PPV), representativeness, timeliness and acceptability. Results: The SSS was simple and flexible with high-quality data. It correlated well with the laboratory surveillance data (P < 0.001) and facilitated early detection of community epidemics. It helped to identify seasonal trends and high-risk groups. Specificity was high (83.4-88.5%), while sensitivity and PPV were borderline satisfactory (38.4-56.8%). The sentinel clinics were representative of the population distribution. The SSS was acceptable to the sentinel doctors, but 17.9-28.2% of them had delays in reporting. Conclusions: The SSS is effective for monitoring HFMD trends in Hong Kong, and is useful for initiating preventive measures. [ABSTRACT FROM AUTHOR]

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This study outlines the perceptions of school leaders regarding the New Senior Secondary Curriculum in Hong Kong. It illustrates the diversity of perceptions and responses of school leaders in terms of the purposes of the reforms, challenges to be faced, and strategies for implementing the reform. The findings suggest that school leaders' perceptions and responses are varied because of the different agendas and cultures of individual schools. This paper argues that planners need to avoid over-prescription in designing a new curriculum so as to allow schools scope to take account of their own characteristics and readiness when implementing the reforms. [ABSTRACT FROM AUTHOR]

This study was designed primarily to investigate the impact of school-based curriculum development teams on teacher development within the tradition of school-based curriculum development. The results are expected to provide valuable insights for teachers, school management and policy making. Teacher interviews in a primary school in Hong Kong were conducted to evaluate the extent to which teacher engagement in curriculum decision-making processes, which are within two school-based curriculum development teams, led to teacher professional development; these were triangulated with video-taped meetings and tryout lessons. Qualitative evidence showed that participating teachers have each undergone professional development through the processes involved in the planning, experimenting and reflecting (PER) model, which is also upon curriculum practice and innovation under certain conditions. However, the complex structures and processes that have been established to involve teachers in curriculum decision making need further empirical and theoretical work. While previous papers on the studies focused on teacher development and pupil learning, this paper, based on interview data, aims to focus on the functions of distributed leadership, and how the leadership styles of consultants and panel heads mediate the interactional patterns and therefore the discourses in the Mathematics and Chinese development teams in the second action cycle of the innovation project. [ABSTRACT FROM AUTHOR]

A construction project is mostly initiated by the needs of the client. In order to satisfy the client’s requirements in terms of time, cost, and quality, various procurement methods are recommended for selection to increase the chance of success for the complex sequence of activities. Design-build (D&B) integrates design and construction to overcome some of the hurdles inherent in the traditional design-bid-build method. It has been extensively used worldwide and its distinctive features are claimed to deal with the problems of the traditional design-bid-build method. An investigation into the determinants of successful D&B projects can therefore help set a benchmark study for industry practitioners to compare their project performance. To better indicate the success level of D&B projects, the writers developed a project success index for D&B projects in the Hong Kong context, which is assessed by the key project performance indicators of time, cost, quality, and functionality. Multiple regression analysis is then applied to show that the project nature, the effective project management action, and the adoption of innovative management approaches are the critical success factors for D&B projects. The identification of success criteria can furnish project participants with indicators to attain success for their D&B projects for benchmarking and control purposes. The predictors for D&B project success were also determined to enrich the knowledge base for the D&B procurement system. [ABSTRACT FROM AUTHOR]

Background: The thalassaemias are the commonest blood disorders worldwide, with South East Asia and southern China as areas of high prevalence. Accurate diagnosis of these disorders helps in clinical management with improved outcome. Methods: The α-globin genotypes of 100 Chinese patients in Hong Kong with haemoglobin H (Hb H) disease were characterised. Single-tube multiplex gap-PCR was used to detect -- SEA, -α3.7 and -α4.2, while Hb CS, Hb QS and codon 30 (ΔGAG) were identified by single-tube multiplex amplification refractory mutation system (ARMS). Automated direct nucleotide sequencing of the amplified α2- and α1-globin genes was performed to characterise other non-deletional α-thalassaemia determinants. Results: In the 100 cases studied, 99 cases had -- SEA in combination with deletional α+-thalassaemia or non-deletional α-globin gene mutation involving the α2-globin gene. In 70 cases of the deletional form, 43 cases showed the genotype of (-- SEA/-α3.7) and 27 cases of ( --SEA/-α4.2). Three of the 27 cases of (--SEA/-α4.2) were found to have Hb Q-Thailand linked in-cis with -α4.2. The remaining 30 cases were of non-deletional form with the following genotypes: 11 cases of (-- SEA/αHbCSα), 9 cases of (--SEA/αHbQSα), 3 cases of (--SEA/αcd30 (ΔGAG)α), 3 cases of (--SEA/αcd31α), 2 cases of (--SEA/αpoly-Aα), 1 case of (--SEA/αHbWestmeadα) and 1 case of (--non-SEA/αHbQSα). Conclusions: Based on two rapid diagnostic tests, multiplex gap-PCR and multiplex ARMS, more than 90% of the cases were genetically characterised. This laboratory strategy should be widely applicable for genetic diagnosis of α-thalassaemia. [ABSTRACT FROM AUTHOR]

The article explores the influence of poet Yang Lian to the literary publishing system in China and the tension between dissidence and accommodation within the sector. During the 1980s, Yang has made some publications aimed at maintaining his dissident independence. His work has been adapted to the demands of censorship. This shows the importance of the accommodations with the official publishing system to the careers of Chinese writers from 1980s to 1990s.

Schistosomiasis is a water-borne parasitic disease endemic in tropical and subtropical areas. Its transmission depends upon the presence of snails, which serve as intermediate hosts for the parasite. Some efforts have been made to classify snail habitats with remotely sensed data, but not to estimate snail abundance that is an important parameter in schistosomiasis transmission modeling. In this research, snail density was predicted by integrating the field survey and satellite images of different spatial resolution. A mountainous environment near Xichang city, in southwest Sichuan province, China, was chosen as the test site. Land-cover and land-use information extracted from 4 m resolution Ikonos data and elevation data derived from ASTER (Advanced Space-borne Thermal Emission and Reflection Radiometer) data were used as reference for scaling up to greater spatial extents. Therefore, we estimated land-cover and land-use fraction data at the 30 m resolution level based on classification results from the Ikonos data. Snail abundance for each 30 m resolution grid was then predicted by regressing field survey data with land-cover and land-use fractions. Subsequently, a snail density map was generated using the territory of each of the over 200 residential groups as a mapping unit. An R2 of 0.87 was obtained between the average snail density predicted and that surveyed for 19 groups. With such a model, we were able to extrapolate scattered snail abundance surveyed at a limited number of sites to the entire area. Spatial autocorrelation of snail distribution was considered as one of the possible factors in predicting snail density and tested for further model calibration. [ABSTRACT FROM AUTHOR]

Nasopharyngeal carcinoma (NPC) is rare among Caucasians but very common among southern Chinese. No information is presently available on the relationship between salivary gland function and xerostomia in irradiated southern Chinese. Salivary gland function and xerostomia were measured in irradiated NPC patients, recently diagnosed NPC patients, and a matched control group. Stimulated whole saliva was collected from each participant and flow rate, pH and buffer capacity measured. All participants completed a multi-item dry mouth questionnaire. Comparisons were made using Chi-square and Mann-Whitney tests and correlations assessed using Spearman's rank correlation coefficients. The mean saliva flow rate and pH were significantly lower and the buffer capacity impaired in irradiated NPC patients compared with the other groups (P<0.01). Significantly more irradiated NPC patients had negative impacts associated with dry mouth generally, sticky saliva, and hoarse voice (P<0.01). Subjective dry mouth symptoms and associated reduced saliva flow were also relatively common in non-irradiated participants. Salivary gland hypofunction and xerostomia were major complications in irradiated NPC patients. In irradiated and non-irradiated southern Chinese, subjective dry mouth symptoms appeared to be correlated with actual salivary gland function. [ABSTRACT FROM AUTHOR]

This article compares the practice of great power federalism in terms of global/local economic policy and relations in a context of expanding regional influence and transcontinental reach. The authors contrast China's recent decentralization experience with that of the FRG and the United States with respect to management of productive ventures, regulation of the economy, trade and commerce, fiscal relations, monetary policy and labor mobility. The three great-power states manage their complex and far-reaching economies through systems of multi-level governance that exhibit elements of convergence at the same time as each is headed in a defining direction. German federalism is making room for supranational involvement, US federalism emphasizes new managerialism at all levels of government and China's post Mao de facto federalism is launching provincial and sub-provincial governments on a booming economic trajectory. China's recent performance is particularly impressive given the size of its population and the extent to which its economy has been transformed and energized. In key respects, China's administrative system is the most decentralized and fluid. The effective participation of Chinese sub-national entities in transterritorial economic undertakings is particularly striking. China's experience suggests that the requisite energy and capacity to tackle trans-national economic challenges might lie at the sub-national level. Given the shifting nature of global pressures and local priorities, the extra-organizational sensitivities and linkages of sub-national public managers must include proximate and distant economic conditions, central government overseers and trans-national actors. In this dynamic context, the most fluid forms of federalism are likely to have an edge. [ABSTRACT FROM AUTHOR]

Background. Variable pulse width frequency doubled Nd:YAG 532 nm laser has previously been shown to be effective in the treatment of vascular lesions in Caucasians. For dark-skinned patients, such as Asians, its role has not been determined. Objective. To assess the clinical efficacy and complication rate of the 532 nm Nd:YAG laser in the treatment of port-wine stain in Chinese patients. Methods. Chinese patients with port-wine stain who had undergone Nd:YAG laser treatment were called for questionnaire assessment of their degree of clearing and clinical examination for complications by two independent observers. For 22 patients with pre- and posttreatment photographs, the two independent observers further assessed the degree of clearing. Results. Assessment of the questionnaire indicated that 62.9% of the patients subjectively considered that they had more than 25% clearing, with 33.3% having more than 50% clearing. For those with pre- and posttreatment photographs, the objective degree of improvement was less impressive with 18.1% of patients having at least 25% improvement and only 13.6% having more than 50% improvement. Pigmentary and texture changes were seen in both groups (33% in group I and 11% in group II). The number of treatment sessions rather than previous use of pulsed dye laser therapy was an important risk factor for complications. Conclusion. Nd:YAG laser is only partially effective for the treatment of port-wine stain in Chinese patients. Although most patients recorded some degree of subjective improvement, many did not improve by objective assessment. High fluence is necessary to achieve the desirable clinical response, and while contact cooling reduces the risk of epidermal damage, texture changes can still occur. Further study is necessary to compare its use with other similar devices, such as a pulsed dye laser with cryogen spray cooling. [ABSTRACT FROM AUTHOR]

Figure Graph: Figure 1 The location of the two study catchments used in this study in China (a), location of study area catchments in Shaanxi and Sichuan provinces (b), respectively, the Yanhe (c) and Guangyuan (d) study area boundary; elevation with the stream network is shown with blue solid lines and red triangles represent meteorological stations. The Impact of Reforestation Induced Land Cover Change (1990-2017) on Flood Peak Discharge Using HEC-HMS Hydrological Model and Satellite Observations: A Study in Two Mountain Basins, China. Reference 1 Kabeja C., Li R., Guo J., Rwatangabo D.E.R., Manyifika M., Gao Z., Wang Y., Zhang Y. The Impact of Reforestation Induced Land Cover Change (1990-2017) on Flood Peak Discharge Using HEC-HMS Hydrological Model and Satellite Observations: A Study in Two Mountain Basins, China. [Extracted from the article]

Abstract: The recent global outbreak of Influenza A (H1N1), or the more commonly known as swine flu, has negatively affected the tourism and hospitality industries in many countries. This article reports a study that applied independent component analysis, a novel statistical technique, to separate the dominant factors which determine the levels of hotel occupancy rates in Hong Kong. Empirical findings would provide useful insights on how the dynamic lodging demand reacts to epidemics based on the severity and duration of the events. [Copyright &y& Elsevier]

Understanding the effect of land use and land cover (LULC) type change on watershed hydrological response is essential for adopting applicable measures to control floods. In China, the Grain to Green Program (GTGP) and the Natural Forest Conservation Program (NFCP) have had a substantial impact on LULC. We investigate the effect of these conservation efforts on flood peak discharge in two mountainous catchments. We used a series of Landsat images ranging from 1990 to 2016/2017 to evaluate the LULC changes. Further to this, the hydrological responses at the basin and sub-basin scale were generated by the Hydrologic Modeling System (HEC-HMS) under four LULC scenarios. Between 1990 and 2016/2017, both catchments experienced an increase in forest and urban land by 18% and 2% in Yanhe and by 16% and 8% in Guangyuan, respectively. In contrast, the agricultural land decreased by approximately 30% in Yanhe and 24% in Guangyuan, respectively. The changes in land cover resulted in decrease in flood peak discharge ranging from 14% in Yanhe to 6% in Guangyuan. These findings provide a better understanding on the impact of reforestation induced LULC change on spatial patterns of typical hydrological responses of mountainous catchment and could help to mitigate flash flood hazards in other mountainous regions. [ABSTRACT FROM AUTHOR]

Floods have caused 20% of the worldwide economic losses resulting from catastrophe events over 2008 to 2018. In China, the annual flood economic losses have exceeded CNY 100 billion from 1990 to 2010, which is equivalent to 1% to 3% of China's Gross Domestic Product (GDP). This paper presents a rainfall-runoff model coupled with an inundation estimation to assess the flood risk for a basin within the Foshan-Zhongshan area of the Pearl River Delta (PRD) region in China. A Hydrologic Engineering Center's Hydrologic Modeling System (HEC-HMS) model was constructed for the crisscrossing river network in the study basin where the West and North Rivers meet, using publicly accessible meteorological, hydrological and topographical datasets. The developed model was used to analyze two recent flood events, that in July 2017 with large upstream river inflows, and in June 2018 with high local rainfall. Results were further used to develop the needed river rating curves within the basin. Two synthetic events that consider more severe meteorological and hydrological conditions were also analyzed. These results demonstrate the capability of the proposed model for quick assessment of potential flood inundation and the GDP exposure at risk within the economically important PRD region. [ABSTRACT FROM AUTHOR]