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BACKGROUND: It is unknown whether questionnaires measuring psychosocial constructs related to low back pain (LBP) that were originally designed for adults are suitable for adolescents, and if paper and web-versions have similar measurement properties. OBJECTIVES: To examine selected psychometric properties for the paper- and web-based Back-Beliefs Questionnaire (BBQ) and the Fear Avoidance Beliefs Questionnaire (FABQ-phys) among adults and adolescents in two diverse countries and to determine whether differences existed between countries and pain groups. METHODS: A sample of 156 adults (Hong Kong, n = 75; Australia, n = 81) and 96 adolescents (Hong Kong, n = 61; Australia, n = 35) participated in this cross-sectional study. RESULTS: Main effects for country and administration mode were observed in adult BBQ scores, where Australian adults reported significantly higher BBQ scores than Hong Kong adults (mean difference (MD); 95% CI: 2.85; 0.96-4.74) and significantly higher scores were recorded on the web mode compared to the paper mode (MD 0.74; 0.10-1.38). Similarly, Hong Kong adults and adolescents reported higher FABQ-phys scores than Australian adults and adolescents (MD; 95% CI: 3.40; 1.37-5.43 and 4.88; 0.53-9.23, respectively). Internal consistency values were mostly acceptable (α⩾0.7). CONCLUSION: Differences exist between cultures for LBP-related beliefs. The BBQ and FABQ-phys have acceptable measurement properties in both administration modes. [ABSTRACT FROM AUTHOR]

Background Tobacco endgame policies are increasingly advocated to end tobacco use. This study investigated public support for a total ban on tobacco sales, use and possession in Hong Kong. Methods A telephone survey was conducted among 1537 randomly selected residents in 2012 to assess their support for a total ban on tobacco sales, usage and possession. Information on sociodemographic characteristics, smoking, and second hand smoke exposure were collected. Logistic regression was used to investigate factors associated with support for a total ban. Results Most of the never smokers (75.3%), ex-smokers (63.9%), and nearly half of current smokers (48.9%) backed some form of a total ban on tobacco. A total ban on tobacco sales was the most popular option among the three groups, with over half (64.8%) of all respondents supporting a ban within 10 years. Current smoking and higher educational attainment were associated with less support for a total ban on tobacco sales. Among current smokers, having quit intentions and attempts to quit were associated with support for a total ban. Conclusions A total ban on tobacco sales was supported by most respondents. Ex-smokers and current smokers also voiced substantial support, although less than never smokers. A total ban on tobacco sales before 2022 should be the goal as it is supported by most of the respondents. Interim tobacco control measures, such as tax increases, expansion of smoking cessation services and plain packaging should be implemented to help current smokers quit and reduce smoking initiation before implementation of the ban. [ABSTRACT FROM AUTHOR]

Situated in Hong Kong's considerably limited discourse on sexuality, this paper aims to examine how introducing the topic of masturbation into our college's gender-and sexuality-related course created pedagogical conundrums (in the words of Kathleen Quinlivan). We discuss how attempts to confront these conundrums enabled us to begin the journey of understanding and breakthe silence about having sexual desire discussed in the classroom and written assignments. Drawing on our earlier classroom discussion of sexual topics, which resulted in moments of silence, and the written assignments of 10 students on the topic of masturbation, this paper borrows Quinlivan's discussion of the possibilities in 'uncomfortable analytic reflexivity' to explore how education can be a highly contested space carved out by students to express, both 'silently' and 'openly', their perceptions of masturbation. Classrooms can be flipped to discover the cracks that allow the journey towards breaking the silence to begin and to provide space for students to discuss sexual desires and pleasures that were previously deemed negative and unspeakable in their previous classroom experience. Remembering and reflecting on such silence can allow it to be reconceptualised as illuminating and meaningful. [ABSTRACT FROM AUTHOR]

The paper explored the extent to which hospital appointed official root cause analysis (RCA) panels consider antecedent and proximal events when they investigate communication related sentinel events (CRSEs) in hospitals. It also explored which CRSEs are most common in the hospital setting in Hong Kong and the communication modes most commonly associated with CRSEs. The data consisted of Risk Alert and Annual Report on SEs issued by the Hong Kong Hospital Authority from October 2007 to September 2017. Over the period studied, there were 379 reported sentinel events (SEs). In 186 of these SEs we identified communication as a contributing factor. We examined the RCA panels' reports on contributing factors and subsequent recommendations in these 186 SEs and found that their recommendations only highlighted the proximal contributing factors and not antecedent factors that may be relevant. RCA panels most often recommended that communication should be enhanced or documentation improved. We propose that it is time to review the RCA process to recognize that many CRSEs may occur because of antecedent factors that result from the complex hospital organizational structure and its associated hierarchical culture. We suggest two ways forward, 1) applying a language and social psychology perspective to the investigations of CRSEs and, 2) the involvement of experts from different disciplines who can work with clinicians during RCA investigations. [ABSTRACT FROM AUTHOR]

Background: This research is inspired by the challenges encountered in interpreter training, changes in learning needs in the technological era, the educational paradigm shift caused by the COVID‐19 pandemic, the lack of studies on combining virtual reality (VR)_and mobile technologies, and literature gaps in the field of the incorporation of technology in interpreter education. Objectives: This research aims to develop a mobile‐based VR application for bi‐directional English‐Chinese and Chinese‐English interpreting learning named 'Virtual Interpreting Practice' (VIP) based on an interpreting competence model and to investigate its impact on students' self‐rated language and interpreting proficiency levels as well as their declarative knowledge and operative skills as reflected in different interpreting modes (sight and consecutive) and language directions (English‐Chinese and Chinese‐English). The VIP app contains learning resources, including 13 learning modules covering both interpreting modes, practical topics and contexts, video lectures and demonstrations, fully immersive VR and non‐VR practice, glossary lists, source texts, translated texts and an online feedback platform. Methods: Thirty‐one native Chinese‐speaking English as a second/foreign (ESL/EFL) undergraduate students used the app for self‐directed learning. The data were collected by the pre‐study and post‐study questionnaires as well as the pre‐test and post‐test. Results and Conclusions: The results indicate that the use of VIP significantly raised the students' self‐rated language and interpreting proficiency levels as well as their interpreting performance in both modes and language directions. While the students performed better in sight interpreting and Chinese‐English interpreting, they achieved a significantly higher improvement rate in consecutive interpreting and English‐Chinese interpreting. Lay Description: What is already known about this topic: A number of studies have demonstrated the use of virtual reality (VR) provides users with senses of multiple presence, enhances learner engagement and motivation, and facilitates collaborative, situated, immersive and experiential learning that is not often available in traditional learning environments.The increasing availability of VR has created new opportunities in the area of mobile‐assisted language learning (MALL), paving the way for a new research area called VR‐assisted language learning (VRALL).Using VRALL, numerous benefits in various language skills have been identified, such as listening, speaking, writing and vocabulary acquisition. What this paper adds: While blending VR and mobile technologies may play a more significant role in education settings and create more advantages, the impact of this combination for interpreting learning has remained an unexplored area in higher education. This paper has addressed the research gaps in which there is a lack of VR language learning apps that are bilingual, mobile‐based and specifically designed for interpreting practice in highly immersive learning environments.The results indicate that the use of VIP significantly raised the students' self‐rated language and interpreting proficiency levels as well as their interpreting performance in both sight and consecutive interpreting and language directions (English‐Chinese and Chinese‐English).While the students performed better in sight interpreting and Chinese‐English interpreting, they achieved a significantly higher improvement rate in consecutive interpreting and English‐Chinese interpreting. Implications for practice and/or policy: The results have implications for the roles of students and teachers. The app developed in this study shifts the teacher‐led approach to student‐centred learning. While it allows more learning autonomy, its effectiveness may largely depend on students' ability to self‐regulate and engage.It appears that the effectiveness of VRALL depends on a number of individual and contextual factors, e.g. the design and functionality of the apps, availability of the internet connection and smartphones as well as learning needs and motivation. [ABSTRACT FROM AUTHOR]

Simple Summary: Genome-wide DNA methylation profiling has emerged as an important diagnostic tool that complements histopathology for characterizing central nervous system (CNS) tumors. The literature describing its application in Asian countries is limited. We report the feasibility and utility of adopting such profiling for children with diagnosed CNS tumors in Hong Kong. The study included samples of 97 patients with CNS embryonal or high-grade neuroepithelial tumors (HGNETs). In our DNA methylation-profiled cohort, 67% of results correlated with the diagnosis and assigned molecular subgroup and 12% of results led to revision/reassignment of diagnosis. Patient outcomes correlated significantly with methylation-based subgroups. In addition, novel clinical–histologic–molecular associations were described. Taken together, epigenomic profiling enabled clinically relevant refinement of disease classification of pediatric CNS tumors. The availability of such methodology in Asia sets the stage for international collaborations in molecularly driven trials. This paper examines the link between CNS tumor biology and heterogeneity and the use of genome-wide DNA methylation profiling as a clinical diagnostic platform. CNS tumors are the most common solid tumors in children, and their prognosis remains poor. This study retrospectively analyzed pediatric patients with CNS embryonal tumors in Hong Kong between 1999 and 2017, using data from the territory-wide registry and available formalin-fixed paraffin-embedded tumor tissue. After processing archival tumor tissue via DNA extraction, quantification, and methylation profiling, the data were analyzed by using the web-based DKFZ classifier (Molecular Neuropathology (MNP) 2.0 v11b4) and t-SNE analysis. Methylation profiles were deemed informative in 85 samples. Epigenetic data allowed molecular subgrouping and confirmed diagnosis in 65 samples, verified histologic diagnosis in 8, and suggested an alternative diagnosis in 12. This study demonstrates the potential of DNA methylation profiling in characterizing pediatric CNS embryonal tumors in a large cohort from Hong Kong, which should enable regional and international collaboration in future pediatric neuro-oncology research. [ABSTRACT FROM AUTHOR]

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Introduction: Health literacy (HL) refers to individuals' abilities to process and use health information to promote health. This study aimed to develop the first HL measurement tool for the Chinese Hong Kong population. Methods: A two‐phase methodology was adopted. In Phase I, evidence synthesis with a deductive method was conducted to formulate the item list from the literature. In Phase II, a modified e‐Delphi survey was conducted among stakeholders (i.e., healthcare providers and healthcare consumers) to confirm the content validity of the item list. The stakeholders were invited to rate the relevance of each draft item on a 4‐point scale and provide suggestions for revisions, removal or adding new items. Results: In Phase I, a total of 34 items covering functional, interactive and critical HL were generated. In Phase II, to obtain a balanced view from experts and laypeople, healthcare professionals (n = 12) and consumers (n = 12) were invited to participate in the Delphi panel. The response rates of the three rounds were 100%. After the third round, the consensus was reached for 31 items, and no further comments for adding or revising items were received. All items exhibited excellent content validity (item content validity index: 0.79–1.00; K*: 0.74–1.00). Conclusions: A Health Literacy Scale for Hong Kong was developed. Compared with existing HL scales, the scale fully operationalized the skills involved in functional, interactive and critical HL. The Delphi study shows evidence supporting the high content validity of all items in the scale. In future studies, these items should undergo rigorous testing to examine their psychometric properties in our target population groups. By illuminating the details in the development process, this paper provides a deeper understanding of the scale's scope and limitations for others who are interested in using this tool. Patient or Public Contribution: Public as healthcare consumers, in addition to healthcare providers, were involved in developing a new HL scale for this study. The input from the public contributed to examining the scale's content validity by judging whether all items reflected the skills that they need to find and use health‐related information in their daily life. [ABSTRACT FROM AUTHOR]

The literature on cross-age interactions suggests that more communication between older and younger generations can foster mutual understanding. Existing studies on intergenerational programs focus more on the perspectives of older people, while young adults' perceptions of intergenerational interactions are less well-understood. Through 448 surveys and 23 qualitative interviews with youth in Hong Kong, this study explored what motivates youth to communicate with retirees beyond their family. The findings reveal that youth in this study had relatively superficial interactions with retirees in community settings, which is partly explained by ageism. Nevertheless, they preferred connecting with retirees who are able to offer transformational benefits that enhance personal growth, which points toward novel forms of ableism based on skill-sharing abilities. The paper concludes by considering the implications of these findings for intergenerational programs, especially the importance of uncovering the latent skills of older people, to extend the possibilities for more in-depth intergenerational interactions. [ABSTRACT FROM AUTHOR]

Background: Artificial Intelligence (AI) literacy is a crucial part of digital literacy that all individuals should possess in today's technologically advanced world. Despite the potential benefits that AI education offers, little research has been done on how to teach AI literacy to children. Objectives: This study aimed to fill that gap by investigating how children were engaged in AI literacy activities that are supported by intelligent agents. These activities were implemented in a Hong Kong kindergarten with a class of six 5‐year‐olds (Mage = 62.83 months, SD = 2.91) over a 6‐week period. Methods: The study gathered data from multiple sources, including classroom observations, teacher interviews, and documents/artefacts. Results and Conclusions: The results showed that children could learn about AI through interaction with intelligent agents in embodied learning contexts. The findings of this study have implications for the broader field of digital technology education, particularly in the context of early childhood education. Lay Description: What is already known about this topic: Artificial Intelligence (AI) literacy is essential in today's world.Little research exists on engaging young children in learning AI literacy. What this paper adds: Technology‐enhanced embodied learning approach affords multimodality in enabling young children's learning with AI‐related agents.Project‐based learning and real‐life examples can enhance children's learning. Implications for practice and/or policy: Early exposure to AI can help children navigate the increasingly digital world.Practical approaches, such as embodied and multimodal learning, seem to be effective.Teachers can enhance children's digital learning by using pedagogical strategies like project‐based learning and real‐life examples. [ABSTRACT FROM AUTHOR]

INTRODUCTION Smoking prevalence among people in custody (PIC) is extremely high, and prison-based smoking cessation interventions are needed. The study explored the quitting experiences of PIC who participated in the 'Quit to Win' contest (QTW). METHODS This qualitative study, conducted from 2019 to 2021 in two Hong Kong prisons, included semi-structured individual interviews with 26 PIC (13 men and 13 women) who were participants in QTW and two correctional staff who coordinated QTW. A semi-structured interview guide with open-ended questions was developed to examine multilevel factors that promote or impede smoking cessation in prisons. Maximum variation sampling was used to ensure a diverse range of social, demographic, and smoking profiles. Data were managed and analyzed using thematic analysis. RESULTS Two themes were identified from the data: 1) quitting in prison: barriers and facilitators; and 2) QTW in prison: a trigger for behavior change. Barriers (i.e. stress, boredom, isolation, lack of self-autonomy, nicotine dependence and lack of cessation medication, barriers to moving to a different wing) and facilitators (i.e. concerns about health, money savings, and the smoke-free wing) that impeded or supported smoking cessation during incarceration were identified. QTW provided health education, quitting incentives, and social support that helped PIC overcome the barriers of quitting by serving as a trigger for behavior change. Notably, social visits with family were identified as key drivers of PIC's quitting success, whereas their suspension during the COVID-19 pandemic disincentivized their abstinence. CONCLUSIONS This study introduced the QTW contest to prisons and provided qualitative evidence on the multilevel factors promoting or impeding smoking cessation in prison. QTW helped PIC overcome the barriers of quitting by serving as a trigger for behavior change. Future prison-based interventions should leverage social support, enhance stress-coping skills, facilitate access to pharmacotherapy, and collaborate with correctional services agencies. [ABSTRACT FROM AUTHOR]

Risk management and empowerment have become key features of social work practice. Despite their increasing salience, relatively little is known about the perspectives of mental health social workers regarding how they navigate competing risk management approaches in modern practice that supports empowerment. The socio-cultural influences on risk management have also received insufficient attention in social work research. Focusing on these issues, this paper explored the perspectives of social workers in two geographically and culturally distinctive settings (i.e. Hong Kong and Sydney). Data were collected through semi-structured interviews with frontline social workers and were analysed using thematic analysis. Similar views were expressed by participants in both settings regarding assessment of clients' readiness for risk-taking. Differences were identified in their practices of negotiating the perspectives of other key stakeholders and can be attributed to the influences of distinctive cultural and socio-political contexts. These insights may contribute to the development of more systematic, localised and practice-based risk assessment guidelines for mental health practitioners working towards the empowerment of clients. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known about this topic?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates.No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. What this paper adds to existing knowledge?: It appears feasible to use the HIP to profile and compare physical health‐related risks in people with SMI across different international settings.The HIP tool identified significant differences in areas of risk across the four countries. What are the implications for practice?: The HIP could be used to identify unique clusters of health promotion needs in different countries.Use of HIP health checks may support implementation of individualized interventions. Introduction: To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim: To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method: An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results: Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion: This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi‐national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice: It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources. [ABSTRACT FROM AUTHOR]

Background: measures of physical capability may be predictive of subsequent health, but existing published studies have not been systematically reviewed. We hypothesised that weaker grip strength, slower walking speed and chair rising and shorter standing balance time, in community-dwelling populations, would be associated with higher subsequent risk of fracture, cognitive outcomes, cardiovascular disease, hospitalisation and institutionalisation.Methods: studies were identified through systematic searches of the electronic databases MEDLINE and EMBASE (to May 2009). Reference lists of eligible papers were also manually searched.Results: twenty-four papers had examined the associations between at least one physical capability measure and one of the outcomes. As the physical capability measures and outcomes had been assessed and categorised in different ways in different studies, and there were differences in the potential confounding factors taken into account, this made it impossible to pool results. There were more studies examining fractures than other outcomes, and grip strength and walking speed were the most commonly examined capability measures. Most studies found that weaker grip strength and slower walking speed were associated with increased risk of future fractures and cognitive decline, but residual confounding may explain results in some studies. Associations between physical capability levels and the other specified outcomes have not been tested widely.Conclusions: there is some evidence to suggest that objective measures of physical capability may be predictors of subsequent health in older community-dwelling populations. Most hypothesised associations have not been studied sufficiently to draw definitive conclusions suggesting the need for further research. [ABSTRACT FROM AUTHOR]

The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the virus, they did so using two very different approaches. Drawing upon data from a cross-national, probability sample Internet survey conducted in May 2020 as well as media and mobility data, we argue that the different approaches were the result of the relative strength of civil society vs. the state at the outset of the outbreak. In protest-ridden Hong Kong, low governmental trust bolstered civil society, which focused on self-mobilisation and community mutual-help. In Singapore, a state-led response model that marginalised civil society brought early success but failed to stem an outbreak among its segregated migrant population. Our findings show that an active civil society is pivotal to effective outbreak response and that trust in government may not have been as important as a factor in these contexts. [ABSTRACT FROM AUTHOR]

Previous research on school experiences has often focused on lesbian and gay students. Far fewer studies have examined trans* students’ experiences, especially with respect to community support. And none of this work has addressed relevant issues in an East Asian Chinese cultural context, where transgender equality has been a hotly debated issue in recent years, and prejudice towards members of this ‘invisible’ population still persists. This paper highlights the school experiences of trans* students based on a literature review of international, regional and Hong Kong publications. A case study analysis of one Hong Kong community support programme is used as an example to highlight the important role that this kind of work can play in filling a gap left by the formal education sector. Findings suggest that, given the influence of genderism and deficiencies of in school environments, community support services provided by non-government organisations can play a significant role not only in raising public awareness, but also in filling education and service gaps for sexual and gender minority students. [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]

INTRODUCTION Mobile interventions enable personalized behavioral support that could improve smoking cessation (SC) in smokers ready to quit. Scalable interventions, including unmotivated smokers, are needed. We evaluated the effect of personalized behavioral support through mobile interventions plus nicotine replacement therapy sampling (NRT-S) on SC in Hong Kong community smokers. METHODS A total of 664 adult daily cigarette smokers (74.4% male, 51.7% not ready to quit in 30 days) were proactively recruited from smoking hotspots and individually randomized (1:1) to the intervention and control groups (each, n=332). Both groups received brief advice and active referral to SC services. The intervention group received 1-week NRT-S at baseline and 12-week personalized behavioral support through SC advisor-delivered Instant Messaging (IM) and a fully automated chatbot. The control group received regular text messages regarding general health at a similar frequency. Primary outcomes were carbon monoxide-validated smoking abstinence at 6 and 12 months post-treatment initiation. Secondary outcomes included self-reported 7-day point-prevalence and 24-week continuous abstinence, quit attempts, smoking reduction, and SC service use at 6 and 12 months. RESULTS By intention-to-treat, the intervention group did not significantly increase validated abstinence at 6 months (3.9% vs 3.0%, OR=1.31; 95% CI: 0.57-3.04) and 12 months (5.4% vs 4.5%, OR=1.21; 95% CI: 0.60-2.45), as were self-reported 7-day point-prevalence abstinence, smoking reduction, and SC service use at 6 and 12 months. More participants in the intervention than control group made a quit attempt by 6 months (47.0% vs 38.0%, OR=1.45; 95% CI: 1.06-1.97). Intervention engagement rates were low, but engagement in IM alone or combined with chatbot showed higher abstinence at 6 months (adjusted odds ratios, AORs=4.71 and 8.95, both p<0.05). CONCLUSIONS Personalized behavioral support through mobile interventions plus NRT-S did not significantly improve abstinence in community smokers compared to text only messaging. The suboptimal intervention engagement needs to be addressed in future studies. [ABSTRACT FROM AUTHOR]

The low impact forces of Tai Chi push-hand exercises may be particularly suited for older people and for those with arthritis; however, the biomechanics of push-hand exercises have not previously been reported. This paper examines the ground reaction forces (GRFs) and plantar force distributions during Tai Chi push-hand exercises in a stationary stance with and without an opponent. Ten male Tai Chi practitioners participated in the study. The GRFs of each foot were measured in three perpendicular directions using two force plates (Kistler). The plantar force distribution of each foot was measured concurrently using an insole sensor system (Novel). The results showed that the average maximum vertical GRF of each foot was not more than 88% ± 6.1% of the body weight and the sum of the vertical forces (103% ± 1.4%) generated by the two feet approximately equals the body weight at any one time. The horizontal GRFs generated by the two feet were in the opposite directions and the measured mean peak values were not more than 12% ± 2.8% and 17% ± 4.3% of the body weight in the medio-lateral and antero-posterior directions respectively. Among the nine plantar areas, the toes sustained the greatest plantar force. This study indicates that push-hand exercises generate lower vertical forces than those induced by walking, bouncing, jumping and Tai Chi gait, and that the greatest plantar force is located in the toe area, which may have an important application in balance training particularly for older adults. [ABSTRACT FROM AUTHOR]

Mobile devices are becoming ubiquitous among older adults, but have also caused unprecedented challenges due to the high demands of interaction techniques and changeable design patterns found across various applications. This paper aims to investigate how older adults navigate with mobile interfaces and identify their potential usability challenges while navigating. To do so, we summarised six state-of-the-art mobile interface design patterns and conducted individual usability test and in-depth interview with 22 older adults. Participants were asked to perform 19 navigation tasks that contain these design patterns under realistic usage scenarios. Follow-up interviews were held to collect their detailed comments on usability issues regarding visual design, ease of understanding, and interaction and navigation of the design patterns, as well as their personal experience. The results found that overall older adults were able to navigate contents more effectively than menus and buttons. Participants experienced great challenges in directing their attention to the menus and buttons, understanding the meaning of icons, and interacting with these menu components. In contrast, the content-oriented navigation design performed better in understanding, navigation, and interaction, which could be a promising direction for elderly-friendly mobile application design. Design implications are further discussed for creating an elderly-friendly mobile interface. [ABSTRACT FROM AUTHOR]

Every year, the majority of Hong Kong young adults who graduate from secondary school progress onto tertiary education. Poor eating patterns among young adults could lead to long-term health implications associated with overweight and obesity. Using the socio-ecological model as a theoretical framework, this paper reviews the current food-related policies in Hong Kong and proposes a comprehensive policy approach relevant to a variety of organizational contexts that has the potential to support positive eating patterns among young adults by enhancing the local food environment. Hong Kong has an unusual food supply in that more than 95% of food is imported, making it vulnerable to food insecurity. Education interventions commonly conducted in Hong Kong are unlikely to be helpful because young adults acquire nutrition-related knowledge when they attend secondary school. There is a need to change the food environment in Hong Kong so that young adults can easily translate their nutrition knowledge into making healthy food choices. Policy approaches might be among the most effective strategies for bringing positive changes in eating patterns because they have the potential to directly influence the food environment and context where an individual lives. A comprehensive suite of approaches that fill the policy gaps, remove barriers of healthy food consumption and create more healthy food choices is required to improve diet and health. [ABSTRACT FROM AUTHOR]

Background Studies have highlighted the impacts of temperature variability (TV) on mortality from respiratory diseases and cardiovascular diseases, with inconsistent results specifically in subtropical urban areas than temperate ones. We aimed to fully determine TV-associated health risks over a spectrum of diseases and various subgroups in a subtropical setting. Methods Using inpatient data from all public hospitals in Hong Kong from 1999 to 2019, we examined the TV-hospitalisation associations by causes, ages, and seasons by fitting a quasi-Poisson regression. We presented the results as estimated percentage changes of hospitalisations per interquartile range (IQR) of TV. Results: TVs in exposure days from 0-5 days (TV0-5) to 0-7 days (TV0-7) had detrimental effects on hospitalisation risks in Hong Kong. The overall population was significantly affected over TV0-5 to TV0-7 in endocrine, nutritional and metabolic (from 0.53% to 0.58%), respiratory system (from 0.38% to 0.53%), and circulatory systems diseases (from 0.47% to 0.56%). While we found no association with seasonal disparities, we did observe notable disparities by age, highlighting older adults' vulnerability to TVs. For example, people aged =65 years experienced the highest change of 0.88% (95% CI = 0.34%, 1.41%) in hospitalizations for injury and poisoning per IQR increase in TV0-4. Conclusions: Our population-based study highlighted that TV-related health burden, usually regarded as minimal compared to other environmental factors, should receive more attention and be addressed in future relevant health policies, especially for vulnerable populations during the cold seasons. [ABSTRACT FROM AUTHOR]

As social inequalities during the COVID-19 pandemic have been recognised, emerging research showed that lesbian, gay and bisexual (LGB) people may be additionally affected during the pandemic. This paper adds to the understanding of the experiences of LGB people during the pandemic with a focus on Hong Kong, where issues of space significantly influence LGB people's lives in this city with high population density. As part of a larger community study of LGB lives in Hong Kong, COVID-19-related impact on 434 Chinese-speaking LGB people was explored. Data collection was conducted from 20 May to 30 June 2020. Inductive thematic analysis of the open-text response survey data found that the LGB participants described both negative and positive impacts brought by COVID-19. Such impacts could be dimensionalised into those related to personal space and privacy, romantic and sexual space, and community space. It was also found that the experiences of COVID-19 among LGB people in Hong Kong were intersectional, along the lines of living arrangement and relationship status. Such findings make unique contributions to the emerging literature. First, there needs to be a more nuanced understanding of sexual minority individuals' experiences during COVID-19 across cultural contexts. Second, COVID-19 was described as having brought positive impact in addition to its widely known negative impact. [ABSTRACT FROM AUTHOR]

INTRODUCTION How changes in smoking routine due to COVID-19 restrictions (e.g. refraining from smoking outdoors and stockpiling tobacco products) influence smoking behaviors remains understudied. We examined the associations of changes in smoking-related practices with quit attempts and smoking consumption in current smokers using a mixed-methods design. METHODS In a community-based telephone survey conducted between the second and third wave of the COVID-19 pandemic in Hong Kong, 659 smokers (87.1% male; 45.2% aged 40--59 years) were asked about quit attempts and changes in cigarette consumption and five smoking-related practices since the COVID-19 outbreak. Logistic regression was used to calculate adjusted odds ratio (AOR), adjusting for sex, age, education level, chronic disease status, heaviness of smoking (HSI), psychological distress (PHQ-4) and perceived danger of COVID-19. A subsample of 34 smokers provided qualitative data through semi-structured interviews for thematic analyses. RESULTS Favorable changes in smoking-related practices, including having avoided smoking on the street (prevalence: 58.9%) and reduced going out to buy cigarettes (33.5%), were associated with a quit attempt (AOR: 2.09 to 2.26; p<0.01) and smoking reduction (AOR: 1.76 to 4.97; p<0.05). Avoiding smoking with other smokers (50.5%) was associated with smoking reduction (AOR=1.76; p<0.05) but not quit attempt (AOR=1.26; p>0.05). Unfavorable changes, including having increased smoking at home (25.0%) and stockpiled tobacco products (19.6%), were associated with increased smoking (AOR: 2.84 to 6.20; p<0.05). Low HSI (0--2) was associated with favorable changes (p<0.01), while high HSI score (3--6) was associated with unfavorable changes (p<0.01). Qualitative interviews revealed a double-edged effect of staying at home on smoking consumption and that pandemic precautionary measures (e.g. mask-wearing) reduced outdoor smoking. CONCLUSIONS Amid the pandemic, favorable changes in smoking-related practices in smokers were mostly associated with quit attempts and smoking reduction, while unfavorable changes were associated with increased smoking. Smokers with higher nicotine dependence were more negatively impacted. [ABSTRACT FROM AUTHOR]

INTRODUCTION We examined the association of workplace smoking cessation (SC) support from employers, in addition to SC interventions, and smoking abstinence. METHODS Smoking employees (≥1 cigarette daily, aged ≥18 years) from companies of various industries joined a workplace SC program in Hong Kong. Self-reported past 7-day point prevalence abstinence was measured at follow-up at 6 months. We assessed 14 types of workplace SC support with higher scores (range: 0--14) indicating greater support. Multivariable logistic regression examined the prospective association between workplace SC support and smoking abstinence, adjusting for intention to quit, nicotine dependence, self-efficacy of quitting, and sociodemographic characteristics. Average marginal effects were calculated to test if the association between overall workplace SC support and self-reported past 7-day PPA at follow-up at 6 months was modified by subgroups. We also interviewed employers from different companies to explore their perspectives of providing workplace SC support, and the data were analyzed by thematic analysis. RESULTS In 383 participants who received a heath talk, a self-help SC booklet, and 15 text messages, greater workplace SC support was associated with smoking abstinence (AOR=1.32; 95% CI: 1.08--1.61), including support for smoke-free environment (AOR=1.51; 95% CI: 1.08--2.11) and for SC attempts/actions (AOR=1.93; 95% CI: 1.21--3.07). The association did not differ by sex, age, intention to quit, nicotine dependence, company size or company type. Qualitative interviews found that employers provided workplace SC support to establish a good company image, cost-benefit considerations were important to the types of workplace SC support provided, and lack of SC knowledge was a barrier to providing workplace SC support. CONCLUSIONS Greater workplace SC support was associated with more abstinence in a workplace SC program. [ABSTRACT FROM AUTHOR]

Purpose: The heterogeneity of autism is well documented, but few studies have studied the heterogeneity of gesture production ability in autistic children. The present study aimed to identify subgroups of autistic children who displayed heterogeneous gesture production abilities and explore the underlying factors, including autism characteristics, intellectual ability, and language ability, that were associated with the heterogeneity. Methods: A total of 65 Chinese autistic children (mean age = 5;3) participated. Their autism characteristics and intellectual ability were assessed by standardized measurements. Language output and gesture production were captured from a parent-child interaction task. Results: We conducted a hierarchical cluster analysis and identified four distinct clusters. Cluster 1 and Cluster 2 both had low gesture production whereas Cluster 3 and Cluster 4 had high gesture production. Both Clusters 1 and 2 had relatively strong autism characteristics, in comparison to Clusters 3 and 4. Conclusions: Our findings revealed that children with stronger autism characteristics may gesture less often than those with weaker characteristics. However, the relationship between language ability and intellectual ability and gesture production was not clear. These findings shed light on the directions of intervention on gesture production for autistic children, especially those with stronger autism characteristics. [ABSTRACT FROM AUTHOR]

Depression is one of the most prevalent mental disorders worldwide. This study examined the effect of a spiritual connectivity intervention on individuals with depression in a randomized waitlist-controlled trial. Fifty-seven participants with mild or moderate depressive symptoms were randomly assigned to either the intervention group (n = 28) or the waitlist control group (n = 29). The intervention comprised eight weekly sessions focusing on divine connection, forgiveness and freedom, suffering and transcendence, hope, gratitude, and relapse prevention. The outcome measures included depressive symptoms, anxiety, hope, meaning in life, self-esteem, and social support. Participants completed self-administered questionnaires at baseline (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Repeated-measures ANOVA and one-way ANCOVA were used to compare the within-group and between-group differences in the changes in outcome variables. Participants in the intervention group showed significant improvements in depression, anxiety, spiritual experience, hope, self-esteem, and perceived social support after the intervention. Effect size statistics showed small to large differences (Cohen's d, 0.308 to −1.452). Moreover, 85.71% of participants in the intervention group also experienced clinically significant reductions in PHQ-9 scores from baseline to immediate post-intervention. This study highlights the effectiveness of a low-cost, accessible intervention suitable for community implementation by clergy and faith-based organizations. [ABSTRACT FROM AUTHOR]

Aim: Internationalization at Home (IaH) strategies play an important role in nursing curricula to enhance nursing students' cultural awareness in the globalized world. The Community of Inquiry (CoI) is a theoretical framework for the optimal design of online learning environments to support critical inquiry and discourse among students and teachers. To optimise nursing students' online cultural awareness learning experiences, it was timely to develop online IaH strategies based on a sound theoretical model. This study aimed to examine the effectiveness of CoI‐guided online IaH strategies on enhancing the cultural awareness of nursing undergraduates who enrolled in a community nursing course. Design: This was an interventional pre‐test post‐test study. Method: One hundred and six nursing undergraduates who enrolled in the course participated in the study. The online IaH strategies were developed focusing on the interactions of teaching presence, cognitive presence and social presence of CoI framework and they were integrated into the course. A previously validated Cultural Awareness Scale was adopted for pre‐post evaluation. Higher scores indicate greater cultural awareness. Results: The results showed that there was a significantly higher total score of cultural awareness of participating students at post‐online IaH strategies. To be effective, aligning CoI‐guided online IaH strategies with course content, pedagogy and assessment was shown to be significant. The inclusion of technological elements in related strategies was also critical to engage student learning. The positive change on the total score of cultural awareness suggested the effectiveness of the deployed strategies. In this ever‐changing educational landscape, it may provide insights to educators regarding considering online IaH strategies with theoretical underpinning for curriculum planning and design. [ABSTRACT FROM AUTHOR]

One thorny issue facing teachers in the higher education sector is how to motivate students to learn. Under the pandemic, reliance on online teaching and learning has intensified the problem. In this paper, we report on a project in which we developed virtual teaching and learning materials in the form of animated videos and case-based videos in a leadership subject for university students. Based on the positive youth development (PYD) approach, experienced teachers developed 24 videos surrounding different PYD constructs. These PYD constructs included self-understanding and selfmanagement, cognitive competence, social-emotional competence, resilience, moral competence, spirituality, law-abiding leadership, cultural competence, effective communication and team building. To understand the effectiveness of the developed videos, we piloted them in Semester 2 of the 2021/22 academic year via online teaching. Initial positive feedback from the students and teachers were observed. [ABSTRACT FROM AUTHOR]

When solving a mathematical problem, students who do not have sufficient conceptual understanding may perform poorly and exhibit misconceptions. This study was aimed to examine students' conceptual understanding and significant misconceptions when solving number sense‐related problems. An online three‐tier diagnostic test was administered to 125 fifth‐grade students with varied socio‐economic backgrounds in Hong Kong. Only 14.40% of the students exhibited high performance with high confidence, indicating that these students had a profound conceptual understanding of number sense. In addition, the majority of the students (66.40%) did not demonstrate number sense; these students exhibited several significant misconceptions and could solve the questions only by using a rule‐based method or guessing. Accordingly, most students performed unsatisfactorily on number sense‐related problems. This study is imperative in identifying early predictors and provides information for further compatible interventions in the teaching and learning of number sense in Hong Kong in particular and worldwide in general. Lay Description: What is already known about this topic: Students must be instilled with conceptual understanding to achieve mastery of mathematical understanding and be able to properly solve complex or novel problems.Students would likely exhibit misconceptions if they do not have sufficient conceptual understanding.Students' conceptual understanding can be examined by evaluating their confidence levels in solving a problem. What this paper adds: A three‐tier diagnostic test (question and answer, reasoning, and confidence) can be used to examine students' conceptual understanding.Students performed unsatisfactorily on number sense because they lack conceptual understanding of topics related to number sense.Students held significant misconceptions on understanding the basic meaning of numbers and operations, recognizing the number size, using multiple representations of numbers and operation, recognizing the relative effect of operations on numbers, and judging the reasonableness of a computational result. Implications for practice and/or policy: Conceptual understanding of related topics reflecting number sense should be prioritized over procedural knowledge and mathematical rules.Lack of conceptual understanding of relevant topics and relying on mathematical rules and formulas are the main root causes of students' unsatisfactory performance.The deliberate use of estimation questions, multiple presentations, and judging the reasonableness of a result can help learners develop their conceptual understanding of number sense. [ABSTRACT FROM AUTHOR]

This study aimed to examine the role and process of reflective assessment supported by the Knowledge Connections Analyzer in helping low academic achievers to develop epistemic agency in knowledge building. The participants were 33 ninth‐grade low achievers from a visual arts course in Hong Kong. A comparison class of 33 students, taught by the same teacher and studying the same topics in a regular knowledge‐building environment, also participated. Qualitative tracing of students' online discourse showed that reflective assessment can help low achievers develop high‐level epistemic agency. Qualitative analysis of the students' prompt sheets revealed that reflective assessment encouraged low achievers to set knowledge‐building goals, collectively and continuously analyse and reflect on their inquiry and ideas, and generate actions to address identified gaps, thus helping them engage in high‐level epistemic agency. The study results have important implications for designing technology‐rich environments that support learners and offer insights into how teachers can help learners develop epistemic agency. Lay Description: What is already known about this topic: Low‐achieving students (LASs) are often disadvantaged in classrooms by a lack of engaging instruction that emphasizes higher‐order competencies.LASs find collaborative inquiry difficult primarily because of the lack of high‐level metacognitive skills and epistemic agency.Reflective assessment has shown its scaffolding function in developing high‐level metacognition and epistemic agency. What this paper adds: Reflective assessment using the Knowledge Connections Analyzer can help LASs to engage in epistemic agency.The design of knowledge‐building environment augmented by reflective assessment can benefit educationally disadvantaged students. Implications for practice and/or policy: Efforts should be made to design technology‐supported learning environments to help LASs to develop epistemic agency and benefit from collaborative inquiry.Knowledge‐building environment augmented by analytics‐supported reflective assessment is proposed as a promising approach to make schoolwork more interesting and accessible for LASs. [ABSTRACT FROM AUTHOR]

A brief intervention using Zero‐time Exercise (ZTEx), a foot‐in‐the‐door approach, was developed to reduce sedentary behaviour and increase physical activity. ZTEx refers to the integration of simple strength‐ and stamina‐enhancing physical activity into daily life, which can be done anytime, anywhere and by anyone. This paper presents the development, feasibility, and preliminary evidence for the effectiveness of this intervention under the Hong Kong Jockey Club FAMILY Project. Needs assessments were conducted with social workers from the Christian Family Services Center(CFSC) and the Social Welfare Department (SWD). This single group prospective ZTEx intervention trial, guided by the Health Action Process Approach, included a 3‐hr core session at baseline and a 1‐hr booster session at 1‐month follow‐up. Fifty‐six participants (social and service‐related workers) from CFSC (n = 28) and SWD (n = 28) received the intervention and completed the self‐administered questionnaires at baseline. Forty‐nine and 43 participants completed the 1‐month and 3‐month self‐administered questionnaires, respectively. Fifteen participants attended the focus group interviews to share their feedback on ZTEx intervention after implementing their community‐based ZTEx activities. Intention‐to‐treat analysis was conducted with missing data replaced by baseline values. Participants reported significant decreases in sitting time by 27 (2, 52) minutes (mean [95% confidence interval]) and 36 (0.2, 71) minutes on a weekday, increases in physical activity while seated by 0.7 (0.2, 1.4) days and 1.1 (0.6, 1.7) days in a week, and improvements in perceived knowledge, outcome expectancies and plan on doing ZTEx at the 1‐month and 3‐month follow‐up, respectively. Balance and muscle strength significantly improved at the 1‐month follow‐up. The effect ranged from small to large (Cohen's d: 0.27–1.05, all p < 0.05). The qualitative feedbacks support the quantitative findings. Our findings show early evidence that ZTEx effectively reduced sedentary behaviour and enhanced physical activity and fitness. Further trials on this simple and low‐cost intervention as the first step to promote higher intensity exercise are warranted. [ABSTRACT FROM AUTHOR]

This study explored how social workers located in Sydney and Hong Kong conceptualised client empowerment. Further, it investigated these professionals' perceived facilitators and barriers to their empowerment practices, based on an ecological framework. A cross-sectional online survey was used, where the original Empowerment Scale for clients with mental health issues was adapted to measure conceptualisation of client empowerment from social workers' perspectives. Eighty-three social workers serving people with mental health issues (MHIs) in Sydney and eighty in Hong Kong responded. A two-factor model was generated suggesting that practitioners tend to conceptualise client empowerment into two aspects: a relation-based dimension and a resource-oriented one. Compared with their Sydney counterparts, the Hong Kong practitioners considered resource-oriented empowerment as more integral to client empowerment (t (161) = 4.17, p  < 0.001). Several key factors were found to be independently associated with endorsement of the two-factor client-empowerment model by practitioners: perceived less support from medical specialists but more support from teams serving the same client, perceived benefits of social work training and, finally, beliefs in the importance of social workers' role in client empowerment. The study highlights the multiple dimensions of client empowerment and a wide range of inter-professional and sociostructural factors enabling social workers' practices that support empowerment. Our paper highlights the role of professional empowerment as a stepping stone to enable their client-empowerment practices through policy support and inter-professional collaboration. [ABSTRACT FROM AUTHOR]

Purpose – Successful implementation of Health Promoting Schools (HPS) depends on putting the model in the schools’ context for both health improvement and school improvement. HPS can only be effective if the change can be sustained over an extended duration. The purpose of this paper is to discuss development of the HPS process by University Research Centre in Hong Kong, resulting in an award scheme, where no additional resources were initially provided by the authorities. Design/methodology/approach – The team adopted a step-by-step approach starting with capacity building of key stakeholders and comprehensive needs assessment, leading to development of a system of evaluation and monitoring and establishment of a “Healthy School Award” system. The system was built on data derived from several different sources and made use of qualitative and quantitative information and were intended to be used to guide practice and actions for improvement. Findings – Schools measured their own performance against established school and student health profiles. The validated system of evaluation and monitoring led to a Healthy School Award scheme for participating schools with “accredited” and “award” designations. The award system evaluated six key HPS areas and identified exemplars of HPS as resource schools to form a strong network. Research limitations/implications – HPS can be regarded as new paradigm of schooling rather than an add-on programme. Practical implications – HPS can be regarded as new paradigm of schooling rather than an add-on programme. The advantage of an academic institution masterminding the development process lies with their strength in education and research, building on the professionalism of school educators in health promotion and developing evidence-based HPS practice. Originality/value – This paper discusses an approach for addressing the key factors associated with initiation of innovation and management of change in an education setting. The involvement of both higher education and an award scheme can act strong catalysts to drive change, resulting in a strong evidence base with and results demonstrating effectiveness, which then led to government support. [ABSTRACT FROM AUTHOR]

Abstract: This paper reports our classroom implementation of a new remote laboratory (RL) system, which was developed by using innovative ideas and methods for applying technology‐enhanced learning to secondary school science education (Grades 7–9 or Ages 12–14). The newly developed RL system, which involves 8 remote experiments, was tested with 32 secondary school students from a local public school in order to evaluate its usability, learning, and their perception. The present study was carried out by using a mixed research method, including a questionnaire survey (open‐ended questions) and interviews. The corresponding research tools were specifically developed to collect data on students' perceptions and the implementation issues of the RL system. The survey results revealed that there was no major refinement required for the RL system, which was good enough for further adoption in secondary science education because its methods used to conduct online experiments could (a) extend/enhance the existing practices (with virtual/simulation experiments only) of e‐learning and (b) largely induce students' favourable views and perceptions in their own learning. Besides, negative comments and suggestions for improvement were purposely collected during a follow‐up period with an aim to pinpoint any ways in which the RL system and its design could be refined. They turned out to be very minor and easily fixed, and so the refined RL system is educationally suitable for use in laboratory activities and demonstrations to enhance the learning and teaching of science within and outside the secondary school environment. [ABSTRACT FROM AUTHOR]

Hong Kong has recently witnessed heightened public awareness of the issues of rights, civil society and citizenship. Contested relations with the Beijing government and slower economic growth in mainland China have seen more Hong Kong citizens become involved in civic engagement and identity politics. Youth service providers thus find themselves forced to respond to a rapidly changing society and changing youth needs while being situated in institutions with their own structural constraints and work culture. The result is that occupational stress is increasingly common amongst Hong Kong secondary school teachers and social workers. This paper presents the findings of a qualitative ethnographic study involving 16 in-depth interviews with community leaders, teachers and school-based social workers. How does a changing society affect youth work in general? How does greater discussion of democracy and human rights in the public sphere affect the way that youth service providers perform youth work? What are the changing roles and responsibilities of these providers in offering support to Hong Kong youth? The research themes that emerged include changing demographics and youth scene, a democratising public sphere in relation to Chinese youth and professionalism as a youth service provider. [ABSTRACT FROM AUTHOR]

Compared to cancers at other sites, lung cancer often results in greater psychosocial distress to both the patients and their caregivers, due to the poor prognosis and survival rate, as well as the heavy symptom burden. In recent years, making protocols of proposed or on-going studies publicly available via clinical trial registries and/or peer-reviewed journals has benefited health sciences with timely communication of the latest research trends and improved transparency in reporting. However, such practice is yet to be a common sight in evidence-informed social work. Hence, this paper discusses the value of publishing protocols in social work research and presents the protocol of a randomized controlled trial that compares the effectiveness of integrative body-mind-spirit intervention with cognitive behavioral therapy for enhancing quality of life of patients with lung cancer and their family caregivers. The data collection process was still on-going at the time of manuscript submission. [ABSTRACT FROM AUTHOR]

This study investigated a Theatresports program implemented in a social work setting in Hong Kong to cultivate all-round positive development in youth. We investigated participants' feelings of the program to generate insights for the development of youth services. Qualitative research was performed with 92 participants of the program. Thematic analysis was performed to analyze the participants' feelings and opinions of the program. Participants acquired a range of skills and abilities, in terms of intrapersonal (e.g., problem-solving skills, positive thinking, self-reflective ability) and interpersonal (e.g., collaborative skills). Besides, they established a positive identity, and obtained support from peers and viewed it as important. Meanwhile, a few of the participants had other feelings and viewpoints, showing that the social workers' role in helping participants consolidate their gaming experiences is important for facilitating participants' personal growth. Based on the results, we recommend that developmental services be extensively developed in youth settings, particularly in Hong Kong. [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]

Purpose: Although multicomponent positive psychological interventions (MPPIs) effectively improve well-being, it is crucial to examine which intervention component plays a critical role. Method: This cluster randomized controlled trial assigned 221 immigrants from mainland China to Hong Kong to either an MPPI arm (n = 116, 11 clusters) or an MPPI + Information arm (n = 105, 11 clusters). Both arms aimed to enhance three intervention outcomes: resilience, happiness, and mental health. The MPPI part in the two arms included four components: self-efficacy, positive thinking, altruism, and goal setting. The information part provided information about Hong Kong. Results: Both arms effectively improved the four intervention components and three intervention outcomes. MPPI + Information increased the immigrants' knowledge of Hong Kong. The network analysis showed that altruism had the greatest strength in the network. Conclusions: Future studies should focus on the specific intervention component of altruism to understand how the MPPI works. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles. Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places. Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4--14% provided sources for help-seeking and 27--90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers. Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between gender, academic achievement, and family functioning in a Chinese cultural background. Primary and secondary school students ( n = 1597) in Hong Kong participated in a survey questionnaire. Two competing hypotheses are derived and empirically tested based on the idea that parents are likely to have higher expectations toward their sons. First, when boys perform well academically, their parents might not feel particularly overjoyed because their sons simply achieved what they were expected to, which would not affect the parents' attitudes within the family and thus the boys' perceptions of the family. Second, when parents have such high expectations for their sons, they would feel particularly satisfied when the outcome fulfills their high expectations. The results indicated that boys did well academically to prevent their parents from potential disappointment, whereas parents were actually happier if their daughters overachieve because they have lower initial expectations. Such differences affected parents' attitudes, family functioning, and thus adolescents' view of family. The results of this study carry implications for the study of family functioning and parenting among Chinese families. In particular, parents should avoid having gender-based expectations toward their children, which could adversely affect how boys view their family. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to describe and discuss the recruitment strategies used in a research study of cervical cancer screening among South Asian women, the challenges encountered and the lessons learnt from the experience. Background Ethnic minority populations face different barriers to participating in research studies. Strategies have been developed to recruit this population to health-related research in Western countries, but there is little information about such research in the Asian region. Design Discussion paper. Data sources The discussion is based on our previous experience. The source of this experience is the recruitment strategies used, their results and the challenges encountered during the process. Implications for nursing Culturally, relevant strategies and maintaining good relationships with stakeholders improved participant recruitment. Familiarity with South Asians' traditional calendar - when cultural and religious festivals are held every year - would aid the setting up of appropriate schedules for participant recruitment, either before or after the periods when they cannot be reached, such as Ramadan. South Asian women are often busy with childcare and housework. This is their major responsibility in the family and any failure to fulfil such duties is a source of stress and may foster feelings of guilt. A better understanding of their daily routines is therefore important. Such information enables the establishment of daily meeting schedules to increase the success rate of recruitment. Conclusion Recruitment is a tedious process, but appropriate planning and taking account of cultural and religious practices and daily schedules will help to improve its rate of success. [ABSTRACT FROM AUTHOR]

Background: The influenza surveillance has been received much attention in public health area. For the cases with excessive zeroes, the zero-inflated Poisson process is widely used. However, the traditional control charts based on zero-inflated Poisson model, ignore the association between influenza cases and risk factors, and thus may lead to unexpected mistakes when implementing monitoring charts.Method: In this paper, we proposed risk-adjusted zero-inflated Poisson cumulative sum control charts, in which the risk factors were put to adjust the risk of influenza and the adjustment was made by zero-inflated Poisson regression. We respectively proposed the control chart monitoring the parameters individually and simultaneously.Results: The performance of our proposed risk-adjusted zero-inflated Poisson cumulative sum control chart was evaluated and compared with the unadjusted standard cumulative sum control charts in simulation studies. The results show that for different distribution of impact factors and different coefficients, the risk-adjusted cumulative sum charts can generate much less false alarm than the standard ones. Finally, the influenza surveillance data from Hong Kong is used to illustrate the application of the proposed chart.Conclusions: Our results suggest that the adjusted cumulative sum control chart we proposed is more accurate and credible than the unadjusted standard control charts because of the lower false alarm rate of the adjusted ones. Even the unadjusted control charts may signal a little faster than the adjusted ones, the alarm they raise may have low credibility since they also raise alarm frequently even the processes are in control. Thus we suggest using the risk-adjusted cumulative sum control charts to monitor the influenza surveillance data to alert accurately, credibly and relatively quickly. [ABSTRACT FROM AUTHOR]

Background: The misestimation of surgical risk is a serious threat to the lives of patients when implementing surgical risk calculator. Improving the accuracy of postoperative risk prediction has received much attention and many methods have been proposed to cope with this problem in the past decades. However, those linear approaches are inable to capture the non-linear interactions between risk factors, which have been proved to play an important role in the complex physiology of the human body, and thus may attenuate the performance of surgical risk calculators.Methods: In this paper, we presented a new surgical risk calculator based on a non-linear ensemble algorithm named Gradient Boosting Decision Tree (GBDT) model, and explored the corresponding pipeline to support it. In order to improve the practicability of our approach, we designed three different modes to deal with different data situations. Meanwhile, considering that one of the obstacles to clinical acceptance of surgical risk calculators was that the model was too complex to be used in practice, we reduced the number of input risk factors according to the importance of them in GBDT. In addition, we also built some baseline models and similar models to compare with our approach.Results: The data we used was three-year clinical data from Surgical Outcome Monitoring and Improvement Program (SOMIP) launched by the Hospital Authority of Hong Kong. In all experiments our approach shows excellent performance, among which the best result of area under curve (AUC), Hosmer-Lemeshow test ([Formula: see text]) and brier score (BS) can reach 0.902, 7.398 and 0.047 respectively. After feature reduction, the best result of AUC, [Formula: see text] and BS of our approach can still be maintained at 0.894, 7.638 and 0.060, respectively. In addition, we also performed multiple groups of comparative experiments. The results show that our approach has a stable advantage in each evaluation indicator.Conclusions: The experimental results demonstrate that NL-SRC can not only improve the accuracy of predicting the surgical risk of patients, but also effectively capture important risk factors and their interactions. Meanwhile, it also has excellent performance on the mixed data from multiple surgical fields. [ABSTRACT FROM AUTHOR]

• We focus on three locations in the Asia-Pacific region—Hong Kong, Shenzhen, and Singapore. • We analyze the impact of variations in research and development (R&D) spending on total factor productivity (TFP) growth. • In each of the three cases, we compare and contrast the role of public and private R&D in boosting TFP growth as well as the pattern of causality between public and private R&D and the capacity of both types of R&D to generate economic spillovers. • We show that the impact of both private and public R&D varies across the three cases, with significant but limited outcomes for TFP growth in the case of Hong Kong, no significant growth in Shenzhen, but strong and positively significant growth in Singapore. In this paper, we focus on three locations in the Asia-Pacific region—Hong Kong, Shenzhen, and Singapore—to analyse the impact of variations in research and development (R&D) spending on total factor productivity (TFP) growth. In each of the three cases, we compare and contrast the role of public and private R&D in boosting TFP growth as well as the pattern of causality involving public and private R&D and the capacity of both types of R&D to generate economic spillovers. Our results show that the impact of both public and private R&D varies across the three cases, with significant but limited outcomes for TFP growth in the case of Hong Kong, no significant growth in Shenzhen, but strong and positively significant growth in Singapore. [ABSTRACT FROM AUTHOR]

Toilet hygiene is an important preventive measure for infectious diseases, including severe acute respiratory syndrome (SARS) and COVID-19. This study explored public's opinions on improving toilet environment and hygiene practices in Hong Kong. A mixed-method approach was applied. We conducted 4 focus groups plus 3 individual interviews among the Hong Kong Chinese, followed by a questionnaire survey with 300 respondents recruited from various districts. Difference in response distributions between groups with different demographics was tested by Pearson χ2 test. Instead of advocating for advanced toilet facilities, respondents were mostly concerned about basic hygiene issues. Malfunctioning facilities resulting from poor toilet management, such as clogged toilets, stained facilities, and problematic flushing systems, were most cited as barriers to toilet hygiene practices. Three quarters of the survey respondents expressed concerns over worn and poorly maintained toilets, shortage of janitors, and cleansing supplies. However, respondents who were older (P <.001), less educated (P <.001), and had lower income (P =.001) were significantly more likely to find hygiene conditions in public toilets satisfactory. The findings reflected the substandard of the current provisions as a developed city in Asia. Enhanced efforts by the government to maintain basic toilet supplies and facilities is the key to improving public compliance to toilet hygiene practices. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: A non-laboratory-based pre-diabetes/diabetes mellitus (pre-DM/DM) risk prediction model developed from the Hong Kong Chinese population showed good external discrimination in a primary care (PC) population, but the estimated risk level was significantly lower than the observed incidence, indicating poor calibration. This study explored whether recalibrating/updating methods could improve the model's accuracy in estimating individuals' risks in PC. Methods: We performed a secondary analysis on the model's predictors and blood test results of 919 Chinese adults with no prior DM diagnosis recruited from PC clinics from April 2021 to January 2022 in HK. The dataset was randomly split in half into a training set and a test set. The model was recalibrated/updated based on a seven-step methodology, including model recalibrating, revising and extending methods. The primary outcome was the calibration of the recalibrated/updated models, indicated by calibration plots. The models' discrimination, indicated by the area under the receiver operating characteristic curves (AUC-ROC), was also evaluated. Results: Recalibrating the model's regression constant, with no change to the predictors' coefficients, improved the model's accuracy (calibration plot intercept: −0.01, slope: 0.69). More extensive methods could not improve any further. All recalibrated/updated models had similar AUC-ROCs to the original model. Conclusion: The simple recalibration method can adapt the HK Chinese pre-DM/DM model to PC populations with different pre-test probabilities. The recalibrated model can be used as a first-step screening tool and as a measure to monitor changes in pre-DM/DM risks over time or after interventions. [ABSTRACT FROM AUTHOR]

Aims: To explore the impact of the coronavirus disease 2019 pandemic on the healthrelated quality of life (HRQoL) of breast cancer survivors. Design: We utilized a qualitative descriptive approach to facilitate interviews among 25 participants, all of whom are survivors of breast cancer and have received treatment in Hong Kong within the preceding 3 years. Methods: Content analysis was performed to understand how patients' HRQoL views and experiences changed during coronavirus disease 2019 pandemic. Results: The results included six themes delineating the impact of the coronavirus disease 2019 pandemic: (i) survivor sensitivities in pandemic times, (ii) coping and conditioning in pandemic times, (iii) transforming work and home dynamics in pandemic times, (iv) cognitive resilience and adaptation to the COVID-19 protective measures, (v) social resilience in pandemic times and (vi) healthcare adaptation and coping in pandemic times. Conclusion: This study provides insights into the experiences and challenges of breast cancer survivors during the coronavirus disease 2019 pandemic. Some survivors had new physical and psychological symptoms, including fear and anxiety, isolation, pain, lymphoedema and burnout, which potentially have long-term impact upon HRQoL. Implications for the profession and/or patient care: This study highlights the unique challenges faced by breast cancer survivors during the coronavirus disease 2019 pandemic, including accessing healthcare services and the impact of social isolation. Healthcare providers should consider the holistic needs of breast cancer survivors in the provision of health care and develop supportive interventions, including telehealth services and online support groups, to address these challenges and improve their HRQoL. Impact: Surgery aimed at treating breast cancer or reducing its risk generally influences the appearance of breast areas and donor sites. The continuing effects of these changes on body image and HRQoL are well-reported, although studies have ineffectively examined the initial experiences of women regarding their postoperative appearance, particularly during the pandemic. Reporting method: The checklist of consolidated criteria for reporting qualitative research (COREQ) was utilized. [ABSTRACT FROM AUTHOR]