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Since Hong Kong returned to Chinese sovereignty, national identity building became an important part of school education meeting some resistance in Hong Kong society. In 2012, thousands of school stakeholders protested against the introduction of the 2012 Guide of Moral and National Education (MNE). These conflicts have influenced teachers' attitudes towards MNE and curriculum choices. Employing the Model of Teachers' Perceptions of Moral and National Education, this research investigates the factors affecting teachers' perceptions of MNE, as a national identity building curriculum. The findings indicated that "perceived other support for MNE," "perceived non-monetary cost--benefits," "perceived concerns of MNE," and "comparison with the previous system (Moral and Civic education)" were the significant predictors for teachers' receptivity of MNE. The results suggested that if teachers were supported by others, they were more likely to support MNE; and they were less likely to support the implementation of MNE when teachers had serious concerns about it. The results recommended adding media and socio-political factors into the Model of Teachers' Receptivity to curriculum changes. The discussion will employ identity grafting (Lee in Managing Chineseness: Identity and ethnic management in Singapore, Palgrave Macmillan, London, 2017) as a point of comparison to identify the theoretical implications of MNE.

Rationale: Current critical care practice does not integrate social determinants of health (SDOH) in systematic or standardized ways. Routine assessment of SDOH in the intensive care unit (ICU) may improve clinical decision making, patient- and family-centered outcomes, and clinician well-being. Objective: Given that the appropriateness and feasibility of SDOH assessment in the ICU is unknown, we aimed to understand how ICU clinicians think about and use SDOH. Methods: We conducted semistructured interviews with clinicians focused on barriers to and facilitators of assessing SDOH during critical illness and perceptions of screening for SDOH in the ICU. We used chart-stimulated recall to assist clinicians in reflecting on how SDOH applied to and was used in patients' care. After deidentifying interviews, we analyzed transcripts guided by a thematic analysis approach using a combination of inductive and deductive coding, the latter framed within the Centers for Disease Control and Prevention SDOH Healthy People framework. Results: We completed interviews with 30 clinicians in a variety of professional roles. The majority of clinicians self-identified as men (n = 17; 56.7%) of White race (n = 25; 83.3%). Clinicians contextualize their use of SDOH within three frames of reference: 1) their own identity and experiences; 2) their relationships and communication with patients and caregivers; and 3) immediate structures of care around ICU patients, including clinician advocacy, care transitions, and readmission. Clinicians identified that discussing SDOH could allow them to recognize bias faced by their patients, elucidate drivers of critical illness, and navigate communication with patients' caregivers. Clinicians worried about ICU-specific factors impeding the discussion of SDOH, including time constraints and acuity, high stakes and emotions, and negative anticipatory emotions. Conclusions: Clinicians gather SDOH during critical illness both to understand their patients' stories and to provide individualized care, which may lead to better clinician satisfaction and patient- and family-centered care outcomes. Educational and operational efforts to increase SDOH assessment and use in critical care should also gather and integrate the perspectives of patients and caregivers regarding the collection and use of SDOH in the ICU. [ABSTRACT FROM AUTHOR]

Background/Objectives: The aim of this study was to report the visual and refractive outcomes of nanophthalmic eyes undergoing phacoemulsification at a tertiary cataract center. Methods: This is a prospective consecutive case series. Patients with an axial length of ≤20.5 mm who underwent phacoemulsification at a tertiary cataract center in Hong Kong were included. Eyes undergoing extracapsular cataract extraction or with a previous history of intraocular surgery including trabeculectomy were excluded. The outcome measures were the corrected distance visual acuity (CDVA) and refractive status at four months post-operation. Different intraocular lens formulas were used to compare the refractive outcomes. Results: Out of 22,847 cataract surgeries performed from May 2011 to March 2020, 14 eyes (0.06%) of 10 patients had axial lengths of ≤20.5 mm and underwent phacoemulsification. The mean axial length was 20.13 ± 0.44 mm. Out of these fourteen eyes, three (21%) had postoperative myopic shift with spherical equivalent refraction of more than or equal to 1D compared to the original target. Eleven eyes (79%) had postoperative refraction within 0.5D compared to the original target. Nine out of fourteen eyes (64%) had improvements in postoperative vision. There were no intraoperative complications. When comparing the Hoffer Q, Holladay 1, Holladay 2, Haigis and Hill-RBF 2.0 formulas, there was no significant difference in the absolute errors between the five formulas (p = 0.072). Conclusions: There was no significant difference in the mean absolute errors between the Hoffer Q, Holladay 1, Holladay 2, Haigis and Hill-RBF 2.0 formulas. Myopic shift was not uncommon, and more studies on intraocular lens (IOL) power calculation for short eyes are warranted. [ABSTRACT FROM AUTHOR]

Inherited retinal dystrophies comprise a clinically complex and heterogenous group of diseases characterized by visual impairment due to pathogenic variants of over 300 different genes. Accurately identifying the causative gene and associated variant is crucial for the definitive diagnosis and subsequent selection of precise treatments. Consequently, well-validated genetic tests are required in the clinical practice. Here, we report the analytical and clinical validation of a next-generation sequencing targeted gene panel, the PrismGuide IRD Panel System. This system enables comprehensive genome profiling of 82 genes related to inherited retinal dystrophies. The PrismGuide IRD Panel System demonstrated 100% (n = 43) concordance with Sanger sequencing in detecting single-nucleotide variants, small insertions, and small deletions in the target genes and also in assessing their zygosity. It also identified copy-number loss in four out of five cases. When assessing precision, we evaluated the reproducibility of variant detection with 2,160 variants in 144 replicates and found 100% agreement in terms of single-nucleotide variants (n = 1,584) and small insertions and deletions (n = 576). Furthermore, the PrismGuide IRD Panel System generated sufficient read depth for variant calls across the purine-rich and highly repetitive open-reading frame 15 region of RPGR and detected all five variants tested. These results show that the PrismGuide IRD Panel System can accurately and consistently detect single-nucleotide variants and small insertions and deletions. Thus, the PrismGuide IRD Panel System could serve as useful tool that is applicable in clinical practice for identifying the causative genes based on the detection and interpretation of variants in patients with inherited retinal dystrophies and can contribute to a precise molecular diagnosis and targeted treatments. [ABSTRACT FROM AUTHOR]

Objective: This study analyses the incidence of subjectively experienced dysphagia and voice change in post-thyroidectomy and parathyroidectomy patients without recurrent laryngeal nerve palsy. Methods: A total of 400 patients were invited to participate in a telephone questionnaire based on the Dysphagia Handicap Index and Voice Handicap Index. At 6–24 months following surgery, participants were divided into: post-thyroid surgery (total, hemi-, parathyroidectomy) groups and controls (other ENT procedures). A total of 254 responses were received (127 following thyroid surgery, 127 controls). Results: Twenty-two per cent of post-thyroidectomy patients had a Voice Handicap Index score of more than 3, compared to 15 per cent of parathyroid patients and 4 per cent of controls. The mean Dysphagia Handicap Index score for patients post thyroidectomy and hemi-thyroidectomy was 2.0. Parathyroidectomy patients had a mean Dysphagia Handicap Index score of 1.3, higher than controls at 1.0. Conclusion: Dysphagia and voice alteration are common following thyroid surgery, even in the absence of recurrent laryngeal nerve injury. Both deficits occur more frequently following thyroid surgery than parathyroid surgery. [ABSTRACT FROM AUTHOR]

Following the return of Hong Kong to Chinese sovereignty in 1997, the government of the Hong Kong Special Administrative Region developed wide-ranging curriculum reforms, including project learning. A recent survey has indicated that over 80% of Hong Kong primary and secondary schools have adopted project learning as a curriculum task. Such an outcome is hard to reconcile both with the culture of Hong Kong schools and the generally bleak picture that pervades the literature on educational change. In seeking an explanation for this apparent success we focus attention on the policy instruments that were used by government agencies to facilitate the process of implementation. Our analysis revealed that teachers were caught in a pincer movement that involved voluntary activities promoting project learning and coercive measures that monitored and evaluated successful implementation. Teachers' views of these policy instruments differed markedly from those of policymakers. This confluence of mixed approaches, while apparently successful, is also shown to be problematic. Finally, the paper is located in a theoretical framework with its origins in recent policy theory that to date has not been applied to educational contexts. (Contains 2 tables.)

"Soft" policy has newly emerged as a policy implementation concept in relation to governance. Non-binding in character, "soft" policy is designed for multi-level systems of governance in which there is relative autonomy at different levels of collective decision-making. "Soft" policy has gained attention since the adoption of curriculum reforms in various countries that involve governance and coordination among multi-level systems. In real practice, "soft" methods or measures are used to assist implementation at various levels. The present study explores how "soft" policy has been realised in recent large-scale curriculum reform in Hong Kong. In essence, the study explores the "soft" measures used by the government in the curriculum change, how these "soft" measures have brought changes to schools, and how they were received by school principals and teachers. Implications are also drawn from these real cases of "soft" policy implementation. (Contains 2 notes.)

Curriculum implementation as both an educational practice and a policy conundrum has been the focus of academic research since the 1970s. A new perspective is taken in this article by borrowing from the literature on policy implementation in multilevel systems of government. The concepts of "hard" and "soft" policy are used to show that policy-makers choose from a range of strategies and it is these choices rather than teacher attitudes that may account for the level of implementation of a policy. A case study of curriculum implementation in Hong Kong is used to show how "hard" and "soft" policy can be identified in practice. (Contains 3 tables.)

A new approach to curriculum and implementation in a new era normally requires schools and teachers to take more responsibility for student learning. This might present a challenge at any time, particularly when teachers have been used to more directives and less professional approaches to curriculum implementation. In order to meet such a challenge, a new approach to curriculum policy, namely "soft" policy, was used by policy-makers to implement curriculum reform. With the provision of substantial resources, it was expected by the policy-makers that schools and teachers would have better opportunities to develop themselves professionally and manage the new changes effectively. However, such a view misread the situation because the historical trend and present situation of teachers' professional development were overlooked. This paper uses case studies of schools and teachers involved in the current reforms to show how teachers and schools implemented the reform process. The cases demonstrate how reforms were understood at the local level and the extent to which it could be claimed that implementation had taken place.

Hong Kong is seeking to increase the use of "assessment for learning" rather than rely on "assessment of learning" through summative examinations. Nearly 300 teachers from 14 primary and secondary schools answered a Chinese translation of the Teachers' Conceptions of Assessment inventory and a new Practices of Assessment Inventory. Structural equation modelling showed that there was clear alignment between conceptions and practices. Further, there were significant differences in the conceptions of assessment held by Hong Kong teachers as compared to New Zealand and Queensland teachers. This sample of Hong Kong teachers strongly associated (r = 0.91) using assessment to improve teaching and learning with making students accountable through assessment, which, in turn, led to a strong use of examination preparation practices (beta = 0.43). Hong Kong teachers believed learning outcomes were improved by using assessments to make students accountable and by preparing them for examinations. These results suggest that broader Chinese cultural norms concerning examinations are part of school culture and may provide barriers for the assessment reform agenda in Hong Kong and other Confucian societies. (Contains 3 figures and 1 table.)

Assessment has become an important topic of debate and even reform in many Western countries. It is equally important in other regions of the world, although less subject to reform. Yet discussions of assessment across cultural boundaries are not frequent and in a globalizing world this can be problematic. The purposes of this article, therefore, are to review concepts such as "formative" and "summative" assessment and how they have developed over time. A focus of this review will be to identify the implications of different kinds of assessment for student learning, especially in relation to the cultural contexts in which they take place. The article will argue that different forms of assessment can be directed towards different learning purposes, especially where cultural pressures dictate certain kinds of assessment practices. Valorizing one form of assessment over another may well be counterproductive in particular cultural contexts.