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1.
Intern Med J ; 50 Suppl 3: 6-14, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32985093

RESUMO

Aripiprazole, a dopamine partial agonist, is a second-generation anti-psychotic that is widely used for the treatment of schizophrenia and other psychotic disorders. A group of psychiatric experts in Hong Kong developed a set of consensus statements, aiming to facilitate the understanding of clinical properties and usages of aripiprazole among local physicians. Of note, because aripiprazole long-acting injectable has been available locally not long before the establishment of the consensus panel, which limited the discussion on its use in the local context, the consensus statements were focused primarily on oral aripiprazole. To draft the consensus statements, the panellists discussed the published evidence and their clinical experience regarding aripiprazole in a series of meetings based on several areas. At the final meeting, each drafted statement was voted on anonymously by all panellists based on its practicability of recommendation in Hong Kong. A set of consensus statements on the characteristics and clinical use of aripiprazole was established and accepted by the panel. These statements serve to provide a practical reference for physicians in Hong Kong, and possibly other parts of the Asia-Pacific region, on the use of aripiprazole in people with schizophrenia spectrum disorders and other psychotic problems.


Assuntos
Antipsicóticos/uso terapêutico , Aripiprazol/uso terapêutico , Esquizofrenia/tratamento farmacológico , Consenso , Hong Kong , Humanos , Esquizofrenia/diagnóstico
3.
Asian J Psychiatr ; 12: 163-9, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25440570

RESUMO

AIM: In view of the clinical importance of the adherence issues in schizophrenia management, a consensus group of experienced local psychiatrists and nurse specialists gathered to outline a number of consensus statements for clinicians to consider enhancing adherence in their patients. PROCESS: Prior to the consensus group meeting, three core members drafted eight statements on the issue of adherence in schizophrenia. Using a modified Delphi method, published literature and published guidelines regarding the management of schizophrenia were reviewed by the full panel during the group meeting. After discussion and reflection from each individual member of the consensus group, the eight statements were reworded and electronically voted on anonymously in two steps: acceptance on quality of evidence and practicability in implementation. RESULTS: After modifications of the original statements, there was very high overall level of agreement and acceptance (reaching international standard) on all the five areas of adherence within the eight statements of the finalised statement. CONCLUSIONS: The present consensus statements are the first in Hong Kong to address systematically adherence issues in schizophrenia management. They include areas on adherence assessment and definition, treatment strategies in enhancing adherence, and treatment considerations at specific phases of schizophrenia. They are tailored to be of practical utility in the local Hong Kong setting.


Assuntos
Antipsicóticos/uso terapêutico , Adesão à Medicação , Esquizofrenia/tratamento farmacológico , Consenso , Técnica Delfos , Hong Kong , Humanos
4.
Acta Psychiatr Scand ; 126(6): 440-7, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22533702

RESUMO

OBJECTIVE: To investigate the impact of a Western mental health training course for Traditional Chinese Medicine (TCM) practitioners. METHOD: A combined qualitative and quantitative approach was applied to examine the changes in the TCM practitioners' clinical practice characteristics and attitudes. Focus groups and structured questionnaire surveys were conducted to compare their responses before and after the Course. RESULTS: After a 10-week training course conducted by psychiatrists and family physicians, there were significant changes in confidence of the TCM practitioners for diagnosis (33% being confident before the Course vs. 76% after the Course) and management (24% vs. 55%) of common mental health problems. The causal effects of better classifications to recognition of mental health problems were explained by the qualitative responses. Proportion of TCM practitioners being confident of referring mental health patients to other healthcare professionals doubled from 25% to 50% after the Course. Nonetheless, there was no significant change in percentage of these patients being recommended to Western doctors owing to a lack of formal referral channel. CONCLUSIONS: Western mental health training for TCM practitioners has positive impact on their clinical practice. However, the practical barriers in making referrals highlight the need of closer collaboration between conventional and traditional medicine.


Assuntos
Medicina de Família e Comunidade/normas , Medicina Tradicional Chinesa/normas , Médicos de Família/educação , Psiquiatria/educação , Adulto , Grupos Focais , Seguimentos , Humanos , Medicina Tradicional Chinesa/psicologia , Pesquisa Qualitativa , Ocidente
5.
J Nanosci Nanotechnol ; 12(12): 9010-7, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23447952

RESUMO

Magnetic iron oxide nanoparticles (MIONPs) must be biocompatible, and a thorough knowledge on their potential cytotoxicity is crucial for their biomedical applications. However, the detailed study about the effects of iron oxide nanoparticles on cell viability, cell morphology, and cellular uptake of different mammalian cells is still insufficient. In this paper, comparative cytotoxicity study of uncoated magnetite nanoparticles at different concentrations was performed on human cervical cancer cell line (HeLa) and immortalized normal human retinal pigment epithelial cell line (RPE). The size, structure, and magnetic behavior of the MIONPs were characterized using transmission electron microscopy (TEM), X-ray diffractometry (XRD), and vibrating sample magnetometry (VSM) respectively. After 24-hour incubation with the MIONPs, the cell viability was determined by live/dead assay, the cell morphology at high magnification was observed under scanning electron microscopy (SEM), and the cellular uptake of MIONPs was measured under TEM and verified by energy-dispersive X-ray spectroscopy (EDX) analysis. Our results indicate that the uncoated MIONPs at a high concentration (0.40 mg/ml) were toxic to both HeLa and RPE cells. However, the cytotoxicity of uncoated MIONPs at low concentrations was cell-type specific, and RPE cells were more susceptible to these MIONPs than HeLa cells. The effects of the MIONPs on cell morphology and the nanoparticles uptake also showed different features between these two cell lines. Hence cell type should be taken into consideration in the in vitro cytotoxicity study of uncoated MIONPs. Additionally, it should be noticed that the cell morphological changes and the uptake of nanoparticles can take place even though no toxic effect of these MIONPs at low concentrations was reflected in the traditional cell viability assay.


Assuntos
Sobrevivência Celular/efeitos dos fármacos , Magnetismo , Nanopartículas , Células HeLa , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Microscopia de Fluorescência , Espectrometria por Raios X , Difração de Raios X
6.
Int J Psychiatry Med ; 42(2): 133-49, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22409093

RESUMO

OBJECTIVE: There are increasing expectations on primary care doctors to care for patients with common mental health problems. This study examines the outcomes of a postgraduate training course in psychological medicine for primary care doctors. METHODS: A questionnaire developed by the research team was sent to the Course graduates (year 2003-2007). A retrospective design was adopted to compare their clinical practice characteristics before and after the Course. Differences in the ratings by the respondents before and after the Course were analyzed using the nonparametric Wilcoxon signed rank test. RESULTS: Sixty-nine graduates replied with a response rate of 58.5% (69/118). Most respondents were confident of diagnosing (96.9%) and managing (97.0%) common mental health problems after the Course, compared to 50.0% and 50.7%, respectively, before the Course. Most graduates had modified their approach, increased their attention and empathy to patients with mental health problems. The percentage of respondents having enough time to treat these patients had increased from 55.8% to 72.1%. The median number of patients with mental health problems seen per week was in the range of 3-6 before, and had increased to the range of 7-10 after the Course. The proportion of respondents being confident of making appropriate referrals had increased from 72.8% to 97.0%, while the number of referrals to psychiatrists had dropped significantly. CONCLUSIONS: The Course is effective in improving graduates' confidence, attitude, and skills in treating patients with common mental health problems. There are significant increases in the number of mental health patients handled, increased confidence in making referrals to psychiatrists, and decreased percentage of patients being referred.


Assuntos
Psiquiatria Comunitária/educação , Educação de Pós-Graduação em Medicina , Médicos de Atenção Primária/educação , Atitude do Pessoal de Saúde , Currículo , Avaliação Educacional , Empatia , Hong Kong , Humanos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Relações Médico-Paciente , Projetos Piloto , Padrões de Prática Médica , Encaminhamento e Consulta , Estudos Retrospectivos , Inquéritos e Questionários
7.
Water Sci Technol ; 48(5): 307-13, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14621178

RESUMO

This study was conducted to: (1) evaluate the performance of constructed wetlands in removing Zn, Pb and Cd, respectively, and Zn, Pb, Cd and Cu in combination and (2) investigate the speciation patterns of the dissolved metals differentiated according to their detectability by anodic stripping voltammetry (ASV) and their lability towards Chelex resin along the treatment path of metal-containing wastewater in horizontal subsurface-flow constructed wetlands. Four laboratory scale wetland units planted with cattails (Typha latifolia) were operated outdoors for six months. Three of the units were, respectively, fed with primary-treated domestic wastewater spiked with Zn(II), Pb(II) and Cd(II) whilst the fourth was spiked with a combination of Zn(II), Pb(II), Cd(II) and Cu(II). The results demonstrate that a metal removal efficiency of over 99% was achievable for wetland units treating the metals singly or in combination provided the sorption capacity of the media was not exceeded. When treating the metals in combination, an antagonistic effect, more significantly for Pb and Cd, on the sorptive metal uptake by media was observed. Based on the metal speciation patterns, the wetland system seemed to be capable of maintaining the ASV-labile metal species at relatively low level (< 10%) before media exhaustion.


Assuntos
Ecossistema , Metais Pesados/isolamento & purificação , Eliminação de Resíduos Líquidos/métodos , Poluentes da Água/isolamento & purificação , Purificação da Água/métodos , Biodegradação Ambiental , Filtração , Metais Pesados/química , Movimentos da Água
8.
Sci Total Environ ; 301(1-3): 13-21, 2003 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-12493181

RESUMO

The objective of this study is to investigate the respective effects of Zn, Pb and Cd as well as the combined effect of Zn, Pb, Cd and Cu on the removal of nitrogen and oxygen demand in constructed wetlands. Four laboratory-scale gravel-filled subsurface-flow constructed wetland units planted with cattails (Typha latifolia) were operated outdoors and fed with primary-treated domestic wastewater at a constant flow rate of 25 ml/min. After 6 months, three of the wetland units were fed with the same type of wastewater spiked with Zn(II), Pb(II) and Cd(II), respectively, at 20, 5 and 1 mg/l for a further 9 months. The remaining unit was fed with the same type of wastewater spiked with a combination of Zn(II), Pb(II), Cd(II) and Cu(II) at concentrations of 10, 2.5, 0.5 and 5 mg/l, respectively, over the same period. The chemical oxygen demand (COD) and ammoniacal nitrogen (AN) concentrations were monitored at the inlet, outlet and three additional locations along the length of the wetland units to assess the performance of the wetland units at various metal loadings. At the end of the study, all cattail plants were harvested for the determination of total Kjeldahl nitrogen and metal concentrations. The results showed that the COD removal efficiency was practically independent of increasing metal loading or a combination of metal loadings during the duration of the study. In contrast, the AN removal efficiency deteriorated progressively with increasing metal loading. The relative effect of the heavy metals was found to increase in the order: Zn

Assuntos
Ecossistema , Metais Pesados/efeitos adversos , Nitrogênio/isolamento & purificação , Oxigênio/metabolismo , Purificação da Água/métodos , Plantas , Typhaceae/fisiologia , Eliminação de Resíduos Líquidos
9.
Can J Psychiatry ; 43(7): 706-13, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9773220

RESUMO

OBJECTIVE: To explore the differential outcome of schizophrenia in developed and developing countries. The 15-year outcome of patients with schizophrenia in Hong Kong is reported. METHOD: In a 15-year retrospective outcome study, 100 patients with first-onset schizophrenia in 1977-1978 were randomly selected for outcome assessment from a pool of 797 patient files. The patterns of outcome were assessed by the same set of instruments and methodology as in other centres, since Hong Kong is 1 of the World Health Organization (WHO) centres for the International Study of Schizophrenia (ISoS). RESULTS: Nineteen subjects were untraceable, and 10 subjects committed suicide. More than one-half of the subjects had a good symptomatic outcome, while about 20% of the subjects were rated as having a good psychosocial adjustment. Over the entire 15-year period, 96% of the subjects were maintained on medications, and 79% were living with family members. CONCLUSION: Despite Hong Kong's developed economy, its schizophrenia outcome is similar to that in developing countries. The existence of good family support and active follow-up treatment may be important contributory factors to better outcome.


Assuntos
Esquizofrenia/etnologia , Adulto , Causas de Morte , Distribuição de Qui-Quadrado , China/etnologia , Países Desenvolvidos , Países em Desenvolvimento , Progressão da Doença , Feminino , Seguimentos , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esquizofrenia/mortalidade , Esquizofrenia/fisiopatologia , Esquizofrenia/terapia , Índice de Gravidade de Doença , Fatores Sexuais , Fatores Socioeconômicos , Resultado do Tratamento
10.
Br J Psychiatry ; 168(6): 757-61, 1996 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8773820

RESUMO

BACKGROUND: The aim was to assess the clinical usefulness and economic viability of an aftercare worker for psychotic patients discharged from half-way houses in Hong Kong. METHOD: A sample of 32 chronic psychotic patients was provided with a full-time aftercare worker. A matched control group received no such service. RESULTS: The experimental group was found to have greater and better employment prospects, better mental status with less hospitalisation and less law-breaking behaviour than the control group. Some of these benefits were converted into economic terms and the tangible costs incurred in the project were calculated. CONCLUSIONS: The provision of an aftercare service is clinically useful and economically viable.


Assuntos
Assistência ao Convalescente , Casas para Recuperação , Alta do Paciente , Transtornos Psicóticos/reabilitação , População Urbana , Adulto , Assistência ao Convalescente/economia , Doença Crônica , Análise Custo-Benefício , Feminino , Casas para Recuperação/economia , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/economia , Alta do Paciente/economia , Readmissão do Paciente/economia , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/economia , Reabilitação Vocacional/economia
11.
Int J Soc Psychiatry ; 42(3): 213-9, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-8889645

RESUMO

The purpose of this survey was to understand how the people of Hong Kong perceive mental health, mental illness, mental patients and mental health facilities. In March 1994, a total of 1,043 successful telephone interviews were conducted out of 2,202 valid telephone numbers. The sample was found to be representative of the Hong Kong adult population in terms of sex ratio, age structure, educational achievement and economic status. It was found that the majority of people of Hong Kong were very concerned about their mental health. Their knowledge on mental health was fairly good. Their attitudes towards mental patients and mental health facilities were, however, quite negative. Unlike previous western findings, these views towards mental patients and their rehabilitation facilities were found to be weakly associated with socio-economic factors including age, educational level and household income.


Assuntos
Atitude Frente a Saúde , Transtornos Mentais/psicologia , Percepção Social , Estereotipagem , Adulto , Fatores Etários , Análise de Variância , Coleta de Dados , Análise Fatorial , Feminino , Hong Kong , Humanos , Masculino , Análise Multivariada , Amostragem , Fatores Sexuais , Fatores Socioeconômicos
12.
Int Dent J ; 43(1): 2-8, 1993 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8478125

RESUMO

Advances in modern technology have undoubtedly been of benefit to dentistry in its preventive and curative activities for populations worldwide. Studies, mainly from Western societies, show nonetheless that utilisation of services or adoption of preventive methods are not taken up at satisfactory levels. The focus of this paper is on the special problems in a Chinese society where major differences exist between the traditional lay health concepts and the modernised professional ones. Traditional Chinese health concepts comprise the balance between and interaction of 'Yin' and 'Yang', the vital forces in both the universe and in man's body, as the basis for maintaining health. To restore a disturbed equilibrium of vital forces, which will manifest itself as disease, a range of dietary products are available in Hong Kong, for example cooling herb tea to reduce fire from the stomach producing gum disease. Seeking dental treatment from dentists could be delayed or made 'unnecessary' due to reliance on home remedies. This could reduce the effectiveness of any planned health education activities and dental services available for improving the oral health status of the community according to prevailing Western concepts. An understanding of the cultural meaning of dental disease is fundamental to changing beliefs and attitudes of people in order to improve the oral health of the community.


Assuntos
Atitude Frente a Saúde/etnologia , Cultura , Doença/etnologia , Saúde , Medicina Tradicional Chinesa , Saúde Bucal , Hong Kong , Humanos
13.
Int J Soc Psychiatry ; 37(2): 107-12, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1655669

RESUMO

This paper reports on a study of the living environment of 64 psychiatric patients discharged from half-way houses in Hong Kong. The majority were living in a deprived situation compared to that of their neighbours. They were leading a very monotonous life throughout the year; the walls of their homes were dirty and very plain; and some even ate scraps from a neighbouring bakery. Many did not have any social life at all, and their hobbies were smoking, watching television and gambling. Their neighbours, by comparison, had hobbies such as floriculture, birds and goldfish; decorated their walls with pictures and had newspapers and periodicals in their houses; more often had telephone facilities, wardrobes and sofas; used town gas rather than kerosene stoves; and were more likely to have electrical appliances, especially an iron, refrigerator and shaver. Judged by their income from employment or from public assistance, the 'quality of life' (QOL) of these patients should not have been in such a desperate state. They lacked guidance and instruction in their management of money, and the care of their homes. It is proposed that an aftercare worker might improve the QOL of these discharged psychiatric patients.


Assuntos
Assistência ao Convalescente , Habitação/normas , Transtornos Mentais/terapia , Qualidade de Vida , Feminino , Hong Kong , Utensílios Domésticos , Humanos , Atividades de Lazer , Estilo de Vida , Masculino , Pobreza , Meio Social , Fatores Socioeconômicos
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