How long do the Hong Kong Chinese expect their URTI to last? – Effects on antibiotic use

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Vocational training in family medicine: A qualitative study of perspectives of trainers in community-based training

Objective: To investigate how trainers perceived the vocational training programme in family medicine in Hong Kong. Design: Structured discussion with trainers who had trainees in the community-based segment of the vocational training programme of the Hong Kong College of Family Physicians. Subjects: Forty seven eligible trainers were identified and invited to attend the discussion. Thirteen trainers participated in two structured discussions. Main outcome measures: The opinions expressed by the participants towards the vocational training programme. Results: The response rate was 27.7%. The trainers were clear about their roles but saw an overlap between their functions and those of the trainees' supervisors. They were unsure on what to teach and how to teach, and looked for guidance from the Hong Kong College of Family Physicians. They felt that there should be more varied training methods, more resources at training centres, better training arrangements and more coordination among training stakeholders. Some trainers experienced difficulties with their trainees. All trainers saw the benefit of an annual trainers workshop. Conclusion: It is recommended that the College provides better organisation for and training of trainers. A trainers co-ordinator, a trainers handbook and an annual trainers workshop are some suggestions.published_or_final_versio

What do family medicine trainees say about their training?

Objective: To survey the vocational trainees' evaluation of their training. Design: Questionnaire survey with quantitative and qualitative components. Setting: All trainees, past and present, registered with the Hong Kong College of Family Physicians up to April 2002. Main outcome measure: Quantitative analysis on trainees' agreement/disagreement on specific items of their training, and qualitative analysis of themes extracted from all the responses to open-ended questions. Results: 247 out of 355 present and past trainees responded. Overall, the trainees found the training useful and they learnt the knowledge and skill of family medicine. The Basic Hospital Trainees were more likely to have dissatisfaction than the other trainees; they perceived low esteem, were engaged more in service than in training, and were uncertain about what they were expected to learn. The Basic Community Trainees had diverse and balanced opinions on their training and were more concerned with the variable quality of supervision. The Higher Trainees would like to have a more structured and organised training program than the present one. The trainees suggested that the College of Family Physicians could do more to assure quality of training and to facilitate more communication among the trainers, trainees and the College. Conclusion: The trainees have given a lot of useful and constructive information about their training.published_or_final_versio

家庭醫生與非家庭醫生對於香港家庭醫學專科培訓所持意見的異同

目的: 探討本地醫生對家庭醫學專科培訓的意見，以作將來規劃醫療體制的參考。 設計: 橫斷面研究。 參與者及安排: 香港所有註冊醫生。 主要結果測量: 醫生對以下幾方面的評價：職業培訓的重要性、專業評核、工作性質和成為家庭醫生所需經驗，以及他們對於職業培訓所需年期的意見。 結果: 共2310位醫生完成問卷，佔本地醫生23%。最多醫生同意專業評核應為資格認可的因素，其他依次為職業培訓、臨床經驗及工作性質。七成以上受訪醫生認為培訓期應為四年或以下。非家庭醫生大多選擇專業評核作為資格認可的因素，他們亦傾向較長的培訓期。 結論: 職業培訓被認為是獲得家庭醫學專科資格的重要因素。大多數醫生認為培訓期應為四年或以下，而非香港醫學專科學院現時所訂立的六年期。因此，現時家庭醫學的職業培訓計劃或有檢討的需要。Objective: To study the local medical profession's opinions on the training requirements for the specialty of family medicine. This was to serve as a reference for future planning of the health care system. Design: Cross-sectional study. Participants and Setting: All registered doctors in Hong Kong. Main outcome measures: Doctors' ratings on the importance of vocational training, professional assessment, job nature, and experience to become suitably qualified as a family doctor, and their opinions on the length of necessary vocational training. Results: A total of 2310 doctors (23% of doctors in the local register) responded. Professional assessment was mostly agreed as a qualification, followed by vocational training, clinical experience, and job nature. Over 70% agreed on a training period of 4 years or less. Non-family doctors were more likely to opt for professional assessment as the qualification and also opt for a longer training period. Conclusion: Vocational training was considered important as a qualification for the specialty of family medicine. The length of training was mostly agreed to be 4 years or less, not the 6 years currently required by the Hong Kong Academy of Medicine. The vocational training programme for family medicine might require reexamination.published_or_final_versio

siRNA Versus miRNA as Therapeutics for Gene Silencing

Discovered a little over two decades ago, small interfering RNAs (siRNAs) and microRNAs (miRNAs) are noncoding RNAs with important roles in gene regulation. They have recently been investigated as novel classes of therapeutic agents for the treatment of a wide range of disorders including cancers and infections. Clinical trials of siRNA- and miRNA-based drugs have already been initiated. siRNAs and miRNAs share many similarities, both are short duplex RNA molecules that exert gene silencing effects at the post-transcriptional level by targeting messenger RNA (mRNA), yet their mechanisms of action and clinical applications are distinct. The major difference between siRNAs and miRNAs is that the former are highly specific with only one mRNA target, whereas the latter have multiple targets. The therapeutic approaches of siRNAs and miRNAs are therefore very different. Hence, this review provides a comparison between therapeutic siRNAs and miRNAs in terms of their mechanisms of action, physicochemical properties, delivery, and clinical applications. Moreover, the challenges in developing both classes of RNA as therapeutics are also discussed.published_or_final_versio

A new fuzzy approach for pattern recognition with application to EMG classification

A fuzzy logic system with center average defuzzifier, product-inference rule, nonsingleton fuzzifier and Gauss membership function is discussed. The fuzzy sets are initially defined by the cluster parameters from the Basic ISO-DATA algorithm on input space. The system is then trained via back error propagation algorithm so that the fuzzy sets are fine-tuned. The system is applied to functional EMG classification and compared with its ANN counterpart. It is superior to the latter in at least three points: higher recognition rate; insensitive to over-training; and more consistent outputs thus having higher reliability.published_or_final_versio

Fuzzy EMG classification for prosthesis control

This paper proposes a fuzzy approach to classify single-site electromyograph (EMG) signals for multifunctional prosthesis control. While the classification problem is the focus of this paper, the ultimate goal is to improve myoelectric system control performance, and classification is an essential step in the control. Time segmented features are fed to a fuzzy system for training and classification. In order to obtain acceptable training speed and realistic fuzzy system structure, these features are clustered without supervision using the Basic Isodata algorithm at the beginning of the training phase, and the clustering results are used in initializing the fuzzy system parameters. Afterwards, fuzzy rules in the system are trained with the back-propagation algorithm. The fuzzy approach was compared with an artificial neural network (ANN) method on four subjects, and very similar classification results were obtained. It is superior to the latter in at least three points: slightly higher recognition rate; insensitivity to overtraining; and consistent outputs demonstrating higher reliability. Some potential advantages of the fuzzy approach over the ANN approach are also discussed.published_or_final_versio

Health-related quality of life of Southern Chinese with chronic hepatitis B infection

<p>Abstract</p> <p>Background</p> <p>Few studies have evaluated the health-related quality of life (HRQOL) of Southern Chinese with chronic hepatitis B (CHB) infection.</p> <p>Aim</p> <p>To evaluate the HRQOL of Chinese patients at different stages of CHB infection and to find out factors associated with HRQOL.</p> <p>Methods</p> <p>520 Chinese adult CHB patients of whom 156 were uncomplicated, 102 had impaired liver function, 139 had cirrhosis and 123 had hepatocellular carcinoma (HCC) were interviewed with a structured questionnaire, the SF-36 Health Survey version 2 (SF-36v2), and the Chronic Liver Disease Questionnaire (CLDQ). The differences in SF-6D health preference values and SF-36v2 scores between each CHB group and Hong Kong population norms were assessed by t-test. ANOVA was used to compare the mean SF-6D health preference, SF-36v2 scores, and CLDQ scores among CHB groups. Multiple linear regressions were performed to identify determinants of HRQOL.</p> <p>Results</p> <p>CHB patients had significantly lower SF-36v2 scores than the population norm. The SF-6D values of CHB patients with uncomplicated disease, impaired liver function, HCC and cirrhosis were 0.755, 0.745, 0.720 and 0.701, respectively, all significantly lower than the population norm of 0.787. Advanced stage of CHB illness, anti-viral treatment, bilirubin level, psychological co-morbidity, younger age and female were associated with poorer HRQOL.</p> <p>Conclusion</p> <p>CHB infection had a negative impact on HRQOL. There was a progressive decrease in health preference values with CHB disease progression. The results can be used for the estimation of quality adjusted life years (QALYs) for CHB patients in cost effectiveness or cost utility studies.</p> <p>Trial Registration</p> <p><url>http://www.hkclinicaltrials.com</url>; HKCTR-151.</p

Inhalable neutralizing antibodies – promising approach to combating respiratory viral infections

Monoclonal antibodies represent an exciting class of therapeutics against respiratory viral infections. Notwithstanding their specificity and affinity, the conventional parenteral administration is suboptimal in delivering antibodies for neutralizing activity in the airways due to the poor distribution of macromolecules to the respiratory tract. Inhaled therapy is a promising approach to overcome this hurdle in a noninvasive manner, while advances in antibody engineering have led to the development of unique antibody formats which exhibit properties desirable for inhalation. In this Opinion, we examine the major challenges surrounding the development of inhaled antibodies, identify knowledge gaps that need to be addressed and provide strategies from a drug delivery perspective to enhance the efficacy and safety of neutralizing antibodies against respiratory viral infections

Design of dry powder formulations of pH responsive peptide/plasmid DNA complexes for pulmonary delivery

Poster Presentation: no. 13PS50Respiratory diseases are substantial public health problems around the world. Recently, nucleic acid was developed as a potential therapeutic strategy to tackle a series of lung diseases. Delivery still poses one of the major challenges for their clinical application. pH responsive peptides containing either histidine or derivatives of 2,3-diaminopropionic acid (Dap) can mediate effective DNA transfection in lung epithelial cells with the latter remaining effective even in the presence of lung surfactant containing bronchoalveolar fluid (BALF), which make them promising vectors for delivering therapeutic nucleic acid to the airways .....published_or_final_versio