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Background: Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries.Method: A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015-2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population.Results: Eighty-four point one percent (95% CI 81.4-86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4-18.6%) were current polytobacco product users, 12.3% (10.2-14.8%) used one tobacco product and 2.52% (1.59-3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75-8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44-2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12-3.61), younger age (AORs range from 1.34-4.65, P for trend < .001) and less ready to quit (2.08, 1.09-3.97).Conclusions: Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU. [ABSTRACT FROM AUTHOR]

Summary: Vitamin D deficiency and insufficiency are highly prevalent among adolescents in Hong Kong, which is a sub-tropical city with ample sunshine. Vitamin D level is significantly correlated with key bone density and bone quality parameters. Further interventional studies are warranted to define the role of vitamin D supplementation for improvement of bone health among adolescents. Introduction: The relationship between bone quality parameters and vitamin D (Vit-D) status remains undefined among adolescents. The aims of this study were to evaluate Vit-D status and its association with both bone density and bone quality parameters among adolescents. Methods: Three hundred thirty-three girls and 230 boys (12-16 years old) with normal health were recruited in summer and winter separately from local schools. Serum 25(OH) Vit-D level, bone density and quality parameters by Dual Energy X-ray Absorptiometry (DXA) and High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT), dietary calcium intake, and physical activity level were assessed. Results: Sixty-four point seven percent and 11.4 % of subjects were insufficient [25 ≤ 25(OH)Vit-D ≤ 50 nmol/L] and deficient [25(OH)Vit-D < 25 nmol/L] in Vit-D, respectively. The mean level of serum 25(OH)Vit-D in summer was significantly higher than that in winter (44.7 ± 13.6 and 35.9 ± 12.6 nmol/L, respectively) without obvious gender difference. In girls, areal bone mineral density (aBMD) and bone mineral content (BMC) of bilateral femoral necks, cortical area, cortical thickness, total volumetric bone mineral density (vBMD), and trabecular thickness were significantly correlated with 25(OH)Vit-D levels. In boys, aBMD of bilateral femoral necks, BMC of the dominant femoral neck, cortical area, cortical thickness, total vBMD, trabecular vBMD, BV/TV, and trabecular separation were significantly correlated with 25(OH)Vit-D levels. Conclusion: Vit-D insufficiency was highly prevalent among adolescents in Hong Kong with significant correlation between Vit-D levels and key bone density and bone quality parameters being detected in this study. Given that this is a cross-sectional study and causality relationship cannot be inferred, further interventional studies investigating the role of Vit-D supplementation on improving bone health among adolescents are warranted. [ABSTRACT FROM AUTHOR]

Background: In Hong Kong, fasting plasma glucose (FPG) is the most popular screening test for diabetes mellitus (DM) in primary care. Individuals with impaired fasting glucose (IFG) are commonly encountered.Objectives: To explore the determinants of regression to normoglycaemia among primary care patients with IFG based on non-invasive variables and to establish a nomogram for the prediction of regression from IFG.Methods: This cohort study consisted of 1197 primary care patients with IFG. These subjects were invited to repeat a FPG test and 75-g 2-hour oral glucose tolerance test (2h-OGTT) to determine the glycaemia change. Normoglycaemia was defined as FPG <5.6 mmol/L and 2h-OGTT <7.8 mmol/L. Stepwise logistic regression model was developed to predict the regression to normoglycaemia with non-invasive variables, using a randomly selected training dataset (810 subjects). The model was validated on the remaining testing dataset (387 subjects). Area under the receiver operating characteristic curve (AUC) and Hosmer-Lemeshow test were used to evaluate discrimination and calibration of the model. A nomogram was constructed based on the model.Results: After a mean follow-up period of 6.1 months, 180 subjects (15.0%) had normoglycaemia based on the repeated FPG and 2h-OGTT results at follow-up. Subjects without central obesity or hypertension, with moderate-to-high-level physical activity and a lower baseline FPG level, were more likely to regress to normoglycaemia. The prediction model had acceptable discrimination (AUC = 0.705) and calibration (P = 0.840).Conclusion: The simple-to-use nomogram could facilitate identification of subjects with low risk of progression to DM and thus aid in clinical decision making and resource prioritization in the primary care setting. [ABSTRACT FROM AUTHOR]

Background: HbA1c ≥ 6.5% has been recommended as a diagnostic criterion for the detection of diabetes mellitus (DM) since 2010 because of its convenience, stability and significant correlation with diabetic complications. Nevertheless, the accuracy of HbA1c compared to glucose-based diagnostic criteria varies among subjects of different ethnicity and risk profile.Objectives: This study aimed to evaluate the accuracy of HbA1c for diagnosing DM compared to the diagnosis by oral glucose tolerance test (OGTT) and the optimal HbA1c level to diagnose DM in primary care Chinese patients with impaired fasting glucose (IFG).Methods: A cross-sectional study was carried out in three public primary care clinics in Hong Kong. About 1128 Chinese adults with IFG (i.e. FG level between 5.6 and 6.9 mmol/l in the past 18 months) were recruited to receive paired OGTT and HbA1c tests. Sensitivities and specificities of HbA1c at different threshold levels for predicting DM compared to the diagnosis by OGTT were evaluated. A receiver operating characteristic (ROC) curve was used to determine the optimal cut-off level.Results: Among the 1128 subjects (mean age 64.2±8.9 year, 48.8% male), 229 (20.3%) were diagnosed to have DM by OGTT. The sensitivity and specificity of HbA1c ≥6.5% were 33.2% and 93.5%, respectively, for predicting DM diagnosed by OGTT. The area under the ROC curve was 0.770, indicating HbA1c had fair discriminatory power. The optimal cut-off threshold of HbA1c was 6.3% for discriminating DM from non-DM, with sensitivity and specificity of 56.3% and 85.5%, respectively. HbA1c ≥ 5.6% has the highest sensitivity and negative predictive value of 96.1% and 94.5%, respectively.Conclusions: HbA1c ≥ 6.5% is highly specific in identifying people with DM, but it may miss the majority (66.8%) of the DM cases. An HbA1c threshold of <5.6% is more appropriate to be used for the exclusion of DM. OGTT should be performed for the confirmation of DM among Chinese patients with IFG who have an HbA1c between 5.6% and 6.4%. [ABSTRACT FROM AUTHOR]

Objective:An association between weight gain and breakfast skipping has been reported, but breakfast location was rarely considered. We investigated the prospective associations between breakfast location, breakfast skipping and body mass index (BMI) change in a large cohort of Chinese children.Design:Our baseline cohort consisted of 113 457 primary 4 (US grade 4) participants of the Hong Kong Department of Health Student Health Service in 1998-2000. Of these, 68 606 (60.5%) had complete records and were successfully followed-up 2 years later. Data on breakfast consumption and location were collected at both time points along with other lifestyle characteristics. BMI was derived from objectively measured height and weight. Associations between breakfast habits and BMI change were assessed by multivariable linear regression, adjusting for demographic, socioeconomic and lifestyle characteristics.Results:At baseline, 85.3, 9.4 and 5.2% of children had breakfast at home, away from home and skipped breakfast, respectively. Prospectively, having breakfast away from home (vs at home) predicted a greater BMI increase over two years (β=0.15; 95% CI: 0.11-0.18). Breakfast skipping had a comparable, slightly smaller effect (0.13; 0.09-0.18).Conclusion:Both breakfast skipping and eating breakfast away from home predict greater increases in BMI during childhood, the effect being slightly stronger in the latter. Having breakfast, particularly at home, could have important implications for weight management and reducing obesity in children. Further research is required to gain insight into potential underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background. Little is known about the quality of care for patients with Type 2 diabetes in primary care setting in Hong Kong.Objectives. To investigate the quality of care for patients with Type 2 diabetes in Hong Kong primary care setting and potential disparities by patient characteristics and clinics.Methods. Cross-sectional study in three general outpatient clinics (GOPCs; public primary care clinics) in Hong Kong involving 1970 patients. Main outcome measures were achievement rates of seven process measures and three intermediate outcome targets and adjusted odds ratios of age, sex, socio-economic status and clinic on the quality measures.Results. The achievement rates for the recording of HbA1c, blood pressure (BP), cholesterol, body mass index, smoking status, nephropathy screening and retinopathy screening in the previous 12 months were 92.8%, 99.9%, 91.0%, 47.9%, 91.3%, 69.0% and 38.0%, respectively. A total of 58.0%, 38.2% and 36.4% of patients achieved the glycaemic, BP and cholesterol targets, respectively. Older patients were less likely to have records of process measures and more likely to achieve the HbA1c target. Women were less likely to have smoking status recorded and to achieve the HbA1c target. Patients of lower socio-economic status were less likely to have records of process measures and to achieve the BP target. Family medicine training practices had better achievements of the quality measures.Conclusions. There is scope for improvement in the quality of diabetes care in the GOPCs. Variations in the quality of care were observed. Family medicine training may enhance the health care quality. [ABSTRACT FROM PUBLISHER]

A novel operation system to detect train vibration and train weight using FBG sensing network has been designed and tested in Hong Kong. The purpose of the system is for real time condition monitoring of trains. Because of the fast response of optical systems, the trains can be monitored in real-time during its normal service without any special arrangement. Hence, the condition checking can be realized without any disruption on the operating condition of the railway system. [ABSTRACT FROM AUTHOR]

Background/Objectives:Childhood obesity is prevalent, and dietary habits are a key determinant. Some children skip breakfast for weight control, but studies have shown mixed results. Therefore, we assessed the association between breakfast skipping and body mass index (BMI) among young Chinese children in Hong Kong.Design/Subjects and Methods:A cohort of 113 457 primary 4 participants of the Department of Health Student Health Service in 1998-2000 was followed up for 2 years, with 68 606 (60.5%) participants available for analysis in primary 6. The sociodemographic characteristics for traced and untraced participants were similar. At baseline and follow-up, students reported breakfast habit (consumed vs skipped) and other lifestyle characteristics using a standardized questionnaire. BMI was derived using height and weight measured by trained nurses. Multivariable linear regression was used to examine the cross-sectional relationship between breakfast habit and BMI, as well as the prospective association between baseline breakfast habit and change in BMI. Models adjusted for demographic, socioeconomic and lifestyle characteristics.Results:A total of 1805 (5.3%) boys and 1793 (5.2%) girls skipped breakfast at baseline. In cross-sectional analyses, breakfast skippers had a higher mean BMI than did eaters among both primary 4 (β=0.77, 95% confidence interval (95% CI): 0.67-0.87) (P<0.001) and primary 6 children (β=0.86, 95% CI: 0.78-0.95) (P<0.001). Compared with eaters, baseline breakfast skippers experienced a greater increase in BMI in the subsequent 2 years (β=0.11, 95% CI: 0.07-0.16) (P<0.001), and this association was stronger among lunch skippers than eaters (P for interaction=0.04).Conclusion:Our study provided prospective evidence that skipping breakfast predicts a greater increase in BMI among Hong Kong children. As breakfast is a modifiable dietary habit, our results may have important implications for weight control. However, the underlying mechanism of this effect warrants further investigation [ABSTRACT FROM AUTHOR]

Objective: To examine the efficacy of a strength-focused mutual support group for reducing stress and enhancing psychological well-being of the caretakers of children with cerebral palsy. Methods: This pre- and post-intervention outcome study, conducted by Department of Orthopaedics and Traumatology, Duchess of Kent Children's Hospital, recruited 12 primary caretakers of children with cerebral palsy in Hong Kong. A strength-focused support group manual was developed to help such caretakers to identify and cultivate the character strengths of their children and enhance their own positive emotions. Participants were asked to complete a full set of questionnaires at 3 time-points: before and immediately after the intervention (consisting of 4 weekly sessions), and after the 1-month follow-up booster session. Two additional questionnaires were administered before each session to check mood. Parenting stress, anxiety, depression, social support, hope, and other psychological well-being measures were also assessed. Results: Half of the caretakers (n = 6) who had attended the full intervention programme were included in the data analysis. Participants exhibited a significantly lower level of parental stress and higher hope level both after the 4 intervention sessions and at the booster session. Their perceived social support was significantly increased when the group was ongoing but not after it ended. Conclusion: This group intervention programme could effectively help caretakers reduce their parenting stress and enhance their hopefulness. Launching a similar programme with more sessions and regular follow-up sessions might help maintain positive effects and establish a social support network. [ABSTRACT FROM AUTHOR]

Background: Recent genome-wide association studies of colorectal cancer (CRC) have identified common single-nucleotide polymorphisms (SNPs) mapping to 10 independent loci that confer modest increased risk. These studies have been conducted in European populations and it is unclear whether these observations generalise to populations with different ethnicities and rates of CRC.Methods: An association study was performed on 892 CRC cases and 890 controls recruited from the Hong Kong Chinese population, genotyping 32 SNPs, which were either associated with CRC in previous studies or are in close proximity to previously reported risk SNPs.Results: Twelve of the SNPs showed evidence of an association. The strongest associations were provided by rs10795668 on 10p14, rs4779584 on 15q14 and rs12953717 on 18q21.2. There was significant linear association between CRC risk and the number of independent risk variants possessed by an individual (P=2.29 × 10(-5)).Conclusion: These results indicate that some previously reported SNP associations also impact on CRC risk in the Chinese population. Possible reasons for failure of replication for some loci include inadequate study power, differences in allele frequency, linkage disequilibrium structure or effect size between populations. Our results suggest that many associations for CRC are likely to generalise across populations. [ABSTRACT FROM AUTHOR]

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Vehicle emissions of volatile organic compounds (VOCs) were determined at the Shing Mun Tunnel, Hong Kong in summer and winter of 2003. One hundred and ten VOCs were quantified in this study. The average concentration of the total measured VOCs at the inlet and outlet of the tunnel were 81 250 pptv and 117 850 pptv, respectively. Among the 110 compounds, ethene, ethyne and toluene were the most abundant species in the tunnel. The total measured VOC emission factors ranged from 67 mg veh-1 km-1 to 148 mg veh-1 km-1, with an average of 115 mg veh-1 km-1. The five most abundant VOCs observed in the tunnel were, in decreasing order, ethene, toluene, n-butane, propane and i-pentane. These five most abundant species contributed over 38% of the total measured VOCs emitted. The high propane and n-butane emissions were found to be associated with liquefied petroleum gas (LPG)-fueled taxis. Fair correlations were observed between marker species (ethene, i-pentane, n-nonane, and benzene, toluene, ethylbenzene and xylenes - BTEX) with fractions of gasoline-fueled or diesel-fueled vehicles. Moreover, ethene, ethyne, and propene are the key species that were abundant in the tunnel but not in gasoline vapors or LPG. The ozone formation potential from the VOCs in Hong Kong was evaluated by the maximum increment reactivity (MIR). It was found to be 568 mg of ozone per vehicle per kilometer traveled. Among them, ethene, propene and toluene contribute most to the ozone-formation reactivity. [ABSTRACT FROM AUTHOR]

We investigated the relationship of sociocultural influences (SI) promoting thinness (parental, peer and media pressures for thinness, and individual value for modernity), age and body mass Index (BMI) to body dissatisfaction (BD) and dieting in 294 Hong Kong community adolescent girls. We proposed that BD mediated SI's relationship with dieting. In bivariate analyses, all variables were significantly (p ≤ .05) related to BD (ß's from 0.14 to 0.59), and, except for modernity, to dieting (ß's from 0.17 to 0.51). In multivariate analyses, peer (ß = 0.32, p < .001) and media pressures for thinness (ß = 0.18, p < .01) bypassed BD and were directly associated with dieting. A culture of thinness appears to be associated with weight loss efforts among girls in modernising cultures independent of BD. Our findings call for public policy to restrict promotion of the impossibly thin ideal, and public education regarding the paradoxical effects of dieting. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Background: Idiopathic inflammatory demyelinating disorders (IIDD) affect the central nervous system. In classical multiple sclerosis (CMS), brain, optic nerves [optic neuritis (ON)] and spinal cord [acute transverse myelitis (ATM)] are affected. In neuromyelitis optica (NMO), optic nerves and spinal cord are predominantly affected. NMO-IgG, an autoantibody targeting aquaporin-4, is a marker for NMO. We studied the frequency and clinical relevance of NMO-IgG seropositivity in IIDD patients. Methods: Neuromyelitis optica-IgG was detected by indirect immunofluorescence using primate cerebellum. Results: Neuromyelitis optica-IgG was detected in six of 10 NMO patients (60%), six of 10 idiopathic relapsing transverse myelitis (IRTM) patients (60%), two of nine idiopathic relapsing ON patients (22%), one of 11 patients (9%) having single ON attack, one of 30 CMS patients (3%), and none of patients having single ATM attack or controls. Comparing NMO-IgG seropositive ( n = 12) with NMO-IgG seronegative ( n = 8) patients having NMO or IRTM, NMO-IgG seropositivity was associated with a higher relapse rate in first 2 years, 1.5 and 0.6 attacks/year for seropositive and seronegative groups respectively ( P = 0.006), and non-significant trend towards more severe ON and myelitis with poorer clinical outcome. Conclusion: Neuromyelitis optica -IgG facilitates diagnosis of NMO spectrum disorders. NMO-IgG seropositivity is associated with higher relapse rate in first 2 years. [ABSTRACT FROM AUTHOR]

Background Asthma is a disease associated with oxidative stress. The glutathione S-transferases (GST) are a group of enzymes that protect cells from oxidative stress. Functional genetic polymorphisms of GST genes ( GSTT1, GSTM1 and GSTP1) have previously been reported. Objective To investigate the association of GST gene polymorphisms and its enzyme activity with the risk of asthma in Hong Kong Chinese adults. Methods An age- and smoking status-matched case–control study was carried out on 315 patients with asthma and 315 healthy controls. Genotyping was carried out on genomic DNA using the PCR and/or restriction fragment length polymorphism (PCR-RFLP). Plasma GST activity was measured by fluorometric assay. Results The distribution of various genotypes or alleles of the GSTT1, GSTM1 and GSTP1 was not significantly different between patients with asthma and healthy controls. The GSTM1 null genotype was found to be protective from the development of asthma in atopic subjects (odds ratios 0.55, 95% confidence interval 0.34–0.90; P=0.017). However, there was no association between GSTT1 and GSTM1 null genotypes and enzyme activity. GSTP1 codon 105 Val variants led to reduced plasma GST activity in healthy controls. Asthma patients had elevated plasma GST activity compared with healthy controls irrespective of their genotypes ( P<0.001). Conclusion Our data suggest that among atopic subjects, the GSTM1 null genotype is associated with a decreased risk for asthma despite increased level of plasma GST activity in asthma, but it could not distinguish whether this increase is a potentially protective compensatory effect or a pathogenic factor. [ABSTRACT FROM AUTHOR]

Objective:To evaluate the validity of currently recommended obesity cutoffs of body mass index (BMI, in kg/m2) and waist circumference (WC, in cm) for Asians by the WHO/IASO/IOTF and for Chinese by the Working Group on Obesity in China (WGOC) using the percentage body fat (%BF)-obesity criteria.Design:A cross-sectional study.Subjects:A total of 1122 community-based Hong Kong Chinese women aged between 41 and 63 years.Measurements:Total %BF and percent truncal fat (%TF) were measured using dual-energy X-ray absorptiometry. Anthropometric indices were measured using standard methods.Results:Regression analyses showed that the BMI cutoffs of 23, 24, 25, and 28 kg/m2 corresponded to the %BF of 34.8, 35.9, 36.9 and 39.5%, and the 80 cm WC corresponded to 34% TF, respectively. Compared with the %BF obesity cutoff (40%), the WHO/IASO/IOTF BMI-obesity criterion (25) shows a good sensitivity (75%) and specificity (71%); and the WGOC criterion (BMI28) had a low sensitivity (41%) but an excellent specificity (93%), respectively. Corresponding to the BMI cutoffs of 23, 24, 25 and 28 kg/m2, the %BF cutoffs associated with peak κ statistic were 33, 34, 35 and 40%, and the relevant %TF linked with 80 cm WC was 33%, respectively.Conclusion:BMI and WC have a good accuracy in the prediction of obesity. Our findings suggest that the WGOC BMI cutoffs are appropriate, but 80 cm of WC is a very rigorous cutoff for this population when using the criteria of 34 and 40% of body fat or truncal fat for overweight and obesity.International Journal of Obesity (2006) 30, 918–925. doi:10.1038/sj.ijo.0803220; published online 24 January 2006 [ABSTRACT FROM AUTHOR]

Background: Costs of tobacco-related disease can be useful evidence to support tobacco control. In Hong Kong we now have locally derived data on the risks of smoking, including passive smoking. Aim: To estimate the health-related costs of tobacco from both active and passive smoking. Methods: Using local data, we estimated active and passive smoking-attributable mortality, hospital admissions, outpatient, emergency and general practitioner visits for adults and children, use of nursing homes and domestic help, time lost from work due to illness and premature mortality in the productive years. Morbidity risk data were used where possible but otherwise estimates based on mortality risks were used. Utilisation was valued at unit costs or from survey data. Work time lost was valued at the median wage and an additional costing included a value of US$1.3 million for a life lost. Results: In the Hong Kong population of 6.5 million in 1998, the annual value of direct medical costs, long term care and productivity loss was US$532 million for active smoking and US$156 million for passive smoking; passive smoking accounted for 23% of the total costs. Adding the value of attributable lives lost brought the annual cost to US$9.4 billion. Conclusion: The health costs of tobacco use are high and represent a net loss to society. Passive smoking increases these costs by at least a quarter. This quantification of the costs of tobacco provides strong motivation for legislative action on smoke-free areas in the Asia Pacific Region and elsewhere. [ABSTRACT FROM AUTHOR]

Worldwide, the incidence of motor neuron disease (MND) has been increasing steadily over recent decades. We reported a follow‐up epidemiology study of MND in this locality. We identified the subjects from the computer database of the government hospital system between 1 January 1997 and 31 January.2002 by searching the ICD code starting from 335.xx. Every retrieved case or their records were reviewed and validated by neurologist(s) of the responsible regional hospitals which the patients attended. One hundred and twenty cases from seven regional hospitals (serving 48.05% of the HKSAR population) were identified, validated and confirmed to be MND or related diseases. Ninety‐eight new cases were diagnosed during the study period. Average age of onset was 58.76 years; SD 14.12 (28–89) years. Male to female ratio was 1.72:1. Peak age of onset was 60–64 years without sex difference. The adjusted incidence rate was 0.60/100,000/year. The adjusted point prevalence at the prevalence date (31 January 2001) was 3.04/100,000. Despite the incidence and prevalence of MND among Hong Kong Chinese, it remained low compared to worldwide figures, and our data suggested a significant rise of MND or related disease in the last decade. A territory‐wide prospective epidemiological study is indicated. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore and compare the views of Hong Kong Chinese adolescents, parents and teachers on the same adolescent health issues. A total of 22 focus groups were conducted with Form 1 students (aged from 11 to 13) who attended the Basic Life Skills Training program organized by the Student Health Service, Department of Health in Hong Kong. The program covered a wide range of topics including emotions, self-image, stress management, drinking, smoking and substance abuse, self-esteem and interpersonal skills. Responses from the three types of participants were somewhat different and inconsistent on the issues of changes during puberty, stress and stress management, smoking, drinking and substance abuse. Compared to the West, Chinese adolescents tended to report more stress from studying and under-report socially undesirable behaviour. The use of focus groups was recommended as an effective method of collecting qualitative data with Chinese populations. Focus groups can help maximize data collection, and sometimes, the groups can also help different individual members to gain more insights or new ideas. [ABSTRACT FROM AUTHOR]

Aim: To study the prevalence of overweight and obesity, and weight-related concerns and behaviours among overweight, obese and non-overweight children and adolescents.Methods: We carried out a cross-sectional survey of all Chinese students in primary schools in the Central and Western District of Hong Kong in March 2002. Thirty-one of 32 schools participated, and 5402 boys and 5371 girls aged 8 to 15 y who completed a standardized questionnaire were included. We used the International Obesity Task Force definition (IOTF reference) to define overweight and obesity.Results: The prevalence (95% CI) of overweight was 16.4% (15.7-17.1%) (19.9% in boys, 12.9% in girls), and that of obesity was 7.7% (7.2-8.2%) (10.3% in boys and 5.1% in girls). The combined prevalence of overweight and obesity was similar to that based on the local reference. Overweight children had more concerns about their weight than obese children. They were more likely than obese children to feel fat, wish to be lighter, diet and exercise to lose weight. Although obese children were heavier, they did not make more effort to lose weight than overweight children.Conclusions: The differences in weight-related concerns and behaviours among overweight, obese and non-overweight children suggested good validity of the IOTF reference and the self-reported data. The differences between overweight and obese children suggested that the two groups had different psychological states and that they needed different weight management programmes and other intervention strategies. [ABSTRACT FROM AUTHOR]

Lam TH, Li ZB, Ho SY, Chan WM, Ho KS, Li MP, Leung GM. Smoking and depressive symptoms in Chinese elderly in Hong Kong. Acta Psychiatr Scand 2004: 110: 195–200. © Blackwell Munksgaard 2004. To examine the association between smoking and depressive symptoms among Chinese elderly in Hong Kong. Cross-sectional data on smoking and depressive symptoms from 56 167 Chinese elderly aged 65 or over in Hong Kong were analysed using logistic regression. Current smokers and former smokers were more likely to have depressive symptoms than never smokers. The adjusted odds ratios (OR) and 95% confidence interval (CI) in males and females respectively were 1.62 (1.34–1.96) and 1.43 (1.20–1.70) for current smokers, and were 1.18 (0.99–1.40) and 1.29 (1.12–1.47) for former smokers. Former smokers were less likely to have depressive symptoms than current smokers (OR = 0.80, 95% CI: 0.70–0.92). Smoking is positively associated with depressive symptoms in Chinese elderly. Health care workers should be vigilant about the detection of depressive symptoms in elderly smokers. [ABSTRACT FROM AUTHOR]

Background. To contain severe acute respiratory syndrome, the Hong Kong Hospital Authority set a policy that stipulated there should be no visitors to hospital wards. A helpdesk service was established with the goal of providing immediate emotional and communication support to relatives while severe acute respiratory syndrome patients were isolated during the acute phase of the illness.Aim. This study describes the results of a rapid assessment of the effectiveness of a helpdesk service designed to meet the immediate needs of relatives of severe acute respiratory syndrome patients in Hong Kong.Design. Survey.Method. Eighty-three respondents, representing about 46.3% of relatives (179), attending the helpdesk on the day of the study were recruited. Service evaluation data was collected using a self-administered questionnaire completed by respondents.Results. Nearly 100% of respondents who used the service found the delivery service with on-site counselling useful for alleviating their anxiety. However, about half of these relatives complained of insufficient information regarding the patient's condition and progress. The majority of respondents were satisfied with the service. In describing the most important traits of the service providers, caring and enthusiasm were mentioned most frequently by respondents who stated that they were very satisfied with the service.Conclusion. The results support the value of the service, and demonstrate that the service is effective in meeting relatives' immediate needs. These needs include information, aid in fulfilling their role as caretaker for the patient (delivering prepared soup) and psychological support. The results suggest that facilitation of visitation of patients by relatives via video conferencing and education of the public on the nature and course of severe acute respiratory syndrome to reduce the social stigma of having a potentially life-threatening disease should be introduced in Hong Kong.Relevance to clinical practice. The results highlight important attributes that helpers (nurses) should have in order to alleviate the suffering of severe acute respiratory syndrome patients and their relatives. [ABSTRACT FROM AUTHOR]

Objective: To examine the public's knowledge and perception of SARS and the extent to which various precautionary measures have been adopted. Design: Cross sectional survey. Setting: General population of Hong Kong at the height of the SARS outbreak (29 March to 6 April 2003). Participants: 1115 ethnic Chinese adults. Main results: Forty per cent did not recognise fomites as a possible mode of transmission whereas 55.1% believed that the infection could be transmitted airborne. A large proportion (30.1%) believed they were very or somewhat likely to contract SARS while only one quarter believed they were very likely to survive if they contracted the disease, benchmarked against an actual case fatality ratio of 2.8% at the time of the survey and 15%-20% according to current best estimates. Precautionary measures directed against person to person droplet spread were generally adopted by most while the prevention of transmission through fomites was not practised as frequently. Respondents with higher risk perceptions and a moderate level of anxiety were most likely to take comprehensive precautionary measures against the infection, as were older, female, more educated people as well as those with a positive contact history and SARS-like symptoms. Conclusions: The findings demonstrate that the promotion of protective personal health practices to interrupt the self sustaining transmission of the SARS virus in the community must take into account background perceptions of risk and anxiety levels of the public at large. Continuing public education about preventive measures should be targeted at the identified groups with low current uptake of precautions. [ABSTRACT FROM AUTHOR]

BACKGROUND:: Associations between dietary factors and glucose tolerance observed in Caucasian populations may not be applicable to Chinese populations, since the traditional Chinese diet contains plentiful vegetables and is rice-based (which has a lower glycemic index than potatoes). To address this question, the dietary patterns in 988 Hong Kong Chinese subjects with normal and impaired glucose tolerance, and diabetes, were examined in a cross sectional survey to determine if there is any association between diet and glucose tolerance. METHOD:: A stratified random population sample of 988 subjects (488 male, 500 female) was recruited. A food frequency questionnaire was used to determine dietary intake, and glucose tolerance was examined using the glucose tolerance test and the WHO criteria used to classify subjects into the three glucose tolerance categories. RESULTS:: Using the standardized world population of Segi, the prevalence rate for DM was 6.6% for men and 5.7% for women; and for IGT 10.3% for men and 15.4% for women aged 30-64 y. Abnormal glucose tolerance is associated with female gender, older age, lower educational attainment and higher body mass index (BMI). No clear pattern of association with dietary factors was observed after adjusting for confounding factors. However, if subjects with BMI=25 kg/m2 were excluded, an increase in mean consumption of rice/noodles/pasta per week was observed in the DM group, after adjusting for total energy intake and other confounding factors. No association between dietary variety, which has been linked with body fatness, and glucose tolerance, was observed. CONCLUSION:: Dietary habit may not be a strong risk factor for the development of glucose intolerance in Chinese populations, given the favorable features of the Chinese diet. The high consumption of rice in the DM subjects who are of normal BMI suggests that further studies examining glycemic indices of Chinese food items may be beneficial.... [ABSTRACT FROM AUTHOR]

: We conducted a cross-sectional population-based study comprising 1010 Hong Kong Chinese (500 men and 510 women) aged 25–74 years during 1995–6. The study examined the important dietary, lifestyle and anthropometric factors associated with urinary calcium excretion. Dietary intakes were assessed by means of food frequency questionnaire. Spot urine was collected to measure the urinary excretion profiles of calcium (Ca), sodium (Na), potassium (K) and creatinine (Cr). When expressed as ratios of cations to urinary Cr, significant relationships were noted between urinary Ca and Na (r: ∼0.6), and between urinary Ca and K (r: 0.17–0.21). Stepwise multiple linear regression analyses were carried out separately in men and women aged below and above 50 years. We found that urinary Na/Cr was the leading independent factor associated with urinary Ca/Cr in all four age and sex groups. It accounted for 22% of urinary Ca/Cr variations in women aged below 50 years, and 35–43% in the other three age and sex groups. We estimated that urinary Ca excretion increased by about 1.4 (range 1.37–1.43) mmol per 100 mmol increase in urinary Na. Except in men aged 50 years and over, urinary K/Cr was inversely associated with urinary Ca/Cr in all groups. Age was independently and positively associated with urinary Ca/Cr in subjects aged below 50 years. We did not observe any significant relation between urinary Ca/Cr and dietary protein, phosphorus, alcohol drinking and smoking. In conclusion, we found that urinary Na/Cr, but not dietary protein, Ca or phosphorus, is the most important factor influencing urinary Ca/Cr excretion in our population. Urinary K is a potential factor for Ca conservation. [ABSTRACT FROM AUTHOR]

Focuses on a study which estimated the number of long-term care places for the aging population in Hong Kong and risk factors for their institutionalization. Subjects and method; Results of the study; Discussion.

An epidemiological study of the environmental and genetic factors as well as the possible interplay between them was conducted among 215 patients with Parkinson's disease and 313 controls in a Chinese population in Hong Kong. In univariate analysis, a regular tea drinking habit was found to be a protective factor, which had not been reported before. Smoking (a protective factor), family history, duration of pesticide exposure (in years) in farming and pesticide exposure during farming in women (both risk factors) have been reported previously. In multivariate analysis, current smoking reached borderline significance at the 5% level and the variables, years exposed to pesticides and family history were significant at the 10% level. By contrast with the common occurrence of polymorphism of the CYP2D6 gene (a gene involved with xenobiotic metabolism) in white people, it is very rare in China and is not thought to be a significant factor contributing to Parkinson's disease in Chinese people. [ABSTRACT FROM AUTHOR]

Background: Besides being the major cause of hip fracture, falls also have important consequences in injuries and mortality, especially in the elderly population. This study investigated the occurrence of and the correlates of falls in a cohort of Hong Kong Chinese elderly aged 70 years and above.Methods: The research was based on the baseline cross-sectional study of an age- and sex-stratified cohort consisting of 1,947 ambulatory subjects. The occurrence of falls was based on the previous 12 months. Logistic regression analysis was used to test the effect of each independent variable, adjusting for age and sex. Multivariate logistic regression analysis based on the backward elimination procedure was used for the final model.Results: Previous white-collar employment, poor self-perceived health, dizziness, slow gait velocity, difficulties in activities of daily living, non-practice of "morning walk," body mass index in the range of 20-24, use of local skin preparation, and presence of cerebrovascular disease were independently associated with falls. Smokers were found to have an independent decreased risk of falls. Neither age nor sex was significantly associated with falls after adjusting for the other explanatory variables.Conclusions: The results from this population-based cross-sectional study form a basis for further prospective study on falls in the Chinese elderly population. Both intrinsic and extrinsic factors including circumstances and consequences of falls are important considerations in the strategy for the prevention of falls. [ABSTRACT FROM AUTHOR]

Background: To compare cost and quality-adjusted life??"years (QALYs) gained by influenza vaccination with or without pneumococcal vaccination in the elderly living in long-term care facilities (LTCFs). Methods: Cost-effectiveness analysis based on Markov modelling over 5 years, from a Hong Kong public health provider's perspective, on a hypothetical cohort of LTCF residents aged ≥65 years. Benefit—cost ratio (BCR) and net present value (NPV) of two vaccination strategies versus no vaccination were estimated. The cost and QALYs gained by two vaccination strategies were compared by Student's t-test in probabilistic sensitivity analysis (10?000 Monte Carlo simulations). Results: Both vaccination strategies had high BCRs and NPVs (6.39 and US$334 for influenza vaccination; 5.10 and US$332 for influenza plus pneumococcal vaccination). In base case analysis, the two vaccination strategies were expected to cost less and gain higher QALYs than no vaccination. In probabilistic sensitivity analysis, the cost of combined vaccination and influenza vaccination was significantly lower (p<0.001) than the cost of no vaccination. Both vaccination strategies gained significantly higher (p<0.001) QALYs than no vaccination. The QALYs gained by combined vaccination were significantly higher (p=0.030) than those gained by influenza vaccination alone. The total cost of combined vaccination was significantly lower (p=0.011) than that of influenza vaccination. Conclusion: Influenza vaccination with or without pneumococcal vaccination appears to be less costly with higher QALYs gained than no vaccination, over a 5-year period, for elderly people living in LTCFs from the perspective of a Hong Kong public health organisation. Combined vaccination was more likely to gain higher QALYs with lower total cost than influenza vaccination alone. [ABSTRACT FROM AUTHOR]