Biomedical subjects

Angela Cheung

Publications and source records attributed to Angela Cheung.

4 recordsLinked to original sources

PubMed2005

Twenty-year secular changes in sex specific lung cancer incidence rates in an urban Chinese population.

The objective of this study was to describe trends in the incidence rates of primary lung cancer in a geographically defined Chinese population. Primary lung cancer cases (N=40,022) diagnosed between 1981 and 2000 were identified by the Tianjin Cancer Registry. Age-specific and age-adjusted incidence rates to the world standard population were examined in both males and females. Age-period-cohort (APC) model and Poisson regression were used to assess the cohort effects and incidence trends. Crude and age-adjusted incidence rates in the study period were: 66.2/100,000 and 45.2/100,000 in males; and 47.7/100,000 and 28.2/100,000 in females, respectively. The major birth cohort effect can be described as for those born before 1940, in every age group lung cancer incidence rate increased as the birth years advanced. For those born after 1940, age specific incidence rates decreased as the birth years advanced. Results from the Poisson regression analyses suggested a statistically significant increasing trend of incidence rates of lung cancer from 1981 to 1990 and changed little afterwards. Through first 10 years of the study period between 1981 and 2000, lung cancer incidence rates increased in both males and females. While the study results suggest that the age-adjusted incidence rates may have reached their peak and may even decline, as the Chinese population ages, and smoking prevalence remains high, the number of new lung cancer cases will continue to increase and overall burden of lung cancer will remain high.

Adult↗

PubMed2004

Cardiovascular Disease.

HEALTH ISSUE: Cardiovascular disease (CVD) is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men. KEY FINDINGS: In 1998, 78,964 Canadians died from CVD, almost half (39,197) were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women.Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women.Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension.Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men. DATA GAPS AND RECOMMENDATIONS: CVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure). Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status.

Journal Article↗

PubMed2004

The effect of English language proficiency on length of stay and in-hospital mortality.

BACKGROUND: In ambulatory care settings, patients with limited English proficiency receive lower quality of care. Limited information is available describing outcomes for inpatients. OBJECTIVE: To investigate the effect of English proficiency on length of stay (LOS) and in-hospital mortality. DESIGN: Retrospective analysis of administrative data at 3 tertiary care teaching hospitals (University Health Network) in Toronto, Canada. PARTICIPANTS: Consecutive inpatient admissions from April 1993 to December 1999 were analyzed for LOS differences first by looking at 23 medical and surgical conditions (59,547 records) and then by a meta-analysis of 220 case mix groups (189,119 records). We performed a similar analysis for in-hospital mortality. MEASUREMENTS: LOS and odds of in-hospital death for limited English-proficient (LEP) patients relative to English-proficient (EP) patients. RESULTS: LEP patients stayed in hospital longer for 7 of 23 conditions (unstable coronary syndromes and chest pain, coronary artery bypass grafting, stroke, craniotomy procedures, diabetes mellitus, major intestinal and rectal procedures, and elective hip replacement), with LOS differences ranging from approximately 0.7 to 4.3 days. A meta-analysis using all admission data demonstrated that LEP patients stayed 6% (approximately 0.5 days) longer overall than EP patients (95% confidence interval, 0.04 to 0.07). LEP patients were not at increased risk of in-hospital death (relative odds, 1.0; 95% confidence interval, 0.9 to 1.1). CONCLUSIONS: Patients with limited English proficiency have longer hospital stays for some medical and surgical conditions. Limited English proficiency does not affect in-hospital mortality. The effect of communication barriers on outcomes of care in the inpatient setting requires further exploration, particularly for selected conditions in which length of stay is significantly prolonged.

Aged↗

PubMed2004

Popular health promotion strategies among Chinese and East Indian immigrant women.

PURPOSE: To advance understanding about the popular health promotion strategies and factors associated with the successful transfer and uptake of health messages among Chinese and Indian immigrant women. METHODS: Eight focus groups were conducted with 46 immigrant women, 24 from Mainland China and 22 from India, who had lived less than 5 years in Canada. Audiotaped data were transcribed, translated and analyzed by identification of themes and subcategories within and between groups. RESULTS: In both ethnic groups, discussions on promoting health messages had five major themes, i.e., sources, barriers, facilitators, credibility and ways to improve access along with group specific sub-themes. Despite identification of several diverse sources of health information in the adopted country, Indian and Chinese immigrant women perceived most strategies as not very effective. The reasons of perceived ineffectiveness were barriers to accessing and comprehending the health messages; and limited prior exposure to institution based or formal health promotion initiatives. These women were more familiar with informal means of obtaining health information such as social networks, mass media and written materials in their mother tongue. CONCLUSION: Existing health communication and health promotion models need to be re-orientated from a one-way information flow to a two-way dialogue model to bridge the gap between program efficacy and effectiveness to reach underserved immigrant women. An "outside the box" approach of non-institutional informal health promotion strategies needs to be tested for the studied groups.

Adult↗