Prevalence of and risk factors for erectile dysfunction in Hong Kong diabetic patients

Aim To estimate the prevalence of erectile dysfunction (ED) in Chinese diabetic men and to identify its risk factors, we carried out a cross-sectional survey of 500 Chinese diabetic men attending a community hospital diabetic clinic in Hong Kong.
Methods Patients were interviewed and asked to report on their experience of ED as defined in the National Institutes of Health Consensus Conference 1993. Diabetic complications and patient clinical data were obtained from patients' medical records.
Results Of the 486 patients studied, the prevalence of ED was 63.6% (95% confidence interval 59.3–67.9%). The prevalence of ED increased with age, from 33.3% to 73.8% for diabetic men aged between 21 and 80 years (P = 0.001). Severity of ED also increased with age. Among diabetic men with ED, there was no report of complete ED for diabetic men aged 40 years and below, whereas the proportion of patients with complete ED increased from 7.4% to 71.1% between the ages of 41 and 80 years. ED occurred early in the course of the disease, with a prevalence increasing from 56.0% in men with diabetes mellitus (DM) for < 5 years to 72.0% in those with DM for > 20 years (P = 0.038). Duration of DM was also associated with severity; the proportion of patients with complete ED increased from 30.8% for those with DM for < 5 years to 72.2% for those with DM for ≥ 20 years (P < 0.001). Using logistic regression analysis, DM duration, diabetic complications including retinopathy, abnormal albuminuria and sensory neuropathy, and higher level of education were associated with a higher risk of ED. By polychotomous logistic regression, age was the only factor found to be associated with the severity of ED, after adjusting for other variables.
Conclusions Chinese diabetic patients have a prevalence of self-reported ED that appears to be higher than that of Western populations. This may be due to cultural differences and the association of abnormal albuminuria and hypertension.

Quality-of-life measurement in patients undergoing radiation therapy for head and neck cancer: a Hong Kong experience

The aims of this study are (1) to establish a reliable and valid quality-of-life (QOL) questionnaire for Chinese patients with head and neck (H&N) cancer who are treated with radiation therapy and (2) to evaluate the impact of the immediate side effects of treatment on the QOL of these patients. The 39-item "Quality of Life Radiation Therapy Instrument with Head and Neck Companion Module" (QOL-RTI/H&N) was translated into Chinese. In the reliability evaluation phase (study module 1), the questionnaire was administered twice to 56 H&N cancer patients, 7 days apart, during the second and third week of radiation therapy. In the validity evaluation phase (study module 2), 138 patients completed the QOL-RTI/H&N before starting and at the end of radiation therapy. Sixty-nine of these 138 patients also completed the QOL-RTI/H&N during the second week of their radiation therapy, at the same time as completing the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaire. Cronbach alpha coefficients were 0.88 for the general-tool QOL-RTI and 0.90 for the H&N subscale. Test-retest reliability was satisfactory with intraclass correlation coefficients of 0.89 for the general-tool QOL-RTI and 0.75 for the H&N subscale. The instrument can discriminate between patients with stage I or II disease and those with stage III or IV disease (P < .05). Concurrent validity was established by the good agreement with the FACT-H&N (r = 0.86, P < .001). A highly significant deterioration was in the QOL from the baseline to the end of treatment (mean difference for general tool = 1.95, P < .001; mean difference for H&N subscale = 4.85, P < .001). The Chinese QOL-RTI/H&N is a reliable and valid tool for determining the QOL in H&N cancer patients receiving radiation therapy. The immediate side effects of treatment had a significantly negative impact on the patients' QOL. The impact was relatively large for the functional and treatment-site aspects.

Developing english skills through reflective portfolios in Hong Kong universities

This research concerns the use of portfolios by teachers of English (L2) to assist non-native speakers in Hong Kong universities to complete their studies in English. Portfolios as an English learning tool have yet to win converts from the ranks of language teachers in Hong Kong chiefly because of concerns about reliability and fairness. Two recent initiatives in Hong Kong have, however, prompted a reappraisal of the place of portfolios in English language learning. They include the use of learning portfolios in secondary school and ePortfolios by university students for learning and employment purposes.

As an English (L2) teacher of many years, I initiated my research to investigate the experiences of seven university students in Hong Kong in using reflective portfolios for English learning. Three research questions framed my research: 1) in what ways can reflective portfolios impact on L2 learning strategies? 2) what are the effects of reflective portfolios on progress in L2 acquisition as perceived by students? 3) what are the perceptions of university students towards reflective portfolios as a method of L2 learning?

To gain a holistic understanding of the complex phenomena under scrutiny, a case study methodology and grounded theory were utilised, the former to organise and generate qualitative data, and the latter to analyse data from three sources provided by the seven participating students: semi-structured interviews, portfolio artefacts, and weekly learning diaries.

There were two levels of data analysis. For the first level, analysis focused on coded data from portfolio artefacts, diary entries and interview transcripts as reported by students. The second level involved analysis from the Confucian and sociocultural perspectives. I pursued interpretation and continuous refinement of the data by using techniques drawn from grounded theory. The findings revealed that students generally employed a wide spread of L2 learning strategies in the cognitive, meta-cognitive, and socio-affective domain, reported increased awareness of effective language strategies, and considered portfolios a means of supporting time management and record-keeping, and a site for extended writing practice through reflection.

The findings suggest that students display a cyclical, context-specific shift in learning conception from quantitative to qualitative. Connected to this is students’ apparent ability to formulate strategic responses to externally imposed demands. It is found that such responses are culturally triggered, underpinned by Confucian beliefs. Although the Confucian tradition emphasises respect for established authority, the findings point to students’ creative re-configuration of mental schemata to engender change in role enactment and power relations, with the portfolio as a mediating tool of their experiences.

Based on the findings, I argue that my research has addressed the three research questions and contributed to two crucial aspects of L2 learning. The first pertains to the need for a balanced view of individual effort and social context in second language acquisition, corroborating the significant link between context and learner engagement. Another contribution centres on an enhanced understanding of the relationship between portfolios, reflection and L2, where students’ diaries in English and portfolio artefacts enable them to engage in critical reflection and to identify strategies for L2 improvement.

Reliability and validity of the IPAQ-L in a sample of Hong Kong urban older adults : does neighborhood of residence matter?

This study examined reliability and validity of the Chinese version of the International Physical Activity Questionnaire–Long Form (IPAQ-LC) in Chinese seniors, including moderating effects of neighborhood walkability and socioeconomic status (SES) on reliability and validity. The IPAQ-LC was interviewer-administered (n = 96), accelerometer and 7-day walk-diary data were collected (n = 94), and the IPAC-LC was readministered (N = 92). Acceptable reliability was found for all measures of physical activity (PA) overall and across different types of neighborhood. Participants from highly walkable neighborhoods were more reliable at estimating walking for transport. Participants from low-SES areas were less reliable at estimating leisure-time PA and sitting but more reliable at estimating transport-related walking. IPAQ-LC walking was significantly related to light- but not moderate-intensity accelerometry-based PA. It was moderately to strongly related to a 7-day diary of walking. The data imply slow-paced walking, probably due to age, climate, and terrain. The findings suggest that the IPAQ-LC’s reliability and validity are acceptable in Chinese seniors.

Ageing in an ultra-dense metropolis: perceived neighbourhood characteristics and utilitarian walking in Hong Kong elders

Objective
The neighbourhood built environment may affect walking behaviour of elders. However, such effects remain underexplored, especially in an Asian context. We examined associations of perceived environmental attributes with overall and neighbourhood-specific walking for transport in a sample of Chinese elders residing in Hong Kong, an ultra-dense Chinese metropolis.

Design
Cross-sectional observational study using a two-stage stratified sampling strategy.

Setting
Hong Kong, China.

Subjects
Chinese-speaking elders (n 484), with no cognitive impairment and able to walk without assistance, residing in thirty-two selected communities stratified by socio-economic status and walkability, were interviewer-administered validated measures of perceived neighbourhood environment and walking for transport.

Results
Much higher levels of transport-related walking (mean 569 (sd 452) min/week) than found in Western samples were reported. The degree of perceived access to shops, crowdedness, presence of sitting facilities and easy access of residential entrance were independently positively related to both frequency of overall and within-neighbourhood walking for transportation. Infrastructure for walking and access to public transport were predictive of higher frequency of transport-related walking irrespective of location, while the perceived degree of land-use mix was predictive of higher levels of within-neighbourhood walking.

Conclusions
The provision of easy access to shops, residential entrances and sitting facilities in the neighbourhood may promote overall transport-related walking, while a good public transport network and pedestrian infrastructure linking destination-poor with destination-rich locations may compensate for the detrimental effects of living in less walkable neighbourhoods. Governmental investment in these micro- and macro-environmental features would help the promotion of an active lifestyle in elders.

Neighbourhood environment, sitting time and motorised transport in older adults: a cross-sectional study in Hong Kong

OBJECTIVES: Sitting time is a public health concern. This study examined associations of objectively measured neighbourhood environmental attributes with non-transport sitting time and motorised transport in 484 Hong Kong older adults. Neighbourhood attributes encouraging walking may help older adults replace some sitting time at home and on motorised transport with light-to-moderate-intensity activities such as strolling around the neighbourhood or walking to/from neighbourhood destinations. Thus, we hypothesised environmental attributes found to be related to walking would show associations with non-transport sitting time and motorised transport opposite to those seen for walking. DESIGN: Cross-sectional. SETTING: Hong Kong, an ultradense urban environment. PARTICIPANTS: 484 ethnic Chinese Hong Kong residents aged 65+ recruited from membership lists of four Hong Kong Elderly Health Centres representing catchment areas of low and high transport-related walkability stratified by socioeconomic status (response rate: 78%). PRIMARY AND SECONDARY OUTCOME MEASURES: Attributes of participants' neighbourhood environments were assessed by environmental audits, while non-transport sitting time and motorised transport were ascertained using the International Physical Activity Questionnaire-Long Form (Chinese version). RESULTS: Daily non-transport sitting minutes were 283 (SD=128) and motorised transport 23 (SD=28). Prevalence of signs of crime/disorder, streetlights, public facilities (toilets and benches) and pedestrian safety were independently negatively related, and sloping streets positively related, to sitting outcomes. Places of worship in the neighbourhood were predictive of more, and prevalence of public transit points of less, non-transport sitting. Associations of either or both sitting outcomes with prevalence of food/grocery stores and presence of parks were moderated by path obstructions and signs of crime/disorder. CONCLUSIONS: The findings suggest that access to specific destinations and relatively low-cost, minimal impact modifications to the urban form, such as street lighting, public toilets, benches and public transit points, could potentially reduce sitting time and associated negative health outcomes in Hong Kong older adults.

Streptococcus sinensis endocarditis outside Hong Kong

Streptococcus sinensis has been described as a causative organism for infective endocarditis in 3 Chinese patients from Hong Kong. We describe a closely related strain in an Italian patient with chronic rheumatic heart disease. The case illustrates that S. sinensis is a worldwide emerging pathogen.

Relationship between work performance and personality traits in Hong Kong organizational settings

Four hundred and thirty-seven employees from four Hong Kong organizations completed the Traditional Chinese versions of the Fifteen Factor Personality Questionnaire Plus (15FQ+) and the Cross-Cultural Personality Assessment Inventory (CPAI-2) (indigenous scales) and provided objective and memory-based recent performance appraisal scores. A number of significant bivariate correlations were found between personality and performance scores. Hierarchical multiple regression analyses revealed that a number of the scales from the 15FQ+ contributed to significantly predicting four of the performance competency dimensions, but that the CPAI-2 indigenous scales contributed no incremental validity in performance prediction over and above the 15FQ+. Results are discussed in the light of previous research and a call made for continued research to further develop and increase the reliability of the Chinese instruments used in the study and to enable generalization of the findings with confidence.

Implementation of Triple P-Positive Parenting Program in Hong Kong: Predictors of programme completion and clinical outcomes

This study examined the effectiveness of the Triple P-Positive Parenting Program in a government child health service delivery context with Chinese parents in Hong Kong. Specifically, the study sought to identify pre-intervention variables that might predict programme outcomes such as, level of clinical improvement and programme completion. Participants were 661 parents of pre-school and primary aged children participating in a group version of the Triple P-Positive Parenting Program. There were significant decreases in disruptive child behaviours, levels of parenting stress, general stress and anxiety and an increase in parenting sense of competence. Greater change in reports of child behaviour problems was related to lower levels of family income, new immigrant family status, and higher pre-intervention levels of parenting stress. The present study provides a profile of parents who are most likely to benefit from parent training programmes.

Challenges for expatriate managers:an exploration of cross-cultural management, adjustment, and training issues faced by Anglo-American managers in Hong Kong

This field work study furthers understanding about expatriate management, in particular, the nature of cross-cultural management in Hong Kong involving Anglo-American expatriate and Chinese host national managers, the important features of adjustment for expatriates living and working there, and the type of training which will assist them to adjust and to work successfully in this Asian environment. Qualitative and quantitative data on each issue was gathered during in-depth interviews in Hong Kong, using structured interview schedules, with 39 expatriate and 31 host national managers drawn from a cross-section of functional areas and organizations. Despite the adoption of Western technology and the influence of Western business practices, micro-level management in Hong Kong retains a cultural specificity which is consistent with the norms and values of Chinese culture. There are differences in how expatriates and host nationals define their social roles, and Hong Kong's recent colonial history appears to influence cross-cultural interpersonal interactions. The inability of the spouse and/or family to adapt to Hong Kong is identified as a major reason for expatriate assignments to fail, though the causes have less to do with living away from family and friends, than with Hong Kong's highly urbanized environment and the heavy demands of work. Culture shock is not identified as a major problem, but in Hong Kong micro-level social factors require greater adjustment than macro-level societal factors. The adjustment of expatriate managers is facilitated by a strong orientation towards career development and hard work, possession of technical/professional expertise, and a willingness to engage in a process of continuous 'active learning' with respect to the host national society and culture. A four-part model of manager training suitable for Hong Kong is derived from the study data. It consists of a pre-departure briefing, post-arrival cross-cultural training, language training in basic Cantonese and in how to communicate more effectively in English with non-native speakers, and the assignment of a mentor to newly arrived expatriate managers.

An Amorous Prehistory of Hong Kong Queer Cinema

Depiction of homoerotic relationships among women in commercial costumed films was a unique phenomenon in 1970s - 1980s Hong Kong cinema. What are the possible cinematic meanings of lesbian images that we can perceive in these films? How should we evaluate the exact representation of a sexuality that had been perceived as deviant in that society? In this essay, I close-read homoerotic scenes and trace through the trajectories of cultural and industrial changes enabling the emergence of two representative films: Intimate Confessions of A Chinese Courtesan (1972) and An Amorous Woman of Tang Dynasty (1984). I do this with a continuous concern for historical context in order to provide an in-depth understanding of how lesbian images are constructed in cinema.

Neighbourhood environment, physical activity, quality of life and depressive symptoms in Hong Kong older adults: a protocol for an observational study

INTRODUCTION: The neighbourhood environment can assist the adoption and maintenance of an active lifestyle and affect the physical and mental well-being of older adults. The psychosocial and behavioural mechanisms through which the environment may affect physical and mental well-being are currently poorly understood. AIM: This observational study aims to examine associations between the physical and social neighbourhood environments, physical activity, quality of life and depressive symptoms in Chinese Hong Kong older adults.

METHODS AND ANALYSES: An observational study of the associations of measures of the physical and social neighbourhood environment, and psychosocial factors, with physical activity, quality of life and depressive symptoms in 900 Hong Kong older adults aged 65+ years is being conducted in 2012-2016. The study involves two assessments taken 6 months apart. Neighbourhood walkability and access to destinations are objectively measured using Geographic Information Systems and environmental audits. Demographics, socioeconomic status, walking for different purposes, perceived neighbourhood and home environments, psychosocial factors, health status, social networks, depressive symptoms and quality of life are being assessed using validated interviewer-administered self-report measures and medical records. Physical functionality is being assessed using the Short Physical Performance Battery. Physical activity and sedentary behaviours are also being objectively measured in approximately 45% of participants using accelerometers over a week. Physical activity, sedentary behaviours, quality of life and depressive symptoms are being assessed twice (6 months apart) to examine seasonality effects on behaviours and their associations with quality of life and depressive symptoms.

ETHICS AND DISSEMINATION: The study received ethical approval from the University of Hong Kong Human Research Ethics Committee for Non-Clinical Faculties (EA270211) and the Department of Health (Hong Kong SAR). Data are stored in a password-protected secure database for 10 years, accessible only to the named researchers. Findings will be submitted for publication in peer-reviewed journals.