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Aim: Young people in Hong Kong have been facing numerous population-level events over the past year, including social unrest and the COVID-19 pandemic. Representative data concerning the mental health of youths, however, is limited. The Hong Kong Youth Epidemiological Study of Mental Health (HK-YES) is commissioned to provide the first representative prevalence estimates and correlates of mental disorders among young people in Hong Kong. It will also examine the help-seeking behaviours, treatment rates, quality of life, and functional outcomes of the young people. More importantly, the direct and indirect economic costs of mental disorders in youths will be estimated., Methods: A total of 4500 community-dwelling participants aged 15-24 years from Hong Kong will be surveyed. Participants will be selected using a multistage stratified sampling design to provide representative estimates of the youth population in Hong Kong. All interviews will be conducted using computer-assisted personal interviewing methods for assessments covering areas of psychiatric diagnoses, symptomatology, functioning, quality of life, disability, service utilization, health economic costs of mental disorders, and sociodemographic and lifestyle characteristics. A population-weighted prevalence will be estimated using survey weights. Methods such as multivariate logistic and linear regression analyses will be used to calculate the risks and odds of factors that might be associated with different mental disorders., Conclusion: As the first population-based youth study in Hong Kong, HK-YES collects extensive and representative data on different mental conditions and their associated factors among young people. The information gathered will be important for future planning on youth mental health services in Hong Kong and will offer the opportunity for a more meaningful comparison of data with other youth populations., (© 2023 John Wiley & Sons Australia, Ltd.)

Aim: Hong Kong's existing mental health services are inadequate in addressing young people's needs. The LevelMind@JC project established an early intervention platform of community-based youth-specific mental health centres involving youth workers, cross-disciplinary professionals, and young people. The project intends to (1) pilot a community platform that incorporates a youth-friendly early screening tool with preventative intervention capabilities, (2) set up a state-of-the-art training system for youth mental health workers, (3) establish a community clinical support team and (4) develop a timely evaluation system to monitor the service and evaluate its outcome and cost-effectiveness against generic youth services., Methods: Six hundred LevelMind@JC service users will be assessed alongside 600 young people visiting generic youth centres and 100 young people in the community. Participants will be matched according to age, gender, years of education, socioeconomic status, and level of distress. Assessments, administered at baseline and at 3, 6 and 12 months, will cover demographic characteristics, psychological distress, quality of life, depressive and anxiety symptoms, functioning, physical health and lifestyle, personality and social measures, cognitive measures and health economics. Mixed-model ANOVAs will be used to indicate interactions between services and between time points., Conclusion: Built upon a community-based support model, LevelMind@JC aims to promote positive mental health in young people through the collaboration of cross-disciplinary mental health professionals. If efficacy and cost-effectiveness are established, the project could be scaled up, implicating a wider reach of care. We anticipate its success to be critical in combatting mental health issues stemming from both personal and population-level stressors., (© 2021 John Wiley & Sons Australia, Ltd.)

Objectives: LevelMind@JC youth mental wellness hubs have been launched as a novel early intervention initiative to mitigate the inevitable youth mental health problems in Hong Kong in 2019. The present study investigated the perceptions and experiences of these hubs amonst three key stakeholders, namely hub youths, hub carers of youths and hub staff., Method: An online survey assessing the perceptions and experiences of hubs on 6 major domains (e.g., youth-friendly and nonstigmatizing characteristics) was administered to three stakeholders in December 2020. Seventy-one hub youths (12-35 years old), 18 hub carers (30-64 years old) and 25 hub staff (24-59 years old) completed the survey., Results: On a 5-point Likert scale with higher ratings representing better outcomes, all three stakeholders reported above-average ratings on their overall satisfaction of hub experiences (hub youths: mean = 4.4, SD = 0.6; hub carers: mean = 4, SD = 0.8; hub staff: mean = 3.8, SD = 0.6). In addition, hub youths and hub carers reported above-average ratings on youth-friendly and nonstigmatizing characteristics regarding hubs (mean >=4.2)., Conclusions: The present findings suggest that the key stakeholders are generally satisfied with and show support to the youth-friendly, empowering and nonstigmatizing LevelMind @JC hubs. These findings along with the suggestions for hub improvement made by the stakeholders highlight the importance of taking cultural values into consideration whilst planning for mental services. More importantly, clinical implications are also highlighted which give insight for the development and implementation of a scalable, effective, and replicable early community intervention for psychiatric practise pertaining to youth mental health., (© 2021 John Wiley & Sons Australia, Ltd.)

Objective: Th17 cells (interleukin-17 [IL-17]-secreting T helper cells) have been implicated in the pathogenesis of rheumatoid arthritis and other autoimmune diseases, but the soluble factors that influence human Th17 differentiation have yet to be fully elucidated. This study was undertaken to investigate the hypothesis that the cytokines secreted by human peripheral blood mononuclear cells (PBMCs) in response to a subset of Toll-like receptor (TLR) ligands would influence Th17 polarization., Methods: Supernatants from human PBMCs treated with a panel of TLR agonists were tested for their ability to induce de novo IL-17 production in naive T helper cells. Multiplex cytokine analysis was used to identify candidate cytokines for subsequent blocking and sufficiency experiments., Results: Conditioned media from PBMCs stimulated with TLR-4 or TLR-8/7 agonists, but not from those stimulated with TLR-2/1, -3, or -9 agonists, evoked robust secretion of IL-17 by T helper cells, independent of coculture with antigen-presenting cells. Multiplex analysis of 22 cytokines and chemokines identified a 6-factor cytokine signature that significantly correlated with IL-17-inducing activity. T cell activation in the presence of recombinant IL-1beta, IL-6, and IL-23 reconstituted robust IL-17 production, and this was enhanced by transforming growth factor beta (TGFbeta). IL-6 suppressed the expression of forkhead box P3 and reversed TGFbeta-mediated inhibition of T cell proliferation, but did not trigger IL-17 secretion. IL-17 production was completely abrogated by anti-IL-1 or IL-1 receptor antagonist and partially inhibited by anti-IL-6, anti-IL-2, or exogenous retinoic acid, but not by anti-tumor necrosis factor alpha. IL-1beta and IL-6 independently induced IL-21 secretion, but the presence of IL-21 alone was not sufficient for IL-17 production., Conclusion: These results indicate that ligation of a subset of TLRs generates proinflammatory cytokines that combine to potentiate human Th17 differentiation.

A retrospective study of brain investigations of 372 male patients in a maximum-security mental hospital patients is described. All computed tomography (CT) scan and electroencephalography (EEG) reports were collected and rated blind; patients were subsequently divided into 3 groups according to the violence rating of their pre-admission offending behaviour. The 3 groups were similar in their mean age, psychiatric diagnosis, Wechsler Adult Intelligence Scale score and proportions of patients investigated with EEG and CT. In the most violent group, 20% had focal temporal electrical abnormalities on EEG (slowing and/or sharp waves) and 41% had structural abnormalities localised to temporal lobe on CT (dilated temporal horn and/or reduced size of temporal lobe). The corresponding figures for the least violent group are 2.4% and 6.7% respectively. These results suggest that high violence rating scores are associated with temporal lobe abnormalities on CT and abnormal temporal electrical discharges on EEG.

Twenty-eight asymptomatic relatives from 7 Chinese families with Huntington's disease (HD) received psychosocial assessment. One third of these subjects (n = 9) had symptoms of anxiety and depression that warranted a Present State Examination (PSE) diagnosis. One quarter of these subjects (n = 8) would contemplate suicide if their predictive testing indicated a high risk of having the disease. This suicidal risk was associated with a PSE diagnosis of depression and a stress-coping repertoire with a high proportion of coping strategies of the avoidance type at the time of interview. Early and close liaison with these subjects for the detection of mental symptoms and provision of counselling on a balanced and positive coping style is essential.

Obstructive sleep apnea, a sleep disorder, is becoming more prevalent and requires prompt and effective treatment by the dental and medical specialties. Conservative treatment modalities (ie, intraoral devices that prevent or minimize airway obstruction by the tongue) are recommended for treating mild to moderate forms of OSA. This article describes a simplified technique for fabricating an intraoral OSA prosthesis.