Wendy Chow

The Use of Skin Fibroblast Cultures in the Detection of Respiratory Chain Defects in Patients with Lacticacidemia

ABSTRACT: Cultured skin fibroblasts from patients with lacticacidemia were incubated with glucose for 1 h and the lactate and pyruvate production measured. Those patients with increased lactate to pyruvate ratios were further analyzed for the cause of the abnormal redox state. Two categories of patients are described. The first contains patients with either severe or partial cytochrome oxidase deficiency; this group can be broken down further into patients with Leighs disease, Kearns-Sayre syndrome, and liver-specific cytochrome oxidase deficiency. In this group, the rise in lactate to pyruvate ratio roughly correlated with the severity of the defect. The second patient category had defects located in complex I of the mitochondrial respiratory chain. This is easily demonstrated in the most severely affected patients with the fatal infantile form of the disease. Patients with severe defects in either complex I or cytochrome oxidase had complexes that were only partially assembled. Patients with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes demonstrated only minor changes in redox state and in the behavior of the mitochondrial respiratory chain.

Multi-family psycho-education group for assertive community treatment clients and families of culturally diverse background: a pilot study.

This study evaluates the incorporation of Multi-Family Psycho-education Group (MFPG) to an Assertive Community Treatment Team developed to serve culturally diverse clients who suffers from severe mental illness. Participants included Chinese and Tamil clients and their family members. Family members’ well-being, perceived burden, and acceptance of clients were assessed before and after the intervention. Focus group interviews with clinicians were conducted to qualitatively examine MFPG. Family members’ acceptance increased after MFPG. Regular attendance was associated with reduction in perceived family burden. Culturally competent delivery of MFPG enhanced family members’ understanding of mental illness and reduced stress levels and negative feelings towards clients.

Adapting ACT to serve culturally diverse communities: a comparison of a Japanese and a Canadian ACT team.

OBJECTIVE The assertive community treatment (ACT) teams of Mount Sinai Hospital in Toronto and the KUINA Center, Hitachinaka, Japan, were compared with regard to ACT fidelity, organizational structure, populations served, and treatment outcomes. Ethnocultural adaptations to the ACT model made by both teams included enhanced family support and intervention, culturally and linguistically matched staff and patients when possible, culturally informed therapy, routine cultural assessments, culturally matched housing and community support, and flexible funding models. METHODS Data were gathered by chart reviews (66 patients in Toronto and 40 patients in Japan), a satisfaction measure, a standard measure of ACT fidelity, and a pre-post measure of treatment outcomes (the Brief Psychiatric Rating Scale), and hospitalization days. RESULTS Both teams achieved good fidelity to ACT and reductions in hospitalization and symptom severity. Family satisfaction scores were high. CONCLUSIONS With culturally informed adaptations, ACT can be effective in a Canadian mixed ethnocultural population and a homogeneous Japanese population.

Localization of the human 75-kDal Fe-S protein of NADH-coenzyme Q reductase gene (NDUFS1) to 2q33→q34

The gene for the human 75-kDal Fe-S protein of the NADH-coenzyme Q reductase was localized to 2q33→q34 by in situ hybridization to human metaphase chromosomes banded, by BrdU-incorporation, to the 500–550 band level of resolution.

ACT Tailored for Ethnocultural Communities of Metropolitan Toronto

The Frontline Reports column features short descriptions of novel approaches to mental health problems or creative applications of established concepts in different settings. Material submitted for the column should be 350 to 750 words long, with a maximum of three authors (one is preferred) and no references, tables, or figures. Send material to Francine Cournos, M.D., at the New York State Psychiatric Institute (fc15@columbia.edu) or to Stephen M. Goldfinger, M.D., at SUNY Downstate Medical Center (steve007ny@aol.com).

O-07 - Adapting ACT to serve culturally diverse communities: a comparison of a japanese and a canadian ACT team

Objective The Assertive Community Treatment (ACT) teams of Mount Sinai Hospital in Toronto and the KUINA Center, Hitachinaka, Japan, were compared with regard to ACT fidelity, organizational structure, populations served, and treatment outcomes. Ethnocultural adaptations to the ACT model made by both teams included enhanced family support and intervention, culturally and linguistically matched staff and patients when possible, culturally informed therapy, routine cultural assessments, culturally matched housing and community support, and flexible funding models. Methods Data were gathered by chart reviews (66 patients in Toronto and 40 patients in Japan), a satisfaction measure, a standard measure of ACT fidelity, a pre-post measure of treatment outcomes (the Brief Psychiatric Rating Scale), and hospitalization days. Results Both teams achieved good fidelity to ACT and reductions in hospitalization and symptom severity. Family satisfaction scores were high. Conclusions With culturally informed adaptations, ACT can be effective in a Canadian mixed ethnocultural population and a homogeneous Japanese population.

P01-446 - Working with cultural diverse persons involved in law and mental health - cultural competency training manual

The goal of this presentation is to introduce a new “Cultural Competency Training/Manual (CCTP) for Law and Mental Health professionals Working with persons involved with law and mental health” sponsored by a grant from the Law Foundation of Ontario and department of psychiatry of Mount Sinai Hospital. The manual is qualitative which includes conducting a literature review, facilitation of multi-stakeholder focus groups, and interviewed key stakeholders, consultation with clinical staff from the Mount Sinai Hospital and other Court Support programs, to address the key challenges in working with culturally diverse persons involved with law and mental health. In the oral presentation, we will present key themes on the challenges in dealing with culturally-diverse persons involved in law and mental health. The themes were consistent with the literature, evidence-based research, and validated by actual provider experience. They include language and communication, mistrust of mainstream services, racism and discrimination, resistance from persons involved with law and mental health and their families, and the need for cultural competency practices, such as interpretation, cultural understanding, community and systemic support. With these themes in mind, we will demonstrate the application of practical skills and cultural competencies using vignettes. A cultural competency model of working with culturally diverse persons involved in law and mental health and the five key responsibilities will be introduced. They include the following domains: language and communication, system support and navigation, education and advocacy, and collaboration.