Suicide in Hong Kong: A case-control psychological autopsy study

Background. The relative contribution of psychosocial and clinical risk factors to suicide among Chinese populations is an important issue. In Hong Kong, this issue requires vigorous examination in light of a 50% increase in suicide rate between 1997 and 2003. Method. Using a case-control psychological autopsy method, 150 suicide deceased were compared with 150 living controls matched by age and gender. Semi-structured interviews were conducted with the next-of-kin of the subjects. Data were collected on a wide range of potential risk and protective factors, including demographic, life event, clinical and psychological variables. The relative contribution of these factors towards suicide was examined in a multiple logistic regression model. Results. Six factors were found to significantly and independently contribute to suicide: unemployment, indebtedness, being single, social support, psychiatric illness, and history of past attempts. Conclusions. Both psychosocial and clinical factors are important in suicides in Hong Kong. They seem to have mediated suicide risk independently. In addition, socio-economic adversities seem to have played a relatively important role in the increasing suicide rate in Hong Kong. © 2006 Cambridge University Press.published_or_final_versio

Multimodality minimally invasive autopsy-A feasible and accurate approach to post-mortem examination

Background: Autopsy examination has been the bedrock of western medicine. With the decline in the autopsy rate secondary to the negative psychological impact to the deceased's relatives, the benefits of autopsy have been undermined. Minimally invasive autopsy has been introduced but has not been widely adopted as an alternative to the 'traditional' open approach. This technique not only provides information on the cause of death abut also minimizes the disfigurement induced to the deceased. Our study aims to explore the feasibility and evaluate the accuracy of this technique. Methods: A series of coroner cases ordered for autopsy were examined by a group including an experienced forensic pathologist and two experienced laparoscopic surgeons using thoracoscopic, laparoscopic, endoluminal or endovascular approaches. The procedure was video-recorded and the provisional diagnoses and causes of death were made based on the findings. These findings were subsequently correlated with the full autopsy examination. A few limited clinical post-mortem examinations were also performed with consent from relatives. Results: A total of 22 cases of minimally invasive autopsies were performed from November 2007 to March 2008. The median duration of the procedures was 78.3 ± 20.7 min. Thoracoscopies and laparoscopies were performed in 18 patients while additional arterioscopic examination with endoscope was performed in two patients with suspected aortic diseases. Four consented limited clinical autopsies were also performed: two of them involved thoracoscopic biopsies of lung tissues, one was a para-mortem upper endoscopy for the investigation of pathology of the stomach and the other one was laparoscopy for a patient, who died of unexplained acidosis. Comparison with full autopsies showed that the accuracy of the diagnosis was 94.4%, the sensitivity was 90%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 88.9%. Conclusion: Minimally invasive autopsy is a feasible approach, yielding accurate findings when compared with conventional autopsies. The former can be a valuable tool for obtaining more valuable information in situations when the next-of-kin of the deceased does not consent to a conventional autopsy. © 2009 Elsevier Ireland Ltd. All rights reserved.postprin

Rape in Hong Kong: An overview of current knowledge

This paper summarises all published and unpublished material available on the topic of rape in Hong Kong. Data including epidemiology, victim profile, assault characteristics, are presented. Most of the data shown are from the 15-year period between 1981 and 1995. Gaps in knowledge are highlighted so as to direct the attention of local researchers and overseas research collaborators.link_to_subscribed_fulltex

Editorial

link_to_OA_fulltex

Editorial

link_to_subscribed_fulltex

Fatal gastrointestinal haemorrhage due to coexisting primary aorto- enteric and aorto-colic fistulae. Complicating untreated atheromatous abdominal aortic aneurysm

We report a case of aorto-enteric and aorto-colonic fistulae in a 73 year old man with no previous abdominal surgery which resulted in massive gastrointestinal haemorrhage and death and was undiagnosed despite several hospital admissions and endoscopic examinations. This case serves to highlight an extremely rare but fatal condition, which is potentially treatable, if an early diagnosis is made.link_to_subscribed_fulltex

To flee or not: Postkilling responses among intimate partner homicide offenders in Hong Kong

Among 112 homicides involving sexual intimates that occurred in Hong Kong between 1989 and 2002, 38% (n = 42) of offenders remained voluntarily at the homicide scene, 21% (n = 24) committed suicide, 20% (n = 22) escaped and denied involvement, 13% (n = 14) disposed or hid the body of their victim, and 9% (n = 10) escaped but later voluntarily surrendered. This study used police investigation reports, coroner's reports, witness statements, and other relevant documents to compare these five types of postkilling behavior. The type of response was explained by the offender's characteristics, the strength of attachment to the victim, and situational factors. The offender's prior criminal conduct or history of violence was not significant in predicting the type of postkilling response. © 2010 SAGE Publications.link_to_subscribed_fulltex

Young Chinese medical students adapt well to problem-based learning

Letters to the editorlink_to_subscribed_fulltex

Test and teach. Number ninety-five: Part 1

link_to_subscribed_fulltex

Medical school culture: more positive than you think

Conference Theme: Inspire... and be inspiredFree e-bookSession 2BB - Posters: Career Choice/Education Environment: abstract 2BB13BACKGROUND: As students progress from junior to senior medical undergraduates, their development as doctors is influenced not only by the taught curriculum but also by the prevailing medical school culture which has been characterised in other studies as competitive, hierarchical and at times, abusive. This has implications on the development of the professional attitudes and behaviours expected of medical graduates. We aim to describe students’ perception of medical school culture in an Asian setting, conceptualised as the behaviours, attitudes, values and customs of the medical school and the people within it. SUMMARY OF WORK: This was a qualitative study of medical students in the Li Ka Shing Faculty of Medicine, University of Hong Kong. Between June 2010 to January 2011, students were identified through random and quota sampling and 31 participated in individual semi-structured interviews. A grounded theory approach was used to determine common themes in students’ perceptions. SUMMARY OF RESULTS: Medical school culture was categorized into peer-related, student-teacher-related, and institutional-related themes. Most of the subthemes were positive with 27% of these referring to positive peer interactions such as cooperative learning, willingness to help and provision of emotional support. CONCLUSIONS: Positive peer behaviour and attitude were perceived as the predominant features of medical school culture. TAKE-HOME MESSAGES: The role of peers in defining medical school culture is significant and may exert a powerful influence on the developing doctor.link_to_OA_fulltex