Pathway to mental health recovery: a qualitative and quantitative study on the needs of Chinese psychiatric inpatients.

BACKGROUND: Exploration of the information and participation needs of psychiatric inpatients is an important step for the implementation of recovery-oriented mental health service. The objective of this study was to explore the information and participation needs of Chinese psychiatric inpatients in the largest psychiatric hospital in Hong Kong. METHODS: The study was divided into two parts. In the first part, eight focus groups with patients, patients' relatives and healthcare professionals were held to identify 22 items of information needs and 16 items of participation needs of Chinese psychiatric inpatients. Basing on the items identified in the first part of the study, a questionnaire was developed to survey on the importance of the different information and participation needs in the second part of the study. Participants were asked to rate in rank order their perceived importance of the items in the questionnaire survey. RESULTS: A hundred and eighty three Chinese psychiatric inpatients completed the questionnaire and the majority of them suffered from schizophrenia (68.3 %). For information needs, the top three needs rated by patients as the most important in descending order were: "Information on the classifications of mental illnesses, signs and symptoms and factors contributing to relapse", "Information on the criteria and arrangements for discharge", and "Information on the importance of psychiatric drug taking and its side effects". For participation needs, the top three needs rated by patients as the most important in descending order were: "Enquiring about personal needs and arrangements", "Keeping in touch with the outside world", and "Learning and practising self-management". CONCLUSIONS: This study reveals that Chinese psychiatric inpatients are concerned about information on their mental illness and its treatments as well as the criteria for discharge. On the other hand, patients are concerned about their personal needs, their self-management, as well as their keeping in touch with the outside world during their hospitalisation. Moreover, patients with different socio-demographic and clinical characteristics have different information and participation needs. The results of the present study serve as a reference for designing guidelines, strategies, and programmes to meet the information needs and participation needs of psychiatric inpatients in Hong Kong.

Brain-derived neurotrophic factor in human subjects with function-altering melanocortin-4 receptor variants.

BACKGROUND: In rodents, hypothalamic brain-derived neurotrophic factor (BDNF) expression appears to be regulated by melanocortin-4 receptor (MC4R) activity. The impact of MC4R genetic variation on circulating BDNF in humans is unknown. OBJECTIVE: The objective of this study is to compare BDNF concentrations of subjects with loss-of-function (LOF) and gain-of-function (GOF) MC4R variants with those of controls with common sequence MC4R. METHODS: Circulating BDNF was measured in two cohorts with known MC4R sequence: 148 subjects of Pima Indian heritage ((mean±s.d.): age, 15.7±6.5 years; body mass index z-scores (BMI-Z), 1.63±1.03) and 69 subjects of Hispanic heritage (10.8±3.6 years; BMI-Z, 1.57±1.07). MC4R variants were characterized in vitro by cell surface expression, receptor binding and cyclic AMP response after agonist administration. BDNF single-nucleotide polymorphisms (SNPs) rs12291186, rs6265 and rs7124442 were also genotyped. RESULTS: In the Pima cohort, no significant differences in serum BDNF was observed for 43 LOF subjects versus 65 LOF-matched controls (age, sex and BMI matched; P=0.29) or 20 GOF subjects versus 20 GOF-matched controls (P=0.40). Serum BDNF was significantly associated with genotype for BDNF rs12291186 (P=0.006) and rs6265 (P=0.009), but not rs7124442 (P=0.99); BDNF SNPs did not interact with MC4R status to predict serum BDNF. In the Hispanic cohort, plasma BDNF was not significantly different among 21 LOF subjects, 20 GOF subjects and 28 controls (P=0.79); plasma BDNF was not predicted by BDNF genotype or BDNF-x-MC4R genotype interaction. CONCLUSIONS: Circulating BDNF concentrations were not significantly associated with MC4R functional status, suggesting that peripheral BDNF does not directly reflect hypothalamic BDNF secretion and/or that MC4R signaling is not a significant regulator of the bulk of BDNF expression in humans.

The protective role of chelators and antioxidants on mancozeb-induced toxicity in rat hippocampal astrocytes.

Mancozeb, manganese ethylene-bis-dithiocarbamate with zinc salts, is one of the most commonly used fungicides in the United States. Epidemiological and experimental data showed that mancozeb causes detrimental effects on various organ systems including the reproductive, endocrine, immune, and central nervous system. Increasing evidence has shown a strong association between pesticides and neurodegenerative diseases. In this study, we examined the neurotoxic potential of mancozeb in rat hippocampal astrocytes. The cytotoxicity of mancozeb was found to be dose dependent and recovery studies showed that cells exposed to mancozeb for 1 h did not recover from mancozeb-induced insult. Atomic absorption data showed a significant accumulation of manganese in astrocytes after 1 h of treatment. This study further investigated whether various chelators and antioxidants could prevent mancozeb-induced cytotoxicity. Our data reported that butylated hydroxytoluene (BHT) was the most effective agent in protecting against mancozeb insult. BHT also increased total cellular antioxidants of astrocytes after 1-h mancozeb exposure. In summary, this study reported for the first time that the manganese portion of mancozeb might be, at least in part, responsible for the toxicity. Mancozeb-induced cytotoxicity in astroyctes can be protected by BHT and that this antioxidant increased the total cellular antioxidant capacity.

Effect of Conditioning Treatments on the Survival of Radopholus similis at High Temperatures.

Heat treatments are an environmentally safe method for eliminating quarantine pests from tropical foliage. Conditioning heat treatments can induce thermotolerance against subsequent and otherwise phytotoxic temperatures in tropical foliage, allowing heat treatments to be even more effective. However, if thermotolerance is also induced in nematodes of quarantine significance like Radopholus similis, heat treatments would be rendered ineffective. A lethal thermal death point (LT(99.9)) was established for R. similis by recording mortality at 25 (control temperature), 43 degrees C, 45 degrees C, 47 degrees C, or 49 degrees C after a 0, 1-, 2-, 4-, 6-, 8-, 10-, 12-, or 15-minute exposure. In a second experiment, nematodes were conditioned at 35, 40, or 45 degrees C for 0, 15, 30, 60, 120, and 180 minutes, allowed to rest for 3 hours, and then challenged at 47 degrees C for 5 minutes. No nematodes survived the challenge heat treatment; rather, nematode mortality was hastened by the conditioning treatment itself. In a third experiment, R. similis inside anthurium roots were conditioned at 25 degrees C or 40 degrees C for 15 minutes and then treated at 45 degrees C for up to 8 minutes. Mortality of conditioned and unconditioned nematodes was similar (P > 0.1). Conditioning treatments increase plant thermotolerance but do not induce thermotolerance in R. similis. Heat treatments have promise as disinfection protocols for quarantines.

Compound odontoma associated with an unerupted and dilacerated maxillary primary central incisor in a young patient.

The occurrence of odontoma in the primary dentition is uncommon. There are very few reports of non-eruption of a dilacerated primary tooth in the literature. A rare case of compound odontoma in association with an unerupted dilacerated maxillary primary incisor in a young patient is reported. There was also a developing supernumerary tooth in the vicinity of the odontoma. The clinical features and management of these conditions are discussed. The relevant literature is reviewed. A possible causal relationship between odontoma and dilaceration is highlighted.