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91.
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BackgroundThe relationships between weight and waist on vascular risk are well described, but the long-term impact of these parameters is less clearly defined, particularly in Chinese populations.MethodsTen thousand four hundred and ten older subjects (50–85 years) were recruited and blood pressure, anthropometric, and fasting vascular risk factors measured. Socioeconomic and demographic data, including self-reported weight and waist gain since 18 years. The association of weight and waist gain with these vascular risk factors was analysed.ResultsWeight, and particularly waist gain were associated with a more adverse vascular risk factor profile, with the most adverse profile associated with gains in both weight and waist. Anthropometric gains were associated with increased risk even in non-obese subjects (p < 0.05). Even after adjustment for a range of demographic and socioeconomic factors, waist gain was associated with additional risk of having the metabolic syndrome and its components and self-reported vascular disease in those centrally obese subjects (p < 0.05 for all).ConclusionIncreased weight and waist increased the level of vascular risk factors and self-reported disease in both non-obese and obese subjects. The high prevalence of vascular risk factors in this population forewarns of a major developing health burden in the rapidly modernising 1.2 billion Chinese population.  相似文献   
93.
To assess the role of hepatic function and alcohol on vitamin D metabolism, serum 25-hydroxyvitamin D (25-OHD) levels were measured in 20 healthy nonalcoholic control subjects, 31 inactive cirrhotics whose alcoholism was in remission, 8 alcoholic cirrhotics, and 15 alcoholics with normal liver function. Cirrhosis, but not alcoholism, was associated with low serum 25-OHD levels. The aminopyrine breath test (ABT) was performed because aminopyrine, like vitamin D3, is metabolized by hepatic microsomes; the ABT correlated highly (r-0.74,P<0.01) with serum 25-OHD in the inactive cirrhotics. After an intravenous injection of 120 g vitamin D3, serum 25-OHD rose significantly within 24 hr in 6 healthy controls and 2 patients with celiac disease but not in 6 inactive cirrhotics. The data suggest impaired 25-hydroxylation of vitamin-D impaired in patients with cirrhosis, related predominantly to the degree of hepatic dysfunction.This work was supported in part by Grant AM 17303 from the National Institutes of Health.  相似文献   
94.
We performed a study to estimate the prevalence of and factors associated with human immunodeficiency virus (HIV) antibody-testing behaviour among youth in Hong Kong. It was a population-based cross-sectional study. Questions on HIV testing were asked as part of a youth sexuality study conducted in July to December 1996 among young adults in Hong Kong. A total of 517 (53.6%) males and 447 (46.4%) females aged 17 to 28 years completed an anonymous structured self-administered questionnaire. Respondents had good knowledge about correct modes of HIV transmission and prevention. 9.4% (95% confidence interval [CI]: 7.0, 12.3) of males and 6.4% (95% CI: 4.3, 9.1) of females had been tested for HIV through blood donation. Excluding blood donation, 3.7% (95% CI: 2.2, 5.7) of males and 3.6% (95% CI: 2.1, 5.9) of females had been tested (voluntary testing). 47.5% (95% CI: 44.4, 50.7) of subjects reported at least one major risk factor for HIV infection. In multivariate analyses, factors independently associated with both voluntary HIV testing and HIV testing by blood donation were age and having had sex with multiple partners. A higher educational level was a predictor of HIV testing by blood donation. Self-assessment of having sufficient sex education was also significantly associated with voluntary HIV testing. HIV testing is not widespread in Hong Kong and those at risk are more likely to have been tested. It is of concern, however, that many of those reporting risk factors have not been tested.  相似文献   
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The COVID-19 pandemic has dramatically disrupted the educational experience of medical trainees. However, a detailed characterization of exactly how trainees' clinical experiences have been affected is lacking. Here, we profile residents' inpatient clinical experiences across the four training hospitals of NYU's Internal Medicine Residency Program during the pandemic's first wave. We mined ICD-10 principal diagnosis codes attributed to residents from February 1, 2020, to May 31, 2020. We translated these codes into discrete medical content areas using a newly developed “crosswalk tool.” Residents' clinical exposure was enriched in infectious diseases (ID) and cardiovascular disease content at baseline. During the pandemic's surge, ID became the dominant content area. Exposure to other content was dramatically reduced, with clinical diversity repopulating only toward the end of the study period. Such characterization can be leveraged to provide effective practice habits feedback, guide didactic and self-directed learning, and potentially predict competency-based outcomes for trainees in the COVID era.  相似文献   
97.
    

Aims

Diabetes development mechanisms vary by weight status. We aimed to compare cardiometabolic risk and characterize fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) trajectories before diagnosing type 2 diabetes in individuals with/without obesity.

Methods

Data from the China Health and Retirement Longitudinal Study (CHARLS) and English Longitudinal Study of Ageing (ELSA) were analysed. Participants without diabetes and with a body mass index of 18.5-40 kg/m2 at baseline were included. Incident diabetes was ascertained by self-reported physician diagnosis and/or antidiabetic drug use, FPG ≥126 mg/dl and/or HbA1c ≥6.5%. The difference in the FPG/HbA1c trajectory before the diabetes diagnosis in participants with/without obesity was examined using mixed-effects models.

Results

Among 11 925 eligible participants, 1361 incident diabetes cases (mean age: 61.4 years; male: 46.2%) were identified within 15 years of follow-up. Obese diabetes showed higher levels of diastolic blood pressure and C-reactive protein at diagnosis than non-obese diabetes. Mixed-effects models indicated the difference in the FPG trajectory before diagnosis by weight status was non-significant with a slope difference of 0.149 mg/dl (SE = 0.642, p = .816, CHARLS) and 0.013 mg/dl (SE = 0.013, p = .337, ELSA). However, obese diabetes showed a steep increase in HbA1c before diagnosis with a slope difference of 0.036% (SE = 0.016, p = .021) in the CHARLS and 0.032% (SE = 0.014, p = .027) in the ELSA, respectively. Sex-stratified analyses showed that the difference in HbA1c trajectory before the diabetes diagnosis by weight status was only significant in males.

Conclusions

Obese and non-obese diabetes developments may share a similar FPG but distinct HbA1c trajectory. Obese diabetes interventions require more attention to cardiometabolic risks. Moreover, studies addressing weight/sex-related differences in diabetes aetiologies and treatments are warranted.  相似文献   
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99.
    
Internationalization at Home (IaH) strategies play an important role in nursing curricula to enhance nursing students' cultural awareness in the globalized world. The Community of Inquiry (CoI) is a theoretical framework for the optimal design of online learning environments to support critical inquiry and discourse among students and teachers. To optimise nursing students' online cultural awareness learning experiences, it was timely to develop online IaH strategies based on a sound theoretical model. This study aimed to examine the effectiveness of CoI-guided online IaH strategies on enhancing the cultural awareness of nursing undergraduates who enrolled in a community nursing course.  相似文献   
100.
Cancer is a major health problem world-wide. Therefore, it is not surprising that cancer is identified as the top priority disease group for an improvement programme by the Hospital Authority in Hong Kong. Laser therapy for patients with nasopharyngeal carcinoma, for example, is evidence of the advancement of the scientific and technological developments for cancer treatment. Furthermore, the establishment of the Cancer Centre has provided ample opportunities for clinical practices and research studies. In response to the proclamation of the 'urgent need for the establishment of a cancer society in every country' by Searle in 1990, the Oncology Care Society of Hong Kong, which aims to promote both cancer education and cancer research, was established in 1993. Adopted from the core curriculum of the European Oncology Nursing Society, the specialist course of cancer nursing care was first implemented in Hong Kong in 1993 and the nurse specialist is now a permanent part of nursing career structure in Hong Kong. This paper attempts to review the development of oncology nursing in Hong Kong according to these factors and to find ways to improve the current situation.  相似文献   
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