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College transition is a phase that every college student must face; however, not everyone experiences it smoothly. With the growing number of First-Generation College Students (FGCS) in rural China, this qualitative study examines how these students and their parents make their college transition. Guided by Schlossberg's Transition Theory, we analyzed students' write-ups that recorded mealtime conversations of 103 rural families in China on three themes: Self, Support and Strategies. It is found that most FGCS felt frustrated because of the lack of concrete strategies to cope with the college transition and choose their study major. While parents functioned as the important emotional support for FGCS to continue their study, these parents also experienced struggles themselves, including a lack of knowledge and experience about the higher education system, and being unprepared to separate from their children who are leaving for college. With this knowledge, recommendations are provided to better support rural FGCS and their parents to go through college transition, such as launching university orientation week, preparing reader-friendly infographic leaflets, and setting up more FGCS funding in China.

This study aimed to explore the relationships between situational and psychological factors and Hong Kong citizens’ plastic waste management (PWM) intentions based on an extended theory of planned behaviour model with situational factors. A total of 996 Hong Kong permanent residents were surveyed, and data were analysed using structural equation modelling. The results revealed that situational factors had a direct and positive effect on PWM intention, but also affected PWM intention indirectly through their significant effects on attitude and perceived behavioural control regarding PWM. The implications for environmental education and policy are discussed.

Knowledge and attitudes are commonly studied variables linked with an individual behaviour. Sports-related concussions are increasingly drawing attention in the school environment, making physical ...

Purpose The purpose of this paper is to examine the association of various family factors with children’s fruit and vegetable (FV) intake. Design/methodology/approach A cross-sectional analysis of data from 601 parent-child dyads with children aged three to six years old was conducted. Parents completed questionnaires on child’s FV intake, parenting styles, parental feeding practices, family functioning, television viewing at mealtimes and frequency of family meals. Logistic regression was used to assess the association between various family factors and the likelihood of meeting the child’s daily FV recommendation with adjustment for different demographic variables. Findings Multivariate model adjusting for sociodemographic data indicated that meeting vegetable recommendation was associated with lower frequency of dining with grandparents (Odds ratio (OR) 0.94, 95% confidence interval (CI) 0.89–0.99, p=0.031) and positively associated with parents using more desirable parental feeding practices (OR 1.15, 95% CI 1.09–1.21, ppp=0.041), lower frequency of dining with father (OR 0.89, 95% CI 0.82–0.98, p=0.014) and higher score on authoritative parenting style (OR 1.05, 95% CI 1.01–1.08, p=0.009). Originality/value This study highlights the potential protective roles of various family factors, in particular authoritative parenting style and parental feeding practices, such as role modeling, moderate restrictive practices for less healthy foods, avoidance of forced feeding, and not using junk food as reward in relation to meeting FV recommendation in children. The role of grandparents in influencing the young children’s eating behaviors within the Chinese family warrants further investigation.

The aim of the study was to investigate the treatment effects of transcranial direct current stimulation combined with neuromuscular electrical stimulation on the motor function of upper extremity in persons with stroke.This study was a pilot double-blind randomized controlled trial. Twenty-six patients due to stroke onset of more than 6 mos were randomly allocated to three groups: transcranial direct current stimulation combined with neuromuscular electrical stimulation group, transcranial direct current stimulation group, or control group. In addition to conventional rehabilitation, all subjects received one of the three protocols in a total of 15 sessions for 3 wks.A significant difference among the three groups was found for the change scores of the Fugl-Meyer Assessment upper extremity subscale from pretreatment to 1-mo follow-up (P = 0.02), in favor of the transcranial direct current stimulation combined with neuromuscular electrical stimulation group. Moreover, the transcranial direct current stimulation combined with neuromuscular electrical stimulation group showed significant within-group improvement on the Fugl-Meyer Assessment upper extremity (from preintervention to postintervention, P = 0.01) and the Action Research Arm Test (from preintervention to postintervention and to 1-mo postintervention, P = 0.03 and P = 0.04, respectively).This preliminary study reveals that combining transcranial direct current stimulation and neuromuscular electrical stimulation with regular rehabilitation programs may enhance better upper extremity functional improvement than regular rehabilitation programs alone in patients with chronic stroke.

Purpose: To describe the development of the Cognition domain of the Hong Kong Comprehensive Assessment Scales for Toddlers (HKCAS-T). Methods: Participants included 345 toddlers aged 18–41 months, ...

Background Owing to the prevalence of neuromyths in education, there has been a call for more teacher training in neuroscience. However, neuroscience is rarely featured in teacher education. This study investigated the neuroscience literacy and perceptions of neuroscience in education among preservice teachers in order to inform future development of initial teacher education. Method Neuroscience literacy of 968 preservice teachers and their perceptions towards applying neuroscience in education were examined using survey items adapted from studies addressing similar constructs. Rasch item response theory and classical test theory techniques were employed for data analysis. Results Most of the preservice teachers had limited brain knowledge and subscribed to many common neuromyths but were positive towards applying neuroscience in education. General brain knowledge was the only predictor for ability to identify neuromyths (β = .564). Conclusion Neuroscience knowledge can help safeguard preservice teachers against neuromyths. Neuroscience training deserves a place in teacher education.

This study investigates whether students with intellectual disability (ID) alone differ from students with combined individual disability and autism spectrum disorder (ASD) in their recognition of emotions. The ability to recognise emotions does not mean that students automatically know how to react to these emotions. Differences in performance on recognition and reaction tasks are examined. Participants were 20 primary 6 students who had ID with ASD and 20 primary 6 students who had ID without ASD from four special schools. The testing and training materials were adapted from a local teaching package. The results showed that both groups exhibited similar performance patterns in recognition tasks. Students with comorbid ASD exhibited inferior performance in tasks requiring reactions to complex emotions.

A hierarchy of inclusive teaching tasks by associated level of teacher efficacy is derived from a group of primary and secondary school teachers in Hong Kong using a Rasch rating scale model on 536 in-service teachers attending a professional development course. Findings show collaboration tasks represented the highest teacher efficacy in primary and secondary teachers. Managing behavior represented the lowest level of teacher efficacy but slightly more in primary than in secondary school. Hence, future training regarding inclusive practices should be specific to the school level, with a strong focus on collaborations between school, parents, and the community.

A two-wave longitudinal study on 470 parent–child dyads examined the impact of family mealtime environment, parenting style and family functioning on preschoolers’ (three to six years old) learning. Measures included parent report on parenting style, family functioning, family meal frequency, mealtime television, feeding practice, teacher/parent report of academic competence and individual assessment of preschoolers’ preschool concepts. Family mealtime environment variables were associated with pre-schoolers’ learning, in addition to parenting style and family functioning, after controlling for family income and wave 1 preschoolers’ learning. The results highlighted the importance of family mealtime environment on preschoolers’ learning.

Inclusive teaching tasks have consistently been found challenging for teachers, but it is unclear how they are ranked in terms of the extent of self-efficacy required. This study aimed at deriving such a hierarchy. A survey was conducted on 107 primary school teachers in Hong Kong using the Teacher Efficacy for Inclusive Practices scale. A Rasch rating scale model was applied to empirically examine the hierarchical structure. Good person reliability (0.89) and model fit (MNSQ 0.6–1.4) were achieved. Managing physical aggression was found at the top of the hierarchy; this and other results could facilitate the identification of training needs.

The understanding and application of forgiveness varies across cultures. The current study aimed to examine the effect of a culture-adaptive Forgiveness Intervention on forgiveness attitude, self-esteem, empathy and anxiety of Mainland Chinese college students. Thirty-six participants were randomly allocated to either experimental groups or a wait-list comparison group, with 28 retained finally. Forgiveness, empathy, self-esteem and anxiety were assessed one week before and after a 10-week forgiveness programme integrating Enright process model and Chinese values. The intervention increased participants' forgiveness attitudes. No significant effect was reported on empathy, self-esteem and anxiety. These findings demonstrate that the Culture-adaptive forgiveness intervention is potentially promising to enhance forgiveness attitude in societies where collectivist, cooperative and interdependent principles are dominant.

Case-control studies have shown that noxious thermal stimulation (TS) can improve arm function in patients with stroke. However, the neural mechanisms underlying this improvement are largely unknown. We explored functional neural activation due to noxious and innocuous TS intervention applied to the paretic arm of patients with stroke. Sixteen participants with unilateral cortical infarctions were allocated to one of two groups: noxious TS (8 patients; temperature combination: hot pain 46°C to 47°C, cold pain 7°C–8°C) or innocuous TS (n = 8; temperature combination: hot 40°C–41°C, cold 20°C–21°C). All subjects underwent fMRI scanning before and after 30 min TS intervention and performed a finger tapping task with the affected hand. Immediate brain activation effects were assessed according to thermal type (noxious vs. innocuous TS) and time (pre-TS vs post-TS). Regions activated by noxious TS relative to innocuous TS (P

BACKGROUND Neuromuscular electrical stimulation (NMES) and noxious thermal stimulation (NTS) have been developed and incorporated in stroke rehabilitation. OBJECTIVE This study aimed to compare the effects of NMES, NTS, and the hybrid of NMES and NTS ("Hybrid") on motor recovery of upper extremity (UE) for patients with stroke. METHODS We conducted a prospective, single-blind randomized controlled trial with concealed allocation. Forty-three patients with chronic stroke (onset >6 months) were randomly assigned to three groups (NMES, NTS, and "Hybrid"). In addition to conventional rehabilitation, participants received 30 min of NMES or 30 min of NTS or 15 min of NTS followed by 15 min of NMES. The treatment period was 8 weeks, 3 days/week, 30 min/time. The UE subscale of Fugl-Meyer assessment (UE-FMA, the primary outcome), Motricity index, modified Ashworth scale, and Barthel index were administered by a blinded assessor at baseline, posttreatment, and one-month follow-up. RESULTS Most of the participants had mild-to-moderate disability in activity of daily living. No significant differences in the outcome measures at posttreatment and one-month follow-up were found among the NMES group (n = 13), NTS group (n = 13), and the hybrid of NMES and NTS group (n = 17). However, significant score changes in UE-FMA (p

LANGUAGE NOTE | Document text in English; abstract also in Chinese. Objectives: College students in China experience unhealthy behaviors such as smoking, drinking, sleep disorders, and sedentary lifestyles, which are common risk factors of chronic diseases. Lifestyle has a profound impact on one’s health. The researchers tried to explore and delineate college students’ motivations for a healthy lifestyle. Methods: 93 undergraduate students (59 males and 34 females; mean age 21.2 years) were interviewed. Verbatim transcripts were analyzed using a theory-directed approach following Self-Determination Theory (SDT). Results: Participants reported five types of health motivation that broadly fall under SDT: absence of motive, external, introjected, identified, and integrated. Sources for motivation identified included health literacy, the environment, and social relationships. Conclusions: Health practitioners in colleges in China should be sensitive to different types of motivation and factors that influence college students’ goals of practicing healthy lifestyles. Effective intervention programs for improving the motivation of college students should address issues related to perceived locus of causality. 目標：中國大學生存在如吸煙，酗酒，睡眠不規律，久坐等不健康的行為方式，這些行為方式是慢性疾病的常見風險因素。 生活方式對一個人的健康產生深遠的影響。在本研究中，研究者試圖探索和描述中國大學生選擇健康生活方式的動機。方法：共訪談了93名本科大學生(其中男性59名，女性34名，平均年齡21.2歲)，並以自我決定理論為依據，對訪談記錄文本進行分析。 結果：參與者大致報告了自我決定理論所描述的五類動機：即缺失的、外部的、攝入的、認同的和整合的等。健康動機的來源大致包括健康素養、環境因素和社會關係。結論：大學的健康實踐者應對影響大學生健康行為的五類不同的動機水準保持敏感，有效的以提高健康動機為目的的教育項目應著重解決因果關係感覺軌跡中的有關問題。

Over the years, high and growing numbers of students on the autism spectrum have posted tremendous stress to the education sector. This article draws from a qualitative study and we examined practical challenges encountered when including learners with autism spectrum disorder (ASD) in regular classrooms. A purposive sample of 12 primary school principals was interviewed. Content analysis and thematic induction were used to investigate insider-perspectives. The most common or serious practical challenges were reported by the participants: (i) school dilemma about inclusive education; (ii) up-skilling teacher capacity in understanding ASD behavior; (iii) teacher support to enhance peer acceptance; and (iv) expert input to improve home-school collaboration. These findings suggested the need of practical application of ASD knowledge to be provided in teacher training. Also, the provision of school-based expert support is suggested to further enhance teacher efficacy. Findings of this study may offer insight to communities experiencing similar educational changes.

Objectives To investigate the effect of rigid taping that induces mechanical displacement of the skin on pain perception. Design Single group experiment design with repeated measures. Methods Twenty-three active healthy volunteers (12 men and 11 women) participated in the study. All participants received three different taping procedures: no tape, taping with tension, and taping without tension. The order of three taping conditions was randomised. Skin displacement was measured during taping with tension. A pressure algometer was used to measure the level of pain perception once before taping, and again after each taping condition, in one testing session. The participants were blind to the values of their pressure pain threshold (PPT) during the experimental period. Results The mean ± SD skin displacement in the condition of taping with tension was 2.58 ± 0.49 cm. There were significant differences in PPT between taping with tension and taping without tension (mean difference (mean diff) ± standard error (SE) 36.43 ± 4.22 kPa, p = 0.000) and no tape (mean diff ± SE 44.31 ± 3.13 kPa, p = 0.000). No significant difference in PPT between no tape and taping without tension was found (mean diff ± SE 7.88 ± 2.83 kPa, p = 0.067). Conclusions Taping with tension increases the threshold of pressure pain perception. Therefore, stretch and compression caused by rigid taping with tension could disturb the nociceptive signal transmission and alter pain perception.

Effectiveness of an exercise program designed for improving postural control and mobility in older adults with type 2 diabetes was investigated. Ninety-three adults 65 or older diagnosed with type 2 diabetes and able to walk unaided were recruited. The intervention group received exercise training focused on ankle strengthening and mobility twice per week for 10 weeks. The control group did not participate in any exercise program. After 10 weeks, the intervention group showed significantly greater improvement in the mean Sensory Organization Test composite score (4.4 vs. 0.3; p = 0.01) as well as visual ratio (0.1 vs. 0.002; p = 0.01) and vestibular ratio (0.1 vs. 0.003; p < 0.001) than the control group after adjusting for covariates. A greater trend of improvement in the Timed Up and Go and Single-Leg Stance Test was also found in the intervention group. Exercise training focusing on the ankle is effective in enhancing the postural stability of older adults with type 2 diabetes and can potentially be effective in improving single-leg standing balance and mobility. [ Journal of Gerontological Nursing, 44 (2), 41–48.]

This study aimed to investigate the effectiveness of biofeedback cycling training on lower limb functional recovery, walking endurance, and walking speed for patients with chronic stroke. Thirty-one patients with stroke (stroke onset >3 months) were randomly assigned into two groups using a crossover design. One group (N = 16; mean: 53.6 ± 10.3 years) underwent conventional rehabilitation and cycling training (30 minutes/time, 5 times per week for 4 weeks), followed by only conventional rehabilitation for another 4 weeks. The other group (N = 15; mean: 54.5 ± 8.0 years) underwent the same training in reverse order. The bike used in this biofeedback cycling training was the MOTOmed viva2 Movement Trainer. Outcome measures included the lower extremity subscale of Fugl-Meyer assessment (LE-FMA), the 6-minute walk test (6MWT), the 10-meter walk test (10MWT), and the modified Ashworth scale (MAS). All participants were assessed at the beginning of the study, at the end of the 4th week, and at the end of the 8th week. Thirty participants completed the study, including the cycling training interventions and all assessments. The results showed that improvements in the period with cycling training were significantly better than the noncycling period in the LE-FMA (p

The aim of this study was to validate a questionnaire on mastery motivation (task and effort) for use with Chinese preschool children in Hong Kong. A parent version and a teacher version were developed and evaluated. Participants included 457 children (230 boys and 227 girls) aged four and five years old, their preschool teachers and their parents. Further, 44 children (39 boys and 5 girls) with developmental disabilities were recruited. The children were assessed on the cognitive sub-test of the Preschool Development Assessment Scale (PDAS). Their parents completed the task and effort motivation scales, as well as the Strengths and Difficulties Questionnaire (SDQ). Their teachers also completed the task and effort motivation scales. Rasch analysis results provided support for the unidimensionality of the parent and teacher versions of the two motivation scales. The parent and teacher versions of the two motivation scales correlated positively with the PDAS cognitive sub-test and the SDQ prosocial scale scores, and negatively with the SDQ total problem behavior scores. Children with developmental disabilities were assigned lower scores by their teachers and parents on the two motivation scales, compared with children with typical development. Reliability (Cronbach's Alpha) of the parent and teacher versions of the two motivation scales were above .70. The results suggested that the task and effort motivation scales were promising instruments for the assessment of motivation among Chinese preschool children.

To systematically assess published reports on the efficacy of electrophysical therapy in the treatment of diabetic foot ulcers, including electrical stimulation, low-level laser therapy, therapeutic ultrasound and electromagnetic therapy. Databases searched included MEDLINE, CINAHL, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) from 1966 to 2011. Studies reviewed included only randomised controlled trials (RCTs) on treatment with electrophysical modalities compared with sham, conventional treatment or other electrophysical modalities. Information extracted were objective measures of healing and data useful for the calculation of effect size. Eight RCTs were eventually included in the critical appraisal, with a combined total of 325 participants. Five studies were conducted on electrical stimulation, two on phototherapy and one on ultrasound. All studies reported that the experimental group was significantly more favourable than the control or sham group. The pooled estimate of the number of healed ulcers of the three studies on electrical stimulation compared to the control or sham electrical stimulation showed statistical significance [mean difference of 2·8 (95% CI = 1·5-5·5, P = 0·002] in favour of electrical stimulation. The results indicated potential benefit of using electrophysical therapy for managing diabetic foot ulcers. However, due to the small number of trials ever conducted, the possibility of any harmful effects cannot be ruled out, and high-quality trials with larger sample sizes are warranted.

The aim of this study was to validate a questionnaire on academic competence behaviour for use with Chinese preschool children in Hong Kong. A parent version and a teacher version were developed and evaluated. The participants included 457 children (230 boys and 227 girls) aged four and five years old, their preschool teachers and their parents. Besides, 44 children (39 boys and 5 girls) with developmental disabilities were recruited. The children were assessed on the cognitive domain of the Preschool Development Assessment Scale (PDAS). Their parents completed a questionnaire on academic competence behaviour, as well as the Strength and Difficulty Scale (SDQ). Their teachers completed the questionnaire on academic competence behaviour. Rasch analysis results provided support for the unidimensionality of the parent and teacher versions of the scale, with one item deleted. The parent and teacher versions of the revised scale correlated positively with the cognitive domain of the PDAS and the prosocial scale of the SDQ and negatively with SDQ total problem behaviour score. Children with developmental delay were assigned lower scores by their parents and teachers, compared with preschool children, on the revised versions of the academic competence behaviour scale. Reliability estimates (Cronbach's alpha) of the parent and teacher versions of this revised scale were above .80. The results suggested that the two versions of academic competence behaviour scales were promising instruments for the assessment of academic competence behaviour among Chinese preschool children.

To compare the short-term and medium-term effect of Functional Fascial Taping to placebo taping on pain and function in people with non-specific low back pain.A pilot randomized controlled trial with a 2-week intervention, and 2-, 6- and 12-week follow-up.Individuals with non-specific low back pain recruited from local communities.Forty-three participants with non-specific low back pain for more than 6 weeks were randomized into either Functional Fascial Taping group (n = 21) or placebo group (n = 22).The intervention group was treated with Functional Fascial Taping while the control group was treated with placebo taping. Both groups received four treatments over 2 weeks.Worst and average pain and function were assessed at baseline, after the 2-week intervention, and at 6 and 12 weeks follow-up.The Functional Fascial Taping group demonstrated significantly greater reduction in worst pain compared to placebo group after the 2-week intervention (P = 0.02, effect size = 0.74; 95% confidence interval 0.11-1.34). A higher proportion of participants in Functional Fascial Taping group attained the minimal clinically important difference in worst pain (P = 0.007) and function (P = 0.007) than those in placebo group after the 2-week intervention. There were no significant differences in either group's disability rating or clinically important difference in average pain at any time.Functional Fascial Taping reduced worst pain in patients with non-acute non-specific low back pain during the treatment phase. No medium-term differences in pain or function were observed.

Background The paradigm shift from the clinically deficit-oriented approach to that of educationally strength-based model in assessing adolescents' psychosocial well-being has brought about a recent increase in school-based health promotion and prevention initiatives. This prompted this systematic review of measuring instruments designed to assess psychosocial well-being of children and adolescents. Methods Using electronic databases on Academic Search Premier, MEDLINE, PROQUEST, PsycINFO, CINAHL Plus and Psychosocial and Health Instrument, a systematic review of literature of measuring instruments was conducted from their inception to December 2009 using the keywords of child, emotion, assessment, scale and measure. Measuring instruments from selected articles were critically appraised using a predetermined set of quality indicators which guided the rating of the psychometric properties of the instruments into grades of A, B, and C. The constructs of psychosocial well-being from the measuring instruments were categorized into themes. Results Twenty-nine out of the 908 articles met the inclusion criteria. Seventeen instruments identified from the selected articles were examined using preset quality indicators. In construct building, the themes identified from the strength-based instruments distinguished the construct of psychosocial well-being primarily into the dimensions of personal emotional competency and social functioning. In the ratings of psychometric properties, one instrument was rated 5A, five rated 4A and four rated 3A. For reliability testing, eight measures received grade A when their intraclass correlation is higher than 0.7; whereas only two instruments reported sensitivity and none investigated responsiveness. Conclusions Strength-based measures focusing on social emotional behavioural outcomes open up a possibility to link up assessment with promotion of psychosocial well-being, away from clinical settings and into adolescents' homes, schools and community. Future research should focus more on investigating the sensitivity and responsiveness of measuring instruments using longitudinal design in efficacy studies to assess change in adolescents' psychosocial status over extended time.

OBJECTIVE This study aimed to examine the relationship between fine and gross motor skills and cerebral palsy-specific quality-of-life in ambulatory children with cerebral palsy. DESIGN Thirty-nine children with cerebral palsy (29 boys, 10 girls; mean age ± SD, 8.8 ± 2.3 yrs) classified under Gross Motor Function Classification System Level I or II were enrolled. Health-related quality-of-life was evaluated using the Cerebral Palsy Quality of Life Questionnaire for Children (parent-proxy version). Motor functions were measured using the Bruininks-Oseretsky Test of Motor Proficiency. RESULTS Regression analysis for QOL revealed fine motor skills, including upper-limb speed and dexterity, which are positively correlated to functioning (r = 0.205, P < 0.01), and visual-motor control that is positively correlated to other domains, including social well-being and acceptance, participation and physical health, emotional well-being and self-esteem, and family health (r = 0.150-0.188, P < 0.05). CONCLUSIONS Fine motor functions, including upper-limb speed and dexterity and visual-motor control, were the most important motor factors associated with health-related quality-of-life in ambulatory children with cerebral palsy.

Objective To systematically review the impact of different interventions on quality of life (QoL) for children with cerebral palsy. Methods English articles were sought from five major English databases from inceptions until March 2010.Keywords used consisted of four components (and their variants):(i) clinical condition: cerebral palsy; (ii) outcome measures:quality of life,well-being; (iii) study design:clinical trials; and (iv) target population:people aged 0‐18. Results Eight studies satisfied the inclusion criteria,all of which are of good to excellent quality (a Jadad score of 4 or above).The Pediatric Evaluation of Disability Inventory,the Pediatric Quality of Life Inventory,the TNO-AZL Children’s Health-Related Quality of Life and the Caregiver Priorities and Child Health Index of Life with Disabilities were used to measure QoL.Significant positive results were reported by two studies using medicinal interventions (diazepam and intrathecal baclofen therapy,effect sizes 5.9,9.1 respectively) and two studies employing motor control approach training (strength training and exercise training,former effect size being 3.8). Conclusion Current review suggests that positive effect was shown in medicinal and motor control interventions on QoL.However,no single interventional approach can demonstrate a consistent positive impact on QoL across different studies.Future studies are recommended to (i) provide a clear definition of QoL,and investigate the relationship between symptoms’ severity and QoL; (ii) measure outcome at different time points to capture real effects of interventions; and (iii) make more use of valid outcome instruments,either self-report or parent/caregiver proxy reports.

The study aimed to investigate the changes in self-perceived quality of life (QOL) of children and adolescents with physical disability (PD). Two hundred students aged 10-18 with PD were recruited from primary and high schools in Taiwan to participate in this longitudinal study. The Student Version of the Comprehensive Quality of Life Scale (COMQOL-S) was used to measure self-perceived QOL, which was recorded at baseline, and 6, 12 and 18 months post-baseline. Statistically, linear mixed models were used to compare the QOL scores among the four time points. At the second, third and fourth visit, 192, 151 and 128 participants completed COMQOL-S, respectively. Significant changes over time were found in overall objective and subjective OQL scores (slope = 0.8, p = 0.002 and slope = -1.3, p 0.001, respectively). Specifically, significant reductions of the subjective QOL scores over the period of the four visits were observed in five domains, namely, Productivity (slope = -1.7, p = 0.005), Intimacy (slope = -1.6, p = 0.004), Safety (slope = -1.6, p = 0.008), Place in community (slope = -1.4, p = 0.019) and Emotional wellbeing (slope = -2.5, p 0.001). Age was negatively correlated with the change of overall subjective score. Positive correlation was found between the change in mean objective scores and mean subjective scores in the Intimacy and Productivity domains.Even though the conditions of material wellbeing and health can be kept steady, the overall QOL of children and adolescents with PD could still decline over time. This might be attributable to the fact that social life becomes more sophisticated when children become older.

Using Rasch analysis, the psychometric properties of a newly developed 35-item parent-proxy instrument, the Caregiver Assessment of Movement Participation (CAMP), designed to measure movement participation problems in children with Developmental Coordination Disorder, were examined. The CAMP was administered to 465 school children aged 5-10 years. Thirty of the 35 items were retained as they had acceptable infit and outfit statistics. Item separation (7.48) and child separation (3.16) were good; moreover, the CAMP had excellent reliability (Reliability Index for item = 0.98; Person = 0.91). Principal components analysis of item residuals confirmed the unidimensionality of the instrument. Based on category probability statistics, the original five-point scale was collapsed into a four-point scale. The item threshold calibration of the CAMP with the Movement Assessment Battery for Children Test was computed. The results indicated that a CAMP total score of 75 is the optimal cut-off point for identifying children at risk of movement problems.

Aim: To explore and compare the features of menstruation, perception and management of menstrual pain between two cohorts of Australian and Chinese women. Methods: A pilot comparison study was carried out using modified valid menstrual questionnaires. The study included 120 Australian women and 122 Chinese women aged from 18 to 45 years with primary dysmenorrhea. Results: Australian women rated menstrual pain as more intense than Chinese women (8.5 ± 1.5 on a 10-point pain scale vs 7.3 ± 1.8, P

Objectives The aim of this study was to measure the time spent providing clinical pharmacy services to individual patient episodes for general medical and surgical patients and to measure the effect of patient presentation and complexity on this workload. Methods We conducted a 5-month study at The Northern Hospital and Western Hospital in Melbourne, Australia, during 2006. Pharmacists recorded a defined range of activities that they provided for individual patients, including the actual times required for these tasks. A customised database, linked to the two hospitals' patient administration systems, stored these data according to the specific patient episode number. We then examined the influence of patient presentation and complexity on clinical pharmacy activities provided. Key findings During intervals when pharmacists recorded the time required to conduct activities, the average time required to perform the medication history and reconciliation exercise on 3052 occasions was 9.6 ± 4.5 min. The 1844 interventions required an average of 5.9 ± 3.0 min, clinical review of the patient's medical record required 5.5 ± 2.7 min and medication order review required 3.5 ± 1.3 min. For all of these activities, the time required was greater for medical patients than for surgical patients and greater for patients whose Diagnosis Related Group classification included a complication or co-morbidity. The average time required to perform all clinical pharmacy activities for 4625 completed patient episodes was 22.4 ± 16.7 min and was again greater for medical patients and for patients with a complication or co-morbidity. Conclusions The times required to perform a range of clinical pharmacy activities for individual patients was affected by whether the patients were medical or surgical patients. Furthermore, the existence of co-morbidities or complications affected these times. The methodology has potential application for other patient presentations and in other practice settings.

Aims Cognitive impairment occurs often in patients with chronic heart failure (CHF) and may contribute to sub-optimal self-care. This study aimed to test the impact of cognitive impairment on self-care. Methods and results In 93 consecutive patients hospitalized with CHF, self-care (Self-Care of Heart Failure Index) was assessed. Multiple regression analysis was used to test a model of variables hypothesized to predict self-care maintenance, management, and confidence. Variables in the model were mild cognitive impairment (MCI; Mini-Mental State Exam and Montreal Cognitive Assessment), depressive symptoms (Cardiac Depression Scale), age, gender, social isolation, education level, new diagnosis, and co-morbid illnesses. Sixty-eight patients (75%) were coded as having MCI and had significantly lower self-care management (η2= 0.07, P < 0.01) and self-confidence scores (η2= 0.05, P < 0.05). In multivariate analysis, MCI, co-morbidity index, and NYHA class III or IV explained 20% of the variance in self-care management (P < 0.01); MCI made the largest contribution explaining 9% of the variance. Increasing age and symptoms of depression explained 13% of the variance in self-care confidence scores (P < 0.01). Conclusion Cognitive impairment, a hidden co-morbidity, may impede patients' ability to make appropriate self-care decisions. Screening for MCI may alert health professionals to those at greater risk of failed self-care.

Objective To describe the extent to which parent- and teacher-reported child mental health problems vary by different indicators of socioeconomic status. Methods Participants were 4–5-year-old children in the Longitudinal Study of Australian Children (LSAC). Parents (N = 4968) and teacher (N = 3245) completed the 3–4-year-old version of Strengths and Difficulties Questionnaire (SDQ). Parents also reported the socioeconomic indicators of income, education, employment, and family composition (1- vs 2-parent families). Logistic regression models were used to predict SDQ total difficulties and each of the 4 SDQ subscales problems, as reported by parents and by teacher, and considered all putative socioeconomic status (SES) predictor variables simultaneously. Results The proportions of children scoring in the abnormal range varied according to SES indicator and mental health subscale. All of the SES indicators independently predicted parent-reported child mental health problems, although odds ratios were generally small to moderate (1.2 to 2.4), and not all reached statistical significance. Low income and parent education showed larger associations than sole parenthood or unemployment. The pattern for teachers was similar, though less consistent. Behavioral problems showed stronger associations with social disadvantage than emotional problems. Conclusions Research examining pathways to young children's mental health should include diverse measures of SES, particularly of family income and education. The fact that mental health problems were most strongly associated with parent education and income should be of interest to policy makers because education and income reflect investments in the lives of our participants' parents during their own childhood and adolescence.

The aim of the present study was to scrutinize the evidence on the use of acupoint stimulation for managing therapy-related adverse events in breast cancer. A comprehensive search was conducted on eight English and Chinese databases to identify clinical trials designed to examine the efficacy of acupressure, acupuncture, or acupoint stimulation (APS) for the management of adverse events due to treatments of breast cancer. Methodological quality of the trials was assessed using a modified Jadad scale. Using pre-determined keywords, 843 possibly relevant titles were identified. Eventually 26 papers, 18 in English and eight in Chinese, satisfied the inclusion criteria and entered the quality assessment stage. The 26 articles were published between 1999 and 2008. They assessed the application of acupoint stimulation on six disparate conditions related to anticancer therapies including vasomotor syndrome, chemotherapy-induced nausea and vomiting, lymphedema, post-operation pain, aromatase inhibitors-related joint pain and leukopenia. Modalities of acupoint stimulation used included traditional acupuncture, acupressure, electroacupuncture, and the use of magnetic device on acupuncture points. Overall, 23 trials (88%) reported positive outcomes on at least one of the conditions examined. However, only nine trials (35%) were of high quality; they had a modified Jadad score of 3 or above. Three high quality trials revealed that acupoint stimulation on P6 (NeiGuang) was beneficial to chemotherapy-induced nausea and vomiting. For other adverse events, the quality of many of the trials identified was poor; no conclusive remarks can be made. Very few minor adverse events were observed, and only in five trials. APS, in particular acupressure on the P6 acupoint, appears beneficial in the management of chemotherapy-induced nausea and vomiting, especially in the acute phase. More well-designed trials using rigorous methodology are required to evaluate the effectiveness of acupoint stimulation interventions on managing other distress symptoms.

Summary Objective To explore the extent to which traditional Chinese medicine (TCM) diagnostic categories for primary dysmenorrhoea are useful in describing the clinical presentation of this condition in Australian women in comparison with Chinese women, and therefore the potential usefulness of these categories in guiding TCM treatment of Australian women. Design and setting A comparative study of 120 Australian and 122 Chinese women aged from 18 to 45 years with primary dysmenorrhoea. Main outcome measures Modified valid TCM diagnostic protocol. Results Difference in menstruation and menstrual pain profiles between the two groups of women found in the same study did not translate into differences in the underlying syndrome according to TCM diagnostic categories. The study found that Australian and Chinese women were represented in broadly similar proportions across the defined five diagnostic categories. Conclusion Some evidence suggests that although the clinical presentation of symptoms in Australian and Chinese women is different, the distribution of women across the diagnostic categories in TCM is similar. Therefore, the TCM protocol used to diagnose primary dysmenorrhoea and guide treatment is unlikely to require adaptation for use with Australian women.

Cognitive functions of 24 patients with early onset parkinsonism (age of onset before 40 years) and 24 controls were investigated by a battery of neuropsychological tests. Patients were shown to be impaired in performance IQ (PIQ), conceptual ability and regulation behavior, memory, visuospatial perception, and manual dexterity. Patients were also shown to have a higher Zung Depression score. However, analysis of the testing scores appeared to indicate that only a small portion of poor performance on neuropsychological tests are depression related. The results demonstrated that patients with early onset parkinsonism, in whom the factor of aging is not as important, still show cognitive dysfunction and suggested that Parkinson's disease itself can cause cognitive impairment.

Motorcycle helmet wearing rates remain low in smaller cities in developing countries. We therefore examined the knowledge, attitudes, and behavior of motorcyclists towards helmet use in two mid-sized cities in China. The methods included roadside observation and interview. Observational sites were randomly selected from main roads and secondary streets; all motorcycles passing by were observed. Riders near the sites were opportunistically approached and asked about knowledge of and perceptions about helmet use. Altogether, 75,949 drivers and 17,230 passengers were observed. A large proportion of both drivers and passengers (34% and 71%, respectively) did not wear a helmet, or did not have their helmet fastened (34% and 14%). Proper helmet usage rates were lower among male drivers, younger people, on secondary streets, and during the evenings and weekends. The majority of the 2325 drivers interviewed (90%) acknowledged the benefits of helmet wearing, but 72% reported that helmets are not always comfortable, and only 20% said they would wear a helmet for preventive purposes. Furthermore, many felt that police enforcement was not strict (62%). These results suggest that educational programs about helmet use in provincial China should emphasize the risks of improper use. Strict enforcement, especially on secondary roads and during non-peak hours, could also improve helmet usage.

Background Understanding the impact of illnesses and morbidities experienced by children and adolescents is essential to clinical and population health programme decision making and intervention research. This study sought to: (1) examine the population prevalence of physical and mental health conditions for children and quantify their impact on multiple dimensions of children's health and well-being; and (2) examine the cumulative effect of concurrent conditions. Methods We conducted a cross-sectional school-based epidemiological study of 5414 children and adolescents aged 5–18 years, and examined parental reports of child health and well-being using the parent-report Child Health Questionnaire (CHQ) PF50 13 scales are scored on a 0–100 pt scale with clinically meaningful differences of five points and the presence of childhood conditions (illnesses and health problems). Results Asthma, dental, vision and allergies are the most commonly identified health problems for children and adolescents, followed by attention- and behaviour-related problems (asthma 17.9–23.2%, dental 11.9–22.7%, vision 7.2–14.7%, chronic allergies 8.8–13.9%, attention problems 5.1–13.8% and behaviour problems 5.7–12.0%). As the number of concurrent health problems increase, overall health and well-being decreases substantively with mean differences in CHQ scale scores of 14 points (−7.69 to −21.51) for physical health conditions, and 28 points (−5.15 to −33.81) for mental health conditions. Conclusions Children's health and well-being decreases linearly with increasing presence and frequency of health problems. Having three or more conditions concurrently significantly burdens children's health and well-being, particularly for family-related CHQ domains, with a greater burden experienced for mental health conditions than physical health conditions.

Aim: To determine the time needed to provide clinical pharmacy services to individual patient episodes for medical and surgical patients and the effect of patient presentation and complexity on the clinical pharmacy workload. Method: During a 5-month period in 2006 at two general hospitals, pharmacists recorded a defined range of activities that they provided for patients, including the actual times required for these tasks. A customised database linked to the two hospitals' patient administration systems stored the data according to the specific patient episode number. The influence of patient presentation and complexity on the clinical pharmacy activities provided was also examined. Results: The average time required by pharmacists to undertake a medication history interview and medication reconciliation was 9.6 (SD 4.9) minutes. Interventions required 5.7 (SD 4.6) minutes, clinical review of the medical record 5.5 (SD 4.0) minutes and medication order review 3.5 (SD 2.0) minutes. For all of these activities, the time required for medical patients was greater than for surgical patients and greater for 'complicated' patients. The average time required to perform all clinical pharmacy activities for 1071 completed patient episodes was 14.4 (SD 10.9) minutes and was greater for medical and 'complicated' patients. Conclusion: The time needed to provide clinical pharmacy services was affected by whether the patients were medical or surgical. The existence of comorbidities or complications affected these times. The times required to perform clinical pharmacy activities may not be consistent with recently proposed staff ratios for the provision of a basic clinical pharmacy service.

To examine the relationship between overweight/obesity in children, socioeconomic status and ethnicity/cultural background.Cross-sectional survey of children aged 4-13 years.A total of 23 primary (elementary) schools in an inner urban municipality of Melbourne, Australia. Participants. A total of 2685 children aged 4-13 years and their parents.Ethnicity/cultural background - maternal region of birth; socioeconomic position (SEP) indicators - maternal and paternal educational attainment, family employment status, possession of a healthcare card, ability to buy food, indicator of disadvantage (Socioeconomic Index for Areas, SEIFA) score for school; parental weight status. Main outcome measure. Prevalence of overweight/obesity.Prevalence of overweight/obesity approached 1 in 3 (31%) in this sample. Prevalence of overweight/obesity was greater for children of both North Africa and Middle Eastern background and children of Southern, South Eastern and Eastern European background compared with children of Australian background. This difference remained after adjusting for age, sex, height, clustering by school, SEP indicators and parental weight status; odds ratio, OR=1.57 (95% confidence interval, CI 1.12-2.19) and 1.88 (95%CI 1.24-2.85), respectively.There is a clear independent effect of ethnicity above and beyond the effect of socioeconomic status on overweight and obesity in children. Further research is required to explore the mediators of this gradient.