6,985 research outputs found
Barriers facing family physicians providing palliative care service in Hong Kong: a questionnaire survey
No full textObjective: To investigate willingness and barriers for family physicians to provide palliative care service in Hong Kong.
Design: A combined qualitative and quantitative research method.
Subjects: All local members of the Hong Kong College of Family Physicians (HKCFP).
Main outcome measures: Demographic data, ideas and factors concerning provision of palliative care in Hong Kong. Generalised Estimating Equations (GEE) model and Logistic Regression analysis to determine factors affecting doctor’s wish and the actual provision of palliative care in practice.
Results: Overall, 750 (48.1%) responses from respondents with a similar distribution in age and gender profile as our target population were returned. General barriers identified were time concern and not enough support from various disciplines. Specific barriers affecting actual provision of service were knowledge and experience (p<0.001), problems dealing with death (p=0.013), current public-private interface (p=0.016) and cultural concerns (p=0.022). Having an interest (p=0.002), continuity of care (p<0.001), patient needs (p<0.001), having a specialist qualification(p=0.009) and primary qualification obtained in Canada (p=0.001) were found to be supporting factors for willingness and actually providing palliative care in their practice.
Conclusion: The factors and suggestions learned from this study should be addressed if collaboration between palliative care and primary care is considered for community palliative care service in Hong Kong. Further studies focusing on patients and their family members’ perspectives are essential to understand the actual need in our cultural context.目的：研究香港基層醫生對提供紓緩治療的意願和在實行時面對的障礙。
設計：混合質量和數量方式。
對象：所有香港家庭醫學學院的本地成員。
主要測量內容：人口統計數據，想法和影響在港提供紓緩治療的因素。以歸納性估計方程式（GEE）和邏輯回歸分析法斷定影響醫生的意願和實行紓緩治療的各種因素。
結果：整體有750位（48.1%）成員回覆，其年歲和性別概況跟目標對象相似。對回覆者的觀點和在基層醫療進行紓緩治療的實踐作分析。一般障礙為時間考量和缺乏支援。具體障礙為知識和經驗方面的考量（P<0.001），處理病人面對死亡時的困難P=0.013），目前公私營醫療系統介面上的溝通（P=0.016）和文化上的顧慮（P=0.0022）。興趣（P=0.002）， 持續治療（P<0.001）， 病人需求（P< 0. 001）， 專科資格（P= 0. 009） 和在加拿大培訓（P=0.001）都是推動醫生提供紓緩治療的正面因素。
結論：若考慮將紓緩療法與基層醫療結合，在香港提供社區紓緩治療服務，文中提及的各種因素和建議應受到正視。此外，亦需在本地文化環境下，對病人及其家人的觀點作進一步專項研究以了解他們的實際需要
Barriers for primary care physicians in providing palliative care service in Hong Kong - Qualitative study
No full textObjective: To investigate the willingness and barriers for primary care physicians in providing palliative care service in Hong Kong. Design: Qualitative study comprising focus groups discussions and individual interviews. Subjects: 20 doctors previously or currently worked in Family Medicine Department in a regional cluster in Hong Kong. Main outcome measures: Perception about palliative care service in Hong Kong. Results: Themes on understanding of palliative care, role of family physicians, support and difficulties in providing the service, effect of Chinese culture in palliative care and suggestions were identified. Conclusion: Doctors with family medicine training have concept and skills of holistic approach, especially psychosocial care. Barriers perceived are similar to those postulated in overseas studies.目的：調查研究香港基層醫生對提供紓緩治療服務的積極性及其面對的障礙。
設計：定性研究，包括專題小組討論及個別面談。
對象：20位曾任或現職於一所香港分區家庭醫學部門的醫生。
主要測量內容：對香港紓緩治療服務的看法。
結果：研究結果可歸納為以下各主題: 對紓緩治療的理解，基層醫生的角色，對提供紓緩治療服務的支持與所遇困難，中國文化的影響及建議。
結論：受家庭醫學訓練的醫生都有掌握全人醫治的概念及技巧，尤其對心理及社交方面的照顧。所察覺到的困難與外國研究結果類似。link_to_subscribed_fulltex
Age is a strong cardiovascular risk factor in hypertensive patients
No full textThe Fifth Annual Scientific Meeting of the Institute of Cardiovascular Science and Medicine, Angiogenesis and Cellular Cardiomyoplasty, Wanchai, Hong Kong, 01-02 December 2001. In Journal of Hong Kong College of Cardiology, 200
Unveiling the genetics of long QT syndrome: a local paediatric experience
No full textPURPOSE: Genetic testing has emerged to become an indispensable component of standard clinical management for patients with long QT syndrome (LQTS). Local data on the genetics of paediatric patients with LQTS are lacking. The current study offers insight into the underlying mutations of these probands, acts as a pilot study for the implementation of a multi-disciplinary inherited ...link_to_OA_fulltextThe 20th Annual Scientific Congress of the Hong Kong College of Cardiology, Hong Kong, 4-6 May 2012. In Journal of the Hong Kong College of Cardiology, 2012, v. 20 suppl. 1, p. A17, abstract no. 4
Clinical and genetic profile of catecholaminergic polymorphic ventricular tachycardia in Hong Kong Chinese children
No full textpublished_or_final_versio
Clinical and genetic profile of congenital long QT syndrome in Hong Kong: a 20-year experience in paediatrics
No full textIntroduction: Congenital long QT syndrome (LQTS) is a genetically transmitted cardiac channelopathy that can lead to sudden cardiac death. This study aimed to report the clinical and genetic characteristics of all young patients diagnosed with LQTS in the only tertiary paediatric cardiology centre in Hong Kong.
Methods: This is a retrospective review of all paediatric and young adult patients diagnosed at our centre with LQTS from January 1997 to December 2016. The diagnosis of LQTS was established with a corrected QT interval (QTc) ≥480 ms, Schwartz score of >3 points, or the presence of a pathogenic mutation.
Results: Fifty-nine patients (33 males) from 52 families were included, with a mean age of 8.17 years (range, 0.00-16.95 years) at presentation. Five patients had concomitant congenital heart diseases. The mean follow-up duration was 5.33 ± 4.65 years. The mean QTc in the cohort was 504 ± 47 ms. They presented with syncope and convulsion (49%), cardiac arrest (10%), bradycardia and neonatal atrioventricular block (12%). Fifteen (25%) patients were asymptomatic at diagnosis. Thirty-eight (64.4%) patients were confirmed to have a pathogenic mutation for LQTS genes. Forty-five (76.3%) patients received beta blocker therapy. Thirteen (22.0%) patients required implantable cardioverter defibrillator. There was no mortality in the study period. The 1-, 5-, and 10-year breakthrough cardiac event–free rates were 93.0%, 80.7%, and 72.6%, respectively.
Conclusion: Identification of the disorder, administration of beta blockers, and lifestyle modification can prevent subsequent cardiac events in LQTS. Genotyping in patients with LQTS is essential in guiding medical therapy and improving prognosis.published_or_final_versio
Posterior Reversible Encephalopathy Syndrome: paediatric heart transplant with cyclosporine neurotoxicity
No full textPosterior reversible encephalopathy syndrome (PRES) is associated with a specific disorder of cerebrovascular autoregulation. Clinical features of PRES consisted of headache, decreased consciousness, altered mental functioning, seizures, visual loss or cortical blindness. Characteristic findings on neuroimaging included high signal intensity on T2-weighted as well as diffusion-weighted imaging MRI in the posterior cerebral hemispheres, indicative of vasogenic subcortical oedema without infarction. Cyclosporine neurotoxicity had been described following bone marrow and organ transplantation; however, there are few reports of PRES in children especially post-paediatric heart transplantation. We report a case of cyclosporine-related PRES in a paediatric heart transplant recipient. She made a good recovery with no residual neurological deficits after withdrawal of cyclosporine, control of possible risk factors as well as symptomatic control of seizure.published_or_final_versionThe 1st Hong Kong Neurological Congress cum 22nd Annual Scientific Meeting of the Hong Kong Neurological Society, Hong Kong, 6-8 November 2009. In Hong Kong Medical Journal, 2009, v. 15 n. 6, suppl. 7, p. 42, abstract P
Dietary niches of birds in Hong Kong
No full textUnderstanding the dietary niche of birds has significant implications for the trophic interactions in ecosystems. Hong Kong has remarkably high biodiversity in both habitats and avian species. However, the dietary niches of many birds in Hong Kong remain understudied. The distinctiveness of dietary niches enables species coexistence and promotes biodiversity. This thesis investigated the dietary niche of birds in Hong Kong, with a focus on niche partitioning and their functional role as plant seed dispersers.
This thesis first analyzed the stopover diets of the critically endangered Yellow-breasted bunting (Emberiza aureola) and five other sympatric bunting species, namely Little bunting (Emberiza pusilla), Chestnut-eared bunting (Emberiza fucata), Yellow-browed bunting (Emberiza chrysophrys), Black-faced bunting (Emberiza spodocephala) and Rustic bunting (Emberiza rustica) in Hong Kong. A total of 109 faecal samples were analyzed using DNA metabarcoding with multiple markers (18S, ITS2 and COI) to ensure a comprehensive coverage of dietary diversity. It was revealed that all bunting species primarily consumed Poaceae, with the Yellow-breasted bunting occupying a distinct niche by consuming a high proportion of cultivated Oryza (rice) compared to other sympatric bunting species. Conversely, other bunting species shared a highly similar diet. Furthermore, wild grasses, such as Echinochloa and Digitaria, were identified as major food sources for migrating buntings. Individual variations in dietary composition were observed between conspecific Yellow-breasted buntings. Morphological measurements such as wing length, tail length, weight and the amount of fat stored were found to have limited influence on these variations. Knowledge of the dietary requirements of buntings will be useful to inform future conservation programmes.
The second study focused on identifying the dietary compositions of five common resident bird species in secondary forest in Hong Kong, including the introduced Huet’s Fulvetta (Alcippe hueti), Silver-eared Mesia (Leiothrix argentauris), Red-billed Leiothrix (Leiothrix lutea), Rufous-capped Babbler (Stachyridopsis ruficeps), and native Swinhoe's White-eye (Zosterops simplex). A total of 107 faecal samples were analyzed using DNA metabarcoding with three markers (18S, ITS2 and trnL) while an additional 48 samples were examined for seed germination experiments. The results revealed that the diets of these birds mainly consisted of a diverse range of plants and a limited amount of invertebrates. Their diets and seed dispersal services were highly overlapping. However, seasonal variations were observed in the diets of forest birds, which were closely associated with the fruiting phenologies of plants. Additionally, it was found that these birds were seed dispersers for many native shrubs, tree and climber species that exhibit avian dispersal syndromes. Furthermore, ingested seeds generally took a longer time to germinate compared to control seeds extracted directly from intact fruits. Overall, seed dispersal through birds is an important ecological process, knowledge of plant-bird trophic interactions and seed dispersal patterns will shed light on the restoration of secondary forests, and natural succession.
This thesis successfully demonstrated the use of DNA metabarcoding to provide fundamental information on the dietary niches of migratory buntings and resident forest birds, as well as their associated ecological functions in Hong Kong. The findings of this study will be valuable for future ecological research and conservation efforts.published_or_final_versionBiological SciencesMasterMaster of Philosoph
Variable response to enzyme replacement therapy in two Chinese children with infantile-onset Pompe disease in Hong Kong
No full textPompe disease, a rare autosomal recessive disorder caused by a deficiency of acid alpha-glucosidase, results in lysosomal accumulation of glycogen in multiple tissues, primarily affecting muscles. Infantileonset Pompe disease is characterised by generalised muscle weakness, hypotonia and lethal cardiomyopathy, resulting in death within the first year of life. The advent of enzyme replacement therapy has changed the natural history of the disease. We report our experience of the use of recombinant human acid alpha-glucosidase in the treatment of two Chinese patients with infantile-onset Pompe disease in Hong Kong.link_to_subscribed_fulltex
Optimising antimicrobial prescription in hospitals by introducing an antimicrobial stewardship programme in Hong Kong: Consensus statement
No full textObjective. To discuss the implementation of an 'antimicrobial stewardship programme' as a means to improve the quality of antimicrobial use in a hospital setting in Hong Kong. Participants. Consensus working group on 'antimicrobial stewardship programme', The Scientific Committee on Infection Control, Centre for Health Protection, Department of Health, comprised 11 experts. The remit of the working group was to discuss the rationale and requirement for optimising antimicrobial prescriptions in hospitals by the introduction of an 'antimicrobial stewardship programme'. Evidence. PubMed articles, national and international guidelines, and abstracts of international meetings published between January 2000 and December 2004 on programmes for improving the use of antimicrobials in hospitals. Only English medical literature was reviewed. Consensus process. Data search was performed independently by three members of the working group. They met on three occasions before the meeting to discuss all collected articles. A final draft was circulated to the working group before a meeting on 3 January 2005. Five commonly asked questions about an 'antimicrobial stewardship programme' were selected for discussion by the participants. Published information on the rationale, components, outcome measures, advantages, and disadvantages of the programme was reviewed. Recent unpublished data from local studies of an 'antimicrobial stewardship programme' were also discussed. The timing, potential problems, and practical issues involved in the implementation of an 'antimicrobial stewardship programme' in Hong Kong were then considered. The consensus statement was circulated to and approved by all participants. Conclusion. The continuous indiscriminate and excessive use of antimicrobial agents promotes the emergence of antibiotic-resistant organisms. Antimicrobial resistance substantially raises already-rising health care costs and increases patient morbidity and mortality. Pattern of prescriptions in hospitals can be improved through the implementation of an 'antimicrobial stewardship programme'. A 'universal' and 'continuous' 'antimicrobial stewardship programme' should now be established in Hong Kong hospitals.published_or_final_versio
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