The effects of topical triptolide in an animal model of contact dermatitis

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Validity and Reliability of the 19-item Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) Questionnaire in Chinese Patients with Type 2 Diabetes Mellitus in Primary Care

Background: This study aimed to determine the psychometric properties of the 19-item ADDQoL (ADDQoL-19) in Chinese patients with Type 2 diabetes mellitus (T2DM) in primary care setting. Methods: The ADDQoL-19 and SF-12v2 were administered to 386 Chinese patients with T2DM in public primary outpatient clinic in Hong Kong. Internal consistency reliability was determined by Cronbach’s alpha whereas construct validity was assessed by the Spearman’s correlations between the scores of the ADDQoL-19 and SF-12v2. Independent t-tests were used in known-groups comparisons to identify the differences in the ADDQoL-19 scores between respondents with different duration of diabetes, treatment modalities, body mass index and glycemic control. Results: The ADDQoL-19 had a moderate to weak correlation with SF-12v2 in convergent validity but with statistically significant results in known-groups comparisons. Good internal consistency was generated with an acceptable value of 0.81, which was comparable to original English version. Construct validity was proven except the convergent validity is found to be weak with the generic SF-12v2, which was similar to the results in prior psychometric studies. Conclusions: Despite weak convergent validity, the ADDQoL-19 was found to have a satisfactory psychometric property especially known-groups comparisons and internal consistency reliability in the primary care setting.postprin

Statin use reduces cardiovascular events and all-cause mortality amongst Chinese patients with type 2 diabetes mellitus: a 5-year cohort study

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Association of estimated glomerular filtration rate and urine albumin-to-creatinine ratio with incidence of cardiovascular diseases and mortality in chinese patients with type 2 diabetes mellitus – a population-based retrospective cohort study

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Five-year Change of Clinical and Complications Profile of Diabetic Patients under Primary Care: A Population-based longitudinal Study on 127,977 Diabetic Patients

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Understanding impacts of accreditation on medical teachers and students: A systematic review and meta-ethnography

Purpose: Accreditation is widely used by medical schools around the word to evaluate their curricula and educational processes, although its impacts on those involved in the ‘frontline’ of medical education receive little attention. This study systematically identified and synthesised qualitative studies that have explored medical teachers’ and students’ experiences of accreditation. / Methods: Four databases (Pubmed, EMBASE, ERIC, and PsychINFO) were searched for relevant published articles. Synthesis was performed using meta-ethnography. / Results: Eighteen articles were included in the final synthesis with 1017 individual participants from 10 countries. Findings were categorised into four domains, including navigating power differentials, evaluating credibility, influencing medical programmes, and culture and behaviour. The synthesis demonstrates divergent views on the value of accreditation in medical schools from students and staff including both positive and negative impacts on medical education programmes and stakeholders. / Conclusions: Although accreditation is perceived to have many benefits, it also has a number of unintended consequences, including on staff morale, student-teacher relationships, and teacher workloads. Medical teachers also have a number of concerns about the credibility of accreditation standards, assessors, and processes. Regulators and policymakers should consider the views of teachers and students as they seek to improve current accreditation practices

For Students, by Students: a Peer-Led Entrepreneurship Course for Medical Students

Recognising the growing importance of clinical leadership and entrepreneurship to implement innovative healthcare solutions, final year UK medical students developed a near-peer elective module for first- and second-year students. To date, five cohorts have completed the module and developed skills in the fields of medical technology, quality improvement, and leadership

Having a family doctor was associated with lower utilization of hospital-based health services

Background: Primary care in the United States and most countries in Asia are provided by a variety of doctors. However, effectiveness of such diversified primary care in gate-keeping secondary medical services is unknown. This study aimed to evaluate health services utilization rates of hospital emergency and admission services among people who used different primary care doctors in Hong Kong. Method: This study was a population-based cross-sectional telephone survey using structured questionnaire on health services utilization rates and pattern in Hong Kong in 2007 to 2008. Information on the choice of primary care doctors, utilization rates and patterns of primary care service were collected. Poisson and logistic regression analyses were used to explore any differences in service utilization rates and patterns among people using different types of primary care doctors. Results: Out of 3148 subjects who completed the survey, 1896 (60.2%) had regular primary care doctors, of whom 1150 (60.7%) regarded their regular doctors as their family doctors (RFD). 1157 (36.8%) of them did not use any regular doctors (NRD). Only 4.3% of the RFD group (vs 7.8% of other regular doctors (ORD) and 9.6% of NRD) visited emergency service and only 1.7% (vs 3.6% of ORD and 4.0% of NRD) were admitted to hospital for their last episode of illness. Regression analyses controlling for sociodemographics and health status confirmed that respondents having RFD were less likely to use emergency service than people who had NRD (OR 0.479) or ORD (OR 0.624) or being admitted to hospital (OR 0.458 vs NRD and 0.514 vs ORD) for their last episode of illness. Conclusion: Primary care is most effective in gate-keeping secondary care among people with regular family doctors. People without any regular primary care doctor were more likely to use emergency service as primary care. The findings supported a family doctor-led primary care model. Trial registration number. ClinicalTrials.gov ID: NCT01422031.published_or_final_versio

Association of Hemoglobin A1c Levels With Cardiovascular Disease and Mortality in Chinese Patients With Diabetes

LettersAmong diabetic patients, hemoglobin A1c (HbA1c) is an important indicator of glycemic control and, together with blood pressure and cholesterol, is an indicator for risk of complications, including cardiovascular disease (CVD) and mortality. At present, there is no universal consensus on the optimal HbA1c level. Despite this, most international guidelines include a recommended HbA1c target range or level as a treatment goal. Several studies have identified a J-shaped curvilinear relationship between HbA1c and CVD incidence and all-cause mortality, but such a relationship has not yet been confirmed in a Chinese population. There are substantial differences in disease risks across racial and ethnic groups due to genetic and environmental factors including life-style and health behaviors, and thus, previous results from Western studies may not be transferable to a Chinese population. We sought to examine the association among mean HbA1c, CVD events, and mortality among Chinese primary care patients with type 2 diabetes mellitus (T2DM) in Hong Kong.postprin

Effect of metformin monotherapy on cardiovascular diseases and mortality: a retrospective cohort study on Chinese type 2 diabetes mellitus patients

Background: Many factors influence whether the first-line oral anti-diabetic drug, metformin, should be initiated to a patient with type 2 diabetes mellitus (T2DM) early in the course of management in addition to lifestyle modifications. This study aims to evaluate the net effects of metformin monotherapy (MM) on the all-cause mortality and cardiovascular disease (CVD) events. Methods: A retrospective 5-year follow-up cohort study was conducted on Chinese adult patients with T2DM and without any CVD history under public primary care. Cox proportional hazard regressions were performed to compare the risk of all-cause mortality and CVD events (CHD, stroke, heart failure) between patients receiving lifestyle modifications plus MM (MM groups) and those with lifestyle modifications alone (control groups). Results: 3400 pairs of matched patients were compared. MM group had an incidence rate of 7.5 deaths and 11.3 CVD events per 1000 person-years during a median follow-up period of 62.5 months whereas control group had 11.1 deaths and 16.3 per 1000 person-years during a median follow-up period of 43.5–44.5 months. MM group showed a 29.5 and 30–35 % risk reduction of all-cause mortality and CVD events (except heart failure) than control group (P < 0.001). MM group was more prone to progress to chronic kidney disease but this was not statistically significant. Conclusions: Type 2 diabetic patients who were started on metformin monotherapy showed improvement in many of the clinical parameters and a reduction in all-cause mortality and CVD events than lifestyle modifications alone. If there is no contraindication and if tolerated, diabetic patients should be prescribed with metformin early in the course of the diabetic management to minimize their risk of having the cardiovascular events and mortality in the long run.published_or_final_versio