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Biomedical subjects

S P Donnan

Publications and source records attributed to S P Donnan.

At least 19 recordsLinked to original sources
PubMed1997

Competencies for Part II of the examination for membership of the Faculty of Public Health Medicine.

BACKGROUND: The assessment of competence is of growing importance in modern educational theory. This paper reports the results of a study to investigate the views of Part II examiners and public health trainees about whether an agreed list of competencies for the practice of public health medicine could be determined. METHODS: A postal questionnaire was sent to Part II examiners and representatives of the Trainee Members Committee of the Faculty of Public Health Medicine. RESULT: A total of 90 questionnaires were sent. Seventy per cent of Part II examiners and 70 per cent of the Trainee Members Committee returned questionnaires. There was a high degree of consensus amongst respondents that most of the skills listed in the Faculty Handbook as being necessary for the completion of training should form core competencies for the Part II examination. Sections of the syllabus dealing with epidemiology and disease prevention were also seen as core competencies. There was less support for the assessment of attitudes or other sections of the Handbook syllabus. The written reports and oral examination were seen as being complementary, with respondents listing different competencies as being appropriately assessed by the two methods. There was little support for the introduction of a standardized skills examination. CONCLUSIONS: This is the first study to assess the face validity of possible components for the Part II examination using the views of both trainees and Part II examiners. This could form the first step to the introduction of an agreed set of competency areas into the examination.

Attitude of Health Personnel↗
PubMed1995

Prevalence and determinants of the use of traditional Chinese medicine in Hong Kong.

We studied 2,822 subjects above 18 years of age in Hong Kong by random telephone interview to assess the role of traditional Chinese medicine in health care. During their most recent illness, 73% consulted Western doctors, 17% self-medicated while 9% consulted herbalists. Age and education were important determinants of their health care choice. The most common reason given for their choice was faith in the practitioners they consulted. When they needed further consultation for the same illness, 42% consulted herbalists, illustrating that herbalists played an important supplementary role when Western medicine failed to provide relief. Compared with previous findings, there appeared to be little decline in the popularity of traditional Chinese medicine in Hong Kong.

Adult↗
PubMed1994

Risk factors for acute myocardial infarction in a southern Chinese population.

Although the mortality rate from coronary artery disease in Hong Kong is only one-fourth of that of northern Europe and the United States, the disease has been and remains the second major cause of death (after all cancers combined). Beginning in 1987, we have conducted a case-control study of acute myocardial infarction in four Hong Kong hospitals. This study, one of the biggest case-control studies conducted in the Chinese population of both men and women, confirms the importance of several risk factors--cigarette smoking, history of hypertension, history of diabetes, body fatness, and lack of physical activity--previously described in data collected in western populations. In addition, more adverse childhood experience was also found to be an important risk factor of acute myocardial infarction. Further research in appropriate intervention measures in education in the prevention and cessation of smoking, the control of blood pressure, diabetes, and overweight, and adequate exercise could significantly help reduce the risk of acute myocardial infarction in the Hong Kong Chinese population.

Aged↗
PubMed1993

The prevalence of diabetes mellitus and impaired glucose tolerance among Hong Kong Chinese adults of working age.

We studied 1513 employees (910 men and 603 women) from a public utility company and a regional hospital to document the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) in the Chinese working population of Hong Kong using a 75-g oral glucose tolerance test and World Health Organisation (1985) criteria. The overall prevalence of DM was 4.5 (95% confidence interval: 3.5-5.7%) and that of IGT 7.3 (6.0-8.6%). The prevalence of DM was 5.1 (3.7-6.5%) in men and 3.6 (2.1-5.1%) in women, while that of IGT was 7.4 (5.7-6.5%) in men and 7.1 (5.1-9.1%) in women. The truncated age-adjusted rate of DM for age 30-64 is 7.7% which is comparable to the age-adjusted prevalence rates among Chinese living in Singapore and Mauritius but in marked contrast to the low prevalence rate in Chinese living in Mainland China. Among the diabetic subjects, 38.2% had been previously diagnosed and 32% gave a family history affecting at least one first degree relative. Using polychotomous logistic regression analysis, the independent predictive factors for the development of DM include age (t = 7.31, P < 0.001), family history (t = 5.1, P < 0.001), waist hip ratio (t = 4.05, P < 0.001) and body mass index (t = 4.62, P < 0.001). Our data further confirm that Hong Kong Chinese have a moderate to high susceptibility to non-insulin-dependent diabetes (NIDDM) when exposed to sufficient environmental and lifestyle factors. The high prevalence of IGT indicates a potential for the prevalence of DM to continue to rise unless effective preventive measures are implemented.

Adolescent↗
PubMed1993

Serum lipid profile and its association with some cardiovascular risk factors in an urban Chinese population.

The lipid profile of a Chinese population, which has a lower prevalence of coronary heart disease compared with Caucasians, is studied to determine whether lipid-modifying disease prevention programs are necessary. The study population consisted of 910 men (mean age 36.7 +/- 9.2 yrs) and 603 women (mean age 38.6 +/- 9.1 yrs), who were employees of a public utility company and non-medical staff of a district hospital. Indices of obesity, fasting cholesterol (TC), and its various subfraction, triglycerides (TG), apolipoprotein A-I (Apo A-I), and apolipoprotein B (Apo B) concentrations were measured. Glucose tolerance was also estimated by measuring fasting and 2 h glucose after a 75 g oral glucose load. The lipid profile was similar to that of the North American population, with an overall prevalence of low density lipoprotein cholesterol (LDL-C) > or = 4.1 mmol/L of 21% and 11% in men and women respectively. Similar variations with age, sex, smoking and glucose tolerance compared with Caucasian populations were observed. The high prevalence of subjects with "undesirable" lipid values in this Chinese population, which at present has a coronary artery disease prevalence of one-eighth to one-quarter compared with that in Caucasians, suggests that the incidence of the disease may well rise in the future to pose a similar problem to that in Caucasian populations. Cut off values of lipids conferring increased cardiovascular risks need to be determined in this population, so that public health strategies may be formulated.

Adult↗
PubMed1992

Influence of socioeconomic status on cardiovascular diseases in Hong Kong.

STUDY OBJECTIVE: The aim was to explore the relationships between five socioeconomic variables and three main cardiovascular diseases (ischaemic heart disease, hypertensive disease, and cerebrovascular disease) in Hong Kong. DESIGN: This cross sectional study used data from the 1986 by-census and registered death data for 1985 to 1987 in Hong Kong. For each of 24 districts, the correlation coefficients between log standardised mortality ratios for the three cardiovascular diseases and the percentages of professional and administrative workers, production and agricultural workers, persons aged 15 and over having tertiary education, households with higher income, and people living in private residential blocks were calculated. Besides simple linear regression and correlation, factor analysis was used to produce a new single surrogate measure summarising the five most useful variables in 24 sets of districts. SETTING: The whole Hong Kong area (population approximately 5.5 million) was divided into 24 districts, which were the study units. MEASUREMENTS AND MAIN RESULTS: For ischaemic heart disease in men, the correlation coefficients of the log standardised mortality ratios with the five socioeconomic variables as well as with the factor score were all statistically significant. For women, statistical significance was obtained in only two of five socioeconomic variables. No such trends were obtained for the other two cardiovascular diseases for either men or women. CONCLUSIONS: The study suggests that in Hong Kong in recent years, a higher level of socioeconomic status is associated with higher risk of death from ischaemic heart disease; but this association is not present for hypertensive disease and cerebrovascular disease.

Adolescent↗
PubMed1990

Intake and blood levels of some minerals in an elderly Chinese population.

Twenty-four hour intakes of potassium, calcium, and iron, and plasma concentration of potassium, copper and zinc were determined in a cluster sample of 400 apparently healthy subjects aged 60 years and over living in the community. Potassium and calcium intakes were lower in older men and lower in men compared to women. Both were much lower than intakes reported among Caucasian elderly, while iron intakes are comparable. Plasma potassium concentration was lower than values from studies of all ages and from studies of Caucasian elderly subjects. Copper and zinc concentrations were comparable to published values for adults of all ages. The significance of low potassium and calcium intake among elderly subjects in the population is discussed.

Journal Article↗
PubMed1990

Falls and hip fracture in Hong Kong Chinese.

The risk factors for hip fracture were studied in four hundred patients and eight hundred community and hospital controls. Falling was found to be important as a direct cause of fracture. A history of falls was a significant risk factor for hip fracture in men and women younger than 70, but was less important in older men and women. Medical conditions and treatments did not occur more frequently in hip fracture patients with a history of falls than in patients without, and the patients with a history of falls was not less ambulant than patients without. Regular weight-bearing exercise programmes are recommended as a practical preventive measure for falls and hip fractures.

Accidental Falls↗
PubMed1989

Epidemiology of coronary arterial disease in the Chinese.

The occurrence of coronary arterial disease and, in particular, acute myocardial infarction in three Chinese communities, namely Hong Kong, Taiwan and China, was reviewed by using a multifaceted approach. Both the prevalence and death incidence of coronary arterial disease or acute myocardial infarction were much lower than those in most western countries: in these three places, the prevalence of coronary arterial disease, the incidence of mortality from coronary arterial disease, the incidence of acute myocardial infarction and the mortality from acute myocardial infarction were roughly one-eighth to one-quarter of the average western figures. While the prevalence and mortality figures have been declining in most affluent western countries, they have been increasing in these three large Chinese communities with 1200 million people. The implication of this increasing trend should certainly deserve more consideration in future planning in these regions. While aging is a contributing factor to such a trend, more work is required to delineate and assess the relative significance of the changes in the socioeconomic and coronary risk factors in the process of modernisation.

Adolescent↗
PubMed1989

Risk factors in non-insulin dependent diabetes mellitus in elderly Chinese in Hong Kong.

The early life environment, 24 h nutrient intake, body mass index, blood pressure and plasma zinc levels among 42 non-insulin dependent diabetic subjects living in sheltered housing were compared to 126 age and sex matched controls from the same community. A high body mass index and systolic blood pressure were the only risk factors. The association with systolic blood pressure was present only among non-obese subjects. No difference in nutrient intake was found. When nutrient intake from all 427 subjects living in sheltered housing was compared to other countries with a higher prevalence of NIDDM, the diet of Chinese subjects consisted of a lower percentage of fat calories and a higher percentage of protein and carbohydrate calories.

Aged↗
PubMed1989

Opportunistic research in general practice using a low cost microcomputer based medical record system as a tool.

A low cost microcomputer-based medical record system was used to facilitate opportunistic research projects in the teaching clinic of the Chinese University of Hong Kong. An example of an actual clinical trial comparing the effectiveness of three methods of teaching breast self-examination to clinic patients was used and the process of setting up the research protocol, the sampling of patients, and the analysis of early results after one and a half years were described. It was found that the sampling bias in opportunistic research was that subjects selected were more likely to be older with more problems, and have a higher attendance rate at the clinic. The bias could be corrected during the analysis of data by stratifying the selected sample into groups of different attendance rates. Another potential sampling bias was due to non-compliance of both the patients and the clinical staff. However, it was found to be possible to obtain useful results from opportunistic research. It was easy to implement this type of research with the help of a computerized medical record system.

Adult↗
PubMed1989

Reproductive and sexual risk factors and human papilloma virus infection in cervical cancer among Hong Kong Chinese.

In this case-control study of cervical neoplasia in Hong Kong, 48 dysplasia and 68 cancer patients were matched with 116 surgical in-patient controls. The cases had an earlier age at first intercourse and more sex partners than the controls. The cases' husbands also had more sex partners and were less likely to use condoms regularly. In a multiple regression model the odds ratio were 6.0 (95% Confidence Interval 2.5-14.6) for the husband having more than one sex partner, 4.0 (1.5-10.7) for the woman having more than one sex partner, and 1.15 (1.05-1.28) per year younger for the woman's age at first intercourse. The odds ratio of 5.4 for women whose partners did not habitually use condoms was not significantly different from 1.0. In a sub-sample, 37% of cancer patients and 18% of dysplasia patients, but only 6% of gynaecological controls, showed a positive DNA hybridization to Human Papilloma Virus (Type 16). These findings suggest that cervical cancer and dysplasia are sexually transmitted in our population, with a possible viral aetiology.

Adult↗
PubMed1989

Plasma 25-hydroxyvitamin D concentration in patients with hip fracture in Hong Kong.

The serum concentration of 25-hydroxyvitamin D level and plasma albumin-adjusted calcium, phosphate, and alkaline phosphatase levels were studied in 200 patients with hip fracture (age range 49-93 years) and 427 elderly subjects living in the community (age range 60-90 years). The mean serum 25-hydroxyvitamin D levels in controls were higher than in temperate countries, but the 25-hydroxyvitamin D concentration was significantly lower in the patients than the controls for all sex and age groups. There was little difference in albumin-adjusted calcium and alkaline phosphatase levels, but the phosphate level was higher in the patients than in the controls. None of the patients with a low 25-hydroxyvitamin D level had a blood picture suggestive of osteopathy resulting from vitamin D deficiency or frank osteomalacia. Hip fracture patients with a low 25-hydroxyvitamin D level were much less ambulant and went outdoors much less frequently than hip fracture patients with a normal vitamin D level. A low vitamin D level was a risk factor for hip fracture in Hong Kong Chinese, and may be prevented by frequent outdoor exposure.

Aged↗
PubMed1988

Nutritional status of healthy, active, Chinese elderly.

1. Anthropometric indices are presented for 402 healthy Chinese elderly subjects leading an active life in the community in Hong Kong. 2. Women had higher body-mass index (weight/height) and body fat, while fat-free mass, arm-muscle circumference and corrected arm-muscle area were higher in men. Body-mass index, fat-free mass, arm-muscle circumference and corrected arm-muscle area did not decline with age. Total body fat was lower in women aged 75 years and above compared with those aged 60-64 years. 3. All values were lower than those for elderly Caucasians. A different criteria for severe wasting malnutrition among elderly Chinese should be established.

Aged↗
PubMed1988

Psychosomatic symptoms, social support and self worth among the elderly in Hong Kong.

A prospective study to test the relationship between social support and health outcomes among the 1000 elderly Chinese subjects aged 70+ is being carried out in a Hong Kong New Town. This paper reports on the study factors related to psychosomatic complaints based on the first phase cross sectional data. Logistic regression analysis shows that being female, living in institutions, having a low level of social support and a low level of self worth independently increased the risk of developing a high level of psychosomatic symptoms. The relative risks for these factors range from 1.4 to 1.9 and all were significantly different from unity.

Aged↗
PubMed1988

Body composition and plasma creatine kinase activity.

Plasma creatine kinase (CK) activity and lean body mass (LBM) (by anthropometry) were measured in 120 women (20-82 years) and 70 men (20-82 years). Plasma CK activity and LBM was higher in men than in women. In men plasma CK activity was significantly correlated (product moment correlation coefficient) with LBM and negatively with age. In women plasma CK activity was significantly correlated with age. Partial correlation coefficient calculation showed a significant correlation between plasma CK and LBM both in men and in women. We conclude that in healthy subjects the plasma CK activity is related to LBM, but the LBM is not a major determinant of plasma activity in healthy subjects.

Adult↗