Cho Lee Wong

Environmental Factors Associated with Altered Gut Microbiota in Children with Eczema: A Systematic Review

Eczema is a common skin condition that impairs children’s daily life activities and quality of life. Previous research shows that gut microbiome composition plays an important role in the development of eczema. The present review summarizes evidence on environmental factors related to altered gut microbiota in children with eczema. We searched Medline, PubMed, Embase, and the Cochrane database of Systematic Reviews through October 2015. The search strategy focused on articles published in peer-reviewed, English-language journals with no publication year limit. Only original studies and review articles that reported environmental factors on gut microbiome specific to eczema were included in this review. We selected six studies (total 1990 participants) for full review and identified that the composition of gut microbiota specific to eczema could be influenced by the following environmental factors: length of gestation, mode of delivery, type of feeding, method of treatment, number of older siblings, and other lifestyle factors. There has been inconsistent empirical evidence as to the modulatory effects of gut microbiota on immunological functions in children with eczema. Further research on the environmental-host-microbial interaction is needed to develop a strong base of knowledge for the development and implementation of prevention strategies and policies for eczema.

Translation and validation of the Chinese-Cantonese version of the Adolescent Dysmenorrhic Self-Care Scale in Hong Kong adolescent girls

AIMS AND OBJECTIVES To translate and evaluate the psychometric properties of the Chinese-Cantonese version of the Adolescent Dysmenorrhic Self-Care Scale. BACKGROUND Adolescent girls prefer engaging in self-care activities for dysmenorrhoea. The Adolescent Dysmenorrhic Self-Care Scale is a reliable and valid scale for measuring the self-care behaviour of adolescent girls with dysmenorrhoea. However, it has not been validated in Hong Kong population. DESIGN A cross-sectional design. METHODS In phase one, the Adolescent Dysmenorrhic Self-Care Scale was translated into Chinese-Cantonese and was reviewed by an expert panel for the semantic equivalence and content validity. In phase two, the Chinese-Cantonese version of Adolescent Dysmenorrhic Self-Care Scale was administered to 396 girls with dysmenorrhoea. The construct validity was tested using confirmatory factor analysis and correlated with the Chinese version of the Generalized Self-Efficacy Scale. The reliability was assessed by Cronbachs alpha and test-retest reliability. RESULTS Item 13 related to school nurses was deleted because of its poor relevance to the Hong Kong situation. Four items (items 26-29) related to the medical-orientated behaviours were considered by the expert panel as not relevant to the self-care construct in Hong Kong population. Therefore, confirmatory factor analyses were carried out to 39-item Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale (deletion of item 13) and the 35-item Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale (with further deletion of items 26-29). Confirmatory factor analysis did not confirm the 39-item Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale, but the results showed the goodness of fit in the 35-item of Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale (root-mean-square error of approximation = 0·075, standardised root-mean-square residual = 0·078, normed fit index = 0·95, non-normed fit index = 0·96, comparative fit index = 0·96). Significant correlations with Chinese version of the Generalized Self-Efficacy Scale (r = 0·46, p < 0·01) were identified. The Cronbachs alpha of 35-item Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale was 0·94. The intraclass correlation coefficient was 0·93. CONCLUSION The 35-item Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale had satisfactory validity and reliability. RELEVANCE TO CLINICAL PRACTICE Nurses may use the 35-item Chinese-Cantonese-Adolescent Dysmenorrhic Self-Care Scale in assessing the self-care behaviour of adolescent girls with dysmenorrhoea, so that girls with a low level of self-care behaviour can be identified and appropriate intervention can be provided.

The Utilization of the Immune System in Lung Cancer Treatment: Beyond Chemotherapy

Lung cancer is ranked first worldwide as one of the main cancers in terms of prevalence and mortality rate. The development of effective treatment strategies against lung cancer is therefore of paramount importance. Traditionally, chemotherapy was employed in the treatment of various cancers. However, the non-specific nature of the actions of chemotherapeutic drugs and the potential for tumors to develop resistance to these drugs may render chemotherapy a less favorable option for cancer treatment. Immunotherapy provides an alternative strategy for this purpose. It involves the utilization of the immune system and the immune effector cells to elicit an immune response to the tumors, thereby eliminating them. Strategies include the administration of pro-inflammatory cytokines for immune stimulation, the removal of immunological checkpoints using monoclonal antibodies, and the use of cancer vaccines to enhance immunity against tumors. This article summarizes the above strategies, highlights the reasons why immunotherapy is superior to chemotherapy for the purpose of tumor removal, and reviews the recent clinical studies comparing the clinical outcomes of patients undergoing immunotherapy and chemotherapy. The article also describes advances in immunotherapeutic strategies for the treatment of lung cancer.

Uptake of breast screening and associated factors among Hong Kong women aged ≥50 years: a population-based survey

OBJECTIVE To examine the uptake of breast screening and its associated factors among Hong Kong Chinese women aged ≥50 years. STUDY DESIGN Cross-sectional population-based survey. METHODS A sample of Hong Kong Chinese women was recruited through telephone random-digit dialling. The survey consisted of six sections: perceived health status, use of complementary medicine, uptake of breast screening, perceived susceptibility to cancer, family history of cancer and demographic data. The factors associated with uptake of breast screening were analysed using logistic regression analysis. RESULTS In total, 1002 women completed the (anonymous) telephone survey. The mean age was 63.5 (standard deviation 10.6) years. The uptake rate of breast screening among Hong Kong Chinese women aged ≥50 years was 34%. The primary reasons for undertaking breast screening were as part of a regular medical check-up (74%), prompted by local signs and symptoms (11%) and a physicians recommendation (7%). Higher educational level, married or cohabiting, family history of cancer, frequent use of complementary therapies, regular visits to a doctor or Chinese herbalist, and the recommendation of a health professional were all independently and significantly associated with increased odds of having had a mammogram. CONCLUSIONS This study provides community-based evidence of the need for public health policy to promote broader use of mammography services among this target population, with emphasis on the active involvement of health care professionals, through the development and implementation of appropriate evidence-based and resource-sensitive strategies.

Association of toll-like receptor 5 polymorphisms (rs5744174 and rs851139) and eczema: a pilot birth cohort study in Hong Kong newborn babies

induced pemphigus. Eur J Dermatol 2011; 21: 696–699. 7 Tang X, Zhang X. Drug-induced pemphigus after six years of treatment with phenytoin and carbamazepine. Int J Dermatol 2012; 51: 483–496. 8 Megro A, Inoko A, Ota M, et al. Association of major histocompatibility complex class I chain-related gene A and HLA-B alleles with Behc et disease in Turkey. Jpn J Ophthalmol 2007; 51: 431–436. 9 Hung SI, Chung WH, Jee SH, et al. Genetic susceptibility to carbamazepine-induced cutaneous adverse drug reactions. Pharmacogenet Genomics 2006; 16: 297–306. 10 Sarig O, Bercovici S, Zoller L, et al. Population-specific association between a polymorphic variant in ST18, encoding a pro-apoptotic molecule, and pemphigus vulgaris. J Invest Dermatol 2012; 132: 1798–1805.

Effects of therapeutic play on children undergoing cast-removal procedures: a randomised controlled trial

Objectives To examine (1) the effectiveness of therapeutic play in reducing anxiety and negative emotional manifestations among children undergoing cast-removal procedures and (2) the satisfaction of parents and cast technicians with cast-removal procedures. Design A randomised controlled trial. Setting An orthopaedic outpatient department of a regional teaching hospital in Hong Kong. Participants Children (n=208) aged 3–12 undergoing cast-removal procedure were invited to participate. Interventions Eligible children were randomly allocated to either the intervention (n=103) or control group (n=105) and stratified by the two age groups (3–7 and 8–12 years). The intervention group received therapeutic play intervention, whereas the control group received standard care only. Participants were assessed on three occasions: before, during and after completion of the cast-removal procedure. Outcome measures Children’s anxiety level, emotional manifestation and heart rate. The satisfaction ratings of parents and cast technicians with respect to therapeutic play intervention were also examined. Results Findings suggested that therapeutic play assists children aged 3–7 to reduce anxiety levels with mean differences between the intervention and control group was −20.1 (95% CI −35.3 to −4.9; p=0.01). Overall, children (aged 3–7 and 8–12) in the intervention groups exhibited fewer negative emotional manifestations than the control group with a mean score difference −2.2 (95% CI −3.1 to −1.4; p<0.001). Parents and technicians in the intervention group also reported a higher level of satisfaction with the procedures than the control group with a mean score difference of 4.0 (95% CI −5.6 to 2.3; p<0.001) and 2.6 (95% CI 3.7 to 1.6; p<0.001), respectively. Conclusion Therapeutic play effectively reduces anxiety and negative emotional manifestations among children undergoing cast-removal procedures. The findings highlight the importance of integrating therapeutic play into standard care, in particular for children in younger age. Trial registration number ChiCTR-IOR-15006822; Pre-results.