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Objective To investigate the simultaneous use of over-the-counter (OTC) and prescription medicines across allopathic western medicine (WM) and traditional Chinese medicine (TCM) modalities amongst urban Chinese patients. Method Secondary analysis of the Hong Kong population representative Thematic Household Survey 2007 dataset (n = 28,923, response rate 76.8%). Results Of the enumerated population, 1.9% reported ever having used TCM OTC medications and WM prescription medicine simultaneously, of whom 59.3% did not disclose this to their WM doctors. Of respondents, 1.3% reported figure co-usage of WM OTC and TCM prescription medicines and 40.1% did not disclose this to their TCM practitioners. The top two reasons for non-disclosure were: the belief that WM and TCM medicines do not interact with each other, and clinicians did not initiate the discussion. Those with regular healthcare providers were more likely to disclose their co-usage. The majority of respondents cited healthcare professionals as their main source of information for OTC products. Conclusion Since self medication is common, clinicians should proactively ask patients about their medication in both modalities of care; and provide appropriate education on potential risks. The population prefers to integrate WM and TCM under supervision of both types of clinicians, instead of making their own choices on medication use across modalities. Discussion Policy makers should enhance interprofessional education for and communication between WM and TCM clinicians. However, further research on patients’ knowledge of herb–drug interactions, as well as accurate ascertainment of co-utilization patterns for each modality is needed before drawing firmer conclusions.

Recognizing the international trend for patients to choose both allopathic western medicine (WM) and traditional, complementary and alternative medicine (TCAM), the World Health Organization has called for stronger collaboration between WM doctors (WMD) and TCAM practitioners. This resonates with the situation in Hong Kong where the dominant modality of patient care is primarily based on WM practice while traditional Chinese medicine (TCM) is often used as a complement. The roots of this utilization pattern lie in colonial history when TCM was marginalised during the British administration. However since 1997 when China regained sovereignty, policies to regulate and professionalize TCM practices have been formally introduced. Despite both its popularity and this policy shift, progress on implementing collaboration between WM and TCM clinicians has been slow. This study, the first since 1997, explores current attitudes and referral behaviours of WMD towards use of TCM. We hypothesised that WMD would have positive attitudes towards TCM, due to regulation and cultural affinity, but that few actual TCM referrals would be made given the lack of a formal collaboration policy between elements within the healthcare system. Our results support these hypotheses, and this pattern possibly rooted from structural inhibitions originating from the historical dominance of WM and failure of services to respond to espoused policy. These have shaped Hong Kong’s TCAM policy process to be closer with situations in the West, and have clearly differentiated it from integration experiences in other East Asian health systems where recent colonial history is absent. In addition, our results revealed that self use and formal education of TCM, rather than use of evidence in decision making, played a stronger role in determining referral. This implies that effective TCAM policies within WM dominated health systems like Hong Kong would require structural and educational solutions that foster both increased understanding and safe referrals.

As businesses grow across continents in terms of reach, scale, and diversity in products, the complexity of management problems and efforts to maximize the profit in corporations have increased significantly. To assist managers and employees at all levels in decision making, corporate modeling is essential to provide decision support information. Corporate modeling within business organizations has moved from standalone database applications to integrated and flexible enterprise-wide information systems. Computer modeling and planning tools such as decision support systems (DSS) are widely used by corporate management to select alternatives based on key business performance measures. Enterprise resource planning (ERP) systems have also been introduced as a new form of corporate modeling that does the same thing as traditional DSS, but they are not confined to the boundaries of business applications. This article reviews the various types of corporate models along with development and applications of advanced DSS and ERP systems. Keywords: corporate modeling; customer-centric enterprise information systems; decision support systems; enterprise resource planning; evolutionary multiagent systems

Background Health-care professionals worldwide have started to appreciate patients' perspectives on the use of complementary and alternative medicine (CAM) particularly given its popularity. However, cultural perspectives may vary and it may not be possible to apply research findings on the use of CAM from the west to the east. Objective This systematic review aims to synthesize usage patterns of traditional Chinese medicine (TCM) amongst Chinese populations in different parts of the world and explore potential geographical variations. Search strategy Six international and four Chinese databases were searched, and manual searches of relevant monographs and government publications were carried out. Inclusion criteria Quantitative, qualitative or mixed-method research that aimed to investigate Chinese patients' perception of, and perspectives on, TCM was included. Data extraction and synthesis For each study included, texts under the headings of ‘results’ or ‘findings’ were extracted and subjected to analysis. A thematic synthesis approach was adopted for synthesizing qualitative and quantitative studies. Main results Amongst the 28 studies included, twenty were quantitative surveys, six were qualitative studies and two were mixed-method studies. The overall methodological quality was mediocre. Data synthesis suggested that patients from all regions share a common cultural affinity to TCM and consider it to be an effective complement to western medicine (WM) for treating chronic or serious diseases. However, heterogeneous views on (i) disclosing TCM use to WM doctors and (ii) the potential harm of herbs emerged across different study locations. Discussion and conclusions Future research should explore how variation in health systems may influence patients' perception of CAM in different countries.

In Hong Kong, statutory regulation for traditional Chinese medicine (TCM) practitioners has been implemented in the past decade. Increasing use of TCM on top of biomedicine (BM) services by the population has been followed; but corresponding policy development to integrate their practices has not yet been discussed. Using focus group methodology, we explore policy ideas for integration by collating views from frontline BM (n=50) and TCM clinicians (n=50). Qualitative data were analyzed under the guidance ofstructuration model of collaboration, a theoretical model for understanding interprofessional collaboration. From focus group findings we generated 28 possible approaches, and subsequently their acceptability was assessed by a two round Delphi survey amongst BM and TCM policy stakeholders (n=12). Consensus was reached only on 13 statements. Stakeholders agreed that clinicians from both paradigms should share common goals of providing patient-centered care, promoting the development of protocols for shared care and information exchange, as well as strengthening interprofessional connectivity and leadership for integration. On the other hand, attitudes amongst policy stakeholders were split on the possibility of fostering trust and mutual learning, as well as on enhancing innovation and governmental support. Future policy initiatives should focus on these controversial areas.

Benefits of engaging community pharmacists in providing wider primary care are internationally acknowledged; in Hong Kong, however, strategies for harnessing their potential contributions are yet to be launched. Here, community pharmacist and Chinese medicine retailers are responsible for providing western and Chinese over-the-counter (OTC) medications. Patterns of OTC uses reflect the characteristics of populations who rely on community pharmacists and Chinese medicine retailers as their main point of contact with the healthcare system. Analyzing the data from a Hong Kong survey (n = 33,263) on self medication and medical consultation patterns, we propose, in this article, an extended role for community pharmacists and Chinese medicine retailers, which entails aspects as follows: (1) referring patients to other medical services where appropriate; (2) providing health education and preventative services; (3) safeguarding the use of Chinese herbal medicines.

Background In 1997 Hong Kong reunified with China and the development of traditional Chinese medicine (TCM) started with this change in national identity. However, the two latest discussion papers on Hong Kong's healthcare reform have failed to mention the role of TCM in primary healthcare, despite TCM's public popularity and its potential in tackling the chronic non-communicable disease (NCD) challenge in the ageing population. This study aims to describe the interrelationship between age, non-communicable disease (NCD) status, and the choice of TCM and western medicine (WM) services in the Hong Kong population. Methods 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%). Results 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. Conclusion 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.

This paper summarizes the effects of Internet use on interpersonal behaviours among university students in Hong Kong. 2427 university matriculants in Hong Kong (mean age = 18.9, response rate 92.1%) completed an anonymous, self-administered questionnaire at the pre-enrollment health check-up. In the week preceding the survey, 99.4% of students had used the Internet with an average of 2.8 h/day; 14.9% reported heavy Internet use (4 h/day). Males (OR = 2.48) and Hong Kong-born students were more likely to be heavy users (OR = 1.67) while students with a religious affiliation (OR = 0.70), with a parent with tertiary education (OR = 0.68), or those in a romantic relationship (OR = 0.72) were less likely to be heavy users. Heavy users were less likely to socialize face-to-face (OR = 0.75) or talking to someone in person (OR = 0.61) in order to relieve feelings of stress, but were more likely to engage in online chatting (OR = 1.73) and online interactive games (OR = 2.43). They were also more likely to skip school (OR = 2.21), to be yelled at by family members (OR = 2.05) and to meet strangers from the Internet in person (OR = 3.31). There is strong evidence of the adverse effects of heavy internet use on interpersonal behaviours among Hong Kong university students, warranting further studies.

To examine the correlates of heavy Internet use and determine the associations of heavy Internet use with various health risk behaviors and health-promoting behaviors among Chinese adolescents, an anonymous, self-administered health behavior questionnaire was completed by 2427 matriculants into a Hong Kong university (mean age=18.9 y) and returned at compulsory health examination. Of students, 14.8% reported heavy Internet use (>4h/day) and such use was associated with lower likelihood of engaging in health-promoting activities such as exercising and seeking medical care. At the same time, heavy Internet use was correlated with multiple risk behaviors such as skipping meals and sleeping late as well as poorer health outcomes such as higher likelihood of being overweight or having hypersomnia. Given the double burden of poorer health outcomes and fewer health-promoting behaviors, heavy Internet users represent a particularly challenging group for adolescent health promotion.

Objective This study investigates differences in perceived communication by patients of the quality of outpatient episodes in an urban Chinese population. Methods A representative, population based survey was conducted in Hong Kong, China. A random sample of respondents aged >15 years who had received outpatient care the 30 days previous to enumeration were invited to evaluate communication with their doctors and the overall quality of their latest consultation. Results The majority thought that their clinicians were listening carefully (93.5%), explaining clearly (93.1%), expressing appropriate respect (93.8%), and were allocating sufficient time for consultation (89.5%). 97.6% gave 5–10 points out of 10 for overall healthcare quality. Compared to users of private western medicine (WM) services, multivariate analysis showed that traditional Chinese medicine (TCM) patients were more likely to rate their clinicians highly for listening skills but low for respect. Users of WM public services were more likely to be dissatisfied with all evaluated aspects. Favourable ratings were more likely to be expressed by those who are older, less educated, and those who paid by indemnity insurance. Conclusions We have highlighted three unique observations: first, patients’ perception of clinician–patient communication in out patients differs between WM and TCM. Second, patients who used public WM services rate the quality of their visits lower than those in the private WM sector. Lastly, we have observed a negative association between higher education background and satisfaction level. Further researches are warranted.

The sections in this article are 1 Decision Support Systems (DSS) 2 Characteristics of Enterprise Resource Planning (ERP) Systems 3 Infrastructure of ERP Systems 4 Conclusions

Purpose: The prevalence of health issues such as depression, eating disorders and internet addiction has increased significantly among teens in Hong Kong. Despite the importance of targeted health risk behaviour screening and counselling for adolescents on issues such asmental health, body image, drug and alcohol use and sexual activity, there is very limited information regarding actual screening practices by health providers in Hong Kong. This study was conducted to determine the frequency of specific screening and counselling practices by providers as well as the associated barriers to screening during health visits among university students in Hong Kong. Methods: In 2011, a cross sectional studywas conducted among469 randomly selected incoming medical, nursing, public health and pharmacy students to a public university in Hong Kong using a self-administered questionnaire. Questionnaires were collected while students attended a required health check-up in the university health service. Descriptive statistics were generated by SPSS 16.0. Results: The mean age of students was 19 years and 66% were female. The majority of students received care in the private system (64%) and saw a traditional Western practitioner (75.9%). Only 1⁄2 (49.5%) reported that the visit was conducted in a confidential manner. Themain reasons for visitswere for acute visits (44.8%), followed by routine health checks (14.7%) Students reported having problems in the last five years with school issues (18.6%), depression (17.1%), body image (16.8%), and internet overuse (11.3%). However, providers only infrequently asked about school issues (3.2%) depression (4.3%), body image (.9%), and internet overuse (2.8%) during encounters. In addition, providers rarely asked about sexual activity (.6%), condomuse (.4%) and drug/ alcohol use (1.3%). Only 2.1% of providers used a written or electronic screening questionnaire to ask about health behaviours. The majority of students cited that they were comfortable and honest in discussing personal information related to dietary habits (80.6%), sleep (77.8%), and depression and stress (59.7%) but less so for drug use (39.9%), sexual activity (34.1%) and sexual identity (35.8%). Some participants responded (40.9%) that they would feel shocked if their provider asked about personal behaviours such as drug use or sexual activity when the student visited for a routine URI and nearly 1⁄2 (53.7%) did not consider it part of the physician’s job to ask about such issues. Main barriers reported by students to disclosing personal information included feeling ashamed (71%) and fear of disclosure to parents (19%). Conclusions:Depression, body image concerns, and internet addiction are important health problems among adolescents in Hong Kong. However, students in this study were infrequently screened or counselled about these issues during visits. Health providers are missing important opportunities to provide preventive care. The use of a standardizedwritten or electronic screening questionnaire could be a useful adjunct to current care. In addition, a more comprehensive approachwhich is confidential and culturally appropriate should be adopted to improve the health of adolescents and young adults in Hong Kong. Sources of Support: None SESSION I: SEXUAL HEALTH