抗Di(a)抗體引起新生兒嚴重溶血症的病例

Red cell allo-antibodies directed against the Diego (Di) blood group antigen have rarely been reported to cause a haemolytic reaction against transfusion or haemolytic disease of the newborn. The frequency of the Di(a+) phenotype among the Hong Kong Chinese population is estimated to be 4.4%. We report on a case of severe haemolytic disease of the newborn due to anti-Di(a) antibody--the first local case to the best of our knowledge. Rare but clinically significant antibodies targeting red blood cells have to be considered in the investigation of haemolytic disease of the newborn when common underlying factors have been eliminated.published_or_final_versio

Strengthening Evidence-based Family Medicine in Hong Kong

published_or_final_versio

The protective function of meaning of life on life satisfaction among Chinese students in Australia and Hong Kong: a cross-cultural comparative study.

OBJECTIVE: The authors compared the predictive effects of acculturative stressors and meaning of life on life satisfaction between Chinese students in Australia and in Hong Kong. PARTICIPANTS: In 2006, the researchers recruited 606 Chinese students studying abroad at the University of Melbourne in Australia and at 6 universities in Hong Kong. METHODS: Participants completed a questionnaire that included measures of acculturative stressors, meaning of life, life satisfaction, and demographic information. RESULTS: The Australian sample experienced a significantly higher level of acculturative stressors than did the Hong Kong sample, but life satisfaction did not differ significantly between the 2 samples. Meaning of life had a strong positive contribution and acculturative stressors had a negative contribution in predicting life satisfaction in both samples. Meaning of life partially mediated the relationship between acculturative stressors and life satisfaction in both samples. CONCLUSIONS: The authors discuss the theoretical and practical implications for Chinese students studying abroad.published_or_final_versio

Use of omaha system in community nursing and transitional care

2009-2010 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Assessing medical student empathy in a family medicine clinical test: validity of the CARE measure

Introduction: The Consultation and Relational Empathy (CARE) measure developed and validated in primary care settings and used for general practitioner appraisal is a 10-item instrument used by patients to assess doctors’ empathy. The aim of this study is to investigate the validity of the CARE measure in assessing medical students’ empathy during a formative family medicine clinical test. Method: All 158 final-year medical students were assessed by trained simulated patients (SPs) – who completed the CARE measure, the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a global rating score to assess students’ empathy and history-taking ability. Results: Exploratory and confirmatory factor analysis identified a unidimensional structure. The CARE measure strongly correlated with both convergent measures: global rating (ρ=0.79 and <0.001) and JSPPPE (ρ=0.77 and <0.001) and weakly correlated with the divergent measure: history-taking score (ρ=0.28 and <0.001). Internal consistency was excellent (Cronbach’s α=0.94). Conclusion: The CARE measure had strong construct and internal reliability in a formative, undergraduate family medicine examination. Its role in higher stakes examinations and other educational settings should be explored.published_or_final_versio

Associations between usual glycated haemoglobin A1c and Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus: A 10‐year Diabetes cohort study

Aims: The long‐term effect of glycated haemoglobin A1c(HbA1c) level on cardiovascular disease(CVD) risks among patients with type 2 diabetes remains controversial. The aim of this study was to investigate their associations. / Materials and methods: This retrospective cohort study conducted in Hong Kong selected patients aged 45‐84 years old with type 2 diabetes mellitus and without CVD in primary care clinics within 2008‐2010. The usual HbA1c measurement was calculated using a mixed effects model to minimize regression dilution bias. The association between usual HbA1c and CVD risk was assessed by Cox regression with adjustment of baseline covariates. Subgroup analyses by patient characteristics were also conducted. / Results: After a median follow‐up period of 8.4years (1.4 million person‐years), 174,028 patients with 34,074 CVD events were observed. Curvilinear association was found between the usual HbA1c and total CVD, stroke, heart failure and CVD mortality risk. No significant difference was found among patients with usual HbA1c7%(53mmol/mol) was 21% (HR: 1.21; 95%C.I. (Confidence Interval): 1.18‐1.23). Similar pattern was identified in patient's subgroups analysis, but the effect of usual HbA1c in younger patients were more prominent than the others. / Conclusions: Increment in usual HbA1c level >7.0% (53mmol/mol) was associated with elevated CVD risk, but no difference was found in population with usual HbA1c<7.0% (53mmol/mol) irrespective of the patients' characteristics. For the CVD prevention, a strict adherence of HbA1c <7% (53 mmol/mol) should apply to patients with younger age

Towards T.R.I.C.K. 2.0 – A tool for the evaluation of the vehicle performance through the use of an advanced sensors system

In the last years, the tire technological development has played a fundamental role in motorsport and in automotive industry. The tire contact patch forces have a great influence on the vehicle behavior, so their correct estimation is a crucial task to understand how to improve the car performance. In order to identify the tire interaction characteristic, it is also necessary to use a procedure that allows the correct evaluation of the slip angles in the different operating conditions. This paper presents an evolution of the T.R.I.C.K. tool developed by the UniNa vehicle dynamics research group. In the first version of this tool an 8 degree of freedom vehicle model has been implemented and, starting from the experimental data acquired, the T.R.I.C.K. calculates the interaction forces and the tire slips using the equilibrium equations. Using more car parameters and further data obtained from track sessions and dedicated tests, in the presented release of the tool, new formulations have been developed for a more accurate calculation of the tire-road forces. The effectiveness of the treatments is assessed using experimental data and the simulator outputs. The new formulations introduced in this paper allows, depending on the availability of additional vehicle data and acquisition sensors, to estimate the interaction forces with different and more accurate methodologies than the equilibrium equations, while retaining very reduced simulation times. In this way it is possible to carry out a more precise study of vehicle dynamics with the possibility of investigating and significantly improving performance

Validation of the perceived stress scale (Pss-10) in medical and health sciences students in Hong Kong

INTRODUCTION: The demanding nature of medical and health sciences studies can cause stress among students in these disciplines affecting their wellbeing and academic performance. The Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress among medical students and healthcare professionals that has not yet been validated among medical and health sciences students in Hong Kong. The aim of this study is to establish the construct validity and reliability of the PSS-10 in this context. METHODS: 267 final year medical and health sciences students were surveyed using the PSS-10. The data were analysed using exploratory factor analysis for construct validity and Cronbach’s alpha coefficient and corrected item-total correlations for reliability. RESULTS: Exploratory factor analysis revealed a two-factor structure for PSS-10, with Cronbach’s alpha of 0.865 and 0.796, indicating good internal consistency. Corrected item-total correlations showed satisfactory correlation ranged from 0.539 to 0.748 for all items and their respective subscale. Both tests supported PSS-10 as a two-factor scale. CONCLUSIONS: The PSS-10 is a valid measure for assessing perceived stress in Hong Kong medical and health sciences students

Patterns of health-related quality of life and associated factors in Chinese patients undergoing haemodialysis

Background: Haemodialysis (HD) is a life-saving but burdensome therapy for patients with end-stage renal disease (ESRD) which can have a detrimental impact on patients’ quality of life and outcomes. There is currently little data on the health related quality of life (HRQOL) of Chinese ESRD patients undergoing HD and this study sought to examine the patterns of HRQOL and its associated factors within this population, as well as in comparison with the general local population. Methods: A cross-sectional study of 244 ESRD patients receiving HD in the hospital and in the community in Hong Kong was conducted using the Short Form-12 Health Survey version 2 (SF-12v2). All study subjects were one-to-one matched with subjects in a Hong Kong general population database by sex and exact age. Independent t-tests were performed to compare the mean SF-12v2 scores between HD patients and the general population, followed by one-way analysis of variance with post hoc Tukey’s HSD tests to compare community-based haemodialysis, hospital-based haemodialysis and the general population. Multiple linear regressions were used to identify the factors (socio-demographic, clinical characteristics and comorbidities) associated with the HRQOL scores of ESRD patients receiving HD. Results: The SF-12v2 Physical Functioning, Role Physical, Bodily Pain, General Health and Physical Component Summary scores of HD patients were significantly lower than the age-sex adjusted general population. However, the SF-12v2 Mental Health and Mental Component Summary scores of HD patients were significantly higher than the corresponding general population. Poorer HRQOL was associated with being female, smoking, unemployment and hospital-based haemodialysis. Conclusions: HD patients had substantially poorer physical HRQOL but better mental HRQOL than the age-sex adjusted general population. Patients receiving HD in the community setting had better HRQOL. Reasons for these observations will need to be further investigated. Those patients who are female, smokers and unemployed may warrant more attention as their poorer HRQOL may be associated with poorer outcomes.published_or_final_versio