The Opportunities and Challenges of the First Three Years of Open Up, an Online Text-Based Counselling Service for Youth and Young Adults.

We present the opportunities and challenges of Open Up, a free, 24/7 online text-based counselling service to support youth in Hong Kong. The number of youths served more than doubled within the first three years since its inception in 2018 in response to increasing youth suicidality and mental health needs. Good practice models are being developed in order to sustain and further scale up the service. We discuss the structure of the operation, usage pattern and its effectiveness, the use of AI to improve users experience, and the role of volunteer in the operation. We also present the challenges in further enhancing the operation, calling for more research, especially on the identification of the optimal number of users that can be concurrently served by a counsellor, the effective approach to respond to a small percentage of repeated users who has taken up a disproportional volume of service, and the way to optimize the use of big data analytics and AI technology to enhance the service. These advancements will benefit not only Open Up but also similar services across the globe.

Predicting influenza vaccination intent among at-risk chinese older adults in Hong Kong.

BACKGROUND: Older adults with major chronic illnesses are very susceptible to influenza and its serious complications, but many do not obtain vaccinations. Little is known about factors associated with intention to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. OBJECTIVES: The aim of this study was to identify factors associated with intent to obtain influenza vaccination among at-risk Chinese older adults in Hong Kong. METHODS: This multicenter descriptive correlational study recruited a convenience sample of 306 Chinese older adults with medical risk factors for influenza and its serious complications from the general outpatient clinics in Hong Kong. Interviews were conducted to assess intent to obtain influenza vaccination for the coming year, health beliefs about influenza, and discomfort following past vaccinations. RESULTS: The current influenza vaccination rate was 58.5%; only 36.3% intended to get vaccinated the following year. After controlling for clinical and demographic factors in a logistic regression model, perceived susceptibility predicted intention to obtain future vaccination (OR = 1.42, 95% CI [1.14, 1.78]), whereas postvaccination discomfort was negatively associated with intention (OR = 0.063, 95% CI [0.006, 0.63]). CONCLUSIONS: Intention to obtain influenza vaccination was low among at-risk Chinese older adults. Strengthening health beliefs and creating strategies to provide positive influenza vaccination experiences are possible approaches to interventions to improve uptake of influenza vaccination rates.

Characterization of secondary aerosol and its extinction effects on visibility over the Pearl River Delta Region, China.

Aerosol samples collected from July 2007 to March 2008 were used to obtain major aerosol constituents in an urban location in the Pearl River Delta Region (PRD), China. The minimum organic carbon (OC)/elemental carbon (EC) ratio was used to calculate the primary and secondary organic carbon and the extinction effect of the secondary aerosol on visibility was estimated. As indicated in the analysis, the mass of secondary aerosol takes up 50% of the total mass of PM2.5; the OC/EC ratio is larger than 2 and there are significant characteristics of secondary aerosol generation; the levels of secondary OC are comparable with those of sulfate; and there is obvious enrichment of secondary aerosol on more polluted days. In a dry environment, the extinction weight is 59% for the secondary aerosol, while it is as high as 82% if the environment is highly humid (relative humidity [RH] = 95%). The hygroscopic growth of the aerosol can reduce visibility greatly; the secondary aerosol shares much larger quotas on more polluted days. For the Pearl River Delta (PRD), secondary aerosol and carbonaceous aerosol, especially secondary organic carbon (SOC), are a very acute problem; the study of the generating mechanism and sources for secondary aerosol is the key to the effort of controlling visibility in this region. The equation set forth in IMPROVE experiments can only be referenced but is not applicable to evaluate the extinction effect of individual aerosol components on visibility in the PRD region.

Esophageal cancers with synchronous or antecedent head and neck cancers: a more formidable challenge?

BACKGROUND: The presence of synchronous or antecedent head and neck cancers may complicate management of patients with primary esophageal cancer. METHODS: From January 1982 to December 2004, by means of a prospectively collected database, we compared information from 119 patients with esophageal cancers who had synchronous or antecedent head and neck cancers with information from 1555 patients who only had squamous cell esophageal cancer in a tertiary referral academic hospital. RESULTS: There were far more men and younger patients in those who had head and neck cancers, and multicentric tumors were also more common. Hypopharyngeal tumors were the most frequently encountered head and neck cancer and were found in 36.1% of patients. Resection rates of the primary esophageal cancers were similar in those who had head and neck cancers and in those who only had esophageal cancer (60.7% vs. 61.7% P = .74). Overall postoperative complication rates were not different. Thirty-day mortality rates were 0% and 2.9% for those who did and did not have head and neck tumors, respectively (P = .25). The respective hospital mortality rates were 10.3% and 9.5% (P = .83). Median survival for resectable esophageal cancers was 9.2 months for the former group and 13.4 months for the latter (P = .02). CONCLUSIONS: Esophagectomy rates did not differ when synchronous or antecedent head and neck cancers were present. Similar postoperative morbidity and mortality rates could be achieved. The presence of additional head and neck tumors imparted a worse long-term prognosis.