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Policy support from the public is gaining importance for successful implementation of environmental policy. Yet the underlying factors of policy support for environmental policy have not been comprehensively examined. While considerable number of studies offered explanation of the phenomenon from the perspective of environmental psychology and social psychology, the growing attention to political factors has not been adequately addressed. In light of this, the present study systematically identified political factors and integrated them with psychological attributes to build a conceptual model for investigating level of policy support for recycling policy. A random household telephone survey was conducted in Hong Kong. 504 valid responses were collected for model testing. The results suggested that although psychological attributes, attitude and perceived benefits, are significant in predicting recycling policy support, political factors are stronger predictors, which perceived policy effectiveness, policy fairness, policy preference, and participatory process demonstrated a significant effect on the level of policy support. In addition, the explanatory power of the conceptual model remarkably increased after political factors were added to the model. The model enables us to compare effects of different sources on the level of policy support, in turn, advances our understanding of the phenomenon. In addition to shaping positive attitude towards recycling and enhancing perceived benefits of recycling practices among the public, policy-makers should put more efforts in formulating a fair, responsive recycling policy that demonstrates capability of policy goal attainment. Public involvement during policy formulation stage is also highly encouraged for mobilizing greater public support. [ABSTRACT FROM AUTHOR]

People living in urban areas are encouraged to use urban green spaces (UGS) because of the physical, psychological and social benefits offered by the green environment to city dwellers. Prior studies have investigated the physical, socio-psychological and demographic factors in explaining the use of UGS; however, the moderating effect of social influence has rarely been examined. Based on the theory of planned behaviour, a model extending the predictors of behavioural intention was proposed in this study. Data were collected by a telephone survey conducted in Hong Kong. The results revealed that attitude, subjective norm, perceived behavioural control, and usefulness positively influence people’s intention of using urban green areas. It was also proved that the interaction terms of usefulness and subjective norm, and perceived quality and subjective norm, negatively influence behavioural intention. Insightful implications for studying UGS behaviour, suggestions for urban planning and promotion of using urban green spaces are discussed. [ABSTRACT FROM AUTHOR]

Environmental quality is important to urban residents’ physical, social and psychological well-being. Governments have been formulating and implementing policies to mitigate environmental deterioration in cities. To effectively implement policies and achieve policy goals, gaining sufficient public support is an essential prerequisite; the policies would be in ruins and the government may also suffer from setbacks in other policy areas in the absence of public support. Therefore, to understand what contributes to public support is a crucial task for policymakers. Though current literature on socio-demographic and attitudinal/psychological factors provides fruitful accounts for policy support, a comprehensive examination of political determinants has yet to be established. In response to this, this review paper explores political factors that influence level of policy support based on existing literature. An integrated framework is proposed to explain policy support for urban environmental policy. This paper also discusses the possible directions of future research. [ABSTRACT FROM AUTHOR]

Prior studies have identified key factors that influence recycling intention. However, these studies rarely pay attention to the interaction of attitude and subjective norm that influences recycling intention. This study applied a conceptual model by extending the Theory of Planned Behavior (TPB) for addressing the gap. The study collected 246 responses through a street survey in Hong Kong. Findings revealed that two interaction terms (i.e., experiential attitude and subjective norm; instrumental attitude and subjective norm) influenced recycling intention. It implies that subjective norm plays a crucial role in motivating recycling behaviors. Moreover, subjective norm could increase the likelihood of recycling for people exhibiting positive experiential attitude, and motivate people who possess limited knowledge on recycling benefits of practicing recycling behaviors. Policy implications were drawn from the findings. Limitations of the study and future research direction were also discussed. [ABSTRACT FROM AUTHOR]

Over the past three decades, the municipal solid waste in Hong Kong had increased by nearly 80% while the population growth was merely 36%. This indicated that the people in Hong Kong were producing waste at an alarming rate. This problem should be addressed systematically. Recycling had been considered as one of the major strategies in the waste management framework both in Hong Kong and across the globe. Hong Kong people have become more outspoken about their demands and asked for higher degree of participation in policymaking since the change of sovereignty in 1997. Therefore, policy makers should understand the determinants of policy support for recycling so as to address the environmental concerns and the rising sentiments of people in policy participation. Previous studies had identified key factors influencing people's willingness to support policy measures in various policy domains. Nevertheless, there is no comprehensive list of well-established constructs in predicting policy support on recycling and little is known about the key psychological determinants in predicting people's support for different policy tools. To research this issue that has parallels in other countries, a model is developed and tested in this study with a sample of 246 people in Hong Kong. The results showed that support for inducement policy measures is influenced by attitude, past behaviour and perceived policy effectiveness, while support for capacity-building policy measures is influenced by external influences and perceived benefits. [ABSTRACT FROM AUTHOR]

Studies have been providing increasing evidence of the direct relationship between place attachment and environmentally responsible behavior and intentions. However, research on indirect and moderating effects of place attachment sub-constructs (i.e., place dependence and place identity) on intentions is scarce. This paper addresses the gap by assessing effects of place dependence and place identity on recycling intention in conjunction with the extended theory of planned behavior (TPB). 1071 Hong Kong respondents recruited using an online survey indicated their intention to participate in recycling behavior. Results suggest that place dependence indirectly influences recycling intention via place identity in the theoretical structure of the TPB. Place identity significantly moderates the relationships between instrumental attitude and recycling intention, and between perceived behavioral control and recycling intention, while the relationship between experiential attitude and intention is not subject to place identity. This study assesses the importance of place attachment as a personal factor influencing environmental outcomes and provides insights into the complex relationships between person-place bonding and pro-environmental behavior. • We integrated place dependence (PD) and place identity (PI) into the extended TPB. • PD indirectly influences recycling intention via PI in the extended TPB. • PI shows similar predictive capability with significant TPB constructs. • PI negatively moderates the relationship between instrumental attitude and recycling intention. • PI positively moderates the relationship between perceived behavioral control and recycling intention. [ABSTRACT FROM AUTHOR]

Abstract: Currently, recycling is one of the main strategies to reduce the reliance on landfills in Hong Kong, where its landfills will reach their full capacities by the end of the 2010s. In this study, we surveyed 246 people in Hong Kong to examine the moderating effect of perceived policy effectiveness on recycling. According to the results, the perceived policy effectiveness negatively moderated the relationships between subjective norm and recycling intention, as well as those between consequences awareness and recycling intention. The findings provided insightful information for policy makers to shape a more effective recycling policy. [Copyright &y& Elsevier]

Highlights: [•] A model extending the theory of planned behaviour is proposed in this study. [•] The correlation between policy measures and recycling behaviour was investigated. [•] Perceived policy effectiveness positively influences recycling intention. [•] Recycling intention influences both direct and indirect behaviours. [Copyright &y& Elsevier]

Background: Many prefer mitral valve replacement (MVR) for patients with obstructive hypertrophic cardiomyopathy (HCM) and concomitant degenerative mitral regurgitation (MR). We reviewed our results of septal myectomy combined with mitral valve repair (MVrep) and MVR when these problems coexist. Methods: Between 1990 and 2006, 32 patients (56% men; mean age, 60.7 ± 16.7 years) underwent extended septal myectomy for HCM with concomitant MVrep or MVR for degenerative MR (4% of myectomies and 3% of isolated MVrep during the same period). Preoperatively, 63% were in New York Heart Association (NHYA) functional class III/IV. Preoperative peak left ventricular outflow tract (LVOT) gradient was 63.7 ± 37.6 mm Hg. Systolic anterior motion (SAM) was present in 94%, with severe MR in 88%. Results: Extended septal myectomy included concomitant MVrep in 28 (88%) or mechanical MVR in 4 (12%). MVrep included leaflet resection in 10 (36%), edge-to-edge stitch in 6 (21%), and leaflet plication in 8 (29%). An annuloplasty ring/band was used in 19 (68%) and commissural annuloplasty in 2 (7%). There was one early death (3%). At discharge, resting LVOT gradient was reduced to 10.2 ± 19.0 mm Hg (p < 0.005). Dismissal echocardiography in MVrep patients demonstrated chordal SAM in 6 (21%, p < 0.005). MR was absent or mild in 21 (75%) and moderate in 6 (21%; p < 0.005 vs preoperatively). At late follow-up, LVOT gradient was 2.5 ± 5.8 mm Hg, SAM resolved in all patients, and 2 had moderate MR; 24 (83%) were in NYHA class I/II (p < 0.005). Conclusions: Concomitant MVrep with myectomy for HCM and degenerative MR can be performed with low early mortality with satisfactory relief of LVOT obstruction and MR. Most patients have significant relief of symptoms. MVR can be avoided in most patients with degenerative MR and HCM. [Copyright &y& Elsevier]

Objective: The optimal management of moderate functional mitral regurgitation at the time of aortic valve replacement remains undefined. Methods: We retrospectively identified 686 consecutive patients undergoing aortic valve replacement between 1993 and 2006 with at least moderate (grade 2 or more) functional mitral regurgitation. Patients with structural valve abnormalities or significant coronary artery disease were excluded, leaving 190 in the study. Analyses for predictors of residual mitral regurgitation and survival were performed. The impact of mitral regurgitation on survival was further analyzed among 91 patients case matched for age, gender, and left ventricular ejection fraction to individuals without mitral regurgitation undergoing isolated aortic valve replacement. Results: The mean age of the study group was 74 ± 11years, 45% were male, and 78% had New York Heart Association III or IV Class classification. The mean preoperative ejection fraction was 48% ± 17%. Operative mortality was 5% (n = 9). Follow-up echocardiographic data were available for 88% of patients at discharge and 57% of patients at midterm. Mitral regurgitation was improved at discharge in 76% of patients and at mid-term follow-up in 67% of patients. Independent predictors of improved mitral regurgitation were lesser degrees of preoperative tricuspid regurgitation or prebypass mitral regurgitation, absence of cerebrovascular disease, and lower left ventricular ejection fraction. Postoperatively, 89% of patients were New York Heart Association Class I or II Symptom; No reoperations for mitral regurgitation were performed. Survival was 68% at 5 years and 42% at 10 years. Independent predictors of late mortality were increasing age, diabetes, dialysis-dependent renal failure, and increased tricuspid regurgitation severity. The survival of 91 patients from this cohort did not differ from case-matched patients without mitral regurgitation undergoing aortic valve replacement (P = .33). Conclusion: Moderate functional mitral regurgitation improved in most patients after aortic valve replacement. Residual mitral regurgitation did not affect survival independently of left ventricular function. [Copyright &y& Elsevier]

Background: Type 2 heparin-induced thrombocytopenia is an uncommon but often fatal complication of heparin, frequently difficult to diagnose after cardiac surgery. In this series, we record the clinical presentation, temporal relationship, and treatment outcome of patients diagnosed with heparin-induced thrombocytopenia postoperatively. Methods: Thirty-three consecutive patients (1.1%) with a diagnosis of heparin-induced thrombocytopenia established by a greater than 50% drop in platelet count with or without a thrombotic event and a positive platelet factor-4 assay were reviewed. We recorded the clinical presentation, the time to presentation, treatment, and outcome (thrombosis, mortality). Univariate analysis was performed on 13 preoperative, operative, and postoperative variables. Results: The cohort was at increased mortality risk as a result of age (69.4 years), reduced cardiac function (46.8%), nonbypass operations (57.6%), emergency surgery (21.2%), and implantation of three assist devices. The mean time to suspect heparin-induced thrombocytopenia postoperatively was 5.4 days, with 22 cases (66.6%) occurring within 5 days. All patients had previous (within 3 months) exposure to heparin, and 66.6% had ongoing treatment with heparin before surgery. Overall mortality was 33%; thrombotic complications occurred in 15 patients (45.5%), with a mortality of 7 (46.6%) despite immediate cessation of heparin and treatment with a nonheparin analog. Thrombocytopenia without thrombosis occurred in 18 patients (54.5%), but a subgroup of 5 patients with nonthrombotic complications accounted for the 4 (22.2%) deaths. Conclusions: Heparin-induced thrombocytopenia after cardiac surgery is uncommon but may occur within 5 days of surgery, further complicating diagnosis and treatment. Thrombotic complications result in a high mortality despite treatment with a nonheparin analog, and a subgroup of patients with thrombocytopenia fared poorly. [Copyright &y& Elsevier]

Users' preferences and values in urban parks is important information for establishing social marketing strategies and therefore policymakers to consider. This study investigates the issue by analyzing social media data. User-generated data were collected from Instagram and content analysis was employed to identify physical features and values people assigned to urban parks from text descriptions of Instagram posts. Findings revealed that natural features are more frequently mentioned than non-natural elements. Aesthetic quality, feeling of happiness, and restorative experience are the most frequently mentioned expressions among the six categories of identified values. Significant association rules are established between physical features and values. Natural elements such as lawns, water features, wildlife and plants are more likely to be associated with happiness and restorative experience than aesthetic value. Artificial elements, flowers, and public art stimulate aesthetic quality. Implications for planning urban green environments are discussed. Social media platforms offer a novel entry point to uncover and monitor public interests and perceptions of specific venues such as recreational settings. Social media data provide actionable insights for promotional campaigns and inform decision-making pertaining to individuals and collective well-being. [ABSTRACT FROM AUTHOR]

• Place attachment is integrated into an extended theory of planned behavior (TPB) for investigating the role it plays in decision-making process of engaging in recycling behavior. • Effect of place attachment on recycling intention is partially mediated by attitude, moral norm, and awareness of consequences identified in the extended TPB. • Effect of place attachment on recycling intention is primarily indirect. • The indirect effect of place attachment via awareness of consequences is the strongest among the three mediated paths. This study addresses the research gap that not much is known about how place attachment plays a role in the decision-making processes of engaging in recycling behavior. It examines recycling intention by integrating place attachment into the framework of extended theory of planned behavior (TPB). We posit that pathways of attitudes, subjective norms, moral norms, and awareness of consequences identified in the extended TPB are responsible for the indirect effect of place attachment on recycling intention. Collecting data from an online survey conducted in Hong Kong, we test the hypotheses using partial least squares structural equation modeling. Results suggest that impact of place attachment on recycling intention is primarily indirect; moreover, it is mainly mediated by attitudes, moral norms, and awareness of consequences. Indirect effect via awareness of consequences is the strongest among the three significant mediated paths. The extended TPB provides a useful framework to conceptualize the effect of place attachment on recycling intention. The theoretical and practical implications of the findings are highlighted. [ABSTRACT FROM AUTHOR]

Research has substantiated the positive role of social cohesion on physical health and psychological well-being, and there is increasing interest in how public urban green spaces ("green spaces" hereafter) promote social cohesion. This review synthesized existing empirical evidence to ascertain the impact of green spaces on social cohesion. 51 published studies met the inclusion criteria were reviewed. Physical characteristics, perceptions, and use patterns of green spaces were found directly influencing social cohesion. Findings also suggested that physical characteristics of green spaces intermingle with environmental perceptions and use patterns to further complicate the impact on social cohesion. A model was proposed to conceptualize the complex relationships between green spaces and social cohesion. The review identified current gaps in the literature which futher research is needed. It also informs interventions for promoting public health and well-being by enhancing social cohesion in urban natural environments. • This review synthesizes current literature about the impact of public urban green spaces on social cohesion. • Physical characteristics, perceptions, and use patterns of green spaces have possible direct impact on social cohesion. • Physical characteristics intermingle with perceptions and use patterns to further complicate the impact on social cohesion. • A model is proposed to conceptualize complex relationships between green spaces and social cohesion. [ABSTRACT FROM AUTHOR]

• This study examines perceived physical and psychological factors that influence relations between people and urban parks. • Facilities and management is the strongest variable within the category of physical influence. • Perceived accessibility is the most robust psychological factor. • Both physical and psychological category of influence should be counted into urban park planning. This paper studied perceived physical and psychological factors that influence relations between people and urban parks. Current literature showed that these factors influence attitudes, behavior, and perceived benefits toward urban parks. While most research focused on either physical factors or psychological determinants, much less grouping them and simultaneously examining their effects on people-environment relations. To study the issue, we collected data by interviewing five hundred park visitors from ten urban parks in Hong Kong. Results showed that both categories of influence are significantly associated with relations between people and urban parks; facilities and management in physical dimension and perceived accessibility in psychological factors are variables most strongly associated with these relations. Besides, psychological factors added explanatory power of regression models. Nevertheless, the inclusion of psychological factors crowded out physical factors as significant variables, and the mediation test suggested that psychological factors play a potential mediating role in the associations between physical factors and the people-environment relations. The findings highlighted the salient factors of urban parks and the effects on health-related benefits. [ABSTRACT FROM AUTHOR]