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Purpose: This paper investigates how individuals' decision-making approach and perceptions of a game's cognitive realism affect the performance of virtual businesses in a web-based simulation game. Design/methodology/approach: Survey data are collected from 274 business simulation game users and is analysed using the fsQCA technique. Findings: The study identifies three alternative pathways to high and low performance in a business simulation game. Results indicate that a flexible decision-making approach exists in all high performance pathway solutions. Where a game is perceived to be realistic, a more focused decision-making approach is associated with high performance. However, where perceived cognitive realism is absent, a less focused experimental decision-making approach is employed, which increases the chances to achieve low performance. Finally, perceived cognitive realism and an experimental decision-making approach are found to be mutually exclusive for achieving high performance. Originality/value: Whilst the learning benefits of web-based simulation games are widely acknowledged, the complex interplay amongst factors affecting performance in games is under-researched. Limited research exists on how perceptions of a game's cognitive realism interact with user decision-making approaches to affect performance. [ABSTRACT FROM AUTHOR]

This paper studies a dynamic principal–agent setting in which the principal needs to dynamically schedule an agent to work or be suspended. When the agent is directed to work and exert effort, the arrival rate of a Poisson process is increased, which increases the principal's payoff. Suspension, on the other hand, serves as a threat to the agent by delaying future payments. A key feature of our setting is a switching cost whenever the suspension stops and the work starts again. We formulate the problem as an optimal control model with switching and fully characterize the optimal control policies/contract structures under different parameter settings. Our analysis shows that, when the switching cost is not too high, the optimal contract demonstrates a generalized control-band structure. The length of each suspension episode, on the other hand, is fixed. Overall, the optimal contract is easy to describe, compute, and implement. This paper was accepted by Ilia Tsetlin, behavioral economics and decision analysis. Funding: The work of P. Cao is financially supported by the National Natural Science Foundation of China [Grants 72122019 and 71771202]. The work of F. Tian is financially supported by the Hong Kong Research Grants Council (RGC) funding (RGC Early Career Scheme 2022/23) [Grant 27500822]. Supplemental Material: The e-companion and data are available at https://doi.org/10.1287/mnsc.2023.4845. [ABSTRACT FROM AUTHOR]

Hong Kong was under the direct hit of Severe Typhoon Koinu (2314) on 8 and 9 October 2023, necessitating the issuance of the Increasing Gale or Storm Signal, No. 9. Koinu was a very challenging case for TC forecasting and warning services due to its compact size and erratic movement over the northern part of the South China Sea. This paper reviews the difficulties and challenges of the forecasting aspect of the severe typhoon. The predicted tropical cyclone track and intensity from both conventional models and emerging artificial intelligence models are examined, as well as local wind and rainfall forecast. Experience in this case study showed that while deterministic global models only performed moderately and were not able to adequately support early warning, a regional model and AI models could more effectively support decision making for an operational tropical cyclone warning service. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to review the development of mental health service policy in Hong Kong. After the return of Hong Kong's sovereignty to China, mental health services in Hong Kong transformed from an institution-based care model supplemented by community care to a staging model covering primary prevention, early identification, treatment and integration. However, the staging model is subject to cultural barriers, including collectivist values and medical dominance. Therefore, the development of a community-based inclusive development model that follows a rights-based strategy and addresses the regression of the staging model (due to cultural barriers) should be considered. Design/methodology/approach: It is a comprehensive literature review which covered the journal articles, policy review papers and service reports. The foundation of this review was laid upon the development of traditional Chinese culture and values. As brought by the influence of the Western world, the mental health service policy was cling towards a medically oriented system. Following the worldwide change in the definition of disability, the ideology of the mental health service system has been developing into a community-based and person-centred model which emphasised on equal participation and human rights. This review serves to evaluate and discuss how a community-based inclusive development can be further developed in Hong Kong. Findings: A formal support system for providing personal assistance to people with mental health issues through supported decision-making and certified peer specialists forms the principal foundation of a community-based inclusive development model. A review and reconsideration of laws governing guardianship, compulsory treatment and detention should be conducted to enable the local implementation of supported decision-making. Originality/value: The paper addressed and integrated the theoretical, historical and practical issues in developing a community-based inclusive mental health service policy in Hong Kong. [ABSTRACT FROM AUTHOR]

Teacher assessment literacy has gained significant attention in recent years due to its critical role in learning and teaching. Various theoretical and empirical conceptualizations of this construct have been emerging with more recent emphasis on building teachers' knowledge and skills. The aim is to make highly contextualized, fair, consistent and trustworthy assessment decisions to inform learning and teaching to effectively support both student and teacher learning. This article explores changes in secondary English language teachers' assessment literacy following the introduction of school-based assessment for learning as part of high stakes secondary school assessment reform in Hong Kong. Drawing on teacher questionnaires completed by almost 4,500 teachers who undertook a common professional development course conducted over the first six years of assessment reform (2005 – 2011), this paper explores the impact of professional development on teachers' assessment literacy. Despite Hong Kong's deeply ingrained competitive examination-oriented culture, an analysis of the quantitative and qualitative data from pre- and post-program evaluations demonstrate signs of positive change in teacher attitudes, confidence and practices, in particular in using assessment criteria, designing and implementing appropriate assessment tasks, involving learners more actively in the assessment process, making trustworthy assessment decisions and providing effective feedback and feed-forward to students to improve student learning. The findings of the study suggest that changes in assessment culture are possible, provided teachers are well supported. The implications for assessment reform and for the development of teacher assessment literacy more generally are also discussed. [ABSTRACT FROM AUTHOR]

The ageing of populations is an unprecedented worldwide phenomenon that has created anxiety about labour and skill shortages in many developed countries. One way to address these concerns is to extend the working lives of seniors through appropriate retirement, retention and recruitment policies. This paper utilises official policy documentation and employment data to compare the policies, practices and predicaments of senior employment in Hong Kong and Singapore, two of developed Asia's most ageing economies. It finds that while labour force participation rates among Hong Kong seniors have declined since the early 1990s, older workers in Singapore remain largely confined to the secondary labour market. This paper examines why these trends are occurring and whether longer working lives will lead to greater opportunities for ‘active ageing’ in employment or, conversely, force older workers into a reserve army of labour to maintain their incomes. [ABSTRACT FROM AUTHOR]

This paper provides an overview of English language education policies and practices in Hong Kong. It examines changes and developments in policymaking and implementation across the education system. Based on a qualitative analysis of government documents and empirical studies, this review utilizes a sociocultural framework in characterizing language policy decision making processes and implementation strategies in colonial and post-colonial Hong Kong. Findings revealed a multilayered context within which English language education policies and practices are enacted, highlighting the interplay among political, social, economic and educational agendas in policy formulation and implementation. The incongruence between policy recommendations and actual classroom practices, as well as the relationship between government responsiveness and public preferences suggested the power and agency of multiple stakeholders (e.g. parents, teachers and community members) in the interpretation and appropriation of language education policies. This review provides additional insights to understanding the status of English against the backdrop of changing local conditions and to identifying forces of continuity and change in the development of language education policies and practices in Hong Kong. Implications for practice, policy and research are discussed. [ABSTRACT FROM AUTHOR]

Many warehouses involved in e-commerce order fulfillment use robotic mobile fulfillment systems. Because demand and variability can be high, scheduling orders, robots, and storage pods in interaction with manual workstations are critical to obtaining high performance. Simultaneously, the scheduling problem is extremely complicated because of interactions between decisions, many of which must be taken timely because of short planning horizons and a constantly changing environment. This paper models all such scheduling decisions in combination to minimize order fulfillment time. We propose two decision methods for the above scheduling problem. The models batch the orders using different batching methods and assign orders and batches to pods and workstations in sequence and robots to jobs. Order picking and stock replenishment operations are included in the models. We conduct numerical experiments based on a real-world case to validate the efficacy and efficiency of the model and algorithm. Instances with 14 workstations, 400 orders, 300 stock-keeping units (SKUs), 160 pods, and 160 robots can be solved to near optimality within four minutes. Our methods can be applied to large instances, for example, using a rolling horizon. Because our model can be solved relatively fast, it can be used to take managerial decisions and obtain executive insights. Our results show that making integrated decisions, even when done heuristically, is more beneficial than sequential, isolated optimization. We also find that positioning pick stations close together along one of the system's long sides is efficient. The replenishment stations can be grouped along another side. Another finding is that SKU diversity per pod and SKU dispersion over pods have strong and positive impacts on the total completion time of handling order batches. Funding: This work was supported by National Natural Science Foundation of China [72025103, 72361137001, 71831008, 72071173] and the Research Grants Council of the Hong Kong Special Administrative Region, China [HKSAR RGC TRS T32-707/22-N]. Supplemental Material: The e-companion is available at https://doi.org/10.1287/trsc.2022.0265. [ABSTRACT FROM AUTHOR]

This paper offers a qualitative analysis of decisions of 64 community-college students in seeking a transfer in Hong Kong. In weighing a number of educational options and then offers, with a similar level of desirability in some cases, in order to achieve their transfers, advantaged-class and disadvantaged-class respondents struggled with different logics of reasoning and negotiated anxiously with their changing structural realities. This qualitative analysis addresses the contextual, processual and emotional aspects of their decision making and provides a more convincing illustration of how the secondary effect of social stratification operates against a changing landscape of higher education. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has tremendously caused significant health impacts leading to high load of ICU critical patients. Multiple Intensive Care Unit (ICU) admission framework and triaging score have been adapted worldwide for admission of COVID-19 patients. The aim of this article is to review the COVID-19 ICU admission policy in five (5) countries, identify challenges and provide recommendations. Materials and Methods: Literature review was carried out through searching available literature from online databases such as EBSCO, PubMed, Research Gate, Google Scholar and Google search engine. The selected information used in this review is taken from any journal, article, report, thesis, national report, news update regarding the topic. Result: The ICU admission policy in 5 countries, namely South Africa, USA, UK, Hong Kong and Malaysia were reviewed. Different countries apply different guidelines to triage, prioritize and admit severe COVID-19 patients to ICU such as Color-coded Priority Scale in South Africa, Critical Care Triage Tool in USA, COVID-19 Critical Care Guideline in UK, COVID- 19 Critical Care Triage Tool in Hong Kong and ICU Admission Prioritization Criteria in Malaysia. The ICU admission decision-making is supported with multiple ICU scorings such as Sequential Organ Failure Assessment (SOFA), Clinical Frailty score and National Early Warning score 2 (NEWS2). Conclusion: The COVID-19 ICU admission policies in these countries are well established and have been practised appropriately despite challenges faced by the ICU practitioners. All five selected national guidelines in this paper correspond to the WHO framework on the ICU admission policy. Ethical issues and legal supports on the ICU practitioners in ICU admission decision-making requires great attention form government and relevant policy stakeholders. [ABSTRACT FROM AUTHOR]

Summary: The social work profession emphasises the development of the personal qualities of social workers in addition to requiring them to possess the necessary professional values, knowledge, theories and practice skills. Until now, we have tended to rely on the perspective of social work professional bodies, educators and employers to assess the personal qualities of social workers. We have seldom inquired about the views of service users on the qualities of social workers, thus disregarding their perspective. This article focuses on identifying the important qualities of social workers from the perspective of service users. Findings: This paper reports on qualitative research on the personal qualities of social workers that service users value in Hong Kong. It draws on a diverse range of service users with direct experiences of the services provided by social workers. A total of 47 service users from 7 core social welfare service settings and 32 service units participated in an in-depth qualitative interview. Six significant personal qualities of social workers from the service users' perspective are identified and discussed. Applications: The findings have several implications for examining directions for development of the social work profession, the relationship between service users and social workers, effective ways to develop the personal qualities of students in social work education and ways to resolve the dilemma between service users' expectations and the existing mode of social work service delivery. Issues of particular relevance to Hong Kong are highlighted in discussing these implications. [ABSTRACT FROM AUTHOR]

Current understanding of financial decision-making among racial/ethnic minority young adults is limited: day-to-day financial decisions of racial/ethnic minorities are underexamined, younger racial/ethnic minorities receive limited attention, studies on racial/ethnic minorities are mainly conducted in Western societies, and research on financial literacy and decision-making is predominantly quantitative in nature. Against this backdrop, this study utilized a qualitative approach to examine a range of financial decision-making among ethnic minority young adults in Hong Kong, including personal budgeting, spending, financial planning, the use of financial products, debt management, and the detection of financial fraud. Individual interviews were conducted with 53 Pakistani, Indian, Nepalese, and Filipino participants aged 18 to 29 who employed various budgeting strategies and faced challenges. Their spending was modest, and they espoused various spending philosophies. Many saved approximately one-third of their income using saving tactics and setting financial goals, and investing in both Hong Kong and their home countries. Informal borrowing was common, though some sought alternative loans. One-third used credit cards, with accompanying occasional risks. Despite employing protective tactics, they still fell victim to scams. Factors facilitating their financial decision-making include family social capital, intrapersonal characteristics, social dynamics factors, command of knowledge, and facilitative contextual circumstances. This study addresses knowledge gaps by providing an in-depth understanding of financial decision-making among ethnic minority young adults in a non-Western context. It has significant implications for timely and tailored financial literacy education for minority societal members. [ABSTRACT FROM AUTHOR]

Michael White described therapy as ‘joining with people around issues that are particularly relevant and pressing to them’. At the moment, considerations about staying or leaving are on the minds of a lot of people in Hong Kong. This paper seeks to demonstrate the application of narrative practice in supporting people to respond to the challenges associated with leaving the land we call home. It addresses different moments in the migration experience, from making the decision and preparing for departure, to finding ways to maintain connection with people and places when separated by distance. The skills and knowledge that participants developed through each of these stages were recorded in a series of collective documents that tell a different story about the resilience of Hongkongers during this period in history, and their eagerness to contribute to others experiencing similar predicaments. [ABSTRACT FROM AUTHOR]

Background: The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. Method: Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick –Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. Findings: The mean score of the Short Warwick–Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (−0.050, p < 0.001) and Short Warwick–Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick–Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. Conclusions: Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population. [ABSTRACT FROM AUTHOR]

Background: The proportion of hospital deaths has declined in the past few decades, while the proportions of nursing home deaths have increased. This trend of increasing deaths in long-term care facilities underlines the importance of improving end-of-life care provisions in these settings to meet individual preferences and needs. Under these circumstances, a comprehensive understanding of end-of-life care preferences in local nursing home residents can help healthcare professionals and policymakers develop strategies to increase the advance directive completion rate and quality of care. This study aimed to explore and compare advance directive and end-of-life care preferences of nursing home residents in Hong Kong and Taiwan. Methods: A structured questionnaire was developed by the research team to investigate advance directive and end-of-life care preferences in older Chinese nursing home residents. Nursing home residents with frail or pre-frail status and over the age of 64 were invited to participate in the study, and information on demographics, functional status, advance directive experiences, and end-of-life care expectations was collected through questionnaire interviews. Results: A total of 325 eligible participants from 32 facilities completed the survey, including 238 older residents in Hong Kong and 87 in Taiwan. A significantly lower proportion of the Hong Kong residents had completed an advance directive compared with the Taiwanese (3 vs. 13%, p = 0.001). Among participants who did not have an advance directive, 46% of the Taiwanese participants said they would consider completing one in the future, compared with 20% of the Hong Kong participants (p < 0.001). A total of 79% of the Hong Kong participants and 80% of the Taiwanese participants responded that prolonging life in the given hypothetical dying scenario was "not important" (p = 0.76). Only 14% of participants in Hong Kong and 18% of participants in Taiwan reported prior occurrence of end-of-life care discussions with family members or health professionals (p = 0.37). Conclusions: This paper adds evidence in support of improving end-of-life communication and the advance directive completion rate in nursing homes in Hong Kong and Taiwan. Further research is necessary to explore cross-cultural differences in end-of-life preferences and its applications in predicting decision-making and the quality of end-of-life care. [ABSTRACT FROM AUTHOR]

In this paper we examine one type of intraprofessional collaborative activity, namely case conferences in a specialist genetics clinic. Our specific focus is on how clinical geneticists manage decision-making through team talk in the event of diagnostic uncertainty which is mainly attributable to limitations in the current state of genomic knowledge, 'uncertain significances' associated with genetic test results, and a lack of information/ evidence pertaining to cases under discussion. The case conference then becomes a means to minimise the uncertainty and arrive at decisions that optimise the significance of the results in terms of clients' life trajectories. Adopting theme-oriented activity analysis, we examine video-recorded data from five case conferences in Hong Kong. Beginning with a prototypical structural mapping of the case conference activity type, our analysis focuses on what we call 'uncertain cases'. Our findings highlight three discourse types constitutive of team talk: pedagogic talk, diagnostic talk and decisional talk. In paying particular attention to how uncertainty is formulated and negotiated, we suggest that access to and assessment of different kinds of evidence as well as the activity-specific expert role-positions of the participants are crucial with regard to establishing a correct diagnosis and/or striving towards a minimisation of current uncertainties. [ABSTRACT FROM AUTHOR]

Hong Kong's adherence to the rule of law has been widely understood as one of its "core values." As such, it has been understood as an institution necessary for good governance and a check against the abuse of governmental power as well as a feature that differentiates Hong Kong's system of governance from other parts of China. At the same time, intervening issues of immigration and of constitutional interpretation have begun to challenge this perception. This paper argues that a recent landmark decision involving the right to permanent residence has served to weaken the rule of law in Hong Kong. It has further high lighted a lack of comm itment by the judiciary to either human rights claims or equal treatment under the law. [ABSTRACT FROM AUTHOR]

Hiring foreign domestic helpers has been seen as a policy to release females from household responsibilities so they can join the labor market. Surprisingly, few studies explore the relative importance of needs to taking care children and elderly. Employing the 2016 Hong Kong census, we found that the number of elderly persons and the number of young children in the household are positively associated with the decision to hire foreign domestic helpers. Our analysis also demonstrates that members are more likely to choose to work and outsource the care of young children to foreign domestic helpers. However, the findings show that households are more likely to take care of elderly without helpers even when household members are employed. Household members may co-ordinate and allocate time to take care of their elderly instead of outsourcing the care to a foreign domestic helper. [ABSTRACT FROM AUTHOR]

Background: Decision aids have been shown to be effective in assisting the decision-making process in healthcare settings. This study aimed to examine the feasibility and acceptability of a linguistically appropriate printed decision aid for cervical cancer screening in South Asian women and to preliminarily estimate its effects on decisional conflicts, clarity of values, risk perception, the screening decision and screening uptake. Methods: This was a pilot randomised controlled trial. Forty-eight South Asian women aged 25 to 64 years were recruited and allocated to either the intervention group or control group. The participants in the intervention group read a linguistically appropriate printed decision aid. Results: All of the participants in the intervention group agreed that the decision aid was useful in aiding their decision-making. These participants showed significantly greater improvement in decisional conflicts, clarity of values and risk perceptions than those in the control group (all p < 0.05). The screening uptake rate was significantly higher in the intervention group than in the control group (p < 0.001). Conclusions: The decision aid was feasible and acceptable among South Asian women, and it resulted in reduced decisional conflict and increased screening uptake compared with usual care. To improve the convenience of using decision aids, they could be developed in various forms, such as printed and mobile application forms, to meet individual requirements. Trial Registration: The trial was registered at the Chinese Clinical Trial Registry on 23 October 2021 (ChiCTR2100052225). [ABSTRACT FROM AUTHOR]

• Predicting departure delay in parallel may cause ambiguity in decision making. • A novel hierarchical integrated machine learning model helps to improve prediction. • The historical data provided by an international airline was used for the study. • The model is the best alternative to regression and multiclass classification. Flight delays may propagate through the entire aviation network and are becoming an important research topic. This paper proposes a novel hierarchical integrated machine learning model for predicting flight departure delays and duration in series rather than in parallel to avoid ambiguity in decision making. The paper analyses the proposed model using various machine learning algorithms in combination with different sampling techniques. The highly noisy, unbalanced, dispersed, and skewed historical high dimensional data provided by an international airline operating in Hong Kong was used to demonstrate the practical application of the model. The result shows that for a 4-h forecast horizon, a constructive neural network machine learning algorithm with the Synthetic Minority Over Sampling Technique-Tomek Links (SMOTETomek) sampling technique was able to achieve better average balanced recall accuracies of 65.5%, 61.5%, 59% for classifying delay status and predicting delay duration at thresholds of 60 min and 30 min, respectively. Similarly, for minority labels, the precision-recall and area under the curve showed that the proposed model achieved better results of 32.44% and 35.14% compared to the parallel model of 26.43% and 21.02% for thresholds of 60 min and 30 min, respectively. The effect of different sampling techniques, sampling approaches, and estimation mechanisms on prediction performance is also studied. [ABSTRACT FROM AUTHOR]

The New Territories Small House Policy in Hong Kong has been controversial, in that the interests of male indigenous villagers in terms of housing are prioritized at the expense of the rest of the population. This colonial-era policy, currently under the protection of the Basic Law, has profound implications on how rural land outside the village environs should be used, particularly so when development pressures are mounting. How planning control decisions on small house applications are made under these conditions, thus, becomes an important and timely policy research topic. This paper, thus, studies these decisions in Greenbelt zone (GB), Agriculture zone (AGR), and Unspecified zone (UNSP), between January 1st, 1990 and June 30th, 2017, using non-aggregate planning statistics. The findings show that the Town Planning Board (TPB) is more likely to reject small house applications that propose a larger site area for each small house in AGR and GB zones, but not those that essentially propose a small-scale small house development (i.e. up to 5 houses). Also, land-use policies in these three zones are found to vary geographically. Further, the TPB’s decisions are flexible in that they are subject to other exogenous factors, such as housing policies and housing market conditions. [ABSTRACT FROM AUTHOR]

This paper examines issues of affordability and justice using the concept of “basic structure” as developed by Iris M. Young in order to produce a more nuanced account of the Pre-primary Education Voucher Scheme. We draw on the experiences of Hong Kong mothers of different socio-economic status who have participated in the voucher scheme. The scheme aims to provide affordable quality early education by giving parents a flat-rate voucher so as to assist them in enrolling their children in non-profit local kindergartens. We base our arguments on the central premise that socially just policy requires meticulous attention to the basic structure that determines distributive patterns. We go on to argue that the basic structure is governed by institutional assumptions, rules, and practices about class, gender, and markets. Our analysis references both quantitative and qualitative data of a three-phased mixed-method study with > 1400 mothers. The key findings reveal how mothers of different socio-economic backgrounds experienced the voucher scheme where power structures and relations are legitimized, thus contributing to the structural processes that reproduce constraints and injustice. Mothers' articulation regarding the policy recommendation of free early education adds insights into the constraints they experience and a notion of collective responsibility in supporting the education of young children. [ABSTRACT FROM AUTHOR]

Patient-centered care (PCC) is the prevailing model of care globally. However, most research on PCC has been conducted in Westernized countries or has focused on only two facets of PCC: decision-making and information exchange. Our study examined how culture influences patients' preferences for five facets of PCC, including communication, decision-making, empathy, individualized focus, and relationship. Participants (N = 2071) from Hong Kong, the Philippines, Australia, and the U.S.A. completed an online survey assessing their preferences for exchange of information, autonomy in decision-making, expression and validation of their emotions, focus on them as an individual, and the doctor-patient relationship. Participants from all four countries had similar preferences for empathy and shared decision-making. For other facets of PCC, participants in the Philippines and Australia expressed somewhat similar preferences, as did those in the U.S.A. and Hong Kong, challenging East–West stereotypes. Participants in the Philippines placed greater value on relationships, whereas Australians valued more autonomy. Participants in Hong Kong more commonly preferred doctor-directed care, with less importance placed on the relationship. Responses from U.S.A. participants were surprising, as they ranked the need for individualized care and two-way flow of information as least important. Empathy, information exchange, and shared decision-making are values shared across countries, while preferences for how the information is shared, and the importance of the doctor-patient relationship differ. [ABSTRACT FROM AUTHOR]

Purpose: Prefabricated components sustainable supplier (PCSS) selection is critical to the success of prefabricated projects. However, limited studies have addressed the uncertainty and complexities during the selection process, particularly in multi-criterion group decision-making (MCGDM) circumstances. Hence, the research aims to develop a group decision-making model using a modified fuzzy MCGDM approach for PCSS selection under uncertain situation. Design/methodology/approach: The proposed study develops a framework for sorting decisions in PCSS selection by using the hesitant fuzzy technique for order preference by similarity to ideal solution (HF-TOPSIS) method. The maximum consistency (MC) model is used to calculate the weights of decision makers (DMs) based on the cardinality and sequence of decision data. Findings: The proposed framework has been successfully applied and illustrated in the case example of CB01 contract section in Hong Kong-Zhuhai-Macao Bridge (HZMB) megaproject. The results show various complicated decision-making scenarios can be addressed through the proposed approach. The MC model is able to calculate the weights of DMs based on the cardinality and sequence of decision data. Originality/value: The research contributes to improving accuracy and reliability decision-making processes for PCSS selection, especially under hesitant and fuzzy situations in prefabricated megaprojects. [ABSTRACT FROM AUTHOR]

This paper studies the use of Remote Sensing (RS) technologies and Geographic Information Systems (GIS) for estimation of city-wide photovoltaic (PV) potential in Hong Kong. It investigates the spatial distribution of cloud coverage through geostationary satellites from the Multi-functional Transport Satellite (MTSAT). The results indicate that a non-prominent spatial variation of cloud cover presides over a majority of Hong Kong territories. Appropriate locations for deploying solar PV panels, such as rooftops, were delineated using RS, GIS, and existing ancillary data. Extraction and filtering of pixels based on a set of criterions were used to identify optimal PV rooftops. This study shows that the summarization of PV potentials in Hong Kong is 2.66 TWh on building rooftops. The methodologies and findings from this study permits detailed spatial estimation of city-wide solar energy potential, and assists the policy-decision process on the use of renewable energy in Hong Kong. [ABSTRACT FROM AUTHOR]

This small-scale exploratory qualitative study examined the career decision-making process of six talented engineering university graduates in Hong Kong. The aim was to investigate major influential factors and barriers that impact their career aspirations and their persistence in remaining in that career. Semi-structured interviews were conducted with each graduate to provide data that could be analyzed. The main focus was on the significance of social and cognitive variables, self-efficacy, interests and outcome expectations for the graduates' motivation and career decision-making process. The findings suggest that primary motivating factors for participants' career aspirations and career persistence strongly aligned with constructs from Social Cognitive Career Theory and Job Embeddedness Theory. Career interests were motivated by self-efficacy, outcome expectations, and interests, while "job embeddedness" promoted career persistence through fit and link to organizations and industry. Based on participants' responses, the study produced an insider's perspective on the career decision-making process of talented young engineers in Hong Kong. [ABSTRACT FROM AUTHOR]

Drug policy has been subjected to much scrutiny from different stakeholder groups who present sometimes very different opinions on solutions to address a problem. Reconciling such differences, that are underpinned by both anecdotal and empirical evidence, is a priority yet to be fully achieved. In this study, we examine: (i) whether differences exist among actor groups regarding their perceived importance in policymaking; (ii) whether those who dominate the decision process value the input of laypeople or minority actors; and (iii) whether differences exist, with regard to i and ii, between study sites (i.e. Australia and Hong Kong) that have markedly different drug strategies. Overall, differential preference weightings between dominant groups reveal a strong influence of political orientation. Results suggest that decisions made by health professionals were regarded as the most important, while most of the respondent groups gave a low preference toward policy decisions made by law enforcers. Dominant groups also tend to discount the inputs of laypeople and other minority groups. Our study highlights the importance for policy actor groups to consider such a differential weighting of inputs when synthesising knowledge and gathering opinions for the development of drug policy. [ABSTRACT FROM AUTHOR]

This study compares the findings of two qualitative research studies on meanings of divorce endorsed by Chinese divorced women in Hong Kong conducted in 1998–2002 and 2016–2018, respectively. It is clearly shown that ideas about divorce have changed enormously in the past two decades. While the ideas that divorce is not acceptable and divorced women are failures were still prevalent, particularly in the divorce decision-making process, there has been a move towards a more dominant modern stance on divorce, although two powerful obstacles, the welfare of children and social stigmatisation, have persisted. [ABSTRACT FROM AUTHOR]

Rationale: Postpartum depression is a worldwide public health issue that can have long‐term impact on the family. It is crucial to evaluate intervention program to help new parents cope with the stress of parenthood to reduce the risk of postpartum depression. The aim of this study was to explore the perceived benefits of the couple‐based psychoeducation to first‐time Hong Kong Chinese parents, and the crucial factors influencing the effectiveness of this program underpinned by the concept of process evaluation. Method: Using an exploratory qualitative design, a purposeful sample of 27 couples who had participated in the program were interviewed at 1‐3 months postpartum. Data were collected using semi‐structured interviews and analysed by thematic analysis. Findings: The findings showed that the parents perceived the program to be useful in enhancing their parenting skills and emotional control, and increasing their sense of support. The effectiveness of the program was facilitated by (a) the predisposing factors such as couple‐based approach to enhance mutual expectation and shared decision making when experiencing and managing challenges, and telephone follow‐up calls to sustain the continuity of care from hospital to the community, (b) the enabling factor for instance, the time of intervention arranged in non‐working hour, and (c) reinforcing factor namely involvement of midwives during program implementation and telephone follow‐up consultation. Conclusions: The results of this study suggest the potential of the couple‐based psychoeducation to support first‐time parents in taking care of their children and controlling their emotions in this critical transition. The program could be integrated into maternal and child care services on a regular basis, and thus accessible to all first‐time parents. [ABSTRACT FROM AUTHOR]

In this study, we explore the common phenomenon of using online review sites to acquire information for decision-making. Nowadays, online review sites such as Yelp in the US and OpenRice in Hong Kong, which provide effective platforms for consumers to share their post-purchase experiences, are getting popular. While we get into a collective decision such as dinner gathering, social influence will also play a role in the decision making process. Based on the elaboration likelihood model (ELM) and social influence theory (SIT), we develop a research model to investigate how participating in online review sites influences collective decisions. [ABSTRACT FROM AUTHOR]

Background: The popularity of ketamine use among Hong Kong young people has dropped substantially after its heyday in the 2000s, but the shift in drug preferences from ketamine to other psychoactive drugs such as methamphetamine remains a concern. This study aims to explore the recent changes in the drugs of choice among young drug users in Hong Kong by examining their narratives of risk toward psychoactive drug use. Methods: In-depth interviews were conducted to collect qualitative data from 45 young drug users recruited through treatment and rehabilitation organizations in 2017. Results: The analysis demonstrated how the decisions about drug use are mediated by the risk knowledge and practices of users including their perceived risk and health consequences, their perceived addictive potential of different illicit drugs, and their own strategies in managing drug risks. Conclusions: This study provides insight into adolescent drug use in a changing drug scene by revealing the importance of experiential understanding of risk among young drug users in the making of drug use related decisions. Implications for drug prevention and intervention are discussed. [ABSTRACT FROM AUTHOR]

Using the career adaptability framework of Savickas and Porfeli (2012), we examined the relationship of career adaptability to interest and competence flexibility and career decision‐making difficulties. Participants were 535 male and 795 female Chinese senior secondary students in Hong Kong. Findings from hierarchical multiple regression analyses showed that competence flexibility was associated with fewer career decision‐making difficulties and higher levels of career adaptability. Conversely, interest flexibility was associated with more decision‐making difficulties and lower levels of career adaptability. Path analyses revealed that career adaptability partially mediated the relationship of competence and interest flexibility with decision‐making difficulties. The mediating effects were significant for lack of information and inconsistent information (Gati et al., 1996), but not for readiness. Overall, findings supported the career adaptability framework. Research and practice implications are discussed, especially in relation to the career development needs of students in Chinese communities. [ABSTRACT FROM AUTHOR]

Background: Creating a treatment plan (TP) through shared decision-making (SDM) with healthcare professionals is of paramount importance for patients with multimorbidity (MM). This study aims to estimate the prevalence of SDM and TP in patients with MM and study the association between SDM/TP with patients' confidence to manage their diseases and hospitalization within the previous 1 year.Method: This cross-sectional study used an internationally recognized survey. A total of 1032 patients aged 60 or above with MM were recruited from a specialist outpatient clinic, general outpatient clinic (GOPC) and a geriatric day hospital. The proportion of patients reported to have SDM and TP was estimated. Associations between the presence of SDM/TP and patients' demographic data, the confidence level to manage their illnesses and hospitalization in previous 1 year were then studied using logistic regression.Results: The prevalence of SDM and TP was 35.8% and 82.1%, respectively. The presence of TP was associated with receiving healthcare from the same doctor or in the same facilities and being recruited from GOPC. The presence of SDM (OR = 1.352, P = .089) and TP (OR = 2.384, P < .001) was associated with enhanced confidence in dealing with diseases.Conclusion: Most people with MM had TP in Hong Kong, but fewer patients had SDM.Practice Implications: Ways to promote SDM in HK are needed. [ABSTRACT FROM AUTHOR]

Background Presenteeism among nurses is the common behaviour of being physically present at work when one should not be due to personal health and well-being, a stressful work environment, lack of work–life balance, or a sense of professional identity or obligation. Aims To explore nurses' decision-making process related to presenteeism in a large Hong Kong public hospital. Methods As part of a larger study on nurse presenteeism in Hong Kong, we conducted focus groups with nurses to understand their considerations related to working sick. Results Eleven major themes emerged from the focus groups, which we grouped into three organizational domains reflecting nurses' decision-making process around presenteeism: consideration for colleagues, organizational factors and professional identity. Conclusions Presenteeism was a familiar behaviour among Hong Kong nurses in our study. We found both overlap and divergence with prior presenteeism research in the domains and themes identified. Loyalty to colleagues, written and unwritten rules and professional identity as nurses all seemed to encourage presenteeism among Hong Kong nurses. Organizations seeking to discourage presenteeism should evaluate policies such as sick leave certificates, ensure appropriate coverage for all nurse ranks and address subcultural norms encouraging presenteeism. [ABSTRACT FROM AUTHOR]

• A federated approach for community-level socio-technical resilience assessment is developed. • A case study in Hong Kong dealing with extreme weather events is conducted to demonstrate effectiveness of the proposed approach. • Mitigation resources would be prioritized after balancing both technical and social perspectives in a community circumstance. Comparative community resilience ranking illuminates resources prioritization in the pre-disruption mitigation process. Nonetheless, previous researchers address community resilience assessment in isolated manner by considering the technical side or social capabilities only. The myopic results generated from the solely designated assessment can be misleading and may affect the subsequent resilience building efforts. More importantly, a single modeling paradigm is insufficient to capture the disparate characteristic of interconnected socio-technical sub-systems in a community. This paper proposes a federated approach to assess the pre-event socio-technical community resilience. It assembles the topological-based evaluation, physics-based performance simulation, and multicriteria decision analysis into a unified framework whereby the results derived from the topological and physics-based methods are treated as inputs for the subsequent multi-criteria decision analysis model to generate comparative socio-technical community resilience ranking. A practical case in Hong Kong is used to demonstrate the applicability of the federated approach. Using the holistic socio-technical assessment results in the illustrative case, mitigation resources can be sensibly prioritized. The strategic implications indicate that the comparative resilience ranking outperforms the results produced by models focusing on the technical or social aspect only. Since the federated approach integrates the strength of multiple models when investigating the static structures and dynamic behaviors of complex socio-technical systems at the community level, it can lead to more reliable and balanced decision making process. [ABSTRACT FROM AUTHOR]

Aripiprazole, a dopamine partial agonist, is a second‐generation anti‐psychotic that is widely used for the treatment of schizophrenia and other psychotic disorders. A group of psychiatric experts in Hong Kong developed a set of consensus statements, aiming to facilitate the understanding of clinical properties and usages of aripiprazole among local physicians. Of note, because aripiprazole long‐acting injectable has been available locally not long before the establishment of the consensus panel, which limited the discussion on its use in the local context, the consensus statements were focused primarily on oral aripiprazole. To draft the consensus statements, the panellists discussed the published evidence and their clinical experience regarding aripiprazole in a series of meetings based on several areas. At the final meeting, each drafted statement was voted on anonymously by all panellists based on its practicability of recommendation in Hong Kong. A set of consensus statements on the characteristics and clinical use of aripiprazole was established and accepted by the panel. These statements serve to provide a practical reference for physicians in Hong Kong, and possibly other parts of the Asia‐Pacific region, on the use of aripiprazole in people with schizophrenia spectrum disorders and other psychotic problems. [ABSTRACT FROM AUTHOR]

This study aimed to examine three major issues: (a) The extent to which registered donors have communicated with family about body donation; (b) The differences in demographics, life and death attitudes, and quality of relationship with family members between those who communicated their body donation decision and those who did not; (c) The factors associated with the act of communicating with family about body donation. A survey was conducted of people who registered in a body donation programme in Hong Kong. A total of 1,070 registered donors completed an online questionnaire between August and September 2016. The majority of participants (80.1%) reported that they communicated with family members about body donation. About one‐third only informed family members of their decisions after registration, and around 15.6% did not communicate with family members. Those who communicated with family were significantly older and married; they also indicated more positive life and death attitudes and a better quality of relationship with family members. Three factors were found to have significant associations with the act of communicating with family members about the decision to donate the body: (a) Age, (b) Quality of life, (c) Quality of relationship with family members. Communication with family members about body donation is still inadequate. Future body donation programmes may focus more on the way body donation decisions can be better communicated with family members. Special attention can be given to younger registered donors who find it difficult to communicate with the older generation, those who indicate more negative life and death attitudes, and who experienced a poorer quality of relationship with family members. [ABSTRACT FROM AUTHOR]

This article investigated the learning experiences of mainland Chinese students in master's degree programmes in Hong Kong. Using a qualitative research approach, 20 mainland Chinese students in master's degree programmes in a first-tier Hong Kong university were interviewed. It observed, first, that mainland Chinese students appreciate the teaching and learning approaches adopted in Hong Kong, but that they take some time to adapt. Thanks to heavy financial support from parents and parental expectations, they are pressed to adapt as soon as possible and get high marks in the one-year programmes in Hong Kong. Second, the mainland Chinese students' previous experiences of participating in campus activities in mainland China and their instrumental views of learning restrict their involvement in informal learning through campus activities. Third, their limited interaction with local and foreign students constrains the development of their intercultural competence. [ABSTRACT FROM AUTHOR]

Encouraging the public to donate their bodies after death is crucial for anatomy teaching in medical education. In Hong Kong, success may be affected if family members override the registered donors' wish after death, and thus the role of family in body donation is worth more attention. This study aims to examine how family is involved in the process of body donation. A qualitative study was conducted in Hong Kong. Registered donors and bereaved family members were recruited from a body donation scheme organised by a medical school. In‐depth interviews were done and thematic analysis was conducted. Five themes were found: (a) decision‐making: individual versus family; (b) family conflicts: avoidance versus confrontation; (c) trust in family members: discuss versus do not discuss; (d) family members' struggles in implementation; (e) informed end‐of‐life planning. Findings revealed that donors may not necessarily discuss their decisions about body donation with family members directly. Instead, it was found that family was involved in the body donation process in different ways and to different extents. For example, donors considered family members' views about body donation, but they chose not to involve them in the discussions if they expected objections, in order to avoid conflicts. Bereaved family members considered understanding family members' body donation decisions prior to death important, and they shared the implications of body donation for funeral arrangements and the grieving process. Findings help to understand the role of the family in body donation, especially in the Hong Kong Chinese context, and may give insights into how the body donation scheme could be enhanced to facilitate better communication between registered donors and family members as well as to support bereaved family members in implementing the decision to donate. [ABSTRACT FROM AUTHOR]

BACKGROUND: Control selection in heavy machinery may be a problem due to the poor compatibility of the commonly-used single line of vertical levers for controls. OBJECTIVE: This study examined the effects of control arrangements on directional compatibility and participant responses in terms of choice/function of controls. METHODS: We investigated experimentally, for a number of new designs of control arrangements, the selection of controls for requested functions of four different machines: fork lift trucks, excavators, tower cranes, and telescopic cranes. Control arrangements were designed with different levels of directional compatibility and participants were requested to nominate which control was related to each of the machine motions and to make ratings of certainty of response. A second part required participants to rank the various control arrangements in terms of their compatibility. RESULTS: The in-line control arrangement was worst for each machine and increased directional compatibility improved the stereotype strength, certainty of response and ranking of control arrangement. CONCLUSIONS: Directional compatibility is the main factor in the design of control/machine output arrangements due to its effect on stereotype strength and correct selection of control of a given function. [ABSTRACT FROM AUTHOR]

Many governments are seeking to encourage the extension of working lives to counteract potential labor market shortages that might result from population aging. Nevertheless, research shows that older workers continue to face a range of barriers to their labor market participation. However, this research has not tended to take a holistic view of the factors shaping employer policy and practice or acknowledge that older workers' experiences are embedded within broader social structures and age dynamics. This article reports on exploratory qualitative research undertaken in Hong Kong. It demonstrates how employer policy and practice toward older workers are shaped by intergenerational dynamics and by the social responsibility that employers feel toward different generations. It is argued that in order to more fully understand employer policy and practice toward older workers, an approach that acknowledges the social context and position of different age groups is required. [ABSTRACT FROM AUTHOR]

Background Health professionals including psychiatrists were reported to have stigmatising opinions on psychiatric patients. Their views may be affected by clinical, social and cultural factors. Objective This study explored the views of Chinese psychiatrists on stigmatisation of psychiatric patients. Methods Focus group discussions with psychiatrists were conducted in Hong Kong. Their views towards stigmatisation of psychiatric patients and strategies to reduce stigmatisation were discussed. Findings The psychiatrists perceived the clinical needs to classify the patients according to the diagnoses and they did not see it as stigmatisation. They believed that some mental illnesses are characterised with violence or deviance, and were not completely curable. Instead of trying to eliminate stigma, they managed in ways that took social expectations into consideration. They might offer a relative vague diagnostic label to save the 'face' of the patients and secure greater acceptance for the illness from the public. They tended to accept family members to make decisions on behalf of the patients. Reconciling public interest and patients' autonomy, they encouraged stable psychotic patients to live in the community but agreed to institutionalise those patients with violent behaviours. Conclusion While the psychiatrists argued that the diagnosis was not a form of stigma, they were sensitive enough and framed responses to patients in ways to minimise stigma. They tended to believe that stigma was inevitable given the nature of some psychotic disorders. Disguising the stigma appeared to be the common approach to deal with stigma in a Chinese context. Clinical Implications The psychiatrists, especially those practicing in a Chinese context, may consider a wider perspective of community mental health rehabilitation which is not limited to social stability but also social life. [ABSTRACT FROM AUTHOR]

Background: Struggling to correct the public-private imbalance in its health care system, the Hong Kong SAR Government seeks to introduce a government-regulated voluntary health insurance scheme, or VHIS, a distinctive financing instrument that combines the characteristics of private insurance with strong government regulation. This study examines citizens' responses to the new scheme and their willingness to subscribe.Methods: First-hand data were collected from a telephone survey that randomly sampled 1793 Hong Kong adults from September 2014 to February 2015. Univariate and multivariate methods were employed in data analysis.Results: More than one third of the respondents explicitly stated intention of subscribing to the VHIS, a fairly high figure considering the scheme's voluntary nature. Multivariate analysis revealed moderate evidence of adverse selection, defined as individuals' opportunistic behaviors when making insurance purchasing decision based on their own assessment of risks or likelihood of making a claim.Conclusion: The excellent performance of Hong Kong's public medical system has had two parallel impacts. On the one hand, high-risk residents, particularly the uninsured, do not face a pressing need to switch out of the overloaded public system despite its inadequacies; this, in turn, may reduce the impact of adverse selection that may lead to detrimental effects to the insurance market. On the other hand, high satisfaction reinforces the interests of those who have both the need for better services and the ability to pay for supplementary insurance. Furthermore, the high-risk population demonstrates a moderate interest in the insurance despite the availability of government subsidies. This may offset the intended effect of the reform to some extent. [ABSTRACT FROM AUTHOR]

Television is a powerful medium through which to convey information and messages to the public. The recent proliferation of forensic science and criminal justice information throughout all forms of media, coupled with raised expectations toward forensic evidence, has led some to suspect that a "CSI effect" ( Crime Scene Investigation effect) is taking place. The present study contributes to the literature addressing the CSI effect in two ways. First, it examines whether the CSI effect exists in the Chinese population of Hong Kong. Second, using a mock-jury paradigm, it empirically examines a more integrative perspective of the CSI effect. It was found that, although the amount of media coverage involving forensic evidence does influence participants' perception of legal evidence to some degree, such a perception does not affect participants' legal decision making. Viewers of forensic dramas were not more likely to convict the defendant when forensic evidence was presented and not less likely to convict when only testimonial evidence was presented. The only significant predictor of the defendant's culpability when scientific evidence was presented was participants' ratings of the reliability of scientific evidence. Results from the present study lend no support to the existence of the CSI effect in Hong Kong. [ABSTRACT FROM AUTHOR]

Governments in low fertility countries tend to tackle low birth rates by addressing macro-level factors rather than the meaning that having a child holds for men and women. Yet whether or not an individual decides to have a child depends in part on what they think having a child will mean for their lives. This study examines the meanings that constitute reasons for wanting a child among a sample of middle-class, married, Hong Kong Chinese women who wanted children. These women were living in Hong Kong when it had one of the lowest total fertility rates in the world and the lowest in its history. Using semi-structured, in-depth interviews, it finds that for these women, to have a child makes one’s family complete; is the next stage of life; provides happiness, fun, and enjoyment; brings care and company in old age; and children are “lovely” and “cute.” Governments concerned about low birth rates can use research on what having a child means for women to improve policy so as to make having a child more attractive, and to create messages that hold greater appeal to women. [ABSTRACT FROM PUBLISHER]

Purpose: Vaccination uptake remained low, although annual subsidies are provided to encourage 6-72-month-old Hong Kong children to be vaccinated against seasonal influenza. This study was aimed to investigate the psychosocial influences on parental decision-making regarding young children's seasonal influenza vaccination. Methods: One-thousand two-hundred twenty-six parents of eligible children were recruited using random digit dialing in August-October 2012 to assess baseline perceptions and re-contacted in March 2013 to record children's vaccination uptake. Structural equation modeling (SEM) was performed to examine factors associated with parental decision about children's vaccination based on the complete data of 1222 respondents. Results: Of the 1226 respondents who completed the follow-up survey, 34.3 % reported that their child was vaccinated during the follow-up period. Child's past influenza vaccination history ( β = 0.48), belief in vaccination safety ( β = 0.35), and social norms ( β = 0.25) were strongly associated with parental intention to vaccinate their child which directly predicted child vaccination uptake ( β = 0.57). Belief in vaccination safety ( β = 0.42) and social norms ( β = 0.36) were strongly associated with vaccination intention of parents whose children never received influenza vaccine. Conclusion: Interventions that address concerns on vaccination safety and utilize social norms may be effective to initiate Chinese parents to vaccinate their children. [ABSTRACT FROM AUTHOR]

This is a first initiative to apply career exploration research to understand and assess a career intervention in Hong Kong. In responding to educational and social changes, a one-semester academic career course was designed to foster the participants’ career exploration in a public university in Hong Kong. Data were drawn from about 380 students enrolled voluntarily across three successive semesters in either the career course or another academic course unrelated to career development. The career course served as an intervention to enhance exploration for enrolled students, with students from an unrelated academic course in the same semester included as a comparison group. Pre- and post-assessments were conducted to assess the career course’s impact in terms of career decision making, career adaptability, and relational support. The reflection and discussion here focus on the course’s effectiveness and cultural appropriateness as a career intervention tool and its strategic value in higher education in Hong Kong and beyond. [ABSTRACT FROM AUTHOR]

Background: Haemodialysis (HD) is one of the life-saving options for patients with end stage renal disease but demand for this treatment exceeds capacity in publicly funded hospitals. One novel approach to addressing this problem is through a shared-care model whereby government hospitals partner with qualified private HD service providers to increase the accessibility of HD for needy patients. The aim of this study is to evaluate and enhance the quality of care (QOC) provided in such a shared-care programme in Hong Kong, the Haemodialysis Public-Private Partnership Programme (HD-PPP).Methods/design: This is a longitudinal study based on Action Learning and Audit Spiral methodologies to measure the achievement of pre-set target standards for the HD-PPP programme over three evaluation cycles. The QOC evaluation framework is comprised of structure, process and outcome criteria with target standards in each domain developed from review of the evidence and in close collaboration with the HD-PPP working group. During each evaluation cycle, coordinators of each study site complete a questionnaire to determine adherence with structural criteria of care. Process and clinical outcomes, such as adverse events and dialysis adequacy, are extracted from the patient records of consenting study participants while face-to-face interviews are conducted to ascertain patient-reported outcomes such as self-efficacy and health-related quality of life.Discussion: The study relies on the successful implementation of partnership-based action research to develop an evidence-based and pragmatic framework for evaluation of quality of care in an iterative fashion, and to use it to identify possible areas of quality enhancements in a shared-care programme for HD patients. The approach we take in this study emphasizes partnership and engagement with the clinical and administrative programme team, a robust but flexible evaluation framework, direct observation and the potential to realize positive change. The experience will be useful to inform the process of coordinating research studies involving multiple stakeholders and results will help to guide service planning and policy decision making.Trial Registration: US Clinical Trial Registry NCT02307903. [ABSTRACT FROM AUTHOR]

In 2013, the ‘right to baby formula’ movement supported by educated, middle-class Chinese families in Hong Kong was launched online challenging the dominant message that ‘breast is best’. In this article, I focus on links between mediatisation, globalisation of formula milk and motherhood in post-colonial Hong Kong. Although previous research has examined ideologies of motherhood and mothers’ infant feeding decisions, little research has focused on the impact of digital media within post-colonial societies undergoing rapid social change. Drawing on data from a study of mothers living in Hong Kong that I conducted during 2010–2011 and 2013–2014, I show how digital media contribute to changes in individuals’ experiences with breastfeeding, perceptions of risk and health, as well as social relations, norms, values and identities in contemporary Hong Kong. I explore how and with what consequences the family, especially as it relates to motherhood and childhood, and the practices of infant feeding are intertwined with digital media and the body politic in neoliberal, post-colonial Hong Kong. I argue that although digital media have globalised the biomedical discourse that ‘breast is best’, mothers in Hong Kong have, through digital storytelling and virtual interaction, generated alternative interpretations of science, health and their embodied illness experience that serve to counterbalance the cultural contradictions of motherhood. I show that through social networking, parents have not only gained sufficient political power to secure formula milk, they are also simultaneously subsumed to consumer desire created by the marketing of international pharmaceutical companies. [ABSTRACT FROM AUTHOR]