Suicidal burn in Hong Kong

The aim of our study is to review our experience in the management of patients who sustained burns associated with suicidal attempts over a 10-year period. In particular, we look into the outcome and incidence of self-harm/suicide after discharge among the survivors. Thirty-one patients with median age 36 years, ranging from 10 to 74, were included. Twenty-three (74%) were males and eight (26%) were females. Nearly three quarters (74%) of our patients had a known history of psychiatric illness: 11 had known history of substance abuse; 3 of them had drug-induced psychosis; 6 had schizophrenia; 5 had depression; 4 had personality disorders; 1 had pathological gambling and another one had adjustment disorder. Relationship problems and work/financial difficulties were the commonest reason for the suicidal attempts. Self-inflicted flame burn was the most frequent (39%; 12 patients) method of burning. Six patients (19%) died. The remaining 25 patients healed and were discharged. Seventeen patients required ICU care. The median length of stay in ICU was 7 days. The overall median length of stay was 35 days. The median follow up time for those survived is 63 months. Only 4 of these patients had further suicidal/parasuicidal attempts. Despite the high mortality, once these patients survived the initial injury, they are unlikely to commit suicide again. Thus, we believe that aggressive resuscitation should therefore be advocated for all suicidal burn patients.     

Emergency contraception in Hong Kong

ＥｍｅｒｇｅｎｃｙｃｏｎｔｒａｃｅｐｔｉｏｎｉｎＨｏｎｇＫｏｎｇＰａｋ－ｃｈｕｎｇＨｏＩｎｔｒｏｄｕｃｔｉｏｎＩｎＨｏｎｇＫｏｎｇ，ｏｒａｌｃｏｎｔｒａｃｅｐｔｉｖｅｐｉｌｌｓａｒｅｆｒｅｅｌｙａｖａｉｌａｂｌｅｏｖｅｒｔｈｅｃｏｕｎｔｅｒｗｉｔｈｏ...     

Women surgeons in Hong Kong

Objective: To survey Hong Kong women surgeon's current situation: their ability to balance career, personal and family life, and to look into some gender-specific issues. Methods: A 28-item questionnaire online survey was emailed to 142 female and 761 male surgeons with questions asking about four areas: demographic data, job satisfaction, work life balance and work opportunity. Results: Fifty-eight female and 114 male surgeons completed the questionnaire. The mean age of female surgeon respondents was significantly younger than male surgeon respondents (33 vs 43 years, P < 0.001). Both female and male surgeons worked long hours (70% female and 64% male worked >= 60 hours per week, P = 0.402); however, both felt satisfied or very satisfied with their current job situation (74% female and 76% male, P = 0.536) and were happy or very happy with other aspects of their lives (84% female and 82% male). More male respondents were married (83% male vs 35 % female, P < 0.001) and more married men had biological children at the time of the survey (83% male vs 62% female, P = 0.034). Both married males and females had family commitments affecting training, career advancement and overseas training. The majority of male and female surgeons did not experience discrimination during training or career advancement; however, more females felt discriminated against during selection and training processes (25% female vs 12% male, P = 0.001) and during career advancement (18% female vs 10% male, P = 0.013). Conclusion: Our survey results showed that both female and male surgeons are able to combine productive careers with satisfactory personal and family lives. However, both female and male surgeons faced many difficulties in their working lives; women may have more difficulties regarding family issues, as our survey showed that more women surgeons remained single and more married women surgeons had no children. Policies that facilitate a work life balance are important to attract and retain the best and talented physicians, regardless of sex. In view of the increasing number of women surgeons, frequent surveys are needed to determine whether women surgeons experience a working environment that ensures a level playing field.     

Trauma system in Hong Kong

The presence of a regionalized trauma system has been shown to improve outcome in trauma. Trauma care has undergone significant changes in Hong Kong in recent years. In 2003, five public hospitals were designated as trauma centres. Since then, there has been a progressive improvement in trauma patient outcome in Hong Kong. Trauma centre designation by itself, however, does not constitute a trauma system. The latter is an integration of prehospital care, interhospital transfer, trauma centres, rehabilitation, prevention, education and research. Under the primary trauma diversion policy, trauma patients in Hong Kong are no longer sent to the nearest hospitals, but transferred directly to trauma centres where definitive care can be implemented earlier. The present article describes some of these changes and addresses issues pertinent to the future development of trauma service in Hong Kong.