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The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.
Social centers for older people.
664 Chinese older adults with chronic pain.
Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.
For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.
The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.
Mycobacterium marinum, a bacterium found in freshwater and saltwater, can infect persons with direct exposure to fish or aquariums. During December 2013, the New York City Department of Health and Mental Hygiene learned of four suspected or confirmed M. marinum skin or soft tissue infections (SSTIs) among persons who purchased whole fish from Chinese markets. Ninety-eight case-patients with non-tuberculous mycobacteria (NTM) SSTIs were identified with onset June 2013–March 2014. Of these, 77 (79%) were female. The median age was 62 years (range 30–91). Whole genome sequencing of clinical isolates revealed two main clusters and marked genetic diversity. Environmental samples from distributors yielded NTM though not M. marinum. We compared 56 case-patients with 185 control subjects who shopped in Chinese markets, frequency-matched by age group and sex. Risk factors for infection included skin injury to the finger or hand (odds ratio [OR]: 15·5; 95% confidence interval [CI]: 6·9–37·3), hand injury while preparing fish or seafood (OR 8·3; 95% CI 3·8–19·1), and purchasing tilapia (OR 3·6; 95% CI 1·1–13·9) or whiting (OR 2·7; 95% CI 1·1–6·6). A definitive environmental outbreak source was not identified.
Some studies demonstrated that physical activity may have beneficial effect on cognitive function. The objective of the study was to estimate the association between physical activity and cognitive function in community-dwelling elderly Chinese in Hong Kong (HK) and Guangzhou (GZ).
In the neighborhood of HK and GZ, a convenience sample of 557 (260 in HK and 297 in GZ) older persons without dementia aged over 60 years (73.4 ± 6.5) was recruited. Physical activity was measured using a checklist. Information on physical activity participation, cognitive function, and other variables were collected. Multivariate linear regression analyses were performed to evaluate the association between physical activity and cognitive function.
Total number of physical activities showed significant association with the delayed recall test (p < 0.01) and category verbal fluency test (CVFT) (p < 0.01). However, with further adjustment for participation in intellectual activity, the coefficients were no longer statistically significant (p > 0.05)
Physical activity may not be associated with better cognitive function among elderly Chinese independently of other factors.
With the proportion of older adults in Hong Kong projected to double in size in the next 30 years, it is important to develop measures for detecting individuals in the earliest stage of Alzheimer's disease (AD, 0.5 in Clinical Dementia Rating, CDR). We tested the utility of a non-verbal prospective memory task (PM, ability to remember what one has to do when a specific event occurs in the future) as an early marker for AD in Hong Kong Chinese.
A large community dwelling sample of older adults who are healthy controls (CDR 0, N = 125), in the earliest stage of AD (CDR 0.5, N = 125), or with mild AD (CDR 1, N = 30) participated in this study. Their reaction time/accuracy data were analyzed by mixed-factor analyses of variance to compare the performance of the three CDR groups. Logistic regression analyses were performed to test the discriminative power of these measures for CDR 0 versus 0.5 participants.
Prospective memory performance declined as a function of AD severity: CDR 0 > CDR 0.5 > CDR 1, suggesting the effects of early-stage AD and AD progression on PM. After partialling out the variance explained by psychometric measures (e.g., ADAS-Cog), reaction time/accuracy measures that reflected the PM still significantly discriminated between CDR 0 versus 0.5 participants in most of the cases.
The effectiveness of PM measures in discriminating individuals in the earliest stage of AD from healthy older adults suggests that these measures should be further developed as tools for early-stage AD discrimination.
Varicella is a common and highly contagious childhood disease which impacts the public worldwide. Hong Kong children can only be vaccinated against the disease in private practice. The varicella vaccination rate of local children in preschool is uncertain. Therefore a cross-sectional kindergarten-based parent-administered questionnaire survey was conducted in Hong Kong during 2012. Twelve kindergartens were randomly selected from a complete school list from the Education Bureau of Hong Kong. In total, 1285/1538 (83·6%) parents consented to join the study and completed the questionnaires. The overall varicella infection rate was 19·5% and the uptake of varicella vaccination rate was 57·6%. Barriers against varicella vaccination were mostly due to parental uncertainties about the effectiveness of vaccine, lack of recommendations from doctors or government, and adverse side-effects of the vaccine. The government and healthcare professional bodies are strongly recommended to further enhance health education among healthcare professionals, encouraging their active promotion of varicella vaccination for their patients. Furthermore, health education through various stakeholders is crucial to enhance parental awareness of varicella, as well as the effectiveness and safety of varicella vaccine.
The epidemiology of varicella is believed to differ between temperate and tropical countries. We conducted a varicella seroprevalence study in elementary and college students in the US territory of American Samoa before introduction of a routine varicella vaccination programme. Sera from 515 elementary and 208 college students were tested for the presence of varicella-zoster virus (VZV) IgG antibodies. VZV seroprevalence increased with age from 76·0% in the 4–6 years group to 97·7% in those aged ⩾23 years. Reported history of varicella disease for elementary students was significantly associated with VZV seropositivity. The positive and negative predictive values of varicella disease history were 93·4% and 36·4%, respectively, in elementary students and 97·6% and 3·0%, respectively, in college students. VZV seroprevalence in this Pacific island appears to be similar to that in temperate countries and suggests endemic VZV circulation.
We examined the impact of the neonatal hepatitis B immunization programme, first provided to all neonates born to mothers screened positive for hepatitis B surface antigen (HBsAg) in late 1983, on the age-specific prevalence of HBsAg carriage in teenage mothers managed in 1998–2008. HBsAg carriage was found in 2·5%, 2·7%, 8·8% and 8·0% of mothers aged ⩽16, 17, 18, and 19 years, respectively (P = 0·004), which was also correlated with advancing age (P = 0·011). While neither difference nor correlation with age was found in mothers born before 1984, the prevalence of 1·2%, 1·5%, 7·1% and 8·3%, respectively, was significantly different among (P = 0·008) and correlated with (P = 0·002) age in mothers born 1984 onwards. Regression analysis indicated there was a significantly higher incidence of HBsAg carriage from age 17 onwards (adjusted odds ratio 2·55, 95% confidence interval 1·07–6·10, P = 0·035), suggesting that the protective effect of the vaccine declined in late adolescence.
During the early phase of the influenza pandemic in 2009, all cases of laboratory-confirmed pandemic (H1N1) 2009 (pH1N1) infection required compulsory isolation in hospital. These cases were offered oseltamivir treatment and only allowed to be discharged from the hospital when three consecutive respiratory specimens were negative for the virus by reverse transcription–polymerase chain reaction (RT–PCR). We reviewed the case records of these patients to assess the viral shedding kinetics of the pH1N1 virus. We defined viral shedding duration as the interval from illness onset date to the date of collection of the last positive specimen from the patients. Fifty-six patients were included in the study, of whom 96% received oseltamivir. The median viral shedding duration of pH1N1 virus by viral culture and RT–PCR were 3 days and 4 days, respectively. Patients who started oseltamivir treatment >48 h after onset had a significantly longer median viral shedding duration by viral culture than those who started treatment within 48 h of onset (4 days vs. 2 days, P=0·014).
Background: The Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery (CERAD-NAB) offers information on the clinical diagnosis of Alzheimer's disease (AD) and gives a profile of cognitive functioning. This study explores the effects of age, education and gender on participants' performance on eight subtests in the Chinese-Cantonese version of the CERAD-NAB.
Methods: The original English version of the CERAD-NAB was translated and content-validated into a Chinese-Cantonese version to suit the Hong Kong Chinese population. The battery was administered to 187 healthy volunteers aged 60 to 94 years. Participants were excluded if they had neurological, medical or psychiatric disorders (including dementia). Stepwise multiple linear regression analyses were performed to assess the relative contribution of the demographic variables to the scores on each subtest.
Results: The Cantonese version of CERAD-NAB was shown to have good content validity and excellent inter-rater reliability. Stepwise multiple regression analyses revealed that performances on seven and four out of eight subtests in the CERAD-NAB were significantly influenced by education level and age, respectively. Age and education had significant effects on participants' performance on many tests. Gender also showed a significant effect on one subtest.
Conclusions: The preliminary data will serve as an initial phase for clinical interpretation of the CERAD-NAB for Cantonese-speaking Chinese elders.
Capacitors, resistors and inductors are surface mounted components on circuit boards, which occupy up to 70% of the circuit board area. For selected applications, these passives are packaged inside green ceramic tape substrates and sintered at temperatures over 700°C in a co-fired process. These high temperature processes are incompatible with organic substrates, and low temperature processes are needed if passives are to be embedded into organic substrates. A new high permeability dual-phase Nickel Zinc Ferrite (DP NZF) core fabricated using a low temperature sol-gel route was developed for use in embedded inductors in organic substrates. Crystalline NZF powder was added to the sol-gel precursor of NZF. The solution was deposited onto the substrates as thin films and heat-treated at different temperatures. The changes in the microstructures were characterized using XRD and SEM. Results showed that addition of NZF powder induced low temperature transformation of the sol-gel NZF phase to high permeability phase at 250°C, which is approximately 350°C lower than transformation temperature for pure NZF sol gel films. Electrical measurements of DP NZF cored two-layered spiral inductors indicated that the inductance increased by three times compared to inductors without the DP NZF cores. From microstructural observations, the increase is correlated with the changes in microstructural connectivity of the powder phase.
A series of conjugated donor-acceptor trienes in which the central double bond is incorporated into an unsaturated isophorone, verbenone or chromone ring has been synthesized. In each case, the donor group consists of an amine and an aromatic or heterocyclic ring system, and the acceptor is the dicyanomethylidene group. The nonlinear optical properties of each of the compounds has been measured and correlated with its structure. The dipole moments and molecular hyperpolarizabilities of these compounds, like those of other conjugated polyenes, are large enough to be used as the active components of electro-optic polymers. Unlike other donor-acceptor polyenes, however, these compounds exhibit the thermal stability required for such applications.
GaN films were grown on sapphire substrates at temperatures below 725 °C utilizing a Constricted Glow Discharge plasma source. A three dimensional growth mode is observed at such low growth temperatures resulting in films that are composed of individual but oriented grains. The strain that originates from the growth on the lattice mismatched substrate with a different thermal expansion coefficient is utilized to influence the thin film growth. The strain can be largely altered by the growth of suitable buffer layers. Thereby, optical and structural film properties can be engineered. It is argued that the surface diffusion of Ga ad-atoms is affected by engineering the strain. Alternatively, surface diffusion can be influenced by surfactants. It is demonstrated that the use of bismuth as a surfactant allows to modify the surface morphology of the GaN films that reflects the size of the grains in the films. The results suggest that a substantial increase of the oriented grain sizes in the films is possible while maintaining a low growth temperature.
The influence of laser irradiation on an electroluminescent polymer, poly(2,5-di-n-hexyloxy-l,4- phenylene vinylene) is studied. Photoluminescence, infrared spectroscopy, and photothermal deflection spectroscopy were used to identify changes in the optical properties of the polymer after laser irradiation. It is found that optical irradiation leads to the opening of the vinyl double bond and decrease in conjugation length. Photo-oxidation of the polymer is believed to be responsible for the optical degradation of the polymer.
In mid-June 2009, an outbreak of pandemic (H1N1) 2009 (pH1N1) infection occurred in a secondary school in Hong Kong. We carried out an epidemiological investigation to delineate the characteristics of the outbreak, gauge the extent of secondary household transmission, and assess the protective role of oseltamivir in household contacts. We interviewed pH1N1-confirmed cases using a standardized questionnaire. Sixty-five of 511 students in the school were affected. Of the 205 household contacts identified, 12 were confirmed as cases. All cases recovered. The estimated secondary household attack rate was 5·9% (95% CI 2·7–9·1). Household contacts aged <18 years were about 15 times more likely to be infected than older contacts. Household contacts who had received oseltamivir prophylaxis were less likely to acquire a secondary infection than those who had not (odds ratio=0). The estimated mean household serial interval of pH1N1 virus was 2·8 days (95% CI 2·1–3·4 days).
Cholera is one of the three diseases subject to the International Health Regulations. After a period of over 30 years, the seventh pandemic of cholera, which started in South East Asia in 1961, still shows no sign of a decline. On the contrary, it has increased its severity and invaded many other countries in Africa and Latin America. In the last two years, there has been a recrudescence of the disease in South East Asia and Western Pacific Regions. The discovery of a new strain of Vibrio cholerae 0139 in these regions is causing concern in view of its potential to cause major epidemics and higher mortality. Hong Kong had two intensive outbreaks of cholera in the last two years. The cause of these outbreaks was not clear, but adverse environmental conditions and increasing pollution of coastal waters have been implicated. The spread of cholera knows no geographical boundaries. There is a need for intensified efforts among health authorities in the affected areas to prevent the international spread of the disease.
The objective of the present study is to explore the association between lower urinary tract symptoms (LUTS) and dietary isoflavone in elderly men. In a large prospective cohort of 2000 Chinese men, the association between dietary isoflavone and LUTS were studied using standardized structured questionnaires. Dietary intake was assessed by a modified version of the Block FFQ. LUTS were assessed by the Chinese version of the International Prostatic Symptoms Score. Demographic, lifestyle and other medical information were also collected and were adjusted for in the analysis. After excluding 299 men with history of bladder surgery, bladder or prostate cancer or who were current users of medication for urinary problems, the association between LUTS and dietary isoflavone was explored. A total of 96·2 % of subjects reported some consumption of genistein, glycitein or daidzein. In ordinal multinominal logistic regression, subjects with dietary total isoflavone of more than 5·1 mg were significantly less likely to suffer from more severe LUTS (dietary intake from 5·1 to 9·5 mg: OR 0·59; 95 % CI 0·44, 0·80; from 9·6 to 14·3 mg: OR 0·81; 95 % CI 0·61, 1·09; from 14·4 to 21·7 mg: OR 0·68; 95 % CI 0·51, 0·92; 21·8 mg and above: OR 0·73; 95 % CI 0·54, 0·98) after adjustment for covariates. In this cross-sectional study, we showed a strong inverse association between dietary intake of isoflavone and the risk of LUTS.
Although there have been many studies of the biological and psychosocial causations of postnatal depression, studies of sociocultural risk factors are rare.
To investigate the sociocultural risk factors of postnatal depression using ethnographically informed epidemiological methods.
Atotal of 959 women were assessed at their first ante-partum visit (baseline), in the third trimester, immediately after delivery, and 3 months post-partum. Six domains of risk factors were examined. The dependent variable was postnatal depression (as defined by the Edinburgh Postnatal Depression Scale) at 3 months post-partum.
Conflict with mother-in-law, marital dissatisfaction, past depression and antenatal depression independently predicted the occurrence of postnatal depression. The cultural practice of peiyue – a Chinese post-partum custom of mandated family support – was associated with better social support and a slightly lower risk of postnatal depression.
Sociocultural aspects of the immediate puerperium shape maternal emotional well-being. In-law conflict is an important source of household distress in many Asian societies. The findings have implications for clinical practice and future studies.
Results of international correlation and migrant studies suggest that dietary fat promotes carcinogenesis in hormone-sensitive sites, but this is disputed. In the present study, we used a Noble rat model of sex hormone-induced cancers to examine the effect of a high-fat diet on the incidence and latency of prostate and mammary cancer in male (n 139) and female (n 72) animals respectively. We also measured α-tocopherol levels in female breast tissue to determine whether a high intake of polyunsaturated fatty acids depletes antioxidant defence in target tissues, providing a possible potentiating mechanism for carcinogenesis. Results showed a very high incidence of hormone-induced adenocarcinomas of prostate and mammary gland, irrespective of diet. There was no difference in the pattern of carcinogenesis in different prostatic locations, weight of the prostate, or weight gain between male rats on the high-fat diet compared with the control (standard, low-fat) diet. In female rats, the incidence of mammary cancer and the body-weight gain were the same in both dietary groups, and breast α-tocopherol was also unaffected by dietary fat intake. Our present results are supportive of recent cohort studies that reported no significant association between intake of fat and the development of human prostate and breast cancer, and do not support a role for dietary fat in promoting sex hormone-induced prostate and mammary carcinogenesis.