Cb Chow

ADHD Drug Prescribing Trend Is Increasing Among Children and Adolescents in Hong Kong

Objective:To investigate the prevalence of ADHD medication prescribing of school-aged children in Hong Kong (HK) from 2001 to 2013 and to compare with other countries. Method: Using the Hong Kong Hospital Authority Clinical Data Analysis and Reporting System, we investigated the epidemiology and prevalence of ADHD medication prescribing. Results: The prevalence of children on ADHD medication increased 14 times throughout the study period—0.072% in 2001 (95% confidence interval [CI] = [0.068%, 0.077%]) to 1.027% (95% CI = [1.008%, 1.047%]) in 2013. Prevalence in females increased at a faster rate than in males. The prescribing trend in kindergarten children (3- to 5-year-old) was relatively steady from 2001 to 2008—0.025% (95% CI = [0.019%, 0.033%]) in 2001—until a marked increase from 2009 to 2013—0.121% (95% CI = [0.105%, 0.139%]) in 2013. Conclusion: The prevalence of ADHD medication prescribing in Hong Kong is increasing but remains lower than most Western countries. However, the prevalence of ADHD medication prescribing for kindergarten children should be monitored to ensure appropriate use.

Use of Internet viral marketing to promote smoke-free lifestyles among Chinese adolescents.

Purpose Youth smoking is a global public health concern. Health educators are increasingly using Internet-based technologies, but the effectiveness of Internet viral marketing in promoting health remains uncertain. This prospective pilot study assessed the efficacy of an online game-based viral marketing campaign in promoting a smoke-free attitude among Chinese adolescents. Methods One hundred and twenty-one Hong Kong Chinese adolescents aged 10 to 24 were invited to participate in an online multiple-choice quiz game competition designed to deliver tobacco-related health information. Participants were encouraged to refer others to join. A zero-inflated negative binomial model was used to explore the factors contributing to the referral process. Latent transition analysis utilising a pre- and post-game survey was used to detect attitudinal changes toward smoking. Results The number of participants increased almost eightfold from 121 to 928 (34.6% current or ex-smokers) during the 22-day campaign. Participants exhibited significant attitudinal change, with 73% holding negative attitudes toward smoking after the campaign compared to 57% before it. The transition probabilities from positive to negative and neutral to negative attitudes were 0.52 and 0.48, respectively. It was also found that attempting every 20 quiz questions was associated with lower perceived smoking decision in future (OR  = 0.95, p-value <0.01). Conclusions Our online game-based viral marketing programme was effective in reaching a large number of smoking and non-smoking participants and changing their attitudes toward smoking. It constitutes a promising practical and cost-effective model for engaging young smokers and promulgating smoking-related health information among Chinese adolescents.

What makes the hospitalisation system more efficient? An application of the decomposition method to Hong Kong morbidity data

Objective To examine the efficiency of the Hong Kong hospitalisation system based on hospitalisation days. Design Retrospective study. Setting Hospitalisation data (2000–2010) for all government-funded hospitals in Hong Kong. Population Hospitalisation data for the entire Hong Kong population (7.0 million in 2011). Methods A decomposition method was used to determine the effects on total hospitalisation days during the period 2000–2010 of the following three factors: (i) hospitalisation rate per person; (ii) the number of visits per patient; and (iii) the mean duration of stay per visit. Main outcome measures The decomposition method provides empirical measures of how the three factors contributed to the change in total hospitalisation days during the period 2000–2010 and identifies the most effective way to contain increases in hospitalisation days. Results The results of decomposition analysis show that the decrease in mean duration of stay per visit (reducing from 6.83 to 4.58 days) is the most important factor in the reduction in the total number of hospitalisation days, despite increases in total population size (from 6.7 to 7.0 million), the number of individual hospital admissions (from 583 000 to 664 000) and the number of episodes (from 1.2 to 1.4 million) from 2000 to 2010. Hospitalisation days per person decreased from 1.18 in 2000 to 0.93 in 2010. The decline in the mean duration of stay per visit contributed 200.6% to this reduction but was offset by −51.1% due to a slight growth in the number of visits per patient and by −49.4% as a result of changed hospitalisation rates per person. Conclusions Better management of the duration of stay of per visit without compromising patient satisfaction levels or the quality of service is the most important factor for controlling increases in health expenditure in Hong Kong.

The importance of online resources for parents of children with special needs in Hong Kong: South China's experience

Background: Caring for children with special needs can be challenging and stressful for parents. Access to information and support is critical for parents to overcome these challenges. This study aims to study parental experiences and needs of searching and utilizing online information to support the care of their children with special needs. Methods: Forty-nine participants were interviewed. All discussions were transcribed and examined using a thematic analysis method. Results: Three main themes were identified, including information needs, experiences of obtaining and using information, and the advantages and challenges of searching and utilizing Internet information. Conclusions: Availability of up-to-date information and emotional support is beneficial to Chinese parents of children with special needs. Although plenty of information can be accessed through the Internet, parents require eHealth literacy to use and interpret this online material. Conventional sources of information such as community groups remain important for those with low eHealth literacy.

Stock Market Fluctuations and Self-Harm among Children and Adolescents in Hong Kong

Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 (p = 0.0339) in children and 1.06 (p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents.

Fall-related attendance and associated hospitalisation of children and adolescents in Hong Kong: a 12-year retrospective study

Objectives The present study aimed to examine the trends and characteristics of fall-related attendance in accident and emergency department (AED) by injury type and the trend in associated average length of stay (LOS) among children and adolescents in Hong Kong. Design A retrospective approach was adopted. Setting AED, involving all local public emergency departments from 2001 to 2012. Participants 63 557 subjects aged 0–19 years with fall injury record were included in the analysis. Primary outcome measures Fall-related injury number and rates were calculated and reported. Poisson and negative binomial regression models were used to study the trends of injury incidence rate at different body regions. Results AED fall-related attendance rate increased significantly with an annual percentage change of 4.45 (95% CI 3.43 to 5.47%, p<0.0001). The attendance number of male subjects was persistently higher than female subjects. The standardised rate of fracture injury increased by 1.31% (95% CI 0.56 to 2.05%, p<0.0001) and that of non-fracture injury increased by 9.23% (95% CI 7.07 to 11.43%, p<0.0001) annually. Upper limb was the most frequently fractured location. It included forearm/elbow, shoulder/upper arm and wrist/hand with descending order of frequency. On the contrary, head was the most frequent non-fracture location, followed by forearm/elbow. Conclusions The rates of fall-related attendance have been increasing and still remain high. There were significant increases in non-fracture injuries. Fractures were most frequently found in the upper extremity of a child while the most common non-fracture location was head. It appears that more efforts should be made and preventive measures should be implemented for children and adolescents in Hong Kong.

An Internet-Based Intervention to Promote Alcohol-Related Attitudinal and Behavioral Change Among Adolescents: Protocol of a Cluster Randomized Controlled Trial

Background Underage drinking is a prevalent risk behavior and common public health problem. Research shows that alcohol abuse not only affects the quality of life of drinkers themselves. The problems resulting from underage drinking pose substantial costs to society as well. The proposed study will address underage drinking with the use of an Internet campaign, which is a cost-effective way of tackling the problem. Objective The aims of this study are to test the effectiveness of an online quiz competition in changing adolescents’ alcohol-related attitudes and behavior and to explore the feasibility of using Internet viral marketing to reach a significant number of adolescents. Methods The study will constitute a cluster randomized controlled trial for 20 secondary schools (6720 Grade 7-9 students). Schools will be randomized to intervention or control arm with equal likelihood. Students in intervention schools will be invited to take part in the Internet campaign, whereas those in control schools will receive relevant promotional leaflets. Results Alcohol-related attitude and behavior will be the primary outcome measures. The results of the proposed study will provide evidence on the efficacy of an Internet intervention in modifying adolescents’ attitudes and behavior and guide further investigation into the prevention of and intervention in such risk behaviors as underage drinking. The project was funded July 2015, enrollment started September 2015, and results are expected July 2017. Conclusions With the Internet increasingly being recognized as a practical and cost-effective platform for health information delivery, the proposed Internet-based intervention is expected to be more effective in altering adolescents’ alcohol-related attitudes and behaviors than traditional health promotion. ClinicalTrial ClinicalTrials.gov NCT02450344; https://clinicaltrials.gov/ct2/show/NCT02450344 (Archived by WebCite at http://www.webcitation.org/6heB2zMBD)

Chinese pediatricians face a crisis: reform is coming.

Xu and Zhang recently described the current crisis in the pediatric community in China.1 The situation stems from predicaments at different levels, from lack of financial support to poor job security to extreme stress and poor work environments. The University of Hong Kong Shenzhen Hospital is a newly developed and reformed hospital financially supported by the Shenzhen city government and managed by the University of Hong Kong. It is a general hospital with a Department of Pediatrics. Although the department is administered by physicians from Hong Kong, its clinical activities are performed primarily by mainland physicians. Our hospital is targeting issues … E-mail: keithklau{at}hku-szh.org