Particulate air pollution and hospitalization for asthma.

Age-specific quarterly asthmatic hospital discharge rates in Hong Kong during 1983 to 1989 were examined in relation to mean levels of six pollutants: sulfur dioxide (SO2), ozone (O3), total suspended particles (TSP), respiratory suspended particles (RSP), nitrogen dioxide (NO2), and nitrogen oxides (NOX). Discharges from the hospital of children under 14 years of age represented 56% of 33,952 discharges recorded in all age groups. Trends of adult hospitalization rates over time remained stable during the study period. In children, however, there was an increase in these rates, particularly marked in the age group of 1 to 4 years. Univariate analysis revealed a strong correlation between quarterly mean TSP and hospital discharge rate for the 1 to 4-year-old children (r = .62, P less than .001). In the 5 to 14-year-old age group, there was an inverse relationship between hospital discharge rate and sulfur dioxide level (r = -.38, P less than .05). Stepwise multiple regression analysis, controlling for confounding variables (seasonal and annual trends of asthma hospitalizations) confirmed these relationships. A highly significant linear regression equation was derived between hospitalization rate for ages 1 to 4 years and total suspended particles (P less than .001). The highly significant correlation between pollution and asthmatic hospitalization rate for the 1 to 4-year-old group suggests that young children are vulnerable to the adverse environmental effects of pollution. Auditing these relationships offers a logical basis for approaching control.

Spotted fever in Hong Kong.

A previously healthy 7-year-old Hong Kong-born Caucasian child developed sudden onset fever, followed by a generalized rash and systemic symptoms of rigor and prostration, mucous membrane involvement (conjunctivitis) and arthralgia. He lives in a rural area of Hong Kong and has been in contact with various domestic animals--rodents, dogs and cows. Chloramphenicol 50 mg/kg/day was given on day 4 with rapid response. Subsequent Weil-Felix test and specific serology suggested the diagnosis of rickettsial infection of the spotted fever group. To our knowledge, this is the first confirmed case of spotted fever reported in Hong Kong.

Low level atmospheric sulfur dioxide pollution and childhood asthma.

Quarterly analysis (1983-1987) of childhood asthma in Hong Kong from 13,620 hospitalization episodes in relation to levels of pollutants (SO2, NO2, NO, O3, TSP, and RSP) revealed a seasonal pattern of attack rates that correlates inversely with exposure to sulfur dioxide (r = -.52, P less than .05). The same cannot be found with other pollutants. Many factors may contribute to the seasonal variation of asthma attacks. We speculate that prolonged exposure (in terms of months) to low level SO2 is one factor that might induce airway inflammation and bronchial hyperreactivity and predispose to episodes of asthma.

Seasonal asthma in Hong Kong and its management implications.

Quarterly analysis of 48,003 hospitalization episodes of asthma in Hong Kong from 1976 to 1985 reveals a consistent bimodal seasonal variation of hospitalization rates most noticeable in younger age groups. Statistical analysis shows that with a drop of relative humidity and an increase in wind speed, more episodes of asthma hospitalization are expected. During seasons of increased susceptibility, aggressive prophylaxis and vigilant monitoring should reduce hospitalization for those with seasonal predisposition.

Nutrition-related backgrounds and counseling practices of doctors of chiropractic.

A questionnaire was designed and mailed to the entire membership (no. = 438) of the San Francisco Bay Area Chiropractic Society to determine their nutrition education backgrounds and counseling practices and the relationship of backgrounds and counseling practices and the relationship of backgrounds and information resources to counseling practices. Results, based on the 23% response rate, indicated that the hours of formal nutrition education in chiropractic college varied widely in the five categories of responses from zero to more than 120, with the median respondent falling in the median category (81 to 100 hours). Sixty percent of the respondents indicated that they provided nutrition information to their patients on a routine basis, and 38% provided information on request only. The major forms of nutrition information dissemination were counseling (87%) and written materials (74%). The majority of respondents reported that they diagnose osteoporosis, arthritis, and allergies and use nutrition treatments for those disorders as a part of overall therapy. Chiropractic journals and texts were the most frequently used sources of nutrition information. Awareness of the educational backgrounds of registered dietitians correlated positively with the use of dietitians as a resource for nutrition information (p less than .005). The survey results suggest a need for dietitians to become involved in the nutrition-related practices of chiropractors as sources for information and referral.

Post-streptococcal glomerulonephritis in Hong Kong.

Of 74 paediatric inpatients with acute glomerulonephritis, 58 (78%) had a raised (greater than 1/200) antistreptolysin O titre. Serum C3 concentration was low in 73, but returned to normal within six weeks. Streptococcal infection remains the commonest cause of acute nephritis in children in Hong Kong, possibly due to overcrowded living conditions.

Setting up a clinical audit of paediatric morbidity in Hong Kong: some early experiences.

A method of clinical audit was devised to document paediatric morbidity patterns at the Prince of Wales Hospital, a new 1428 bed general hospital serving the eastern part of the Hong Kong New Territories (with a current population of about 750,000). The applicability of the method is illustrated by considering morbidity in 1654 children aged from 1 month to 12 years admitted to the hospital over a 13 month period in 1984-85.

Cultural foods education: an exploratory study of dietitians and Plan IV programs in California.

California dietitians require skills in working with the large ethnic populations in that state. Cultural foods education needs must be identified and evaluated so that they can be appropriately addressed in the nutrition and dietetics curriculums. Dietitians employed in California hospitals were surveyed to assess their cultural foods knowledge and determine cultural foods education needs. Demographic and opinion data were requested, and knowledge of the food habits of the six largest ethnic groups in the state was tested. California colleges and universities offering ADA Plan IV programs were sent questionnaires regarding the goals, content, and methodology of and the enrollment in cultural foods courses. Results of the dietitian survey (no. = 184; response rate 51%) showed a positive association (p less than .05) between the total score on the cultural foods knowledge test (average score = 62% correct) and completion of a college cultural foods course. Results of the Plan IV program survey (no. = 16; response rate 93%) indicate that 86% of the colleges and universities offer at least one cultural foods course. In 53% of those colleges and universities, Plan IV students are required to take such a course. Course content corresponds well to needs identified in the answers to the dietitian questionnaire. More emphasis on "ethnic food habits" and "disease and food habits" is recommended in the nutrition and dietetics curriculums.

Comparison of two methods of educating dietitians.

This study investigated whether graduates having a master's degree with 6 months of qualifying experience are as knowledgeable and perceived as being as competent as graduates having traditional bachelor's degrees with a 12-month internship. Twenty-nine graduates (17 with bachelor's degrees and 12 with master's degrees) from San Jose State University, San Jose, CA, participated in the study. Our results showed: (a) The mean registration examination scores of the two groups were not significantly different; the scores of those with master's degrees, however, were more clustered around the mean. (b) No significant difference in graduates' self-ratings was found between the two groups. (c) The supervisors' ratings of clinical competencies were higher for graduates with bachelor's degrees than for those with master's degrees. There was no significant difference in the supervisors' ratings of administrative competencies for the two groups. Other results showed various significant correlations between demographic data, registration examination scores, self-ratings, and supervisors' ratings. This study gave evidence that the university-sponsored master's qualifying experience is a viable route to membership in The American Dietetic Association.

Some dietary and food selection changes or jejunoileal bypass patients.

Twenty-seven persons who had undergone jejunoileal bypass surgery eight months or more previously returned a questionnaire which sought information about: (a) Demographic characteristics and weight loss; (b) pre- and postoperative eating behavior and food selection; (c) dietary instruction; (d) postoperative complications; and (e) postoperative attitudes. Twenty other patients were seen in a surgery clinic and interviewed informally to aid in the evaluation of data. Neither demographic characteristics nor weight loss correlated with other variables, including food selection, behavior, attitudes, or complications. Postoperative complications did relate to the consumption of green vegetables and "snacking." Postoperative changes noted were diminished appetite and less use of alcoholic beverages. Changes in post-operative eating behavior were positively correlated with changes in patients' attitudes of self-confidence and self-esteem. Neither a dietitian nor a nutritionist had been available on a structured consultation basis. During the interviews, subjects did express a desire for dietary discussions with trained professionals. In spite of distress and complications, most subjects were satisfied with the operation and perceived an improvement in their lives.