Participation in a government-subsidised colorectal cancer screening programme for asymptomatic individuals in Hong Kong

BackgroundA Government-subsidised colorectal cancer screening programme (CRCSP) was launched in Hong Kong. This study aimed to assess the participation rate in CRCSP among Chinese individuals between the ages of 50 and 75 years and to survey individuals’ reasons for declining to participate in the CRCSP.MethodsA cross-sectional study was performed. Asymptomatic Chinese individuals aged 50–75 years in Hong Kong who did not have a history of colorectal cancer were recruited. A survey was used to collect information about individuals’ participation in the CRCSP.ResultsThe survey was completed by 1317 participants. Of these, 432 (32.8%) joined the CRCSP and the remaining 885 participants (67.2%) did not join the CRCSP. The most common reason that participants provided for not joining the CRCSP was thinking that the screening was not necessary because they had no health problems (29.3%). Some (14.4%) of the participants claimed to lack information about the CRCSP and screening procedures. Some (12.5%) of them completed the screening before the CRCSP was launched, and the cost was covered by other sources.ConclusionThe participation in CRCSP for a screening among the Hong Kong population has generally increased, but obstacles to participating in screening programme remain.     

Paths to psychiatric care in Hong Kong

The pattern of psychiatric consultation in Hong Kong is examined among 226 patients at a public outpatient clinic and 56 patients at a private psychiatric clinic. The approach to psychiatric services is marked by lengthy delay during which patients get help from their family members or close friends. Arrival at the present psychiatric clinic was diverted through other medical resources, primarily Western-style medical services, and to some extent, traditional Chinese medicine. Individual routes were diverse, characterized by frequent switches among resources especially in the private sector. The nature of the patients' presenting complaints as well as the conceptualization of their initial complaints were multi-faceted, including both psychological and somatic factors. The overall consultation pattern of patients in Hong Kong is compared with other studies on Chinese and Western patients. Questions are raised for further analysis.The study was funded by the United Board for Christian Higher Education in Asia Faculty Research Grant made through Chung Chi College of The Chinese University of Hong Kong.     

Malaria parasitaemia among infants and its association with breastfeeding peer counselling and vitamin A supplementation: a secondary analysis of a cluster randomized trial

Background

Malaria is the second highest contributor to the disease burden in Africa and there is a need to identify low cost prevention strategies. The objectives of this study were to estimate the prevalence of malaria parasitaemia among infants and to measure the association between peer counselling for exclusive breastfeeding (EBF), vitamin A supplementation, anthropometric status (weight and length) and malaria parasitaemia.

Methods

A cluster randomized intervention trial was conducted between 2006 and 2008 where 12 of 24 clusters, each comprising one or two villages, in Eastern Uganda were allocated to receive peer counselling for EBF. Women in their third trimester of pregnancy (based on the last normal menstrual period) were recruited in all 24 clusters and followed up until their children''s first birthday. Blood was drawn from 483 infants between 3 and 12 months of age, to test for malaria parasitaemia.

Results

The prevalence of malaria parasitaemia was 11% in the intervention areas and 10% in the control areas. The intervention did not seem to decrease the prevalence of malaria (PR 1.7; 95% CI: 0.9, 3.3). After controlling for potential confounders, infants not supplemented with Vitamin A had a higher prevalence for malaria compared to those who had been supplemented (PR 6.1; 95% CI: 2.1, 17.6). Among children supplemented with vitamin A, every unit increase in length-for-age Z (LAZ) scores was associated with a reduced prevalence in malaria (PR 0.5; 95% CI:0.4, 0.6). There was no association between LAZ scores and malaria among children that had not been supplemented.

Conclusion

Peer counselling for exclusive breastfeeding did not decrease the prevalence of malaria parasitaemia. Children that had not received Vitamin A supplementation had a higher prevalence of malaria compared to children that had been supplemented.

Trial registration

Clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT00397150","term_id":"NCT00397150"}}NCT00397150.     

香港特区公营医院运行机制评估及对内地的启示

回顾香港医疗融资的发展历程并简述香港公营医院的运营状况与开支构成比,重点分析香港公营医院的管理机构——香港医院管理局,研究其宗旨任务与目标策略相结合的管理医院管理战略,跟踪其主要经费来源的变化趋势,对其财务状况进行深入探究并进行预测。在对香港公营医院运行机制进行评估的基础上,探讨香港公营医院存在的问题以及对内地的启示,为内地医院管理机构借鉴香港逐步建立以政府投入为主体的医疗融资体系提供参考。     

Corticolous ascomycetes in Hong Kong

Some corticolous ascomycetes from Hong Kong are reported, based on materials recently collected by the first author. Corticolous ascomycetes form a component of the biodiversity in the tropics that has been neglected until now. Some unexpected species were found, including species so far only known from temperate areas.     

Visualizing Marriage in Hong Kong

ABSTRACT

In this article, I propose using bridal photography and wedding video-recording to gain a better understanding of the meanings of romance and the ideal life among young generations and to consider how relevant images of getting married shed light on the changing social life in Hong Kong. Bridal photography and wedding videorecording not only play the role of documentation but also reflect the social change and values among new married couples in the society. By examining packaged bridal photography and the process of wedding video-shooting, I propose to state how visualization brings subtle influences into the new dynamism of marriage as a ritual and reflects the changing social contexts in today's Hong Kong everyday life.     

Ipomoea aquatica as a vegetable crop in Hong Kong

The aquatic plant Ipomoea aquatica is grown in southeastern Asia as a summer leaf vegetable. It is particularly common in south China and Hong Kong, where it has a very ancient history. Two methods of cultivation are used in Hong Kong: the dry-land method utilizing raised beds and the wet-land method on flooded paddy-fields. During the summer months I. aquatica supplies up to 15% of local vegetable production.     

Effect of antenatal peer support on breastfeeding initiation: a systematic review

Background

Our objective was to examine the effect of antenatal peer support on rates of breastfeeding initiation.

Methods

We performed a systematic review of randomized controlled trials, quasi-randomized trials and cohort studies with concurrent controls. We searched the Cochrane Library, MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Research Register and the British Nursing Index from inception or from 1980 to 2009. We carried out study selection, data abstraction and quality assessment independently and in duplicate. We defined high-quality studies as those that minimized the risk of at least three of the following types of bias: selection, performance, measurement and attrition bias. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for individual studies and undertook separate meta-analyses for high-quality trials of universal peer support and targeted peer support. We did not include low-quality studies.

Results

We selected 11 studies, which involved 5445 women in total. Seven of these studies (involving 4416 women in total) evaluated universal peer support, and four studies (involving 1029 women in total) targeted antenatal peer support. In the three high-quality studies of universal peer support, all involving low-income women, the relative risk for not initiating breastfeeding was 0.96 (95% CI 0.76–1.22). In the three high-quality studies of antenatal peer support that targeted women considering breastfeeding, the relative risk for not initiating breastfeeding was 0.64 (95% CI 0.41 – 0.99).

Interpretation

Universal antenatal peer support does not appear to improve rates of breastfeeding initiation, but targeted antenatal peer support may be beneficial. This effect may be related to context, however, so any new peer-support program should undergo concurrent high-quality evaluation.Breastfeeding confers numerous benefits for mother and infant,^1–3 yet many women still do not initiate breastfeeding.⁴ The World Health Organization recommends exclusive breastfeeding to six months,⁵ and national governments have implemented initiatives to increase initiation rates.^6,7 Peer support has been examined as one intervention to increase breastfeeding rates, but there have been few high-quality randomized controlled trials (RCTs) examining initiation. One systematic review⁸ (published in 2000) concluded, based only on two nonrandomized studies, that antenatal peer support had a positive effect on breastfeeding initiation. Another⁹ (published in 2005 and updated in 2007) included only RCTs but excluded those whose primary purpose was to affect duration. Based only on one RCT, that review concluded that peer support is likely to result in improvements in initiation of breastfeeding among low-income women where baseline breastfeeding rates are low. These weaknesses in the available evidence make recommendations uncertain. Despite this uncertainty, antenatal peer support for breastfeeding is being incorporated into routine maternity care in some parts of the world.¹⁰Antenatal peer support can be provided as a universal service or targeted to women who are considering breastfeeding. Although trials have made this distinction, previous reviews have not. New evidence has become available, and it appears appropriate to re-examine antenatal peer support through a systematic review. The purpose of our review was to assess the effectiveness of antenatal peer support, as either a universal or a targeted service, including all studies that examined breastfeeding initiation using concurrent controls.     

Phytogeography of Hong Kong bryophytes

Aim Hong Kong is in a biogeographically interesting location on the northern margins of the Asian tropics. This paper analyzes the phytogeography of Hong Kong's bryophyte flora for the first time. Location Hong Kong lies on the South China coast, 22°9′–22°37′ N, 113°52′–114°30′ E. It is one of the most densely populated places in the world, but because of the rugged topography only 20% of the total land area of 1100 km² is urbanized. Although 130 km south of the Tropic of Cancer, it has a subtropical climate with distinct hot, humid and cool, dry seasons. Methods The analysis is based on a new and relatively complete inventory of Hong Kong's bryoflora. Each taxon was assigned to a phytogeographical pattern on the basis of its present worldwide distribution. Krober's percentage similarity was employed to evaluate the floristic affinities between different regions. Results The bryophyte flora consists of at least 360 species and twelve infraspecific taxa in 159 genera and seventy families, of which four taxa are locally endemic. The largest families are Lejeuneaceae (fifty‐one taxa), Fissidentaceae (28), Hypnaceae (21), Dicranaceae (20), Calymperaceae (18), and Sematophyllaceae (15). The largest genera are Fissidens (28), Cololejeunea (17), Lejeunea (10), Syrrhopodon (9), Frullania (8), and Macromitrium (8). Fourteen phytogeographical patterns are recognized. The East Asian pattern is the commonest (seventy‐three taxa, 19.6%), followed by Asian–Australian–Oceanian (45, 12.1%) and Temperate (44, 11.8%). Overall, a third of taxa have tropical distributions. The bryofloras of eleven regions were compared with that of Hong Kong. The most similar regions are Hainan Province, Taiwan Province, and Japan. Mosses and liverworts show very similar phytogeographical distributions. Main conclusions (1) The Hong Kong bryoflora is best described as northern marginal tropical, with a strong Eastern Asian and Temperate influence; (2) the region of closest phytogeographical affinity for which information is available is Hainan; (3) in comparison with vascular plants, vertebrates and those invertebrate groups for which there is information, the bryoflora has a relatively low proportion of tropical taxa; (4) the bryoflora of Hong Kong appears to be exceptionally rich for its small area.     

Seasonal dynamics of invertebrate drift in a Hong Kong stream

Drift samples were taken with paired nets on 19 occasions over a 12-month period in Tai Po Kau Forest Stream (TPKFS), Hong Kong. Mean drift density (±1 S.E.) was 277·9 ± 25·0 individuals 100 m^-3; peaks in density were apparent during autumn and spring. One hundred and two taxa were recovered from the drift, and the total number of taxa drifting was positively related to water temperatures. Over 99% of the aquatic animals collected in drift samples were insects, 10 taxa of which constituted 67·3% of the entire catch. Baetid mayflies dominated the composition of the drift, comprising 40·4% of individuals caught.
Seasonal changes in the drift of individual taxa were evident, reflecting significant relationships between drift densities and water temperature: Simulium T₁ (Diptera). Anisocentropus maculatus (Trichoptera) and Amphinemura chui (Plecoptera) drifted most in winter, whereas Chimarra T₁, Polymorphanisus astictus (Trichoptera), Helodes #1 and cf. Rhantus sp. (Coleoptera) were most numerous in summer. Drifting mayflies showed spring ( Indobaetis sp., Cinygmina T₁, Serratella T₂), autumn ( Baetiella sp., Pseudocloeon T₂), or spring and autumn ( Baetis nr pseudofrequentus ) peaks which were not clearly related to water temperature. In only two cases ( A. maculatus and P. astictus ) was TPKFS drift seasonality associated with life-cycle events. Overall, there was no evidence of community-level trends in the periodicity of stream drift in this seasonal tropical habitat.     

Mycorrhizal associations in Hong Kong Fagaceae

A rapid method of screening has been devised whereby the large seeds (acorns) of Castanopsis, Lithocarpus and Quercus growing in Hong Kong can be germinated in the presence of a variety of known mycorrhizal fungi and observations made on the initiation of host/fungal associations. Early stages of Hartig net formation could be detected in bleached roots, and an observation was made on the antibiotic activity of the mycorrhizal fungus, Pisolithus tinctorius. The method offers a simple and effective means of assessing the potential of fungi to form mycorrhizal associations under non-sterile conditions.     

Mycorrhizal associations in Hong Kong Fagaceae

Castanopsis fissa Rehd. & Wils. is widely distributed from the tropics to the temperate regions of China and Japan and is an important forest component in Hong Kong. Pot-grown C. fissa seedlings inoculated with vegetative mycelial inocula of seven ectomycorrhizal fungi for 20 weeks were analysed for growth performance and mineral nutrient uptake of N, P, K and Ca. Shoot growth stimulation in all fungal treatments generally occurred in the first 4–8 weeks of seedling development. Uptake of P was generally enhanced by all fungi inoculated. Seedlings inoculated with Pisolithus tinctorius (Pers.) Coker and Couch and Cenococcum geophilm (Sow.) Fredinard et Winge, which colonized 22% and 33% of roots respectively, exhibited growth stimulation. The results indicate that P. tinctorius and C. geophilum are suitable for use in large-scale nursey inoculation.     

Mycorrhizal associations in Hong Kong Fagaceae

Polyphenols histochemically detected in fresh uninfected roots of Quercus, Castanopsis and Lithocarpus growing in Hong Kong and shown to be condensed tannins were found mainly as intracellular material in the cells of the root cap, the epidermal layer and the endodermis. The cell walls of the outer cortex and the endodermis also contained suberin. Following invasion by compatible ectomycorrhizal symbionts, condensed tannins disappeared from cells of the root cap and the epidermal layer but hyphae were prevented from colonizing the cortex presumably due to suberin barriers. In vitro experiments indicated that a number of broad-host ectomycorrhizal fungi could utilise various polyphenolic compounds, including tannins found in the root exudates of the host trees, with different degrees of efficiency.