Measuring and Validating a General Cancer Predisposition Perception Scale: An Adaptation of the Revised-IPQ-Genetic Predisposition Scale

Background Illness perceptions are linked to individual help-seeking and preventive behaviors. Previous illness perception studies have identified five dimensions of illness-related experience and behaviour. The Revised Illness Perception Questionnaire (IPQ-R) for genetic predisposition (IPQ-R-GP) was developed to measure illness perceptions in those genetically-predisposed to blood disease. We adapted the IPQ-R-GP to measure perceptions of generalized cancer predisposition. This paper describes the development and validation of the Cancer Predisposition Perception Scale (CPPS). Methods The draft CPPS scale was first administered to 167 well Hepatitis B carriers and 123 other healthy individuals and the factor structure was examined using Exploratory Factor Analysis. Then the factor structure was confirmed in a second sample comprising 148 healthy controls, 150 smokers and 152 passive smokers using Confirmatory Factor Analysis (CFA). Results Six-factors comprising 26 items provided optimal fit by eigen and scree-plot methods, accounting for 58.9% of the total variance. CFA indicated good fit of the six-factor model after further excluding three items. The six factors, Emotional representation (5 items), Illness coherence (4 items), Treatment control (3 items), Consequences (5 items), Internal locus of control (2 items) and External locus of control (4 items) demonstrated adequate-togood subscale internal consistency (Cronbach's a = 0.63-0.90). Divergent validity was suggested by low correlations with optimism, self-efficacy, and scales for measuring physical and psychological health symptoms. Conclusion The CPPS appears to be a valid measure of perceived predisposition to generic cancer risks and can be used to examine cancer-risk-related cognitions in individuals at higher and lower cancer risk.published_or_final_versio

Unmet supportive care needs: A cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer

The comparison of psychosocial needs across different cultural settings can identify cultural and service impacts on psychosocial outcomes. We compare psychosocial needs in Hong Kong Chinese and German Caucasian women with breast cancer. Completed questionnaires were collected from 348 Chinese and 292 German women with breast cancer for assessing unmet psychosocial needs (Supportive Care Needs Survey Short Form), psychological distress (the Hospital Anxiety and Depression scale), and listed physical and psychological symptoms. Only 11% of the participants reported not needing help for any of the 34 items. More German (14%) than Chinese women (8%) reported no unmet needs (χ 2 = 6.16, P = .013). With both samples combined, the Health System and Information domain unmet needs were the most prevalent, apart from one Psychological need domain item, ''Fear about the cancer spreading.'' Chinese and German samples differed significantly in prevalence and patterns of unmet psychosocial needs. Multivariate adjustment for demographic, clinical, and sample characteristics, psychological distress, and symptoms showed that significantly greater unmet Health system and Information, and Patient care and support domain needs, associated with the presence of symptoms (β = .232, P<.001), high HADS Anxiety (β = .187, P<.001), higher education attainment (β = .120, P = .002), and Chinese sample membership (β = .280, P<.001). Greater unmet Psychological, Physical and Daily Living, and Sexuality domain needs were associated with the presence of symptoms, psychological distress, and German group membership, among others. German women reported more anxiety (t = 10.45, P<.001) and depression (t = 3.71, P<.001). In post hoc analyses, German, but not Chinese women reporting greater anxiety and depression had greater unmet Psychological and Sexuality domain needs (P<.001). It can be concluded that culturespecific differences in supportive care needs exist. Hong Kong Chinese women prioritize needs for information about their disease and treatment, whereas German Caucasian women prioritize physical and psychological support. Planning for cancer supportive care services or interventions to reduce unmet needs must consider cultural and/or health service contexts. © Springer Science+Business Media, LLC. 2011.link_to_subscribed_fulltex

Factors affecting humoral immune responses to seasonal influenza vaccination in older adults in Hong Kong

Background: In the winter of 2014-15, emergence of a drifted non-matched influenza A(H3N2) strain led the local Centre for Health Protection to procure and administer the 2015 southern hemisphere (SH) seasonal inactivated influenza vaccine (IIV) which included an updated and matching H3N2 strain, in additional to the northern hemisphere (NH) formulation that is used annually. We investigated factor affecting the humoral immune responses to NH IIV in 2015/16. Methods: In summer 2015, we enrolled older adults aged ≥75 years who were receiving SH IIV and followed them through to winter 2015-16 when they received NH IIV and collected pre- and post-vaccination sera. For comparison we enrolled a separate group of older adults who received NH IIV in winter 2015-16 without prior receipt of the 2015 SH IIV. Antibody titres against vaccine strains were measured by haemagglutination inhibition assays. Multivariate log-linear regression models were fitted to explore potential factors associated with vaccine responses in both groups of older adults winter 2015-16 in terms of post-vaccination antibody titres and the titer rises from pre-vaccination to post-vaccination. Results: We enrolled 419 participants in the twice-annual and 408 participants in the once-annual vaccination group. Significantly lower post-vaccination titres and titre rises against influenza A strains but higher geometric mean post-vaccination titres against B/Victoria were found among older age groups. Female participants showed higher geometric mean post-vaccination titres and titre rises against A(H1N1), and ever-smokers showed higher post-vaccination titres against both influenza A strains. We observed blunted immune responses in participants with recent prior vaccination which varied somewhat by strain. Conclusions: We observed some evidence of different humoral immune responses to NH IIV in 2015/16 between different ages, sexes, behaviours, and vaccination histories. The response differences were likely to be associated with the pre-vaccination titres via previous vaccination or exposure to the virus, while different age, sex, and behaviours may also link to the variation in innate and adaptive immune responses among individuals. However, we believe that these factors do not stand alone in affecting the antibody response in older adults

Waiting to see the doctor: Understanding appraisal and utilization components of consultation delay for new breast symptoms in Chinese women

Background Delayed consultation for potential cancer symptoms influences treatment outcomes and remains problematic. Delay components (Appraisal versus Utilization) and respective associations are poorly understood. Methods Eligible participants were Cantonese-speaking Chinese women, ≥21 years old, with self-discovered breast symptoms, recruited in surgical clinics before their first consultation, and naïve to their diagnosis. Overall 425/433 (98%) women completed a questionnaire on psychosocial, demographic and medical factors, how and when women discovered their breast symptom(s), and their subsequent decision making; 135/425 women (32%) were later diagnosed with breast cancer. Results Twenty-two per cent of women delayed >3 months before consultation. Women with breast cancer (28%) more often had prolonged delay than women with benign disease (19%). Attributing symptom to a non-cancerous condition, low fear on symptom discovery, not disclosing symptoms to others, and no prior breast symptom history predicted prolonged (>60 days) Appraisal Delay. Low fear on symptom discovery, seldom thinking about the symptom, and consultation for other reasons predicted prolonged (>14 days) Utilization Delay. Factors predicting Appraisal and Utilization Delays differentiated cancer from non-cancer groups. Conclusions Indecision over symptom meaning comprised the main component of Appraisal and Total Delay, suggesting that educational strategies targeting atypical symptoms should reduce avoidable delays following self-discovered breast symptoms. Copyright © 2011 John Wiley & Sons, Ltd.link_to_subscribed_fulltex

Neuropathic corneal pain : tear proteomic and neuromediator profiles, imaging features, and clinical manifestations

202405 bcchVersion of RecordSelf-fundedPublishedC

Immune Responses To Twice-annual Influenza Vaccination In Older Adults In Hong Kong

Purpose This observational study was to assess the immunogenicity of the southern hemisphere (SH) seasonal influenza vaccine (SIV) among older adults in Hong Kong and its effect on the immunogenicity of subsequent northern hemisphere (NH) SIV in 2015-16. Methods In 2014/15, Hong Kong experienced a substantial A(H3N2) winter epidemic with a mismatched vaccine. Local authorities procured and administered to older adults the 2015 SH SIV which included an updated and matching A/Switzerland/9715293/2013(H3N2) strain. We compared immune parameters in pre- and post-vaccination sera from older adults ≥75 years of age who received one versus two influenza vaccines per year. Results We enrolled 978 older adults with 470 vaccinations for summer 2015 and 827 vaccinations for winter 2015/16. Recipients of SH vaccination had boosts in haemagglutination inhibition (HAI) titers against all three vaccine strains. When receiving influenza vaccination for the subsequent winter, the southern hemisphere vaccine recipients had higher pre-vaccination HAI titers but lower post-vaccination HAI titers, compared to those who had not received the SH vaccine. Furthermore, cellular immunity was impacted by bi-annual vaccination, with reduced influenza-specific CD4 T cell responses in the second season of vaccination. Conclusions We observed blunting of immune responses in the twice-annual vaccination group compared to once-annual vaccination group, in the context of unchanging vaccine strains, while protection was likely to have been improved during the summer and autumn for the twice-annual vaccination group due to the continued circulation of the A/Switzerland/9715293/2013(H3N2) virus

Variations in perceptions of the learning environment and approaches to studying among university students in Pakistan

In Western countries students in higher education have been found to adopt various approaches to studying depending on their perceptions of their learning environment. There is evidence that certain constructs in this perspective transfer to other contexts such as Pakistan. In Western countries, students’ perceptions and approaches are also related to demographic and contextual factors such as age, subject of study, gender and year of study. Our aim was to determine whether similar relationships were apparent in Pakistani students. A survey was administered to 494 male and 418 female undergraduates in four subject areas across four years of study at two universities in Pakistan. The questionnaire concerned their perceptions of the learning environment, learning preferences, motivation and approaches to studying. Our research hypotheses were that their perceptions and approaches would vary with age, subject area, gender and year of study. Consistent with Western research, students in the arts and the social sciences perceived their programmes more positively and were more likely to adopt a deep approach to studying than were students in science and technology or business and management. Contrary to Western research, there were variations with age in students’ perceptions of their learning environment but not in their approaches to studying; there were gender differences in their perceptions and motivation; and there were variations in students’ perceptions but not in their approaches to studying across different years of the programmes. These variations appear to be specific to the context of higher education in Pakistan