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woo h. & twinn s. (2004) Journal of Advanced Nursing 45(6), 595–602 Health needs of Hong Kong Chinese pregnant adolescents The outcomes of adolescent pregnancy have been associated with health risks such as obstetric complications and depression, and educational risks such as school dropout and reduced employment opportunities. These outcomes arise from a range of needs including perceived health needs, which are the focus of this paper. This paper reports a study to identify the perceived needs of Hong Kong Chinese adolescents following confirmation of an unintended pregnancy. An exploratory qualitative approach was used with a purposive sample of 10 Hong Kong Chinese pregnant adolescents. The study was undertaken during their stay in a non-government organization maternal shelter. Semi-structured interviews were used to explore adolescents’ perceptions of their psychological, social and health needs and the extent to which each of these needs was met. Six major categories were identified within the context of need, of which three were related to health needs: acceptance of the pregnancy; psychological reactions to the pregnancy; and use of contraception and health advice. The findings contribute to an understanding of the perceived health needs of Chinese adolescents, in particular those that are culturally determined. Implications for nursing practice indicate the significance of comprehensive health assessments and health promotion strategies to help adolescents increase their knowledge about sexual health and contraception. [ABSTRACT FROM AUTHOR]

This paper reports the results of a qualitative inquiry into the aetiology of anorexia nervosa in Hong Kong. These results are part of our main research project about family treatment and families with a daughter suffering from anorexia nervosa. This present qualitative study adopts a multiple case study approach ( n = 8) and employs a multiple-source data collection method, involving pre- and post-family treatment interviews, clinical observations of the participants during the treatment sessions and home visits, as well as detailed field notes. The findings indicate that there are biological, psychological, socio-cultural and familial interpretations of the aetiology of anorexia nervosa. This study challenges the dominant discourse on anorexia nervosa in Hong Kong, which states that the root of the disease lies in a desire for slenderness and beauty, and suggests instead that the aetiology of anorexia nervosa can be discovered only if approached from the systems level. Implications for social work practice are highlighted. [ABSTRACT FROM AUTHOR]

Controlling entry to an island continent proved more complex than the Immigration Restriction Act, 1901 framers imagined. Chinese people had been coming to Australia in numbers since the 1850s and by 1901 had substantial community, family, and economic links with their Pearl River Delta villages, around the colonies and with Hong Kong and Shanghai. Resistance was fought out on the boats themselves; musters were held, documents examined, searches made, and dictation tests administered. Secrecy, fraud, informers, and harassment reduced but did not eliminate communities while also causing governments much embarrassment before this first attempt at halting boat people was abandoned. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the differences in developmental skills between children with and without handwriting difficulties in their last year of kindergarten education. Methods: Standardised tests on handwriting performance and developmental skills were administered to 20 typically developing children, 21 children with handwriting difficulties in Chinese and 23 children with handwriting difficulties in both Chinese and English. We used one‐way MANOVA, univariate ANOVA and post hoc comparisons, to compare the developmental skills between children with and without handwriting difficulties. Multiple regression analysis was used to identify the significant predictors of developmental skills for Chinese and English handwriting performance. Results: Higher proportion of children faced handwriting difficulties in Chinese than in English. Their major problem in Chinese handwriting was on stroke formation, while the results did not indicate the key factor leading to English handwriting difficulties. The results also showed that children with handwriting difficulties had significantly poorer visual motor integration, some aspects of visual perception and fine motor skills than typically developing children. Reading skills were not a key factor contributing to handwriting performance. In addition, visual and fine motor integration and spatial relationship were the significant predictors of Chinese and English handwriting performance, which accounted for 39.7 and 43.6% of the variance respectively. Conclusion: First, the results suggested that more resources should be devoted to coaching children to learn Chinese than English handwriting. Second, besides direct repetitive practice on handwriting, there is a need to incorporate learning activities to facilitate the development of visual motor skills, visual perception, and fine motor skills as a preparation for learning to write or in improving handwriting performance among kindergarten children. [ABSTRACT FROM AUTHOR]

University study has been considered to be one of the most stressful periods in a person's life. University students may have irrational beliefs that could play a significant role in causing emotional disturbance. Nevertheless, a suitable instrument for measuring irrational beliefs in college students in Chinese society has been lacking. The aim of this study was to construct a culturally relevant scale for measuring irrational beliefs among university students in the Hong Kong Chinese context. The construction of the Chinese Irrational Beliefs and Rational Attitude Scale (CIBRAS) for university students was based on (1) literature review and expert panel review for evaluation on content validity, (2) a pilot test of 200 local Hong Kong university students to determine the scale's psychometric properties and probe the exploratory factor analysis, and (3) confirmatory factor analysis to test for construct validity of the CIBRAS (conducted with a further 655 local Hong Kong university students). The results showed that the five‐factor 19‐item CIBRAS has good psychometric properties, including good internal consistency (Cronbach's alphas ranging from.64 to.80), content validity (content validity index = .96 for relevance,.94 for clarity, and.94 for representativeness), construct validity (explaining 60.1% of the total variance), and adequate fit indices (normed chi‐square = 2.8, comparative fit index = .94, normal fit index = .93, non‐normed fit index = .93, incremental fit index =.94, root‐mean‐square error of approximation = .077, and standardized root‐mean residual = .074). The limitations and implications of the study were discussed. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To assess the potential of screening for pre-eclampsia (PE) in a Chinese population.Design: Case-control study.Setting: Teaching hospital in Hong Kong.Population: A total of 3330 women having a viable singleton pregnancy attending first-trimester Down-syndrome screening.Methods: Mean arterial pressure (MAP), bilateral uterine artery pulsatility index (UtA-PI), and placental growth factor (PlGF) were measured. Screening markers were transformed to multiples of the gestational median (MoM) and adjusted for maternal and pregnancy characteristics. MoM distributions in PE and non-PE pregnancies were compared with published expected values. PE screening performance was assessed using area under receiver operating curves (AUROC).Main Outcome Measures: PE detection rate.Results: A total of 30 (0.9%) women developed either early (<34 weeks) or late (≥34 weeks) onset PE. MAP was dependent on maternal BMI, UtA-PI on fetal crown rump length, uterine artery peak systolic velocity (UtA-PSV) on maternal age and gestation, and PlGF on gestation in non-PE pregnancies. MoM distributions determined using published Fetal Medicine Foundation models deviated significantly from one for both MAP (P < 0.0001) and PI (P < 0.0001), but not PlGF (P = 0.52) in non-PE pregnancies, whilst PlGF MoM distributions in those who developed early as opposed to late onset PE were significantly higher (P = <0.05). AUROC for any PE using multiple markers was 0.72 (95% CI: 0.64-0.81) with detection rates of 72 and 55% for early and late PE, respectively, for a 10% false positive rate.Conclusion: Detection rates for PE in our Chinese population were lower than the expected 90-95% even after adjusting MoM for local women's characteristics.Funding: General Research Fund (Project number 470513).Tweetable Abstract: Pre-eclampsia screening in the Chinese population had detection rates lower than previously published results. [ABSTRACT FROM AUTHOR]

Abstract: Background: Researchers have found breastfeeding disparities between immigrant and native‐born women in many countries. However, most studies on immigration and breastfeeding practices have been in Western countries. The aim of this study was to examine the effect of length of time since immigration on the breastfeeding practices of Mainland Chinese immigrants living in Hong Kong. Methods: We recruited 2704 mother‐infant pairs from the postnatal wards of four public hospitals in Hong Kong. We examined the effect of migration status on the duration of any and exclusive breastfeeding. Results: Breastfeeding duration was progressively shorter as the time since immigration increased. When compared with mothers who had lived in Hong Kong for <5 years, Hong Kong‐born participants had a 30% higher risk of stopping any breastfeeding (hazard ratio [HR] 1.34 [95% confidence interval {CI} 1.10‐1.63]) and exclusive breastfeeding (HR 1.33 [95% CI 1.11‐1.58]). In both Hong Kong‐born and immigrant participants, breastfeeding cessation was associated with return to work postpartum and the husband's preference for infant formula or mixed feeding. Intention to exclusively breastfeed and to breastfeed for >6 months, and previous breastfeeding experience substantially reduced the risk of breastfeeding cessation for both Hong Kong‐born and immigrant participants. Conclusions: Health care professionals should consider immigration history in their assessment of pregnant women and provide culturally adapted breastfeeding support and encouragement to this population. [ABSTRACT FROM AUTHOR]

Breastfeeding has many benefits for mother and infant. Whether breastfeeding also protects against type 2 diabetes is unclear. To clarify the role of breastfeeding in type 2 diabetes, we assessed the association of breastfeeding with insulin resistance in late adolescence in a birth cohort from a non-Western setting where breastfeeding was not associated with higher socio-economic position. We used multivariable linear regression, with multiple imputation and inverse probability weighting, to examine the adjusted associations of contemporaneously reported feeding in the first 3 months of life (exclusively breastfed, mixed feeding, or always formula-fed) with fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) at 17 years in a subset ( n = 710, 8.6% of entire cohort) of the Hong Kong Chinese birth cohort 'Children of 1997.' We found a graded association of breastfeeding exclusivity in the first 3 months of life with lower fasting insulin and HOMA-IR ( p-for-trend < .05), but not fasting glucose, at 17 years. Exclusively breastfed adolescents (7%) had nonsignificantly lowest fasting insulin and HOMA-IR, adjusted for sex, birth weight, parity, length of gestation, pregnancy characteristics, parents' education, and mother's place of birth. Exclusively breastfeeding for 3 months may be causally associated with lower insulin resistance in late adolescence. Further follow-up studies into adulthood are required to clarify the long-term protection of breastfeeding from type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background Individuals with ID are often withheld information about the death of their loved ones as it has often been thought that they do not understand death or cannot grieve. This grief exacerbates the stress of individuals with ID as they often encounter secondary losses such as transitioning to a care facility. The aim of this study is to investigate men and women with ID understanding death concepts and to what extent . Method Adopting a stratified random sampling method, 156 Chinese people with ID were invited to join the study. One hundred and ten participants were interviewed using simple death related vignettes expanding upon and replicating a published study carried out in Ireland. The understanding of the five death concepts: causality, irreversibility, nonfunctionality, universality and inevitability was examined. The correlates of demographics, bereavement experiences and comprehension were explored. Results The majority of the participants did understand concepts such as death is irreversible and that the deceased no longer function. One third of the participants understood causality and the universality of death. One fifth understood the inevitability of death. Previous bereavement experiences were correlated with higher understanding. Communication and community skills were correlated with all concepts of death except universality. Conclusion The results indicate that individuals with ID do have a partial to full understanding of the concepts of death. The culture of Hong Kong is one that considers death to be a taboo or unlucky subject. Therefore, the results mirror the the lack of understanding of universality and inevitability concepts as it is forbidden to speak of these concepts. An open and honest environment is encouraged to educate individuals with ID about death and bereavement. [ABSTRACT FROM AUTHOR]

Copyright of BJOG: An International Journal of Obstetrics & Gynaecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer-related fatigue (CRF) is common in women with breast cancer, but little is known of its relationship with perceived stress. We conducted a cross-sectional study to explore the associations of CRF with perceived stress, anxiety, depression, pain and sleep quality in 133 Chinese women (aged 25-68 years) with early stage breast cancer. The majority of women had completed surgery and chemotherapy and were awaiting radiotherapy. Self-administered questionnaires consisting of the Brief Fatigue Inventory, Perceived Stress Scale-10, Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pittsburgh Sleep Quality Index were used to collect data. Forty-five per cent of the women were severely fatigued. Compared with local healthy women and US breast cancer patients, the group's mean perceived stress score was significantly higher (both p < 0.01). Higher perceived stress (β = 0.18, p = 0.032), higher anxiety (β = 0.30, p < 0.001) and higher pain severity (β = 0.38, p < 0.001) were associated with increased severity of CRF. The association of CRF with perceived stress was partially mediated by anxiety, suggesting a possible pathway from cancer and cancer treatment to CRF via stress appraisals and emotional distress. The findings indicate the importance of monitoring the psychological status of patients during treatment. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim To investigate the cross-sectional association between smoking and happiness in Chinese adults in Hong Kong. Design, Setting and Participants Telephone surveys were conducted between 2009 and 2012, with 4553 randomly sampled Chinese adults (male 54%, mean age 58.3 years) in Hong Kong. Measurements Happiness was measured using the four-item Subjective Happiness Scale ( SHS) and single-item Global Happiness Item ( GHI). Smoking status was categorized as current smokers (7.7%%), ex-smokers (6.5%, 93% quit for >6 months) and never smokers (85.8%). Linear and ordinal logistic regressions were used to calculate adjusted β-coefficients for SHS and proportional adjusted odds ratios (a OR) for GHI in relation to smoking. Findings Compared with current smokers, ex-smokers enjoyed greater happiness according to both SHS (adjusted β = 0.16, P < 0.05) and GHI (aOR = 1.52, P < 0.05) measurements, but current and never smokers were similar. Among current smokers, the number of cigarettes smoked was not associated with happiness, but the lack of any attempt to quit was associated significantly with greater happiness (adjusted β = 0.31 for SHS, a OR = 1.82 for GHI) compared with smokers who had tried to quit but not succeeded. Smokers not intending to quit in the next 6 months had higher odds of happiness ( GHI) than those wanting to quit within 6 months (a OR = 1.86, P < 0.05). Conclusions Ex-smokers in Hong Kong are happier than current smokers and never smokers, whose happiness measurements are similar. Causal associations have yet to be established. [ABSTRACT FROM AUTHOR]

The authors provide an overview of recent developments in professional counseling as related to schools, career counseling, and community services in Hong Kong. The strategic position of counseling professionals, counseling associations, and counselor certification is discussed. The future development of counseling in Hong Kong is also considered. [ABSTRACT FROM AUTHOR]

This interpretative study aims to offer metaphors that describe family meanings from the adolescent's perspective by encouraging them to give a metaphor with their own explanation on a self-administering essay form. This study has three objectives: to explore the family meanings as a metaphor from the Hong Kong adolescent's perspective; to reveal any common and unique features of these metaphors; and to search for the possibilities of collecting metaphors from adolescents as a pre-counselling assessment tool. The 12 participants for this study were referred to me for family counselling because of poor self-esteem, loss of life goals or ineffective relationships with their parents. Based on the 12 metaphors, the following five themes can be discerned: (i) gender role in a family, (ii) Chinese culture in a family, (iii) heat in a family, (iv) security in a family and (v) the family as honey and a loan company. Based on the above five themes, there are some common metaphors (e.g. a warm place, honey, a shelter, a boat shelter, a chick and a hen, a volcano, a fire, an oven and a loan company), trans-cultural and unique metaphors (e.g. a wet market and 'Kung Fu' experts), and those that are culturally specified. Both strengths and limitations of collecting and analysing metaphors were discussed. [ABSTRACT FROM AUTHOR]

This study evaluated the factors associated with adherence to oral hypoglycemic agents (OHAs) among Chinese patients. A validated clinical database was used to include all adult patients who were prescribed an OHA in any of the government clinics in a large territory of Hong Kong from January 1, 2004, to June 30, 2007 and made 1 or more subsequent visits for OHA refill. Patients with medication possession ratio (MPR) 0.8 or greater were regarded as medication adherent. One binary logistic regression analysis was performed to test the association between age, gender, visit types (new vs follow-up visits), and MPR while controlling for socioeconomic status, service settings, number of comorbidities, and the medication class prescribed (sulphonylurea vs biguanide vs combination of both). Among 26 782 patients, 89.6% were adherent. Older patients (aged 50-59 years; adjusted odds ratio [AOR] 1.19; 95% confidence interval [CI], 1.06-1.34, P = .004; 60-69 years; AOR 1.37; 95% CI, 1.21-1.55, P < .001; ≥70 years; AOR 1.52; 95% CI, 1.34-1.72, P < .001) and follow-up visitors (AOR 3.89; 95% CI, 3.55-4.27, P < .001) were more likely to be medication adherent. Male subjects were less likely to adhere (AOR 0.84; 95% CI, 0.77-0.91, P < .001). Newer medication adherence-enhancing strategies should be implemented, especially among younger patients, male subjects, and new clinic attendees to secure optimal adherence. [ABSTRACT FROM PUBLISHER]

Prevalence estimates of insomnia in western general populations are well documented, but population-based epidemiological data on insomnia in Chinese adults are scarce. The aims of the present study were to determine the prevalence of insomnia in the general population of Hong Kong, compare components of sleep disturbances and lifestyle factors stratified by sex, and identify risk factors for insomnia. Using a population-based cross-sectional design, a total of 5001 Chinese adults aged ≥18 years completed a telephone interview on the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS) and measures of quality of life (QoL) indexed by Medical Outcomes Study 12-item Short-Form Health Survey (SF12), lifestyle and sociodemographic details. Insomnia was defined by a PSQI global score >5. The resultant weighted prevalence of insomnia was 39.4%, equivalent to 2.2 million affected adults in Hong Kong. Women reported significantly poorer component and global sleep quality (all P < 0.05). Fully adjusted stepwise regression analyses identified non-full-time employment status, existing long-term health problems, alcohol consumption four to seven times per week, higher HADS scores, poor mental health component of QoL and low self-perceived health were associated significantly with insomnia (all P < 0.05). Our results suggest that insomnia is highly prevalent among Hong Kong Chinese adults and is associated with frequent use of alcohol, poor mental health and QoL. [ABSTRACT FROM AUTHOR]

The article presents a study which observes women with a spontaneously conceived singleton pregnancy and regular menstrual cycle in the preceding 12-month period. It aims to develop a sonographic dating formula based on fetal crown-rump length (CRL) in a population in Hong Kong, China. It derived a formula which is suitable for dating of naturally conceived pregnancies between 6 to 15 weeks of gestation having no prediction error and was compared favorably with established CRL dating formulae.

Family interventions in schizophrenia have shown positive effects on patients but little attention has been paid to their effects on family members, particularly those in non-Western countries. This randomized controlled trial evaluated the effectiveness of a bi-weekly, 12-session, family-led mutual support group for Chinese caregivers of schizophrenia sufferers over 6 months compared with standard psychiatric care. It was conducted with 76 families of outpatients with schizophrenia in Hong Kong of whom 38 were assigned randomly to either a mutual support group or standard care. Families’ psychosocial health status and patients’ symptom severity and length of re-hospitalizations at recruitment, one-week and 12-month post-intervention were compared between groups. Results of repeated-measures mixed model indicated that the mutual support group experienced significantly greater improvements in families’ burden, functioning and number of support persons and length of patients’ re-hospitalizations at two post-tests. The findings provide evidence that mutual support groups can be an effective family-initiated, community-based intervention for Chinese schizophrenia sufferers. [ABSTRACT FROM AUTHOR]

The article describes the construction and development of new reference charts and equations for fetal biometry in the Hong Kong ethnic Chinese population in comparison with existing references from different populations. The results indicate the development and application of a new set of reference centiles for fetal biometric measurements and equations for clinical use and research in appropriate Chinese groups.

Aim. To describe and understand the experiences of Chinese family members of terminally ill patients during the end of life process in a palliative care unit. Background. Palliative care aims to provide care to dying patients and their family members. Skillful interventions are necessary to help family members cope with the impending death of the patient and maintain their emotional equilibrium. Hence, it is important to understand the experiences of family members of palliative care. Design. A phenomenological study was conducted. Data were collected by semi-structured interviews. We interviewed a purposive sample of 20 family members of terminally ill patients in a palliative care unit in Hong Kong. The data were analysed following Colaizzi's phenomenological methodology. Results. Family members experienced anticipatory grief, with reactions that included anger, unease, sadness and helplessness. This was particularly acute when the patient was first admitted to the palliative care unit. However, the family members quickly accepted the reality and committed themselves to the care of the patient, seeking informational and emotional support from the nurses. The families wanted to be assured that the patient had been offered good care and suffered no pain. It was considered important to be with the patient during the dying process. Conclusion. This study demonstrated that Chinese family members were committed to the care of the patients in the palliative care unit. Cultural beliefs played a part in influencing family emotions and concerns. Relevance to clinical practice. This study offers a direction for family interventions that acknowledge the reactions of family members to the admission of a patient to a palliative care unit. It highlights that families need active informational and emotional support from nurses. [ABSTRACT FROM AUTHOR]

Objective To assess the measurement accuracy and the utility of the Chinese Abuse Assessment Screen (AAS). Design A cross-sectional study. Setting An antenatal clinic of a public hospital and a community centre in Hong Kong. Sample A total of 257 Chinese women consisting of 100 pregnant women and 157 nonpregnant women. Method The Chinese AAS was administered first, followed by the Chinese Revised Conflict Tactics Scales (CTS2). This was performed in the same sitting, and each participant was interviewed once either at an antenatal clinic (for the pregnant women sample) or at a community centre (for the nonpregnant women sample). Main outcome measures Estimates of the sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios. Results Using the Chinese CTS2 as the standard, the specificity estimates of the Chinese AAS for emotional, physical and sexual abuse were ≥89%, while the sensitivity estimates varied from 36.3 to 65.8%. The sensitivity improved in the screening for more severe cases (66.7%). The positive predictive values were ≥80%, and the negative predictive values varied from 66 to 93%. Factors such as the age difference between the couple and the woman’s need for financial assistance were found to be associated with intimate partner violence (IPV). Conclusion The Chinese AAS has demonstrated satisfactory measurement accuracy and utility for identifying IPV when the Chinese CTS2 was used as the standard. [ABSTRACT FROM AUTHOR]

Objective To establish whether women’s preference for elective caesarean section (ELCS) changes as gestation advances. Design A prospective longitudinal observational study. Setting Two units providing obstetric care in Hong Kong, one public and one private. Sample Five hundred and one nulliparous Chinese pregnant women attending their routine fetal anomaly scan in either unit. Methods Consented subjects had two interviews using a structured questionnaire at 18–22 weeks and 35–37 weeks of gestation, respectively. Multivariate analysis was performed to identify determinants for preferring ELCS at the two gestational ages. Main outcome measure The preferences for the mode of delivery at the two gestational ages. Results The prevalence of maternal preference for ELCS in the study cohort was 17.2% (95% CI 13.9–20.5) and 12.7% (95% CI 9.6–15.8) at mid-trimester and at term, respectively. Significantly more women who preferred ELCS at mid-trimester changed to a trial of vaginal delivery (VD) at term than vice versa (42.0 versus 3.8%). The partner’s preference for ELCS was a significant determinant for women preferring ELCS throughout the antenatal period. Among the women booked in the public sector, more women who preferred ELCS at term changed to deliver in private hospitals than those who preferred VD (46.2 versus 9.7%). Conclusions Many women changed from preferring ELCS to preferring VD as their pregnancy approached term. The partner’s preference was a significant determinant for the women’s choice. If a decrease in the proportion of women preferring ELCS is desired, the intervention programme should target the women and their partners who hold such a preference at 20 weeks. [ABSTRACT FROM AUTHOR]

Objective To examine the effectiveness of first-trimester fetal trisomy 21 screening using a combination of maternal age, nuchal translucency thickness (NT) and maternal serum free beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) levels in a predominantly Chinese population in Hong Kong. Methods This was a prospective study over a 1.5-year period of 2990 women who underwent combined screening for trisomy 21 between 11 + 0 and 13 + 6 weeks of gestation in a university fetal medicine unit. NT was measured according to the criteria set by The Fetal Medicine Foundation (FMF), maternal serum free β-hCG and PAPP-A levels were measured, and the risk of trisomy 21 was calculated using The FMF' s algorithm. Fetal karyotyping was advised when the risk was 1:300 or above. All subjects were followed up for pregnancy and fetal outcome. Results Of the 2990 women who underwent the screening program, 99% were Chinese. There were 57 twin pregnancies, giving a total of 3047 fetuses. Thirty-one percent of the women were 35 years old or above. One hundred and eighty-five (6.1%) fetuses were screen-positive; this included 14 cases of trisomy 21 and 17 cases of other chromosomal abnormalities. The positive predictive value was 16.7%. Among the 2862 screen-negative fetuses, only 18 (0.6%) cases had an unknown fetal outcome. There were no cases in which trisomy 21 was missed and the infant was liveborn. Conclusion First-trimester combined screening for fetal trisomy 21 is highly effective among Chinese subjects. [ABSTRACT FROM AUTHOR]

In Chinese society the family not the individual is the basic structural and functional unit. Family beliefs significantly determine the impact of the illness, choice of coping patterns and ultimately the physical and behavioral reactions of both the women and their family members. The purpose of this study was to identify the family beliefs about breast cancer and how the beliefs influenced family functioning. Twenty Hong Kong Chinese families where the woman had breast cancer (N=59) were interviewed using a minimally structured schedule. Interpretive phenomenology was the qualitative methodology used in the study. Gadamer's philosophical hermeneutics related to the process of understanding, application and interpretation was used to guide the analysis. Patterns of disharmony related to stress and emotion, diet, exercise, genetics and fate were evident in the family beliefs about the causes of breast cancer and guided the cognitive, emotional and behavioral strategies they adopted to negotiate the illness experience. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This study explored the relationship between three types of living arrangements, namely living alone, living with family, and living in a hostel, and the psychological well-being of older people in Hong Kong. The impact of various sociodemographic factors on the choice of living arrangements of older people was also studied.Ninety healthy Hong Kong Chinese were recruited from four multi-service centres and one hostel. An individual interview was conducted with each participant and the General Health Questionnaire-12 and the Center for Epidemiological Studies Depression Scale-10 were administered.The results suggested that the psychological well-being of older people living in hostels was better than that of older people living alone, but that the psychological well-being of older people living with their family was not different from that of older people living alone.That the psychological well-being of older people in different living arrangements is different may be explained by the differences in time for leisure, access to social services, as well as changes in their attitude towards co-residence with children. [ABSTRACT FROM AUTHOR]

Colon transit study with radio-opaque markers is helpful in the evaluation of chronic constipation. Normal reference values, based on radio-opaque markers, have not been reported from Chinese adults in Hong Kong.Fifty-one healthy Chinese (27 men, age 42 ± 12 years) were enrolled through a newspaper advertisement. They were requested to fill in detailed dietary records and a gastrointestinal symptom questionnaire. Each subject swallowed, under supervision, a total of three Sitzmarks capsules, one capsule at the same time on each of day 1, 2 and 3. Abdominal films were taken on days 4 and 7, also at the same time of the day. Total and segmental transit times were calculated using Metcalf's method.The upper limit of normal total colonic transit time (CTT) was 62 h, while right, left and rectosigmoid CTT were 16 h, 31 h and 32 h, respectively. Women of age 18–35 years had a longer rectosigmoid and total CTT compared with their male counterparts (mean total CTT: 39 hvs18 h,P = 0.05). The CTT appeared to be unaffected by the usual dietary components.A single normal reference value for CTT appeared to be applicable to Chinese adults in Hong Kong, irrespective of age, sex and dietary content. However, young Chinese women (age 18–35 years) appeared to have longer total and rectosigmoid CTT. [ABSTRACT FROM AUTHOR]

Objective: To describe factors associated with breastfeeding failure during the first 6 months post-partum in a sample of Hong Kong Chinese women participating in a longitudinal study of maternal nutrition. Methodology: Forty-four Hong Kong Chinese lactating mothers who intended to breastfeed exclusively for at least 3 months were recruited and followed for 6 months post-partum. Demographic data were compared with 20 mothers who intended to use formula feeding. Mothers were followed up at 2 and 6 weeks and 3 and 6 months and details of infant feeding practices were obtained. Information was sought on breastfeeding management in hospital, reasons for discontinuation of breastfeeding or for providing supplements to babies and intention to seek, and sources of, lactation support. Results: Thirty-nine mothers who planned to breastfeed completed the follow up. Compared with mothers in the formula-feeding group, breastfeeding mothers were more likely to be professionals or housewives. Continuation of any breastfeeding (total and partial) was noted in 30 (77%), 22 (57%), 16 (41%) and 12 (31%) mothers at 2 and 6 weeks and 3 and 6 months post-partum, respectively. The majority (97%) of mothers stated that they were given information on the benefits and management of breastfeeding. However, late initiation of breastfeeding and providing supplements to babies were common. Perceptions of insufficient milk supply (44%), breast problems (31%) and being too tired (28%) were the main reasons stated for stopping breastfeeding or for providing supplements to babies. Midwives from the postnatal wards and hotlines were the main sources of lactation support. Conclusions: These results highlight difficulties in sustaining breastfeeding, either exclusive or partial, in Hong Kong Chinese women. Despite being recruited on the basis of intending to exclusively breastfeed for 3 months, less than half these mothers were still breastfeeding and only approximately one-third were exclusively or predominantly breastfeeding at 3 months. More needs to be done within the hospital environment to initiate breastfeeding immediately after birth and to avoid giving unnecessary supplements and more effort is needed to foster a mother’s confidence, commitment and knowledge of breastfeeding. [ABSTRACT FROM AUTHOR]

Objective: To study the early dietary practices in relation to growth of Hong Kong children from birth to 7 years.Methodology: One hundred and seventy-three full-term Hong Kong Chinese babies were recruited at birth and were followed up for anthropometric measurements using standardized methods and dietary assessment using a combination of dietary history, 24 h recall and food frequency. At 7 years, 125 children remained in the study.Results: Mean (SD) birthweight was 3.3 (0.38) kg for boys and 3.1 (0.38) kg for girls. Mean (SD) weight at 7 years was 22.4 (4.2) kg for boys and 21.1 (3.7) kg for girls, and mean (SD) height was 120.3 (4.8) cm for boys and 119.8 (5.1) cm for girls. Hong Kong children were lighter and shorter than Australian children and the National Centre for Health Statistics (NCHS) references, but the magnitude is less than one standard deviation score. Mean weight and height of Hong Kong children were lower compared to Caucasian and Beijing children, with more obvious differences between 1 and 5 years. At 1 year, mean (SD) daily energy intake was 98 (24) kcal/kg/day for boys and 100 (26) kcal/kg/day for girls. By 7 years, it decreased to 82 (18) kcal/kg/day for boys and 73 (22) kcal/kg/day for girls. Between 2 to 4 years of age the energy intake of studied children were slightly lower than the Australian and Finnish children, but the protein intake was higher. Percentage of fat contributing to total daily energy intake was lower throughout at a level of 30%. Such differences in diet reflect a lower consumption of milk fat, higher consumption of meat and lower level of physical activity in Hong Kong children. Intakes of calcium, iron and vitamin C all reached 60% or above of US recommended daily allowance.Conclusions: The smaller body build of Chinese compared to Caucasians cannot be explained by dietary differences. The diet of Hong Kong children is changing to one which is more Westernized with a higher consumption of animal products. [ABSTRACT FROM AUTHOR]

Abstract Aim: Locally validated symptom questionnaires are essential instruments in dyspepsia research. A symptom score for Chinese dyspeptics was developed. Multiple aspects of validity and reliability were assessed. Methods: Sixty-five patients with endoscopy-negative dyspepsia and 65 healthy controls were presented with a list of 24 previously determined common abdominal symptoms and asked to rate the severity in a five point Likert scale. Comprehensibility and relevance of symptoms were assessed. The questionnaire was administered 3 h later to assess for reproducibility. A locally validated Short Form-36 quality-of-life questionnaire was also administered. Cisapride 5 mg thrice daily was prescribed to dyspeptic patients but not to the controls. The dyspepsia symptom and SF-36 questionnaires were repeated after 3 weeks for patients under treatment. Global change in symptoms and the need for further medical care were assessed. Concept, content, construct and criterion validity, consistency and reproducibility of the dyspepsia symptom questionnaire were assessed. Results: All items were considered comprehensible by more than 90% of subjects. Relevance of individual symptoms to dyspeptic patients ranged from 10.8–76.9%. Twelve items were selected by logistic regression to account for most of the differences between control and dyspeptic patients. Test–retest reproducibility and internal consistency were good with the intraclass correlation coefficient of 0.89 and Cronbach's alpha coefficient of 0.90. A cut-off score of equal to or greater than 16 was determined to discriminate between controls and dyspeptic patients. The dyspepsia score correlated negatively with all domains of the SF-36 quality of life scale except physical functioning. The dyspepsia questionnaire also discriminated between patients who reported a subjective improvement in symptoms and those who reported no change or worsening. Conclusions: The dyspepsia symptom index was easy to... [ABSTRACT FROM AUTHOR]