RESUMO
OBJECTIVES: To investigate the effectiveness of eight 45-minute sessions of computer-assisted cognitive training programme (CCTP) on improving the cognitive and functional performance of patients with Severe Mental Illness (SMI). METHODS: Medical records of 16 women and 13 men aged 26 to 62 (mean, 46.34) years who participated a CCTP were reviewed. The CCTP lasted a total of 6 hours in eight sessions over 8 weeks and comprised a series of mobile applications customised to patients' specific impaired cognitive domains. Pre- and post-test performance of cognition and functioning were assessed using the Montreal Cognitive Assessment Hong Kong version (HK-MoCA) and the Brief Assessment of Prospective Memory (BAPM), respectively. RESULTS: After the CCTP, the mean HK-MoCA score increased significantly (23.62 ± 5.34 vs 25.48 ± 3.75, d = 0.403, p = 0.001), with a significant increase in delayed recall (3.14 ± 1.75 vs 3.93 ± 1.44, d = 0.493, p = 0.003), and the mean BAPM score decreased significantly (1.44 ± 0.47 vs 1.26 ± 0.23, d = 0.486, p = 0.012). The improvement was greater in participants with primary-level education than in participants with secondary- or tertiary-level education in terms of the HK-MoCA score (3.83 ± 3.06 vs 1.35 ± 2.12, d = 0.942, p = 0.046) and the BAPM scores (-0.49 ± 0.43 vs -0.10 ± 0.29, d = 1.063, p = 0.035). CONCLUSION: Our shortened CCTP effectively enhanced the cognitive performance and daily functioning of patients with SMI. Verbal episodic memory showed the most improvement. The improvement was greater in those with primary-level education than in those with secondary- or tertiary-level education.
Assuntos
Cognição , Disfunção Cognitiva/complicações , Disfunção Cognitiva/terapia , Transtornos Mentais/complicações , Aplicativos Móveis , Adulto , Disfunção Cognitiva/psicologia , Feminino , Humanos , Intervenção Baseada em Internet , Masculino , Memória Episódica , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Comportamento VerbalRESUMO
OBJECTIVES. To assess primary care patients for their awareness, knowledge, and attitude towards colorectal cancer and screening, to report on the uptake of faecal occult blood test screening and the results of screening, and explore predictors of screening uptake. DESIGN. Cross-sectional study. SETTING. Four primary care clinics in Hong Kong. PATIENTS. A total of 1664 patients aged 50 to 74 years attending the clinics in the period July 2006 to July 2007. MAIN OUTCOME MEASURES. Percentage of subjects who were aware that colorectal cancer is common and curable at an early stage, and who knew that faecal occult blood test or colonoscopy is useful for screening; relevant knowledge score; uptake rate of faecal occult blood testing; rate of testing positive; and factors predicting uptake. RESULTS. A total of 1645 questionnaires were collected. In all, 89% (95% confidence interval, 88-91%) were aware that colorectal cancer is common, 95% (94-96%) believed faecal occult blood test and colonoscopy are useful for screening, and 58% (56-61%) achieved a knowledge score of 50% or above. The uptake rate of the faecal occult blood test was 35%. Uptake was higher among those with a positive family history (odds ratio=1.57; 95% confidence interval, 1.08-2.27; P=0.02), those who were more aware that colorectal cancer is common (1.86; 1.29-2.69; P=0.001), and that colorectal cancer is potentially curable at an early stage (1.76; 1.32-2.36; P=0.0001). Rate of testing positive was 2.1% (95% confidence interval, 0.9-3.3%); no colorectal cancer was detected and the neoplasia detection rate (for cancers and adenomas) was 5.1 per 1000 subjects screened. CONCLUSIONS. Patients were aware that colorectal cancer is common in our community, and faecal occult blood test or colonoscopy is useful for screening. The uptake of screening was low, though relatively higher for those with a positive family history and greater awareness of the high frequency and potential for cure of colorectal cancer. Faecal occult blood test positivity rate was 2.1%, and neoplasia detection rate 5.1 per 1000 screened.
Assuntos
Adenoma/diagnóstico , Pólipos do Colo/diagnóstico , Neoplasias Colorretais/diagnóstico , Conhecimentos, Atitudes e Prática em Saúde , Sangue Oculto , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Atenção Primária à Saúde , Idoso , Colonoscopia , Neoplasias Colorretais/genética , Estudos Transversais , Feminino , Hong Kong , Humanos , Modelos Logísticos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Distribuição Aleatória , Inquéritos e QuestionáriosRESUMO
Pharmacokinetics of melamine has not been studied in pregnancies despite of the many reports on the effect on renal damage in adult and neonates. In this study, Sprague-Dawley rats have been used as a model to study the single-dose effect of melamine administration in late pregnancy and in neonates within 24h. Melamine concentrations in maternal serum, breast milk, whole foetus, amniotic fluid, neonatal serum and neonatal kidney was measured by liquid chromatography coupled with mass spectrometry. Melamine was detected in all the samples, including foetal rats and amniotic fluid in utero. Melamine was able to pass through placenta and reach the foetus, and to accumulate in lactating mammary gland and neonatal kidney. Moreover, melamine was eliminated through the placenta of the foetus and the kidneys of the neonates, and later excreted into the amniotic fluid. The study characterised for the first time the distribution of melamine in foetuses and neonates, providing reference for toxicological study of melamine during pregnancy.
Assuntos
Feto/metabolismo , Triazinas/farmacocinética , Animais , Animais Recém-Nascidos , Feminino , Leite/metabolismo , Placenta/metabolismo , Gravidez , Ratos , Ratos Sprague-Dawley , Distribuição TecidualRESUMO
A total of 1951 species of freshwater and marine fishes belonging to 704 genera and 186 families are recorded in Malaysia. Almost half (48%) are currently threatened to some degree, while nearly one third (27%) mostly from the marine and coral habitats require urgent scientific studies to evaluate their status. Freshwater habitats encompass the highest percentage of threatened fish species (87%) followed by estuarine habitats (66%). Of the 32 species of highly threatened (HT) species, 16 are freshwater and 16 are largely marine-euryhaline species. Fish extinctions in Malaysia are confined to two freshwater species, but both freshwater and marine species are being increasingly threatened by largely habitat loss or modification (76%), overfishing (27%) and by-catch (23%). The most important threat to freshwater fishes is habitat modification and overfishing, while 35 species are threatened due to their endemism. Brackish-water, euryhaline and marine fishes are threatened mainly by overfishing, by-catch and habitat modification. Sedimentation (pollution) additionally threatens coral-reef fishes. The study provides recommendations to governments, fish managers, scientists and stakeholders to address the increasing and unabated extinction risks faced by the Malaysian fish fauna.
Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Extinção Biológica , Peixes , Animais , Ecossistema , Espécies em Perigo de Extinção , Peixes/classificação , Água Doce , Malásia , Gestão de Riscos , Água do Mar , Poluição da ÁguaRESUMO
Pneumoconiosis is one of the major occupational health problems in China and increasing numbers of migrant workers suffered from this occupational disease after working in a dusty environment for few years. These migrant workers panicked after being diagnosed as suffering from pneumoconiosis and facing physiological disturbances including progressive dyspnea, respiratory failure or complications like silico-tuberculosis after their return to their rural village. This article reviews the preliminary results of a community rehabilitation pilot project conducted in a rural village in Guizhou, one of the provinces in southwest China. It shares the joint effort of professionals from Guangdong Province and Hong Kong SAR on supporting the migrant workers to manage and cope with this occupational disease. Finally, strategies including early intervention were suggested to help migrant workers to manage the disease. Most importantly, occupational health promotion and prevention were urged as the measures of utmost importance in reducing the risk for migrant workers suffering from pneumoconiosis.
Assuntos
Pneumoconiose , Desenvolvimento de Programas , Centros de Reabilitação/organização & administração , Migrantes , Adulto , China , Comportamento Cooperativo , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Doenças Profissionais , Projetos Piloto , Pneumoconiose/diagnóstico , Pneumoconiose/fisiopatologia , Pneumoconiose/terapiaRESUMO
OBJECTIVES: To estimate the prevalence and risk factors of diabetic retinopathy in type 2 diabetic patients, and to investigate the difference in retinopathy progression in patients with normal fundi or established retinopathy at baseline and the risk factors implicated in the progression. DESIGN: Retrospective community-based study. SETTING: Ten primary care clinics in Hong Kong. PATIENTS: Type 2 diabetic patients; subsidiary analysis included subjects with more than one screening event. MAIN OUTCOME MEASURES: Patient demographics, baseline prevalence, and risk factors of diabetic retinopathy; progression of retinopathy in patients with normal fundi and established retinopathy at baseline, and the associated risk factors. RESULTS: A total of 6165 patients were recruited from January 1998 to May 2004. Primary analysis included 4423 patients with good-quality retinal photographs. The mean age of the patients was 60.36 years (standard deviation, 10.80 years; range, 28-94 years), the mean duration of diabetes was 4.71 years (standard deviation, 4.67 years; range, 0.1-40.6 years), and the mean level of glycated haemoglobin was 7.47% (standard deviation, 1.44%). The prevalence of retinopathy at baseline was 28.4%. Subsidiary analysis showed progression to sight-threatening retinopathy was more common in the group with baseline retinopathy than that without (7.9% vs 0.7%), and occurred at a faster rate (mean, 1.5 [range, 0.5-3.0] vs 2.0 [1.0-4.2] years). Logistic regression revealed that the level of glycated haemoglobin was positively associated with both the onset (P<0.001) and progression of retinopathy (P=0.03). CONCLUSION: Optimal glycaemic control is important for reducing sight-threatening retinopathy. Close observation is required for patients with established retinopathy as progression occurs more rapidly.
Assuntos
Retinopatia Diabética/epidemiologia , Atenção Primária à Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/etiologia , Progressão da Doença , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
The need for a culturally sensitive instrument to assess quality of life (QOL) of patients in international oncology clinical trials has been well documented. This study was designed to evaluate the psychometric properties of the traditional Chinese translation (TCHI) of the Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) Version 4. The FACT-BMT consists of the FACT-General and treatment-specific concerns of bone marrow transplantation. The Chinese translation follows the standard Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology. Bilingual teams from the United States and Hong Kong reviewed the translation to develop a provisional TCHI FACT-BMT, which was then pre-tested by interviewing 20 native Chinese-speaking BMT patients in Hong Kong. The pre-test results indicated good content coverage and overall comprehensibility. A refined translation, taking into account patient comments, was validated by 134 BMT patients in Hong Kong. The results indicated the high internal consistency of the TCHI FACT-BMT scales, with Cronbach's alpha coefficients ranging from 0.71 (emotional well-being) to 0.92 (FACT-BMT total). The FACT-BMT also demonstrated good construct validity when correlated with SF-36 Health Survey scales. The QOL of Chinese BMT patients can now be evaluated using a well-validated international QOL instrument in their own language.
Assuntos
Transplante de Medula Óssea , Neoplasias/terapia , Qualidade de Vida/psicologia , Adolescente , Adulto , Idoso , China , Comparação Transcultural , Feminino , Humanos , Cooperação Internacional , Idioma , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , TraduçãoRESUMO
The authors investigated factors related to firm attractiveness as an employer in the People's Republic of China. The organizational attributes of type of ownership, nationality of the supervisor, and firm familiarity in organizational descriptions were manipulated and their effects were measured on firm attractiveness. In addition, the authors adopted a person-organization fit perspective to investigate how individual difference characteristics moderated the effects of these organizational attributes on attractiveness. Although, in general, participants were more attracted to foreign than state-owned firms and to familiar than unfamiliar firms, results provided support for the person-organization fit perspective in that the individual differences moderated the effects of the organizational attributes on firm attractiveness. For example, participants were more attracted to state-owned versus foreign firms when they were more risk averse and had a lower need for pay. Thus, the results provide initial support for the generalizability of the person-organization fit perspective to a non-Western setting.