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Inguinal Bladder Hernia: Case Report  [PDF]
Guo Liang Yong, Mun Yee Siaw, Amelia Jia Ling Yeoh, George Eng Geap Lee
Open Journal of Urology (OJU) , 2013, DOI: 10.4236/oju.2013.35040

Sliding inguinal scrotal herniation of the bladder is rare but well-documented in the medical literature. The majority of the patients are asymptomatic and the hernia is usually diagnosed incidentally. Most authors had advocated surgically repair of the hernia with the reduction or resection of the bladder as the definitive management. We present an unusual case of inguinal scrotal herniation of the bladder presented as acute abdominal pain and treated with conservatively with urethral catheterization.

Development of Conceptual Framework from the View of Patients and Professionals on Patient Engagement: A Qualitative Study in Hong Kong SAR, China  [PDF]
Eliza Laiyi Wong, Richard Huan Xu, Suifai Lui, Annie Wailing Cheung, Eng-Kiong Yeoh
Open Journal of Nursing (OJN) , 2018, DOI: 10.4236/ojn.2018.85026
Abstract: Objective: To investigate patient engagement to gain understandings of professional and patient’s views and inform the development of a patient engagement conceptual framework for further development of a valid and reliable evaluated measure. Method: 17 selected hospitals from Hong Kong East Cluster, Hong Kong West Cluster, Kowloon Central Cluster, Kowloon East Cluster and New Territory East Cluster of Hospital Authority Hong Kong involved in the study. Focus groups were conducted with 37 medical staffs, which included 15 doctors and 22 nurses, and 33 patients. Semi-structured qualitative interview study, with purposive sampling and constant comparative analysis. Results: Data were analyzed using a qualitative approach of latent content analysis. Patient engagement is a multi-dimensional concept. Five hierarchical themes separately from the patient and medical staff’s perspectives containing different conceptions and attitudes related to patient engagement have been identified and summarized. Through analyzing both professional and patients’ perspectives, a hierarchical framework incorporating patients-professional dynamically fluctuating relationship was built. The framework divides engagement into five levels and five stages. Conclusions: Patient engagement is recognized by more patients and professionals as a means and a cornerstone to build the foundation of patient-centered-care. Our framework encourages that patient engagement related to not only an individual patient’s behavior but a reciprocal, dynamic and pluralistic relationship with their professionals and healthcare systems. Understand this relationship can help us better conceptualizing, evaluating, and implementing interventions to improve the population’s health.
A Consensus-Based Policy Framework on Pharmacist-Led Self-Management Using the Delphi Process  [PDF]
Fiona Y. Y. Wong, Frank W. K. Chan, Joyce H. S. You, Eliza L. Y. Wong, Eng-Kiong Yeoh
Journal of Service Science and Management (JSSM) , 2012, DOI: 10.4236/jssm.2012.53027
Abstract: Fragmentation of the healthcare system and lack of connectivity between in-hospital and community services, have posed an impact on management of patients with chronic conditions. As self-management is an essential component in chronic disease management model and pharmacists are underutilized in Hong Kong, this study developed a consensus-based policy framework on pharmacist-led self-management using a Delphi panel consisted of medical doctors, pharmacists, Chinese medicine practitioners and dispensers. We had studied a local population survey to understand the use of over-the-counter medication, conducted focus groups and telephone survey to explore the views of the four health professions and the general population, respectively, on pharmacist-led approach in self-management. The find- ings served as the base for developing the self-administered questionnaire in Delphi. A total of 19 experts completed the questionnaires and rated the validity and clarity of each statement in a 9-point scale. The Delphi process was completed in two rounds. Community pharmacists could only play an assisting role in patient self-management. They should focus primarily on drug-related issues and were suggested to work on lifestyle modifications collaboratively with physicians and nurses. The government has to develop supportive measures to enhance pharmacist-led patient self-management in the future.
Age, chronic non-communicable disease and choice of traditional Chinese and western medicine outpatient services in a Chinese population
Vincent CH Chung, Chun Lau, Eng Yeoh, Sian Griffiths
BMC Health Services Research , 2009, DOI: 10.1186/1472-6963-9-207
Abstract: This study is a secondary analysis of the Thematic Household Survey (THS) 2005 dataset. The THS is a Hong Kong population representative face to face survey was conducted by the Hong Kong Administrative Region Government of China. A random sample of respondents aged >15 years were invited to report their use of TCM and WM in the past year, together with other health and demographic information. A total of 33,263 persons were interviewed (response rate 79.2%).Amongst those who received outpatient services in the past year (n = 18,087), 80.23% only visited WM doctors, 3.17% consulted TCM practitioners solely, and 16.60% used both type of services (double consulters). Compared to those who only consulted WM doctor, multinomial logistic regression showed that double consulters were more likely to be older, female, NCD patients, and have higher socioeconomic backgrounds. Further analysis showed that the association between age and double consulting was curvilinear (inverted U shaped) regardless of NCD status. Middle aged (45-60 years) NCD patients, and the NCD free "young old" group (60-75 years) were most likely to double consult. On the other hand, the relationship between age and use of TCM as an alternative to WM was linear regardless of NCD status. The NCD free segment of the population was more inclined to use TCM alone as they become older.In Hong Kong, most patients have chosen WM provided in the public sector as their sole outpatient service provider for NCD. Amongst TCM service users, middle aged NCD patients are more likely to choose both TCM and WM outpatient services. Meanwhile, older people without NCD are more likely to use TCM as their main form of care, but the size of this population group is small. These utilization patterns show that patients choose both modalities to manage their NCD and TCM should be considered within policies for supporting patients with NCD under the wider primary health and social care system that supports patient choice.In conte
A Proposed Implementation of Elliptic Curve Exponentiation over Prime Field (Fp) in the Global Smart Cards
T. Abdurahmonov,Eng-Thiam Yeoh,Helmi Mohamed Hussain
International Journal of Information and Electronics Engineering , 2013, DOI: 10.7763/ijiee.2013.v3.269
Abstract: this paper is explained about elliptic curve exponentiation over prime field ( Fp) which are Affine, projective, Jacobian, Chunnovsky-Jacobian and the modified Jacobian coordinate systems that how to implement elliptic curve exponentiation over prime field (Fp) into Elliptic Curve (EC) encryption and digital signature in the global smart cards. These coordinate systems are explained the underlying arithmetic operations with formulae and geometrical diagrams. Point addition and doubling of coordinate systems over prime field Fp are mentioned for every coordinate system. Thus, we proposed mixed coordinate systems over prime field (Fp) in the EC encryption and digital signature of the global smart cards.
Public perception on the role of community pharmacists in self-medication and self-care in Hong Kong
Joyce H You, Fiona Y Wong, Frank W Chan, Eliza L Wong, Eng-kiong Yeoh
BMC Pharmacology and Toxicology , 2011, DOI: 10.1186/1472-6904-11-19
Abstract: A cross-sectional phone survey was conducted, inviting people aged 18 or older to complete a 37-item questionnaire that was developed based on the Thematic Household surveys in Hong Kong, findings of the health prorfessional focus group discussions on pharmacist-led patient self management and literature. Telephone numbers were randomly selected from residential phone directories. Trained interviewers invited eligible persons to participate using the "last birthday method". Associations of demographic characteristics with knowledge, attitudes and beliefs on self-medication, self-care and role of pharmacists, and spending on over-the-counter (OTC) products were analysed statistically.A total of 1, 560 phone calls were successfully made and 1, 104 respondents completed the survey which indicated a response rate of 70.8%. 63.1% had adequate knowledge on using OTC products. Those who had no formal education/had attended primary education (OR = 3.19, 95%CI 1.78-5.72; p < 0.001), had attended secondary education (OR = 1.50, 95%CI 1.03-2.19; p = 0.035), and aged ≥60 years (OR = 1.82, 95% CI 1.02-3.26; p = 0.042) were more likely to have inadequate knowledge on self-medication. People with chronic disease also tended to spend more than HKD100 on western (OR = 3.58, 95%CI 1.58-8.09; p = 0.002) and Chinese OTC products (OR = 2.94, 95%CI 1.08-7.95; p = 0.034). 94.6% believed that patients with chronic illnesses should self-manage their diseases. 68% agreed that they would consult a pharmacist before using OTC product but only 45% agreed that pharmacists could play a leading role in self-care. Most common reasons against pharmacist consultation on self-medication and self-care were uncertainty over the role of pharmacists and low acceptance level of pharmacists.The majority of respondents supported patients with chronic illness to self-manage their diseases but less than half agreed to use a pharmacist-led approach in self-care. The government should consider developing doctors
The Relationship with Previous Use of Community-Based Services and Informal Caregiver Support and Elderly and Informal Caregivers’ Views of Living Arrangement: Analysis of Official Statistics from 2004 to 2014  [PDF]
Kailu Wang, Stephen Chi-Kin Law, Eliza Lai-Yi Wong, Eng-Kiong Yeoh
Open Journal of Nursing (OJN) , 2019, DOI: 10.4236/ojn.2019.95042
Abstract: Background and Objectives: Views on living arrangement from elderly and informal caregivers are crucial to “ageing in place”. They might be related to the experience in the use of elderly care services, which remains inconclusive in previous literature. This study aimed to explore the association of previous experience in formal and informal long-term care services with views of both elderly and their informal caregivers on living arrangement. Research Design and Methods: This study adopted a cross-sectional design. Assessment records of Minimum Data Set-Home Care for community-dwelling elderly who were eligible for subsidized long-term care services in Hong Kong from 2004 to 2014 were made available. Multivariate logistic regression was applied to examine associations between both views on elder’s living arrangement from the elderly, caregivers and their previous informal caregiver support, and experience in formal care services. Results: 82,306 dyads of elderly and informal caregivers were included in the analysis. The elderly with previous use of home and community-based services (OR = 0.84, 95% CI 0.80 - 0.88) and informal caregivers (OR = 0.78, 95% CI 0.76 - 0.81) believed that the elderly should live away from home. Temporal trends of fewer elderly and caregivers supporting the idea of living away from home were also observed. Discussion and Implications: The results highlighted the importance of informal caregiver’s support and previous utilization of formal home and community-based services. It was concluded that resources and information of community-based care have a significant association with views on living at home also proper support services and training of care for the elderly should be made available to informal caregivers to reduce their burden.
Use of chinese and western over-the-counter medications in Hong Kong
Vincent Chi Ho Chung, Chun Lau, Frank Kin Chan, Joyce Sze You, Eliza Yi Wong, Eng Yeoh, Sian Griffiths
Chinese Medicine , 2010, DOI: 10.1186/1749-8546-5-41
Abstract: In Hong Kong, community pharmacists work independently from medical doctors who often prescribe and dispense medications in a clinical setting. On the other hand, patients often seek first line treatment from community pharmacists [1]. Community pharmacists have long been an underutilized part of the human resources in primary care [2,3] as a result of the interplay between demand, supply and organization factors [4]. In Hong Kong, the use of over-the-counter (OTC) medications is popular in the local population. Previous studies found that 65% of the respondents used OTC medications [5] and that 32.9% of outpatients had taken OTC two weeks prior to their visits [6]. The majority of community pharmacists in Hong Kong admitted that they were most frequently asked about OTC [7].Chinese OTC medications are used as often as their western medicine counterparts in Hong Kong [8]. Unlike pharmacists, tertiary education is not a prerequisite for retailing Chinese medicine OTC [9]. Historically, Chinese medicine retailers worked alongside with Chinese medicine practitioners [10]. Since 1997, Chinese medicine practitioners as a medical profession have been recognized [11] and have become less dependent on Chinese medicine retailers.This article describes the behavioral patterns of both Chinese and western medical consultations and OTC use in a representative sample of the Hong Kong population. This information will provide timely input for planning pharmacists' and Chinese medicine retailers' future roles within the Hong Kong primary care system [12].Thematic Household Survey (THS) was conducted between November 2005 and March 2006 by the Census and Statistic Department (CSD), Hong Kong [13]. The THS covered the entire land-based population of Hong Kong and interviewed a total of 33,263 non-institutional individuals (response rate: 79.2%). The interviews were conducted in Cantonese. The sample represents a population of 6,750,652 persons of the general population.The questionna
Barriers to effective discharge planning: a qualitative study investigating the perspectives of frontline healthcare professionals
Eliza LY Wong, Carrie HK Yam, Annie WL Cheung, Michael CM Leung, Frank WK Chan, Fiona YY Wong, Eng-Kiong Yeoh
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-242
Abstract: Focus groups interviews were conducted with different healthcare professionals who were currently responsible for coordinating the discharge planning process in the public hospitals. The discussion covered three main areas: current practice on hospital discharge, barriers to effective hospital discharge, and suggested structures and process for an effective discharge planning system.Participants highlighted that there was no standardized hospital-wide discharge planning and policy-driven approach in public health sector in Hong Kong. Potential barriers included lack of standardized policy-driven discharge planning program, and lack of communication and coordination among different health service providers and patients in both acute and sub-acute care provisions which were identified as mainly systemic issues. Improving the quality of hospital discharge was suggested, including a multidisciplinary approach with clearly identified roles among healthcare professionals. Enhancement of health professionals' communication skills and knowledge of patient psychosocial needs were also suggested.A systematic approach to develop the structure and key processes of the discharge planning system is critical in ensuring the quality of care and maximizing organization effectiveness. In this study, important views on barriers experienced in hospital discharge were provided. Suggestions for building a comprehensive, system-wide, and policy-driven discharge planning process with clearly identified staff roles were raised. Communication and coordination across various healthcare parties and provisions were also suggested to be a key focus.Hospital discharge is a complex and challenging process for healthcare professionals, patients, and carers. Effective discharge planning could significantly improve a patient's health and reduce patient readmission [1-6]. A systematic review from 21 randomised controlled trials involving 7,234 patients by Shepperd showed that a structured discharge pl
Risk factors of hospitalization and readmission of patients with COPD in Hong Kong population: Analysis of hospital admission records
Frank WK Chan, Fiona YY Wong, Carrie HK Yam, Wai-ling Cheung, Eliza LY Wong, Michael CM Leung, William B Goggins, Eng-kiong Yeoh
BMC Health Services Research , 2011, DOI: 10.1186/1472-6963-11-186
Abstract: This is a retrospective study analyzing COPD admissions to all public hospitals in Hong Kong. All admission episodes to acute medical wards with the principal diagnosis of COPD (ICD-9:490-492, 494-496) from January 2006 to December 2007 were captured. Unplanned readmission was defined as an admission which followed a previous admission within 30 days.In 2006 and 2007, 65497 (8.0%) of episodes from medical wards were identified as COPD admissions, and among these, 15882 (24.2%) were unplanned readmissions. The mean age of COPD patients was 76.81 ± 9.59 years and 77% were male. Unplanned readmission was significantly associated with male gender, receiving public assistance and living in nursing homes while no association was found with the Charlson comorbidity index. Patients who were readmitted unplanned had a significant longer acute length of stay (β = 0.3894, P < 0.001) after adjustment for other covariates.Unplanned readmission of COPD patients has a huge impact on the public healthcare system. A systematic approach in programme provision and a good discharge planning process targeting on COPD patients who are at high risk of unplanned readmission are essential.Chronic Obstructive Pulmonary Disease (COPD) is described as a group of lung diseases characterized by airflow limitation [1]. COPD is a leading cause of morbidity and mortality worldwide and it remains a major public health problem. It has been estimated that by the year 2020, COPD will be ranked third among the most important causes of death and fifth among the conditions with a high burden to society for both sexes worldwide [2]. In Hong Kong, its prevalence rate has been reported to be 10% among the older population [3].Acute exacerbation of COPD is a common cause of hospital admission and readmission. The COPD admission rate in the UK doubled between 1991 and 2000 and by 2000 accounted for 1% of all hospital admissions [4]. COPD is also the greatest burden on the health care system [1,5]. In the Europ
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