Psychiatric Rehabilitation Association

This paper investigates the challenges and effectiveness of Hong Kong’s regulatory framework for digital assets and cryptocurrencies in the wake of the JPEX Scandal. The scandal serves as the first significant test of the city’s regulatory measures aimed at protecting consumers and investors from fraudulent activities within the crypto space. The study delves into the background and development of blockchain technology and cryptocurrencies, highlighting their rapid evolution and the associated regulatory challenges. By examining the JPEX case, the paper evaluates the robustness of Hong Kong’s regulatory tools and their ability to balance consumer protection with fostering innovation. The paper employs a doctrinal legal methodology, supplemented by a case study of JPEX, to assess whether the current regulatory framework is adequate or if further adjustments are required. The findings suggest that while significant strides have been made, certain gaps remain, particularly concerning decentralised finance (DeFi) and decentralised autonomous organisations (DAOs). The paper concludes with recommendations for enhancing regulatory clarity and ensuring the sustainable growth of Hong Kong as a global crypto hub.

IntroductionThe European Alliance for Sport and Mental Health (EASMH) is a partnership of scientific institutions, charity associations and sport organizations, funded by EU-Erasmus+. It aimed at developing good clinical practice in psychiatric rehabilitation through sport-based interventions as an integration of pharmacological and psychological therapies. Within the framework of the EASMH projects, several actions have been promoted including an assessment of the dissemination of sport-based interventions, a training course for specialized coaches and the implementation of pilot actions in four European Countries.ObjectivesTo briefly describe EASMH pilot actions performed in Finland, Italy, Romania and United Kingdom, where trained coaches delivered sport-based interventions to patients with severe mental disorders.MethodsAfter completing pilot actions, charity associations and sport organizations belonging to EASMH network described general and specific aims, sport activities, composition of staff, timing and tools for assessing the outcomes.ResultsIn Italy, “Crazy for Rugby”, including adolescents and young patients, and “Not only headshots”, a football project for adults with severe mental disorders were performed. In UK, a football-based activity called “Imagine Your Goal” and a walking-football program for participants aged more than 40 were delivered. In Romania, two courses including gymnastics, yoga and pilates called “Get fit!” were provided. Different team sport-based activities were implemented in Finland, where “Multiple Sport Group” and “Rehabilitating Sports” aimed at increasing patients’ autonomy. Assessment of psychopathological, social, cognitive and sport/fitness outcomes confirmed the overall beneficial effects of sport on mental health.ConclusionsPilot actions represent the final step of EASMH project, which showed improvement of mental health outcomes by also delivering sport-based rehabilitation to patients with severe mental disorders. Institutions and stakeholders are now called to promote the implementation of such initiatives on a broader scale.Disclosure of InterestNone Declared

BackgroundAlthough text messaging has the potential to be the core intervention modality, it is often used as an adjunct only. To improve health and alleviate the distress related to insomnia, pain, and dysregulated eating of people living in urban areas, text messaging–based mindfulness-based interventions were designed and evaluated in 3 randomized controlled trials.ObjectiveThis study investigated the effectiveness and mediating mechanisms of text messaging–based mindfulness-based interventions for people with distress related to insomnia, pain, or dysregulated eating.MethodsIn these trials, 333, 235, and 351 participants were recruited online and randomized to intervention and wait-list control conditions for insomnia, pain, and dysregulated eating, respectively. Participants experienced 21 days of intervention through WhatsApp Messenger. Participants completed pre-, post-, 1-month follow-up, and 3-month follow-up self-report questionnaires online. The retention rates at postmeasurements were 83.2% (139/167), 77.1% (91/118), and 72.9% (129/177) for intervention groups of insomnia, pain, and dysregulated eating, respectively. Participants’ queries were answered by a study technician. Primary outcomes included insomnia severity, presleep arousal, pain intensity, pain acceptance, and eating behaviors. Secondary outcomes included mindfulness, depression, anxiety, mental well-being, and functional impairments. Mindfulness, dysfunctional beliefs and attitudes about sleep, pain catastrophizing, and reactivity to food cues were hypothesized to mediate the relationship between the intervention and outcomes.ResultsFor all 3 studies, the intervention groups showed significant improvement on most outcomes at 1-month follow-up compared to their respective wait-list control groups; some primary outcomes (eg, insomnia, pain, dysregulated eating indicators) and secondary outcomes (eg, depression, anxiety symptoms) were sustained at 3-month follow-up. Medium-to-large effect sizes were found at postassessments in most outcomes in all studies. In the intervention for insomnia, mediation analyses showed that dysfunctional beliefs and attitudes about sleep mediated the effect of the intervention on all primary outcomes and most secondary outcomes at both 1-month and 3-month follow-ups, whereas mindfulness mediated the intervention effect on presleep arousal at 1-month and 3-month follow-ups. In the intervention for pain, pain catastrophizing mediated the effect of intervention on pain intensity and functioning at both 1-month and 3-month follow-ups, whereas mindfulness only mediated the effect of intervention on anxiety and depressive symptoms. In the intervention for dysregulated eating, power of food mediated the effect of intervention on both uncontrolled and emotional eating at both 1-month and 3-month follow-ups and mindfulness was found to mediate the effect on depressive symptoms at both 1-month and 3-month follow-ups.ConclusionsThese 3 studies converged and provided empirical evidence that mindfulness-based interventions delivered through text messaging are effective in improving distress related to sleep, pain, and dysregulated eating. Text messaging has the potential to be a core intervention modality to improve various common health outcomes for people living a fast-paced lifestyle.Trial RegistrationClinical Research and Biostatistics Clinical Trials Registry CUHK_CCRB00559; https://tinyurl.com/24rkwarz

Videoconference treatment has a long tradition in psychiatry -it was first used in 1959. In February 2021, the World Psychiatric Association (WPA) published global guidelines concerning teleconsultation in psychiatry WPA standards dictate that a telepsychiatry (TP) consultation be treated as equivalent to a standard in-person consultation, and the choice of the type of consult at any given moment should belong to both the service provider and the patient. By a service provider we understand a doctor, psychologist, psychotherapist or any other psychiatric healthcare professional. A TP consultation should preferably assume the form of a videoconference communication, enabling the assessment of not only the patient's verbal report, but also their facial expression and body posture/movement. According to the WPA standards, there are no contraindications for TP consultations, just as there are no contraindications for onsite in-person consults. The general principle of remote videoconference consultation (teleconsultation) conducted by a psychiatrist is that it should be as close as possible

WHAT IS KNOWN ON THE SUBJECT?: There have been some studies on the experience and community life of mental health clients receiving integrated community mental health service (ICMHS). Evaluation of ICMHS suggests that the service could have positive clinical and social outcomes, but the results are inconclusive. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Research studies have focused on clients and/or staff of the ICMHS, while in this study, the experiences and perspectives of family members are also explored. More comprehensive knowledge about the work for, and community life of, people previously under the services of ICMHS is added to the existing knowledge. This study found that with "timely support" and "family presence," people who had received the services of ICMHS continued to engage in more social activities ("expanding social networks"), had "better family relationships," were "letting go" of thinking too much and more able to relax, and had "better self-efficacy and self-caring" in the community. Professional contact after ICMHS through continuous conversations (e.g. home visits and follow-up calls) and social activities are essential for both clients and their families to carry on living with the illness. Timely support, family presence, support to family members in the community and better social networks are key experiences of ICMHS clients. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Although the ICMHS' resources are limited, better promotion is urgently needed for the public to realize the services and to support mental health clients. Mental health professionals may develop practice models through exploratory and confirmatory factors analyses of the themes identified from this study as the outcome measures. The cost-effectiveness of services and relapse rates over time should also be evaluated for future practice development. Further studies for practice on the difference that family support can make to the community life of former ICMHS clients are warranted. This may be achieved through research designs that compare people with, and without, family members. ABSTRACT: Introduction More comprehensive understanding, from the experiences and multiple perspectives of the clients, families and staff, about the community life of former clients of the integrated community mental health service (ICMHS) is scarce. Aim To explore the community life experiences of people after their discharge from the ICMHS. Method A qualitative approach with an interpretative phenomenological analysis was utilized for this study. Data were collected through individual semi-structured interviews of 37 participants, including people discharged from an Integrated Community Centre of Mental Wellness, their family members and staff members. Results Six themes emerged from the analysis: "timely support," "family presence," "better family relationships," "expanding social networks," "letting go" and "better self-efficacy and self-care," under the main theme of "walking with the illness and life." Discussion Over and after the ICHMS, with timely support and family presence, there was a positive trend in the experiences of clients in expanding social networks, having better family relationships, letting go of thinking too much and being more able to relax, and improving self-efficacy and self-caring. Implications for practice The study provides a more comprehensive understanding of the experiences of clients, family and staff about the community life of people post-ICMHS, providing insights and clearer directions for research and practice development.

This study aimed to verify the relationship between assignment of professional registered dietitians (RDs) and other healthcare professionals and body weight or functional outcome in underweight patients. This was a secondary analysis of the nation-wide survey data from Kaifukuki (convalescent) rehabilitation wards (KRWs). Data of patients aged ≥20 y with disabilities and body mass index (BMI) <18.5 kg/m2 and who were discharged from 1,099 KRWs were analyzed. The primary outcome was BMI at discharge. Secondary outcomes were Functional Independence Measure (FIM) at discharge and returning to home. Patients were divided into two groups: those in KRWs with ≥1 or <1 dedicated RD per ward (KRW/RD+ and KRW/RD-, respectively). Of 5,843 eligible participants (female, 63%; median age, 82 y; hip/vertebral/knee fracture, 47%; stroke, 34%; disuse syndrome secondary to acute illness, 11%; others, 8%), 1,288 and 4,555 were from the KRW/RD+ and KRW/RD- groups, respectively. At discharge, KRW/RD+ patients had higher FIM (93 vs. 90) and BMI (17.1 vs. 17.0 kg/m2) than did KRW/RD- patients. Multivariable analysis showed that assignment of dedicated RDs (B=0.213, 95% confidence interval [CI], 0.036-0.389), number of nurses (B=0.023, 95% CI, 0.003-0.043), and daily rehabilitation dose were significantly associated with changes in body weight. Furthermore, these factors positively affected BMI at discharge. Number of nurses and rehabilitation dose correlated with FIM, but assignment of RDs did not correlate with FIM. In conclusion, assignment of RDs, nurses, and sufficient rehabilitation dose may contribute to BMI gain. Nurses and daily rehabilitation dose may positively affect functional recovery.

Introduction Barth syndrome is a rare X-linked genetic disorder caused by a mutation or deletion of the tafazzin gene. Approximately 50–70% of affected males have family-reported feeding issues that affect eating habits and/or restrict dietary intake. Research to date suggests that these feeding problems may be related to differences in responsivity to taste and smell stimuli. The purpose of this study was to use indices of chemosensory function to study differences in food-related sensation and anatomy in males with and without Barth syndrome.

The aim of this study was to examine the fit accuracy of e.max crowns by investigating marginal and internal gaps. In experiment 1, 60 e.max computer-aided design/computer-assisted manufacture (CAD/CAM) crowns were manufactured. The crowns were fabricated using optical scanning of artificial teeth (Op group) or scanning of a plaster model following a silicone impression (M group). Cement space settings of 90, 120, and 150 μm were applied. Marginal and internal crown gaps were compared among six conditions (Op90, Op120, Op150, M90, M120, M150). In experiment 2, e.max CAD crowns from the Op group (CADop group) and the M group (CADm group) were compared with e.max Press crowns (Press group) by measuring marginal and internal gaps of the crowns using Scheffe multiple comparison test. The level of significance was set at .05. In experiment 1, the marginal gap of the Op90 group was significantly higher than that of the Op120 and Op150 groups. The marginal gap of the M90 group was significantly higher than those of the M120 and M150 groups, and the internal gap of the M90 group was significantly lower than that of the M150 group. Although there was no statistically significant difference in marginal gap among the three groups, the internal gap of the CADm group was significantly higher than the Press group. Although the variation in cement space settings and fabrication techniques affected accuracy, e.max CAD crowns fabricated using optical scanning of melamine teeth achieved a clinically acceptable fit.

「緩和ケア」という用語を患者に使い難いという医療者の声を聞くことがある．用語を使うのが遅れると患者や家族が緩和ケアを知る機会が遅れる可能性がある．われわれは「緩和ケア」という用語を用いた医療者から患者・家族への説明について調査した．2010年2月，広島大学病院の医師387名・病棟看護師518名に，質問紙調査を行った．回答率は医師70.3％，看護師54.8％で，そのうち77.2％の医師，56.0％の看護師が「緩和ケア」という用語を使用すると回答した．過半数の医師が診断時か症状出現時にはじめて用語を使用していた．看護師では医師が緩和ケアについて説明してから用語を使うとした者が約3割で，臨床経験年数が少ないほどその割合は多かった．医師は早い時期にはじめて用語を使う者が多く，看護師は早い時期に使う者も多いが医師より先に用語を用いにくい者も少なからずいることがわかった．