Janet Y. H. Wong

Pickled vegetables in the aetiology of oesophageal cancer in Hong Kong Chinese

Oesophageal cancer is common in Chinese populations, but individual-based epidemiological studies have provided little explanation. A case control study with 400 cases and 1598 controls (800 hospital and 798 general practice) was conducted among Hong Kong Chinese. In multivariate analyses, statistically significant effects on risk were detected for several potentially preventable exposures with high attributable risks (ARs). These included preference for consuming drinks or soups at high temperature (AR = 14%), infrequent consumption of green leafy vegetables (AR = 15%) and citrus fruits (AR = 26%), ingestion of pickled vegetables (AR = 29%), tobacco smoking (AR = 44%), and alcohol drinking (AR = 48%). On the assumption of multiplicative risk, the combined AR due to these exposures was 89%. This is the first case control study to show an association between pickled vegetable consumption and oesophageal cancer risk. The finding considerably strengthens the evidence for carcinogenicity of N-nitroso compounds in man and helps to explain the very high risk among Chinese.

Depression Among Women Experiencing Intimate Partner Violence in a Chinese Community

Background:Depression is one of the significant mental health impacts of intimate partner violence. However, there is a lack of empirical evidence on the factors associated with depression among abused Chinese women. Objective:The purpose of this study was to identify the factors associated with a higher level of depression among abused Chinese women. Methods:This was a cross-sectional study with participation of 200 abused Chinese women in a local community center in Hong Kong. The measurement tools used are the Chinese Abuse Assessment Screen, the Chinese Beck Depression Inventory Version II, the Revised Conflict Tactics Scale, the Interpersonal Support Evaluation List 12, and the demographic data. Structured multiphase regression analysis was used for data analysis. Results:Factors significantly associated with a higher level of depression in Chinese abused women were low educational level (estimate = −2.49, p = .038), immigration (estimate = 4.99, p = .025), financial support from friends and relatives (estimate = 4.72, p = .006), and chronic psychological abuse (estimate = 0.09, p < .001). A protective factor against depression is the perception of social support (estimate = −1.11, p < .001). Discussion:An overwhelming number of abused Chinese women have moderate or severe levels of depression. There is a need for more awareness of the detrimental mental health impact of abuse on women, screening for depression when women are found to be abused, and provision of social support at an earlier stage to minimize depression.

Bridging Intimate Partner Violence and the Human Brain A Literature Review

Past studies mainly focused on the physical and structural brain injuries in women survivors with a history of intimate partner violence (IPV), but little attention has been given to the biological impact and cognitive dysfunction resulting from such psychological stress. In this article, we aim to establish the connection between IPV and the brain by reviewing current literature examining (1) the biological mechanisms linking IPV, stress, and the brain; (2) the functional and anatomical considerations of the brain in abused women; and (3) the abused women’s behavioral responses to IPV, including fear, pain, and emotion regulation, by utilizing functional neuroimaging. The major significance of this study is in highlighting the need to advance beyond self-reports and to obtain scientific evidence of the neurological impact and cognitive dysfunction in abused women with a history of IPV, an area in which current literature remains at a descriptive level.

Psychological Intimate Partner Abuse among Chinese Women: What we know and what we still Need to know

Although increasing attention has been given to psychological abuse in intimate partner relationships, relatively little is known about this complex problem among Chinese women. A better understanding of psychological abuse in Chinese intimate relationships is warranted because Chinese culture is shame-oriented. Women, therefore, may be more susceptible to shameful feelings induced by psychological abuse. This may explain why psychological abuse, in the absence of physical and/or sexual abuse, has such adverse mental health effects on Chinese women. In this paper, what is known about psychological abuse in Chinese intimate relationships and what still needs to be known are highlighted, together with the mental health impact. Implications for future research are also presented.

Safety-promoting behaviors of community-dwelling abused Chinese women after an advocacy intervention: A randomized controlled trial

OBJECTIVE To examine the effect of an advocacy intervention on the use of safety-promoting behaviors in community-dwelling abused Chinese women as compared to a control condition of usual care. DESIGN This efficacy trial used a randomized controlled, parallel group design. PARTICIPANTS AND METHODS A total of 200 Chinese women in a community setting who screened positive for intimate partner violence using the Chinese version of the Abuse Assessment Screen were randomized to receive either an advocacy intervention (intervention group, n=100) or usual community care (control group, n=100). The outcome measured was the change in the self-reported safety-promoting behaviors as measured by the Safety-promoting Behavior Checklist over three time-points (baseline, 3-month follow-up and 9-month follow-up). Participants and assessors were blinded to the study hypothesis. Assessors were further blinded to the group membership of the participants. RESULTS The Safety-promoting Behavior Checklist scores in the intervention group increased from the baseline on average by 5.65 (95% confidence interval [CI], 4.92-6.39) at 3-month and 6.65 (95% CI, 5.90-7.39) at 9-month follow-ups, while the scores in the control group also increased by 1.71 (95% CI, 1.06-2.37) at 3-month and 1.79 (95% CI, 1.15-2.43) at 9-month follow-ups. After adjusting for baseline differences, the between-group differences in scores were significant at 3-month and 9-month follow-ups (p=0.04). The intervention group increased the scores by 3.61 (95% CI, 2.61-4.61, p<0.001) more than the control group at 3-month and by 4.53 (95% CI, 3.53-5.53, p<0.001) at 9-month follow-ups. CONCLUSION An advocacy intervention is efficacious in increasing the use of safety-promoting behaviors as compared to usual community care in community-dwelling abused Chinese women.

Changes in heart-rate variability of survivors of nasopharyngeal cancer during Tai Chi Qigong practice

[Purpose] To explore the changes in heart-rate variability (HRV) of survivors of nasopharyngeal cancer (NPC) before, during, and after a Tai Chi (TC) Qigong exercise. [Subjects and Methods] Eleven survivors of NPC participated voluntarily in the study. The heart rate of each participant was measured continuously for 1 minute before the TC Qigong intervention, during the 5-minute TC Qigong intervention, and for 1 minute after the intervention, using a Polar heart-rate monitor. Spectral HRV was expressed in terms of normalised low frequency (LF) power, normalised high frequency (HF) power, and the low frequency/high frequency (LF/HF) power ratio. [Results] Both the LF-power and the HF-power components had significant time effects. However, the time effect of the LF/HF power ratio was not significant. Post hoc contrast analysis revealed a significant decrease in LF power and a concomitant increase in HF power during the 4th minute and 5th minute of the TC Qigong exercise. [Conclusion] Five minutes of TC Qigong exercise was found to improve HRV by increasing HF power and decreasing LF power, but these effects were transient. TC Qigong might be an appropriate exercise for improving the ANS function and psychological and cardiac health of survivors of NPC.

The effects of a 6-month Tai Chi Qigong training program on temporomandibular, cervical and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors

Introduction. Nasopharyngeal cancer (NPC) survivors often sustain head–neck–shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. Methods. Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. Results. Intention-to-treat analysis revealed improvement in cervical side flexion ROM only (P < .008) and unchanged shoulder and TMJ mobility (P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time (P < .008). Sleep problems also decreased in the TC Qigong group (P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training (P < .05). Conclusions. The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.

Patterns, aetiology and risk factors of intimate partner violence-related injuries to head, neck and face in Chinese women

BackgroundIntimate partner violence (IPV) related injuries have been recognized among health care professionals. However, few studies have provided detailed information on injuries to the head, neck and face regions in Chinese women. As abused Chinese women are generally unwilling to disclose IPV and there are differences in socio-demographic characteristics, societal norms and behaviours, the women may exhibit different patterns, aetiology and risk factors of IPV-related HNF injuries. This study aims to examine the patterns of head, neck and face injuries presenting to Accident and Emergency departments, including the anatomical regions, types, severity, aetiology and demographic and non-demographic risk factors of injuries inflicted by intimate partners in Chinese context.MethodsMedical charts of 223 women presented to the Accident and Emergency departments of two regional hospitals in Hong Kong between January 2010 and December 2011 were reviewed independently by two reviewers.ResultsHead, neck and face injuries remained the most common injuries found in abused Chinese women (77.6%), and punching with a fist was the most common aetiology (60.2%). In particular, punching with a fist was significantly associated on the upper third of the maxillofacial region (p = .01) and the back part of the head (p = .03). Moreover, cohabiting and separated women were more likely to have multiple injuries than those who were married (OR = 3.3, 95% CI = 1.4, 7.8; OR = 2.1, 95% CI = .4, 11.9).ConclusionsThe findings enhance the understanding of head, neck and face injuries and inform clinicians about the linkage among injuries and risks in abused Chinese women.

The use of social networking applications of smartphone and associated sexual risks in lesbian, gay, bisexual, and transgender populations: a systematic review

ABSTRACT The use of social networking applications (apps) on smartphones has the potential to impact sexual health and behaviour. This was the first systematic review to critically appraise and summarize the existing literature on the use of social networking apps on smartphones and their associated sexual health and sexual behaviour effects in lesbian, gay, bisexual and transgender populations. A systematic search was conducted in five databases (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Thirteen articles from 11 studies were included in this review. Studied outcomes included rates of unprotected sexual intercourse, the number of sexual partners, drug/alcohol use prior to/during sexual intercourse, sexually transmitted infections (STIs) testing and the prevalence of STIs. Among app users, the prevalence of unprotected sex ranged from 17.0% to 66.7%. The mean number of sexual partners ranged from 1.4 to 2.9 (last 1-month period), and from 46.2 to 79.6 (lifetime). Two studies found that the prevalence of HIV infection was 1.9% and 11.4%, respectively. The self-reported prevalence of prior diagnosis of STIs other than HIV ranged from 9.1% to 51.0%. It should be noted that the heterogeneity of the study design and outcome measures across different studies hindered the comparison of findings across different studies. Furthermore, the findings in some studies are not reliable due to methodological problems. Our results highlight the need for more research with rigorous methodology to understand the negative impacts of using these apps on sexual health and sexual behaviour. For future studies, the operational definition of outcomes, including social networking app use and unprotected anal intercourse (UAI), should be clearly outlined. The use of validated tools to measure sexual behaviour and biological measures of HIV and other STDs is preferable so that outcomes can be standardized to facilitate comparisons between studies and the pooling of data.

The association between smartphone dating applications and college students' casual sex encounters and condom use

OBJECTIVE This study aims to explore the association between using smartphone dating applications (apps) and having unprotected sex with a casual sex partner. STUDY DESIGN This is a cross-sectional study. Students were recruited from four university campuses in Hong Kong by convenience sampling. MAIN OUTCOME MEASURES Subjects completed a structured questionnaire asking about the use of dating apps, sexual history and socio-demographic information. Multiple logistic regressions were used to explore the association between using dating apps and having unprotected sex with a casual sex partner. RESULTS Six hundred and sixty-six subjects were included in the analysis. Users of dating apps were more likely to have had unprotected sex with a casual sex partner the last time they engaged in sexual intercourse (aOR: 10.06). Using dating apps for more than 12 months was associated with having a casual sex partner in the last sexual intercourse (aOR: 3.21), as well as having unprotected sex with that casual partner (aOR: 13.56). CONCLUSION We found a robust association between using dating apps and having unprotected sex with a casual sex partner, implying that using dating apps is an emerging sexual risk factor. We recommend that interventions promoting the safe use of dating apps should be implemented.