Andy S. K. Cheng

Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses.

BACKGROUND Cancer is a leading cause of death worldwide. Mind-body interventions are widely used by cancer patients to reduce symptoms and cope better with disease- and treatment-related symptoms. In the last decade, many clinical controlled trials of qigong/tai chi as a cancer treatment have emerged. This study aimed to quantitatively evaluate the effects of qigong/tai chi on the health-related outcomes of cancer patients. METHODS Five databases (Medline, CINAHL, Scopus, the Cochrane Library, and the CAJ Full-text Database) were searched until June 30, 2013. Randomized controlled trials (RCTs) of qigong/tai chi as a treatment intervention for cancer patients were considered for inclusion. The primary outcome for this review was changes in quality of life (QOL) and other physical and psychological effects in cancer patients. The secondary outcome for this review was adverse events of the qigong/tai chi intervention. RESULTS A total of 13 RCTs with 592 subjects were included in this review. Nine RCTs involving 499 subjects provided enough data to generate pooled estimates of effect size for health-related outcomes. For cancer-specific QOL, the pooled weighted mean difference (WMD) was 7.99 [95% confidence interval (CI): 4.07, 11.91; Z score=4.00, p<0.0001]. The standardized mean differences (SMDs) for changes in depression and anxiety score were -0.69 (95% CI: -1.51, 0.14; Z score=1.64, p=0.10), and -0.93 (95% CI: -1.80, -0.06; Z score=2.09, p=0.04), respectively. The WMDs for changes in body mass index and body composition from baseline to 12 weeks follow-up were -1.66 (95% CI: -3.51, 0.19; Z score=1.76, p=0.08), and -0.67 (95% CI: -2.43, 1.09; Z score=0.75, p=0.45) respectively. The SMD for changes in the cortisol level was -0.37 (95% CI: -0.74, -0.00; Z score=1.97, p=0.05). CONCLUSION This study found that qigong/tai chi had positive effects on the cancer-specific QOL, fatigue, immune function and cortisol level of cancer patients. However, these findings need to be interpreted cautiously due to the limited number of studies identified and high risk of bias in included trials. Further rigorous trials are needed to explore possible therapeutic effects of qigong/tai chi on cancer patients.

A comparison of the hazard perception ability of accident-involved and accident-free motorcycle riders

Hazard perception is the ability to read the road and is closely related to involvement in traffic accidents. It consists of both cognitive and behavioral components. Within the cognitive component, visual attention is an important function of driving whereas driving behavior, which represents the behavioral component, can affect the hazard perception of the driver. Motorcycle riders are the most vulnerable types of road user. The primary purpose of this study was to deepen our understanding of the correlation of different subtypes of visual attention and driving violation behaviors and their effect on hazard perception between accident-free and accident-involved motorcycle riders. Sixty-three accident-free and 46 accident-involved motorcycle riders undertook four neuropsychological tests of attention (Digit Vigilance Test, Color Trails Test-1, Color Trails Test-2, and Symbol Digit Modalities Test), filled out the Chinese Motorcycle Rider Driving Violation (CMRDV) Questionnaire, and viewed a road-user-based hazard situation with an eye-tracking system to record the response latencies to potentially dangerous traffic situations. The results showed that both the divided and selective attention of accident-involved motorcycle riders were significantly inferior to those of accident-free motorcycle riders, and that accident-involved riders exhibited significantly higher driving violation behaviors and took longer to identify hazardous situations compared to their accident-free counterparts. However, the results of the regression analysis showed that aggressive driving violation CMRDV score significantly predicted hazard perception and accident involvement of motorcycle riders. Given that all participants were mature and experienced motorcycle riders, the most plausible explanation for the differences between them is their driving style (influenced by an undesirable driving attitude), rather than skill deficits per se. The present study points to the importance of conceptualizing the influence of different driving behaviors so as to enrich our understanding of the role of human factors in road accidents and consequently develop effective countermeasures to prevent traffic accidents involving motorcycles.

Meta-Analysis of Randomized Controlled Trials of Acupuncture for Cancer-Related Fatigue

Background. Fatigue is a distressing and pervasive problem for people with cancer. In recent years, acupuncture has gained increasing attention among researchers as an alternative management strategy for cancer-related fatigue (CRF). This review aimed to evaluate the effectiveness of acupuncture for CRF. Methods. Five databases (Medline, CINAHL, Scopus, the Cochrane Library, and CAJ Full-text Database) were searched up to May 2013. Randomized controlled trials (RCTs) of acupuncture for the treatment of CRF were considered for inclusion. Results. Seven RCTs were included for meta-analysis, involving a total of 689 subjects. Three studies compared acupuncture with sham acupuncture for CRF with follow-up at 10 weeks; the standardized mean difference (SMD) for general CRF change values was −0.82 (95% confidence interval [CI] = −1.90 to 0.26). When acupuncture plus education intervention was compared with usual care, there was a statistically significant difference for the change score of general CRF (SMD = −2.12; 95% CI = −3.21 to −1.03). The SMD for general CRF change scores between acupuncture with no treatment or wait-list control was −1.46 (95% CI = −3.56 to 0.63). Finally, the SMD for general CRF change scores between acupuncture with acupressure or self-acupuncture was −1.12 (95% CI = −3.03 to 0.78). Three trials reported data for general quality of life and functioning status, reporting enough data for statistical pooling but showing no statistically significant difference (Z score = 1.15, P = .25, SMD = 0.99, 95% CI = −0.70 to 2.68 and Z score = 1.13, P = .26, SMD = 1.38, 95% CI = −1.02 to 3.79, respectively). The I2 statistics of all statistically pooled data were higher than 50%, indicating heterogeneity between the trials. Conclusions. There were 4 sets of comparison for the effectiveness of acupuncture for CRF; statistical pooling of the reduction in CRF from baseline to follow-up showed in favor of acupuncture. However, 3 sets of comparison for the pooled estimates of effect sizes had no statistical significance. Although one set of comparison (acupuncture plus education interventions vs usual care) had statistically significant differences, it is unclear whether this pooled positive outcome is attributable to the effects of acupuncture or to the education intervention. In addition, the duration of follow-up in these included trials was up to 10 weeks, and some RCTs had methodological flaws. Further rigorously designed RCTs adhering to acceptable standards of trial methodology are required to determine the effectiveness of acupuncture and its long-term effects on CRF.

Prevalence and risk factors of work-related musculoskeletal disorders in the catering industry: a systematic review.

OBJECTIVE This paper aims to systematically explore the prevalence and risk factors of Work-related Musculoskeletal Disorders (WMSDs) in the catering industry by reviewing relevant published literature with the goal of developing future prevention strategies. METHODS The systematic review was carried out in nine English medical databases, two Chinese-dominated full-text databases and seven web sites with the designated search strategies. Studies were included if they met the defined inclusion criteria hierarchically to investigate prevalence and or risk factors associated with WMSDs in the catering industry with appropriate epidemiological methodology. RESULTS Nine English databases yielded 634 citations, and two Chinese databases yielded 401 citations, although only five English and three Chinese studies passed the inclusion criteria. Three-fourths of the studies were cross-sectional. The prevalence of WMSDs varied from 3% to 86% depending on the type of establishment and positions. The most important risk factors were physical job demands, such as work posture, force applied, and repeated movement. CONCLUSIONS The lack of epidemiological information about WMSDs in the catering industry is apparent. Further studies are needed to investigate the relation among prevalence, risk factors and forms of WMSDs, in particular the interaction of risk factors in psychosocial aspects of the catering industry.

Symptom Profiles, Work Productivity and Quality of Life among Chinese Female Cancer Survivors

Background: Cervical and breast cancer are very common forms of malignancy among women. With increasingly long survivorship rates, it is essential to explore the impact of cancer survivorship on the work productivity and quality of life (QOL) of cancer survivors. Objectives: This study aimed to assess the symptom prevalence, work productivity and QOL among Chinese breast cancer survivors (BCS) and cervical cancer survivors (CCS), and to explore factors related to their work productivity and QOL. Methods: A cross-sectional study design was used. Chinese women with a history of primary breast or cervical cancer were included. Results: A total of 192 subjects joined the study. Participants reported a mean reduction in work productivity of 16%, although these women reported relatively good QOL compared with EORTC reference values. Significant predictors for work productivity loss included depression symptoms and cognitive limitations. Job stress, disease stage, anxiety symptoms, cognitive limitations, and physical functioning levels were statistically significant predictors of global QOL. These variables accounted for 55.4% of variance of QOL. Conclusion: This study found that cancer survivors reported higher levels of anxiety and cognitive limitations, and lower levels of work productivity and QOL. Cognitive symptoms were significantly related to cancer survivors’ work limitation and QOL. Implications for practice: Nurses and other healthcare professionals should be aware that BCS and CCS reported higher levels of work limitations and lower levels of QOL. Future research should develop relevant interventions to maximize cancer survivors’ work productivity and QOL.

Impulsivity and risky decision making among taxi drivers in Hong Kong: An event-related potential study

Taxi drivers play an important role in providing safe and professional public transport services. However, they tend to be more involved than other professional driver groups in accidents caused by deliberate recklessness. This study used an event-related potential (ERP) experiment to examine risk-taking behavior arising from impulsivity by comparing the underlying neural processes of taxi drivers with and without traffic offence records in Hong Kong. A sample of 15 traffic offenders and 15 nonoffenders, matched by sociodemographic characteristics, was recruited. The results show that the offender group demonstrated significantly less negative-going (less negative) feedback-related negativity but more positive-going (more positive) feedback-related P300 when than with their nonoffending counterparts. These findings show that taxi drivers with traffic offence records were less sensitive to the consequences of behavior and more attuned to the magnitude of potential reward. In addition, behavioral data revealed that they were more willing to make risky decisions. All these characteristics pertain to impulsive personality traits. Based on these findings, we can conclude that the offenders in this sample were more impulsive than their nonoffending counterparts.

Relationship Between Driving-violation Behaviours and Risk Perception in Motorcycle Accidents

Objective/Background Riding motorcycles is a popular means of community mobility in many Asian and developing countries. However, the potential harm associated with accidents is greater for motorcyclists and their passengers than for other vehicle users. The primary aims of this study were to explore the relationship between driving-violation behaviours and perceptions of the risk associated with potential accident causes, and to assess the contribution of these factors to active involvement in accidents among Chinese motorcyclists. Methods A total of 621 Chinese motorcyclists were recruited. All were asked to fill in a specially developed questionnaire to assess their driving-violation behaviours and perceptions of potential causes of motorcycle accidents. Results A relationship was identified between driving-violation behaviours and risk perceptions. Furthermore, both were significant predictors of involvement in motorcycle accidents. The motorcyclists involved in accidents demonstrated more aggressive and ordinary driving-violation behaviours. In addition, these motorcyclists exhibited lower perceptions of risk from both driving and environmental factors. Instead, these motorcyclists were more likely to identify risk in terms of belief-related causes. Conclusion This study could assist occupational-therapy practitioners involved in driving rehabilitation and training to identify strategies to deal with drivers’ violation behaviours and risk perception. It could also provide evidence-based recommendations for drivers’ education, driving-safety campaigns, or even licensing policies.

Risky Driving and the Perception of Motorcycle Accident Causes Among Chinese Motorcyclists in Hong Kong

Objective: The primary purposes of this study were to explore the relationship between risk-taking acts while driving motorcycles and perceived causes of motorcycle accidents, as well as their contribution to active involvement in traffic accidents among Chinese motorcyclists in Hong Kong. Active involvement means the riders was likely at fault for the crash. Methods: A total of 774 motorcyclists were recruited, of whom 292 had been involved in active motorcycle accident in the previous 3 years. All were asked to fill in a questionnaire, which was developed to assess their risk-taking acts while driving a motorcycle and perception of motorcycle accident causes. Results: The results of the study revealed 3 dimensions of accident causes, namely, driving-related, environment-related, and belief-related causes. These motorcycle accident causes were correlated with risk-taking acts while driving a motorcycle. A multivariate logistic regression analysis showed that risk-taking acts while driving motorcycles (adjusted odds ratio [OR]: 1.036, 95% confidence interval [CI]: 1.020–1.052), perception of driving-related cause (adjusted OR: 0.941, 95% CI: 0.916–0.967), and belief-related cause (adjusted OR: 1.134, 95% CI: 1.088–1.182) were significant factors contributing to involvement in active traffic accidents by motorcycle riders after controlling for concurrent demographic variables. Conclusions: The study highlights that perceived causes of motorcycle accidents are multidimensional, including those areas related to driving, the environment, and beliefs. It substantiates previous studies that a higher degree of driving-related risk perception is related to a lower degree of risk-taking acts while driving. Further research is needed to understand why belief-related causes, sometimes called superstitions, lead riders to believe that it is beyond their ability to affect accident causation and prevention.

Implementing the work disability prevention paradigm among therapists in Hong Kong : facilitators and barriers

Introduction This is a discussion paper to examine the issues surrounding management of work-related injuries by physiotherapists and occupational therapists in Hong Kong. Therapists working in public hospitals are faced with managing injured workers with limited resources and this frequently results in suboptimal outcomes. Methods In this paper, five experienced therapists critically reviewed the current practices in the physiotherapy and occupational therapy professions in Hong Kong, with regard to managing patients with work injuries. In many hospitals, therapists still practice with a disease-based model focusing on symptom relief and restoration of general physical function. We collated information about current programs initiated by physiotherapists and occupational therapists to provide more strategic intervention strategies for early screening of high-risk patients and adaptive biopsychosocial interventions targeting return-to-work outcomes. Clinical and system-level barriers and facilitators of a major paradigm shift towards work disability prevention are discussed. Conclusion Physiotherapists and occupational therapists need to develop more strategic collaborations and actively voice out the need for major systematic changes within the local healthcare system, in order to provide a more effective management approach in line with the concept of Work Disability Prevention.

Meta-analysis of the effects of neuropsychological interventions on cognitive function in non-central nervous system cancer survivors

Background. Cognitive impairment is a common complaint among cancer survivors, significantly impacting working memory, attention, executive function, and information processing speed. This meta-analysis aims to evaluate the effect of neuropsychological interventions on the cognitive function of non–central nervous system (non-CNS) cancer survivors. Methods. Three databases (PubMed, PsycInfo, and CAJ Full-text Database) were searched from January 2010 to September 2015. Controlled clinical trials of neuropsychological interventions for the treatment of cognitive impairment in cancer survivors were considered for inclusion. Results. A total of 10 eligible trials were included in this meta-analysis. Three trials assessed the effects of cognitive rehabilitation (CR) interventions, and the weighted mean difference (WMD) for the overall intervention effect was −0.19 (95% confidence interval [CI] = −2.98 to 2.61). Two trials examined the effects of cognitive training (CT) interventions on the cognitive function of cancer survivors; the standardized mean difference (SMD) for the overall effect was 0.52 (95% CI = 0.06 to 0.98). The overall effect of CR interventions on neuropsychological status at postintervention was 5.66 (95% CI = 2.97 to 8.35). The SMD of CR and CT intervention for objective function by verbal learning tests was 0.50 (95% CI = 0.19 to 0.81) at postintervention, and 0.58 (95% CI = 0.19-0.98) at follow-up assessment within 6 months. Conclusion. Findings from this meta-analysis indicate that neuropsychological interventions can improve cognitive function in non-CNS cancer survivors, and support the need for future research. However, the conclusion from this meta-analysis was based on trials with small sample sizes. Future research should be conducted using a larger sample size. Relevant clinical implications were discussed accordingly.