A socio-biological explanation for social disparities in non-communicable chronic diseases: The product of history?

This study places social disparities in the major non-communicable chronic diseases within their global economic and historical contexts. Rapid economic transition outside the developed world provides a unique opportunity to re-examine the origins of, and biological mechanisms driving, social disparities. Gaps in prevailing theories focusing on material resources, civic infrastructure and social structure are identified. Using longstanding experimental evidence and epigenetic theories, it is suggested that exposure to economic development over generations (ie, improved living conditions over historical time) could by acting on different biological axes (somatotrophic and gonadotrophic) generate specific patterns of social disparities. Moreover, these same processes could initially generate a transient epidemic of diabetes as well as a permanent increase in male risk of premature ischaemic heart disease. As such, this study demonstrates the importance of context, and implies that current evidence from the developed world may be largely uninformative for preventing or mitigating social disparities in non-communicable chronic diseases elsewhere, suggesting research efforts should be focused on developing countries.published_or_final_versio

The effects of regulatory focus on teachers' classroom management strategies and emotional consequences

The study investigated how regulatory focus affected teachers' selection of classroom management strategies and the emotional consequences they experienced when these strategies failed. Primary school teachers (n = 179) were randomly assigned to two framing conditions: promotion focus and prevention focus. As predicted, teachers with promotion focus adopted more approach strategies (e.g., praise) but less avoidance strategies (e.g., punish) than their counterparts with prevention focus. When the strategies failed, teachers with promotion focus experienced more dejection-related emotion (e.g., disappointment) than agitation-related emotion (e.g., anger) whereas teachers with prevention focus experienced more agitation-related emotion than dejection-related emotion. However, some results were inconsistent with the prediction. Compared to their counterparts with prevention focus, teachers with promotion focus experienced less negative emotion, either dejection-related or agitation-related. © 2002 Elsevier Science (USA). All rights reserved.postprin

Age-period-cohort analysis of tuberculosis notifications in Hong Kong from 1961 to 2005

Background: Despite its wealth, excellent vital indices and robust health care infrastructure, Hong Kong has a relatively high incidence of tuberculosis (TB) (85.4 per 100 000). Hong Kong residents have also experienced a very rapid and recent epidemiological transition; the population largely originated from migration by southern Chinese in the mid 20th century. Given the potentially long latency period of TB infection, an investigation was undertaken to determine the extent to which TB incidence rates reflect the population history and the impact of public health interventions. Methods: An age-period-cohort model was used to break down the Hong Kong TB notification rates from 1961 to 2005 into the effects of age, calendar period and birth cohort. Results: Analysis by age showed a consistent pattern across all the cohorts by year of birth, with a peak in the relative risk of TB at 20-24 years of age. Analysis by year of birth showed an increase in the relative risk of TB from 1880 to 1900, stable risk until 1910, then a linear rate of decline from 1910 with an inflection point at 1990 for a steeper rate of decline. Period effects yielded only one inflection during the calendar years 1971-5. Conclusions: Economic development, social change and the World Health Organisation's short-course directly observed therapy (DOTS) strategy have contributed to TB control in Hong Kong. The linear cohort effect until 1990 suggests that a relatively high, but slowly falling, incidence of TB in Hong Kong will continue into the next few decades.published_or_final_versio

Associations of birth order with early adolescent growth, pubertal onset, blood pressure and size: Evidence from Hong Kong’s “Children of 1997” birth cohort

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Changes to the groundwater system, from 1888 to present, in a highly-urbanized coastal area in Hong Kong, China

Historical groundwater levels in a coastal region of Hong Kong Island (China) were reviewed and compared with data collected recently to reveal changes to the groundwater regime over the last century. The coastal springs and seeps have disappeared and the lower boundary of the seepage zone has moved uphill. Groundwater was found to be flowing upward along the boundary of natural slopes and urbanized areas. Artesian flows were commonly noted in the deep piezometers in the lower urbanized areas. Moreover, an overall rise in water levels in a 10-year period was observed in the urbanized areas, except in areas with good drainage. Extensive urbanization since the 1950s has included large-scale land reclamation, deep foundations of high-rise buildings, an underground transport system, water mains and horizontal drains in slopes; the effect has been a slow but gradual increase in the water level of the hillslope groundwater system. Further urbanization activities such as the westward extension of the underground transport system and new major drainage systems in the slopes, should be assessed for possible further changes to the groundwater system. The results presented here may serve as reference for other highly-urbanized coastal areas in the world. © Springer-Verlag 2008.postprin

Maternal age of menarche and blood pressure in adolescence: evidence from Hong Kong’s “Children of 1997” birth cohort

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A randomised-controlled trial of two educational modes for undergraduate evidence-based medicine learning in Asia

BACKGROUND: As the overall evidence for the effectiveness of teaching of evidence based medicine (EBM) is not strong, and the impact of cultural and societal influences on teaching method is poorly understood, we undertook a randomised-controlled trial to test the effectiveness and learning satisfaction with two different EBM teaching methods (usual teaching vs. problem based learning (PBL)) for undergraduate medical students. METHODS: A mixed methods study that included a randomised-controlled crossover trial with two intervention arms (usual teaching and PBL) and a nested qualitative study with focus groups to explore student perceptions of learning and to assess the effectiveness and utility of the two teaching methods.All 129 second-year medical students at the University of Hong Kong in 2007.The main outcomes measures were attitudes towards EBM; personal application and current use of EBM; EBM knowledge; future use of EBM. RESULTS: PBL was less effective at imparting knowledge than usual teaching consisting of a lecture followed by a group tutorial. After usual teaching students showed improvement in scores for 'attitudes towards EBM', 'personal application and current use of EBM' and 'EBM knowledge, which were not evident after PBL. In contrast to the usual teaching, students found PBL difficult as they lacked the statistical knowledge necessary to support discussion, failed to understand core concepts, and lost direction. CONCLUSION: The evidence presented here would suggest that the teaching of EBM within an Asian environment should adopt a format that facilitates both the acquisition of knowledge and encourages enquiry.published_or_final_versio

Social patterning in adiposity in adolescence: prospective observations from the chinese birth cohort ‘‘Children of 1997’’

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Impact of breastfeeding on infectious disease hospitalisation: the Children of 1997 cohort

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