4,698 research outputs found
Letter from Cy Donner to Michi Weglyn, June 2, 1967
No full textA letter from Cy Donner to Michi Weglyn encouraging her to come out to California to talk to producers about two shows called "Youthquake" and "Pretty Talk".These materials are from box 73 and 74 of the Frank Chin Papers. The Frank Chin Papers contain personal and professional correspondence between Frank Chin and Michi Weglyn relating to particular projects on which either author was working as well as files related to the Day of Remembrance Tribute to Michi Weglyn
Consensus statement on ischaemic stroke care in Hong Kong
Full text linkObjective. To issue guidelines for the care of acute stroke in Hong Kong, with the target audience of all health care professionals who are involved in acute stroke care. Participants. The Hong Kong Neurological Society and the Hong Kong Stroke Society. Evidence. The panel applied the 'rule of evidence' used by the United States Agency for Health Care Policy and Research. When there is insufficient evidence, the recommendation was based on customary practice and was circulated among the members and fellows of the two societies before coming to a consensus. Consensus process. Group meetings were held in 2002 to review the literature about acute care for patients with ischaemic stroke and to issue a consensus statement with reference to the local health care system. Participants of the meetings were appointed by the councils of The Hong Kong Neurological Society and the Hong Kong Stroke Society. The draft statement was circulated among the members and fellows of the two societies for comments before it was finalised. Conclusions. Ischaemic stroke is a heavy health care burden to Hong Kong. The current consensus statement provides a framework to establish a multidisciplinary approach towards its acute management.published_or_final_versio
Socio-economic burden in patients with rare diseases in Hong Kong
No full textBackground: The socio-economic burden of rare diseases is extremely important for healthcare planning but difficult to estimate. In Hong Kong, one in 67 people is living with at least one rare disease. The burden of rare diseases comprises an economic dimension. Costs of rare diseases can be incurred directly through healthcare expenditure, but also through non-healthcare formal and informal costs and indirectly through productivity and opportunities lost. The socio-economic burden of rare diseases is unknown in Hong Kong. The study aims to fill in this literature gap to guide policy makers for healthcare
planning.
Methods: The Client Service Receipt Inventory for the rare disease population (CSRI-Ra) was used
to collect direct and indirect cost-related data in the rare disease population in Hong Kong. It includes five key areas: socio-demographic characteristics, community support, employment and earnings, service and resource utilisation record, and household and carer support. The CSRI-Ra was distributed to independent rare disease patients and carers via multiple rare disease organisations and patient groups. Rare diseases were categorised into 22 disease categories according to the 10th version of the International Classification of Diseases and Related Health Problems (ICD-10). Costs were estimated
from the societal perspective using a bottom-up approach. Data collected for the 6 months were extrapolated to the entire year, allowing the mean annual costs to be estimated per patient. Cost estimation for this pilot study included hospital inpatient admission, patient’s and unpaid carer’s loss of productivity, and employment of paid carers.
Results: A total of 276 independent participants (162 rare disease patients and 114 carers of patients with rare diseases) were recruited between 25 April and 6 August, 2020, covering 118 unique rare diseases. Among the 276 rare disease patients, 74% required care from a paid or unpaid carer. It was found that each rare disease patient requires an average of three rare disease-related inpatient days annually. Job opportunity was affected in 60% of patients, and 61% of carers, which included unemployment, changed from full-time job to part-time job and early retirement. Due to the patient’s rare
disease condition, patients and carers who were employed were required to take an annual average of five and 15 days of annual leave, respectively. The total annual cost for the 276 rare disease patients was estimated to be a minimum of HKD82,504 per patient per year in Hong Kong.
Conclusion: The pilot study demonstrated the feasibility of using CSRI-Ra in Hong Kong to estimate
the direct and indirect costs of rare diseases. It reflects the importance of rare diseases in health policies. It also provides a framework for long-term monitoring for efficient and effective healthcare planning
A synopsis of current care of thalassaemia major patients in Hong Kong
Full text linkOBJECTIVE: To provide a synopsis of current thalassaemia major patient care in Hong Kong. DESIGN: Retrospective study. SETTING: All haematology units of the Hospital Authority in Hong Kong. PATIENTS: All patients with thalassaemia major with regular transfusion. RESULTS: To date, there were 363 thalassaemia major patients under the care of the Hospital Authority. Prenatal diagnosis has helped to reduce the number of indigenous new cases, but in recent years immigrant cases are appearing. The patients have a mean age of 23 (range, 1-52) years, and 78% of them are adults. In 2009, they received 18 782 units of blood. This accounted for 9.5% of all blood consumption from the Hong Kong Red Cross. In the past, cardiac iron overload was the major cause of death (65%) and few patients survived beyond the age of 45 years. The availability of cardiac iron assessment by magnetic resonance imaging (T2 MRI) to direct the use of oral deferiprone chelation has reduced the prevalence of heart failure and cardiac haemosiderosis, which should reduce mortality and improve life expectancy. CONCLUSION: The future for thalassaemia care in Hong Kong is bright. With better transfusion and chelation, it should be possible to avoid growth and endocrine deficiencies in younger patients.published_or_final_versio
The prevalence and healthcare utilization of rare neurological diseases in Hong Kong: 2014-2018
No full textBackground: Rare neurological diseases (RND) constitute a large proportion of rare diseases (RD).
However, there has not been any study dedicated to the elucidation of prevalence and healthcare utilization pattern of RND and its subtypes. There is also a lack of understanding into the state of pharmacological research in RND.
Methods: A list of ICD-10 codes corresponding to RNDs was compiled with adaptation from the
Orphanet Classification of Rare Diseases, and classified into rare epilepsy, movementrelated, neurocutaneous, neuroimmune, neurometabolic and neurodegenerative, neuromuscular and other RNDs. Using the Clinical Data Analysis and Reporting System (CDARS), which holds public hospital healthcare records of Hong Kong in an anonymous manner, we calculated the prevalence and healthcare utilization of patients RNDs between 2014 and 2018. The list of RNDs was also used to look up pharmacological research related to RNDs within the International Clinical Trials Registry Platform (ICTRP) between 2009-2018.
Results: The prevalence of RND in Hong Kong is 3.6 in 1000, without major difference between
paediatric and adult population. Patients with RNDs have frequent emergency department, inpatient and outpatient healthcare utilization, with average annual cost per patient estimated at HKD 175404 (USD 22488) excluding pharmacological costs. Different categories of RND also showed different patterns of healthcare utilization. On the other hand, there were only 677 RND-related pharmacological trials in the past decade, and no such trial was found for up to 78% of RNDs. Only 41 (6%) of the trials were conducted within Chinese speaking communities.
Discussion: This is the first comprehensive review on the prevalence, healthcare utilization, and state of pharmacological research in RNDs. It shows high healthcare utilization rate amongst patients with RND in the Emergency Department, inpatient and outpatient settings. It also shows a wide research gap in many of the RNDs, particularly within Chinese speaking communities. We call for better attention and tailored healthcare for these patients
Differential brainstem atrophy in multiple sclerosis and neuromyelitis optica spectrum disorders among Hong Kong Chinese
No full textIntroduction: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the most
common inflammatory demyelinating disorders of central nervous system in Hong Kong. Brainstem is
commonly involved in both disorders. We aimed to study the regional brainstem atrophy of local MS and
NMOSD patients.
Methods: Semi-automated segmentation and volumetric measurement of brainstem were performed and
compared among MS, NMOSD, and healthy controls (HC). Clinical symptoms and severity were graded using Expanded Disability Status Scale (EDSS) and Kurtzke Functional System Scores (FSS). Associations between the volumes of interest (VOIs) and clinical disability scores were assessed by partial correlation and multiple regression analyses.
Results: Baseline characteristics were comparable across the three groups, without significant difference in disease duration and severity between MS and NMOSD subjects. Normalised whole brainstem, midbrain, and pons volumes were significantly smaller in MS subjects compared to HC (-5.2%, P=0.027; -8.3%, P=0.000; and -5.9%, P=0.048; respectively) while only the normalised medulla volume was significantly smaller in NMOSD subjects compared to HC (-8.5% vs HC, P=0.024). Normalised midbrain volume was significantly smaller in MS compared to NMOSD subjects (-5.0%, P=0.014) while normalised medulla volume was significantly smaller in NMOSD compared to MS subjects (-8.1%, P=0.032). Smaller normalised whole brainstem, pons, and medulla oblongata volumes were associated with greater disability on EDSS, FSS-brainstem, and FSS-cerebellar in NMOSD patients.
Conclusion: Our findings revealed different patterns of brainstem atrophy between MS and NMOSD patients. This can be related to different underlying pathologies and pathophysiological mechanisms
Ideological orientation and political transition in Hong Kong: Confidence in the future
No full textIn the two-component model of ideological orientation, a person's ideological position is jointly influenced by attitudinal and affective components. The present study adopted this conceptual model to predict confidence in the future of Hong Kong, Questionnaire responses were collected from 395 adults (56.8% men and 43.2% women) in Hong Kong in April 1995, some 2 years before its transfer from British to Chinese control The results show that the level of confidence in Hong Kong was related to both attitudinal and affective identification with Hong Kong and China. These findings suggest that the transfer of government may have brought to the surface a collision of the divergent political cultures of Hong Kong and mainland China, resulting in two antagonistic political orientations that predicted confidence in the future of Hong Kong.link_to_subscribed_fulltex
Respiratory Distress Syndrome in Hong Kong
No full textIn the past, very few new-borns were reported to develop RDS in Hong Kong (unpublished observation). The general impression is, however, that the incidence of RDS has increased during the past decades. The aims of this study were to compare the incidence of RDS in premature babies during the last two decades and also to identify possible risk factors for the development of RDS.
In a retrospective descriptive study the incidence perinatal factors of RDS in premature babies treated in Queen Mary Hospital, Hong Kong was delineated in 1979, 1983 and 1993. The RDS diagnose criteria were: immature lungs, below 37 weeks of gestation, early onset of respiratory distress, respiratory rate >60/mm, subcostal or substernal retractions on inspiration, O2 requirement to abolish cyanosis in room air, blood gases showing acidosis, chest X-ray showing presence of reticulogranular pattern and at post mortem showing hyaline membranes. The control group consisted of infants with a gestational age of 23 to 30 weeks and a birth weight of less than 3000 grams with no diagnosis of RDS. For the three study years a total of 132,162 and 188 hospital records of premature babies were analysed.
The results showed no clear difference in the RDS incidence during these years; 13%, 9% and 15%, respectively. Comparing our results with the results of previous studies we conclude that the incidence of RDS in Hong Kong is similar or slightly lower than the incidence in other parts of the world. The overall mortality due to RDS decreased sharply during the study years. Babies who developed RDS were far more likely (p<0.0001) to die (32%) from RDS than the prematurely born infants without RDS (4%). Being born with a length of gestation below 30 weeks, with a birth weight of less than 1500g, breech delivery and an apgar score below 6 at 5 minutes after birth appeared individually to be associated with an increased risk of RDS. However, when applying a multiple linear logistic model to the series only prematurity remained as a significant risk factor for RDS (odds ratio=1.59).
In summary, the incidence of RDS has not changed during the last 15 decades in Hong Kong but the mortality rate in RDS has decreased substantially. Prematurity remained as the single significant one in a multivariate analysis.link_to_OA_fulltex
Shunt outcome of idiopathic normal pressure hydrocephalus: a Hong Kong-wide review of 15 years
Full text linkBACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is a potentially treatable cause of dementia and impaired mobility in the geriatric population. There are no standard diagnostic criteria and reliable predictors of treatment response is lacking. Ventriculo-peritoneal shunt (VPS) is the standard treatment with variable success rate. OBJECTIVE: To assess the functional outcome, complications and predictors of treatment response of iNPH patients treated with VPS in Hong Kong over the last 15 years …published_or_final_versio
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