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Effectiveness and optimal duration of early intervention treatment in adult-onset psychosis: a randomized clinical trial
- Christy Lai Ming Hui, Andreas Kar Hin Wong, Elise Chun Ning Ho, Bertha Sze Ting Lam, Priscilla Wing Man Hui, Tiffany Junchen Tao, Wing Chung Chang, Sherry Kit Wa Chan, Edwin Ho Ming Lee, Yi Nam Suen, May Mei Ling Lam, Cindy Pui Yu Chiu, Frendi Wing Sai Li, Kwok Fai Leung, Sarah M. McGhee, Chi Wing Law, Dicky Wai Sau Chung, Wai Song Yeung, Michael Gar Chung Yiu, Edwin Pui Fai Pang, Steve Tso, Simon Sai Yu Lui, Se Fong Hung, Wing King Lee, Ka Chee Yip, Ka Lik Kwan, Roger Man Kin Ng, Pak Chung Sham, William G. Honer, Eric Yu Hai Chen
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- Journal:
- Psychological Medicine / Volume 53 / Issue 6 / April 2023
- Published online by Cambridge University Press:
- 11 February 2022, pp. 2339-2351
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- Article
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Background
Contrasting the well-described effects of early intervention (EI) services for youth-onset psychosis, the potential benefits of the intervention for adult-onset psychosis are uncertain. This paper aims to examine the effectiveness of EI on functioning and symptomatic improvement in adult-onset psychosis, and the optimal duration of the intervention.
Methods360 psychosis patients aged 26–55 years were randomized to receive either standard care (SC, n = 120), or case management for two (2-year EI, n = 120) or 4 years (4-year EI, n = 120) in a 4-year rater-masked, parallel-group, superiority, randomized controlled trial of treatment effectiveness (Clinicaltrials.gov: NCT00919620). Primary (i.e. social and occupational functioning) and secondary outcomes (i.e. positive and negative symptoms, and quality of life) were assessed at baseline, 6-month, and yearly for 4 years.
ResultsCompared with SC, patients with 4-year EI had better Role Functioning Scale (RFS) immediate [interaction estimate = 0.008, 95% confidence interval (CI) = 0.001–0.014, p = 0.02] and extended social network (interaction estimate = 0.011, 95% CI = 0.004–0.018, p = 0.003) scores. Specifically, these improvements were observed in the first 2 years. Compared with the 2-year EI group, the 4-year EI group had better RFS total (p = 0.01), immediate (p = 0.01), and extended social network (p = 0.05) scores at the fourth year. Meanwhile, the 4-year (p = 0.02) and 2-year EI (p = 0.004) group had less severe symptoms than the SC group at the first year.
ConclusionsSpecialized EI treatment for psychosis patients aged 26–55 should be provided for at least the initial 2 years of illness. Further treatment up to 4 years confers little benefits in this age range over the course of the study.
2 - Black and Red: Post-War Hong Kong Noir and its Interrelation with Progressive Cinema, 1947–57
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- By Law Kar
- Edited by Esther C.M. Yau, The University of Hong Kong, Tony Williams, Southern Illinois University
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- Book:
- Hong Kong Neo-Noir
- Published by:
- Edinburgh University Press
- Published online:
- 24 April 2021
- Print publication:
- 28 April 2017, pp 30-50
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Summary
Shanghai noir emerged in the immediate post-war years as a response to Hollywood imports. China's war against Japan (1937–45) had scarcely ended in August 1945 when its people faced another kind of ‘invasion’ from movies of the USA. Having been deprived of Hollywood pictures during wartime, China's filmgoers embraced American imports while local filmmakers looked on with envy and anxiety. From 1946 to 1949, hundreds of American releases flourished on Chinese screens, among them war, espionage, musicals, romantic love and crime pictures the most popular genres. Chinese cinema, including that of Hong Kong, fought back by producing genre films of similar and mixed conventions. The latter combined melodramas, musicals and comedies with darker elements of murder, crime, suicide, horror and psychological dissociation. In no other comparable period were audiences of Chinese cinema so drawn to the dark side of human nature.
Some of these productions can now be identified wholly or partly under the description of film noir, or what is called ‘heise dianying’ (dark film) in Chinese. As we know, the term itself is never singly or homogeneously defined, and it is not my intention to differentiate these films as a genre but rather as a ‘feeling’ and ‘tone’. In this chapter I examine the dark elements and pessimistic tone in post-war Chinese cinema and its extension from Shanghai to Hong Kong involving key directors, actresses and films, along with specific cinema and social contexts.
Right after the war ended, the nationalist government took over the film industry in Shanghai, Peking and Manchuria, centralising film production and distribution under state control. The move was to disallow Chinese communists from using film for ideological propagation. In Nanking, the state-owned China Productions and two small studios were given support to produce nationalist propaganda and educational films; in Peking and Shanghai, China Film Studio was reorganised to become the biggest state-owned studios producing commercial films and newsreels. These studios were well equipped with facilities taken over from the Japanese occupiers and gave their employees regular salaries at a time of economic depression.
2 - The American Connection in Early Hong Kong Cinema
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- By Law Kar
- Edited by Poshek Fu, University of Illinois, Urbana-Champaign, David Desser, University of Illinois, Urbana-Champaign
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- Book:
- The Cinema of Hong Kong
- Published online:
- 05 June 2012
- Print publication:
- 26 June 2000, pp 44-70
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Summary
Cinema activities in Hong Kong may be traced back to the late 1890s. However, primary materials related to those early activities, particularly before the 1920s, are extremely scarce. As elsewhere in China, the early film industry in Hong Kong was generated by Western businessmen who either came to the Far East for that purpose or seized their opportunities to establish theatres and make films.
As cinema was an imported art form, and technically a new one, it took some time for Hong Kong artists to adjust to the new medium. When a film industry eventually emerged in the 1920s, it turned to the live theatre for material and personnel because theatre had been the traditional form of mass entertainment in China for centuries. It continued as such for far longer than in the West. Hong Kong cinema would have its first “golden age” between 1937 and 1941, quite suddenly achieving a very high output – peaking at the 125 films produced in 1939 – and a diversity of genres that had never appeared before. This extremely fertile period is important to researchers of the earliest developments in the industry, as stimulated by two key factors, which are examined in this chapter.
The first factor was the “American experience” of the film pioneers – not so much in their exposure to Hollywood films as in their having worked with Americans or lived in the United States.