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The benefits of parental involvement in children’s education have been well established but increasing evidence suggests that overparenting may have adverse effects on children. The question of whether excessive parental involvement hinders children’s academic and psychosocial development warrants further investigations. This study examined the associations of parental educational involvement at home and in school with academic performance and psychological health of 507 Chinese Grade 3 schoolchildren in Hong Kong. Parents reported on their level of involvement in children’s schooling and their children’s psychosocial issues. Children were surveyed to determine their school engagement, and their Chinese language and mathematics attainment was assessed. We also explored the underlying mechanism by testing children’s engagement with school as a mediator of the relationships. Our results showed that home-based parental educational involvement was positively associated with children’s language competence and psychosocial wellbeing, and the associations were linked through engaging children with school. However, the benefits reached a plateau at higher level of parental involvement in children’s learning at home. School-based parental involvement had an indirect effect on children’s prosocial behavior through school engagement. These findings highlight the significance of optimal level of parental involvement in children’s education at home for children’s development. [ABSTRACT FROM AUTHOR]

The recent increase in zoonotic avian influenza A(H7N9) disease in China is a cause of public health concern. Most of the A(H7N9) viruses previously reported have been of low pathogenicity. We report the fatal case of a patient in China who was infected with an A(H7N9) virus having a polybasic amino acid sequence at its hemagglutinin cleavage site (PEVPKRKRTAR/GL), a sequence suggestive of high pathogenicity in birds. Its neuraminidase also had R292K, an amino acid change known to be associated with neuraminidase inhibitor resistance. Both of these molecular features might have contributed to the patient's adverse clinical outcome. The patient had a history of exposure to sick and dying poultry, and his close contacts had no evidence of A(H7N9) disease, suggesting human-to-human transmission did not occur. Enhanced surveillance is needed to determine whether this highly pathogenic avian influenza A(H7N9) virus will continue to spread. [ABSTRACT FROM AUTHOR]

Objective Previous genome-wide association studies (GWAS), which were mainly based on single-variant analysis, have identified many systemic lupus erythematosus (SLE) susceptibility loci. However, the genetic architecture of this complex disease is far from being understood. The aim of this study was to investigate whether using a gene-based analysis may help to identify novel loci, by considering global evidence of association from a gene or a genomic region rather than focusing on evidence for individual variants. Methods Based on the results of a meta-analysis of 2 GWAS of SLE conducted in 2 Asian cohorts, we performed an in-depth gene-based analysis followed by replication in a total of 4,626 patients and 7,466 control subjects of Asian ancestry. Differential allelic expression was measured by pyrosequencing. Results More than one-half of the reported SLE susceptibility loci showed evidence of independent effects, and this finding is important for understanding the mechanisms of association and explaining disease heritability. ANXA6 was detected as a novel SLE susceptibility gene, with several single-nucleotide polymorphisms (SNPs) contributing independently to the association with disease. The risk allele of rs11960458 correlated significantly with increased expression of ANXA6 in peripheral blood mononuclear cells from heterozygous healthy control subjects. Several other associated SNPs may also regulate ANXA6 expression, according to data obtained from public databases. Higher expression of ANXA6 in patients with SLE was also reported previously. Conclusion Our study demonstrated the merit of using gene-based analysis to identify novel susceptibility loci, especially those with independent effects, and also demonstrated the widespread presence of loci with independent effects in SLE susceptibility genes. [ABSTRACT FROM AUTHOR]

Diagnosis of active tuberculosis (TB) in children remains difficult. This study aimed at evaluating the ability of interferon-gamma release assays (IGRAs) in the detection of active TB in human immunodeficiency virus-negative children vaccinated with Bacille Calmette-Guérin and investigating the effect of prednisolone treatment on the IGRAs performance. Among the 162 children with suspected TB disease recruited in China, 60 were tested with QuantiFERON-TB Gold In Tube (QFT-GIT) and 102 were tested with T-SPOT.TB. QFT-GIT presented a sensitivity of 83.9 % (95 % CI 66.9-93.4 %) and a specificity of 88.5 % (95 % CI 70.2-96.8 %), while T-SPOT.TB had a sensitivity of 75.9 % (95 % CI 63.4-85.2 %) and a specificity of 94.7 % (95 % CI 81.8-99.5 %). The positive predictive value was high in both assays, 92.9 % for QFT-GIT and 95.7 % for T-SPOT.TB. In total of these two kinds of IGRAs, false negative rate was significantly higher in children receiving systemic prednisolone (1 mg/kg/day) therapy for >1 week (two tested with T-SPOT.TB and five tested with QFT-GIT) than in those with ≤1 week of prednisolone therapy and without prednisolone therapy (57.1 vs. 18.3 %, p = 0.035). There was no significant difference of the positive rate of both tests in children <5 years old compared with those ≥5 years old. Both types of IGRAs showed good diagnostic values in detecting childhood TB before microbiological evidence was available. Glucocorticoids had a significant negative influence on IGRAs if treated for >1 week. Age made no difference on the performance of these tests in children. [ABSTRACT FROM AUTHOR]

This article aims to explore Chinese couples' perspectives on sexual dysfunctions in the socio-cultural context of Hong Kong. It enables us to expand our understanding of sexual dysfunction, from etiology to an understanding of human significance. In this qualitative study employed with in-depth interviews, eight couples with sexual dysfunctions were recruited to provide personal accounts of marital experience and perceived significance of sexual dysfunctions in marriage. According to the findings, the spouses reported diversified marital relationships and their views of sexual dysfunctions were inter-subjective in light of socioeconomic, relational and temporal context, more than as a biological given. They interpreted sexual dysfunction in a horizon of temporality stretching through past, present and future, from the sphere of coitus to the sphere beyond coitus. Besides, their reproductive plans were emphasized. Stress arising from their busy lives with household conditions and in socioeconomic context was prominent. In addition, the spouses also sought alternatives for satisfaction apart from coitus, e.g., masturbation, caressing, hugging, kissing and sweet words. [ABSTRACT FROM AUTHOR]

Objectives The objectives of the study were (1) to validate the Chinese version of Health Utilities Index (HUI-Ch); (2) to examine the Health-related Quality of Life (HRQoL) of Chinese subjects with Down syndrome (DS); and (3) to study the impact of chronic health conditions on HRQoL of Chinese with DS. Methods The multiple choice questionnaire for scoring Health Utilities Index Mark 2 (HUI2) and Health Utilities Index Mark 3 (HUI3) was translated and validated. In addition to the HRQoL scores from HUI2 and HUI3, proxy-data on socio-demographics, and 10 common chronic health conditions for people with DS were collected and analyzed. Data analysis involves multiple imputation and multiple regression analysis to predict variations in HRQoL in relation to different factors. Lastly, a gradient interval was constructed on the number of chronic health conditions in relation to HRQoL. Results HUI-Ch was validated according to standard guidelines. People with DS were found to have a lower HRQoL as compared to the general population, with the majority categorized as moderate or severe on the scale. Behavioral and hearing problems on HUI2, and hearing problems on HUI3 were found to be statistically significant predictors of a lower HRQoL score. A significant gradient relationship existed showing when the number of health problems increased, the HRQoL scores decreased. Conclusions HUI-Ch is a valid instrument to assess HRQoL. It can have broad application in Chinese subjects with DS including the study of the impact of different chronic health conditions on their quality of life. The quantifiable nature of HUI-Ch will facilitate longitudinal study on the well-being of subjects with DS and evaluation of effectiveness of intervention programs in the near future. [ABSTRACT FROM AUTHOR]

Objective. This study aims to identify the existence of, and relationship between autoantibody clusters and clinical subsets in Chinese SLE patients.Methods. Data from 1928 SLE patients from Hong Kong were analysed. Using cluster analysis, patients were grouped by autoantibodies into clusters. The frequencies of various clinical manifestations were then compared between each cluster. Separate association analyses between individual autoantibodies and clinical manifestations as well as between clinical manifestations were also performed without any prior clustering.Results. Three separate autoantibody clusters were identified, each with significantly different clinical manifestations. Cluster 1 was characterized by anti-dsDNA and the greatest prevalence of renal disorder but the lowest frequencies of other clinical manifestations. Cluster 2 was represented by the predominance of anti-Smith, anti-RNP and aPL, with greater prevalence of malar rash, oral ulcers, arthritis and serositis. Cluster 3 was characterized by anti-Ro and anti-La with greater prevalence of discoid rash, photosensitivity and haematological involvement. Individual association analysis also revealed similar findings. Patients of clusters 2 and 3 were more closely related, while cluster 1 was more distinct, associated with renal disorder only and negatively associated or not associated with other manifestations.Conclusion. We conclude that autoantibody clustering and clinical subsets exist in SLE patients of our locality. These clusters may be viewed as a bipolar spectrum of related autoantibody and clinical manifestations. At one end are patients with over-representation of anti-dsDNA and renal disorder, while at the other end are two distinct autoantibody clusters (anti-Sm/anti-RNP/aPL and anti-Ro/anti-La) with overlapping of other clinical manifestations. [ABSTRACT FROM AUTHOR]

Background: Etiologies of pediatric intensive care unit (PICU) mortality are diverse. This study aimed to investigate the pattern of PICU mortality in a regional trauma center, and explore factors associated with prolonged non-survival. Methods: Demographic data of all PICU deaths in a regional trauma center were analyzed. Factors associated with prolonged nonsurvival (length of stay) were investigated with univariate log rank and multivariate Cox-Regression forward stepwise tests. Results: There were 88 deaths (males 61%; infants 23%) over 10 years (median PICU stay = 3.5 days, interquartile range: 1 and 11 days). The mean annual mortality rate of PICU admissions was 5.8%. Septicemia with gram positive, gram negative and fungal pathogens were present in 13 (16%), 13 (16%) and 4 (5%) of these patients, respectively. Viruses were isolated in 25 patients (28%). Ninety percent of these 88 patients were ventilated, 75% required inotropes, 92% received broad spectrum antibiotic coverage, 32% received systemic corticosteroids, 56% required blood transfusion and 39% received anticonvulsants. Thirty nine patients (44%) had a DNAR (Do-Not-Attempt-Resuscitation) order with their deaths at the PICU. Comparing with non-trauma category, trauma patients had higher mortality score, no premorbid disease, suffered asystole preceding PICU admission and subsequent brain death. Oncologic conditions were the most prevalent diagnosis in the non-trauma category. There was no gunshot or asthma death in this series. Prolonged non-survival was significantly associated with DNAR, fungal infections, and mechanical ventilation but negatively associated with bacteremia. Conclusions: Death in the PICU is a heterogeneous event that involves infants and children. Resuscitation was not attempted at the time of their deaths in nearly half of the patients in honor of parents' wishes. Parents often make DNAR decision when medical futility becomes evident. They could be reassured that DNAR did not mean "abandoning" care. Instead, DNAR patients had prolonged PICU stay and received the same level of PICU supports as patients who did not respond to cardiopulmonary resuscitation. [ABSTRACT FROM AUTHOR]

Abstract: Aconite poisoning is one of the most serious types of herb-related medical emergencies. In Hong Kong, many if not most of these poisoning cases are due to confusion in herbal species; that is, the wrong herbs are used in prescriptions. Such human errors, while inevitable perhaps, can be serious, and sometimes fatal. The chemical components responsible for aconite poisoning are yunaconitine and crassicauline A. In the present study, a rapid and sensitive method for the screening and quantification of yunaconitine and crassicauline A in human serum, using LC–MS/MS, was developed and validated. Methyllycaconitine was chosen as the internal standard. The limit of detection (LOD) of yunaconitine and crassicauline A were found to be 0.022 and 0.021ng/mL, respectively. The limit of quantification (LOQ) was 0.1ng/mL for both yunaconitine and crassicauline A. The recovery of yunaconitine and crassicauline A ranged from 78.6% to 84.9% and 78.3% to 87.2%, respectively. The matrix effect of yunaconitine and crassicauline A ranged from 110.0% to 130.4% and 121.2 to 130.0%, respectively. Both yunaconitine and crassicauline A were stable in serum for at least 3 months at −20°C, and the extracts were stable for at least 7 days. For clinical applications, serum samples of two patients confirmed to have had aconite herbs poisoning in 2008 were quantified using the developed method. The result showed that this method can be utilized in clinical routine applications. This screening method expedites the diagnosis in cases of suspected aconite poisoning, thus enabling doctors to treat the condition more quickly and effectively. [Copyright &y& Elsevier]

Construction workers (CWs) are the key and indispensable contributors to every construction project. Their psychological feelings greatly influence their behaviors and safety performance. To improve CWs' safety performance in dangerous working environment, the current research aims to identify the various stressors affecting two types of stress of CWs (i.e., job stress and emotional stress) and to explore the impacts of the two types of stress on CW injury incidents in Hong Kong. Eleven stressors were identified through factor analysis: work overload, role ambiguity, lack of autonomy, unfair reward and treatment, appropriate safety equipment, optimism, interrole conflict, poor workgroup relationship, lack of feedback, poor physical environment, and unsafe environment. The results of correlation and regression analyses reveal that (1) among the two types of stress identified, injury incident of CWs was found to be affected by emotional stress only, (2) emotional stress is predicted by work overload, interrole conflict, poor physical environment, unfair reward and treatment, and appropriate safety equipments, and (3) poor workgroup relationship, work overload, and interrole conflict predict job stress of CWs. Based on the result, various recommendations are suggested to employers on how to minimize CW injury incidents. [ABSTRACT FROM AUTHOR]

Starting from September 2009, Liberal Studies will be one of the core subjects in the New Senior Secondary curriculum. In the face of this curriculum reform which focuses on subject integration, lots of subject teachers have started to look for opportunities for further professional development and self-enhancement. Taking the experience of students of the Master of Arts Programme in Curriculum Development and Teaching of Liberal Studies offered by a university in Hong Kong, this article attempts to find out: (1) the characteristics of students in the program in terms of their "teaching experience," "subject background, .... role in the development of the subject Liberal Studies, " and "learning motivation"; (2) the learning outcomes achieved by students. The purpose is to understand how frontline teachers perceive teacher professional development. Questionnaire, focus interview, and analysis of students' learning log were used to collect data. [ABSTRACT FROM AUTHOR]

Abstract: Air-conditioning settings are important factors in controlling the comfort of passengers on buses. The local bus operators control in-bus air quality and thermal environment by conforming to the prescribed levels stated in published standards. As a result, the settings are merely adjusted to fulfill the standards, rather than to satisfy the passengers'' thermal comfort and air quality. Such “standard-oriented” practices are not appropriate; the passengers'' preferences and satisfaction should be emphasized instead. Thus a “comfort-oriented” philosophy should be implemented to achieve a comfortable in-bus commuting environment. In this study, the achievement of a comfortable in-bus environment was examined with emphasis on thermal comfort and air quality. Both the measurement of physical parameters and subjective questionnaire surveys were conducted to collect practical in-bus thermal and air parameters data, as well as subjective satisfaction and sensation votes from the passengers. By analyzing the correlation between the objective and subjective data, a combined comfort models were developed. The models helped in evaluating the percentage of dissatisfaction under various combinations of passengers'' sensation votes towards thermal comfort and air quality. An effective approach integrated the combined comfort model, hardware and software systems and the bus air-conditioning system could effectively control the transient in-bus environment. By processing and analyzing the data from the continuous monitoring system with the combined comfort model, air-conditioning setting adjustment commands could be determined and delivered to the hardware. This system adjusted air-conditioning settings depending on real-time commands along the bus journey. Therefore, a comfortable in-bus air quality and thermal environment could be achieved and efficiently maintained along the bus journey despite dynamic outdoor influences. Moreover, this model can help optimize air-conditioning control by striking a beneficial balance between energy conservation and passengers'' satisfaction level. [Copyright &y& Elsevier]

Background. Human coronavirus NL63 (HCoV-NL63) is a recently discovered human coronavirus found to cause respiratory illness in children and adults that is distinct from the severe acute respiratory syndrome (SARS) coronavirus and human coronaviruses 229E (HCoV-229E) and 0C43 (HCoV-0C43). Methods. We investigated the role that HCoV-NL63, HCoV-0C43, and HCoV-229E played in children hos- pitalized with fever and acute respiratory symptoms in Hong Kong during the period from August 2001 through August 2002. Results. Coronavirus infections were detected in 26 (4.4%) of 587 children studied; 15 (2.6%) were positive for HCoV-NL63, 9 (1.5%) were positive for HCoV-0C43, and 2 (0.3%) were positive for HCoV-229E. In addition to causing upper respiratory disease, we found that HCoV-NL63 can present as croup, asthma exacerbation, febrile seizures, and high fever. The mean age (± standard deviation [SD]) of the infected children was 30.7 ± 19.8 months (range, 6-57 months). The mean maximum temperature (± SD) for the 12 children who were febrile was 39.3°C ± 0.9°C, and the mean total duration of fever (± SD) for all children was 2.6 ± 1.2 days (range, 1-5 days). HCoV-NL63 infections were noted in the spring and summer months of 2002, whereas HCoV-0C43 infection mainly occurred in the fall and winter months of 2001. HCoV-NL63 viruses appeared to cluster into 2 evolutionary lineages, and viruses from both lineages cocirculated in the same season. Conclusions. HCoV-NL63 is a significant pathogen that contributes to the hospitalization of children, and it was estimated to have caused 224 hospital admissions per 100,000 population aged E6 years each year in Hong Kong. [ABSTRACT FROM AUTHOR]

Laparoscopic surgery burst into the surgical scene in the late 20th century and completely changed the art, craft and scene of surgery in a most dramatic fashion. With the dawn of a new century, much of the pioneering literature is now invaluable surgical relics. A comprehensive review of publications from Fellows of the College of Surgeons of Hong Kong prior to the year 2000 reveals many significant innovations in major fields of surgery: a rich legacy worthy of a permanent, orderly record in the Annals of the College. Some of the novel techniques proposed therein have stood the test of time and have now become a standard of care worldwide. [ABSTRACT FROM AUTHOR]

The current study examined the effects of socioeconomic status (SES) on the school readiness of Chinese preschool children in Hong Kong. A total of 69 teachers from 20 kindergartens in both rich and poor districts in Hong Kong rated the school readiness of 567 preschool children using the Chinese version of the Early Development Instrument. Information about home learning activities and kindergarten characteristics was obtained from parents and preschool teachers, respectively. The results indicated a gradient relationship between SES and total EDI scores, with children from higher-SES families rated as being very ready for school on more domains of the Chinese version of the Early Development Instrument than those from lower-SES families. Home learning activities (reading and recreational activities) and teachers’ experience and kindergarten facilities significantly mediated the socioeconomic gradient effects. These findings highlight that efforts are much needed in tackling the developmental disparity and the promotion of better parent–child interaction, teacher quality, and kindergarten facilities might be able to help all children attain their own developmental potential. [ABSTRACT FROM AUTHOR]

Ethnopharmacological evidence: Danggui Buxue Tang (DBT), a Chinese medicinal decoction that is being commonly used as hematopoietic medicine to treating woman menopausal irregularity, contains two herbs: Radix Astragali and Radix Angelicae Sinensis. Pharmacological results indicate that DBT can stimulate the production of erythropoietin (EPO), a specific hematopoietic growth factor, in cultured cells. Aim of the study: In order to revealing the mechanism of DBT''s hematopoietic function, this study investigated the activity of the DBT-induced EPO expression and the upstream regulatory cascade of EPO via hypoxia-induced signaling in cultured kidney fibroblasts (HEK293T). Materials and methods: DBT-induced mRNA expressions were revealed by real-time PCR, while the change of protein expressions were analyzed by Western blotting. For the analysis of hypoxia-dependent signaling, a luciferase reporter was used to report the transcriptional activity of hypoxia response element (HRE). Results: The plasmid containing HRE, being transfected into HEK293T, was highly responsive to the challenge of DBT application. To account for the transcriptional activation of HRE, DBT treatment was shown to increase the mRNA and protein expressions of hypoxia-inducible factor-1α (HIF-1α). In addition, the activation of Raf/MEK/ERK signaling pathway by DBT could also enhance the translation of HIF-1α, suggesting the dual actions of DBT in stimulating the EPO expression in kidney cells. Conclusion: Our study indicates that HIF pathway plays an essential role in directing DBT-induced EPO expression in kidney. These results provide one of the molecular mechanisms of this ancient herbal decoction for its hematopoietic function. [Copyright &y& Elsevier]