Reform of nursing education in Hong Kong : a study of nurse leadership and policy development

Nursing education in Hong Kong has undergone major reform in recent year similar to that in some Western countries, involving the introduction of degree level preparation. This reform occurred just before Hong Kong was returned to the sovereignty of China. While a combination of complex factors contributed to the reform, the role of nurse leaders was instrumental in influencing policy development. This study investigated the role of nurse leaders in this reform and the factors influencing their effectiveness. A case study approach was used with multiple data collection methods that included a documentary search of report newspapers, newsletters and journal articles; semi-structured interviews (n=26) nurse leaders and policy makers; and a questionnaire survey of nurses from fh regional hospitals in Hong Kong (n=678). The period studied extended from the first proposal for a nursing degree programme in 1985, to 1995 when 180 nursing degree places were secured. An integrated leadership model is derived from this study that contains dimensions that influence leadership effectiveness: situational variables, leader power base, leaders' attributes and style, and leaders' reciprocal relationships with followers. Data analysis indicated that nursing education reform could be conceptualised as an evolution process. Nurse leaders' roles focused on the acquisition of power which involved: establishing goals, communicating directions, increasing power through unity, increasing power through influences empowering followers and preparing self. Situational variables that impacted on leadership effectiveness were categorised as inertia and facilitation. Though the findings indicated that nurse leaders had the ability to influence nursing education reform to some extent, the questionnaire survey suggested that frontline nurse did not regard nurse leaders as having good leadership skills. Their evaluation of nurse leaders' effectiveness was generally negative. Furthermore, a lack of experience in the political arena and lack of unity within nursing further weakened nurse leaders' power. Nurse leaders' potential had not been maximised This study expands the knowledge on leadership by providing a multidimensional framework to comprehend or predict leadership behaviour. The findings also highlight the problems associated with nursing leadership development in Hong Kong and suggest the importance of education, positive socialisation professionalisation and power base in promoting nursing leadership development Further studies, using a prospective design, of nurse leadership in other areas are needed to test the generalisability of these findings

The Mental Health of Unemployed and Socially Isolated Middle-aged Men in Tin Shui Wai, Hong Kong

This study investigates the poor mental health of unemployed middle-aged men (with women as a reference for comparison) in Hong Kong, who were unemployed and isolated socially in what is officially described as a new town, Tin Shui Wai. The study also explores the different aspects of social capital that may improve mental health for middle-aged individuals, drawing on data from ten in-depth interviews with five men and five women, two focus groups with five men and six women and a survey using questionnaires completed by 188 men and 215 women. The results showed that men in the sample had poorer mental health than women. In particular, levels of depression and alcohol abuse were higher in the men than the women. By contrast, women in the sample manifested more anxiety than the men. The findings also showed that unemployment had more negative effects on men than on women, with the men having more free time but nothing to do, feeling stressed, going out less with family members, drinking more alcohol and so on. Drawing on theories of social capital (Lin et al. 1985, McKenzie 2006), I argue that the poor mental health among men was associated with weak social capital. The data showed that for both men and women, social capital could have a positive association with reducing depression and anxiety. In particular, for men, community networks and social support had a positive association with reducing depression and alcohol abuse. For women, group membership, community networks and social cohesion had a positive association with reducing depression and anxiety. Based on these findings, I suggest an approach that focuses on increasing social capital to promote mental health among men and women. The approach argues for the need to introduce policies and strategies to promote social capital at the community and individual level for men, and at the community level for women

New Approaches to the Controversies in International Economics

This dissertation examines the validity of the Fisher hypothesis and the Balassa-Samuelson hypothesis by using an approach which is different from those employed in the previous studies. The importance of the hypotheses in the field of international economics is reflected by the ample volume of research work directed to them. Nevertheless, the validity of the hypotheses remains controversial and the findings on the issues are diverse. In light of this, I use a different empirical approach to examine the two hypotheses and hope that the findings here would bring new insight to the literature.In the first chapter of my dissertation, I investigate whether the Fisher effect holds for the US. The Fisher relationship maintains that nominal interest rates and expected inflation move in a one-to-one manner. As conventional unit root tests find that both nominal interest rates and inflation are unit root processes, most recent papers have used a cointegration approach to verify if the fisher effect holds. Given that US nominal interest rates and inflation fell and rose after reaching certain peaks and troughs over the last few decades, there is doubt in treating the time series as non-stationary. I investigate the issue for the US using two different approaches. In the structural break analysis, I find that the direction and magnitude of breaks in nominal interest rate and inflation follow approximately to what the Fisher effect predicts. The stability of real interest rates provides further support for the validity of the Fisher link. In the second part of the paper, I use a VAR model to examine the dynamic relationship between nominal rates and inflation. As volatility clustering is present, I include a GARCH effect in the estimation. The results show that nominal rates respond positively to a shock in inflation and the magnitude of cumulated response is only slightly below that predicted by the Fisher hypothesis. The findings are strongly in favor of the presence of the Fisher effect.The second chapter examines validity of the Balassa-Samuelson hypothesis (BSH) in a sample of nine OECD countries with the US taken as the benchmark. The BSH admits the importance of productivity in explaining the fluctuations of real exchange rates via its impact on the relative non-tradable prices. The results from the structural break analysis indicate that four countries tie with the hypothesis while the other three countries are in partial fit. Similar findings are obtained when government spending is considered in the estimations. Examining the dynamic relationship among the variables by a VAR-GARCH model, the findings support a strong link between productivity shocks and real exchange rates. The results are robust when the time series are either treated as I(0) or I(1). The responses of relative prices to productivity shocks are in the expected directions, however, the sizes are mild in most cases. In this regard, I examine an alternative transmission channel for productivity shocks. The results suggest that the real exchange rate of tradable goods maybe an important channel through which productivity impacts on real exchange rates. As a whole, the findings in this paper are slightly in favor of the hypothesis.In the third chapter, I extend my study on the Fisher hypothesis to cover the same sample of nine OECD countries. I employ a similar empirical approach as in the first chapter. In the structural break analyses, I investigate if real interest rates are stable over the entire sample period. Since the findings show that the real rates for most of these countries have experienced major shifts over time, I examine the reasons behind these changes by considering some possible factors suggested by the literature. Employing VAR-GARCH models and innovation analyses, I find that nominal interest rates have limited response to inflation shock. The failure of achieving the hypothesized one-to-one relationship is not due to an inappropriate tax adjustment of the nominal rates. After considering the overall results, only two countries in the sample follow closely with the predictions from the Fisher hypothesis. While the evidence of three countries rejects the Fisherian link, the findings for the rest are mixed. I suggest that the evidence for the Fisher hypothesis is weak

A Preliminary Study to Enhance the Tribological Performance of CoCrMo Alloy by Fibre Laser Remelting for Articular Joint Implant Applications

CoCrMo alloy has long been used as a pairing femoral head material for articular joint implant applications because of its biocompatibility and reliable tribological performance. However, friction and wear issues are still present for CoCrMo (metal)/CoCrMo (metal) or CoCrMo (metal)/ultrahigh molecular weight polyethylene (UHMWPE) (plastic) pairs in clinical observations. The particulate wear debris generated from the worn surfaces of CoCrMo or UHMWPE can pose a severe threat to human tissues, eventually resulting in the failure of implants and the need for revision surgeries. As a result, a further improvement in tribological properties of this alloy is still needed, and it is of great interest to both the implant manufacturers and clinical surgeons. In this study, the surface of CoCrMo alloy was laser-treated by a fibre laser system in an open-air condition (i.e., no gas chamber required). The CoCrMo surfaces before and after laser remelting were analysed and characterised by a range of mechanical tests (i.e., surface roughness measurement and Vickers micro-hardness test) and microstructural analysis (i.e., XRD phase detection). The tribological properties were assessed by pin-on-disk tribometry and dynamic light scattering (DLS). Our results indicate that the laser-treated surfaces demonstrated a friction-reducing effect for all the tribopairs (i.e., CoCrMo against CoCrMo and CoCrMo against UHHMWPE) and enhanced wear resistance for the CoCrMo/CoCrMo pair. Such beneficial effects are chiefly attributable to the presence of the laser-formed hard coating on the surface. Laser remelting possesses several competitive advantages of being a clean, non-contact, fast, highly accurate and automated process compared to other surface coating methods. The promising results of this study point to the possibility that laser remelting can be a practical and effective surface modification technique to further improve the tribological performance of CoCr-based orthopaedic implants

The Quality of Distance Learning from an Economic Perspective: A Case Study from Hong Kong

This paper examines the quality of distance education in terms of its impact on the earnings of workers, based on Hong Kong’s 2001 census and 2006 by-census data. Education and training, which are an investment in human capital, enhance the productivity of workers and increase their lifetime incomes: a more productive investment will produce a higher rate of return. The effects of education and training on workers’ earnings can be regarded as a proxy for measuring the quality of education undertaken. This study shows that, as regards earnings, and therefore (indirectly) quality, there is no statistically significant difference between distance and traditional education

Choosing a story for measuring language development in Cantonese-speaking children

Also available in print.Thesis (B.Sc)--University of Hong Kong, 2006."A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, June 30, 2006."published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Polarization gaps in spiral photonic crystals

We studied the optical properties of a dielectric photonic crystal structure with spirals arranged in a hexagonal lattice. The dielectric constant of the material is 9 and the filling ratio is 15.2%. We found that this kind of structure exhibits a significant polarization gap for light incident along the axis of the spirals. The eigenmodes inside the polarization gap are right-hand (left-hand) circularly polarized depending on the whether the spirals are left-handed (right-handed). The transmission spectrum of a slab of such a structure has been calculated and matches well with the analysis of the eigenmodes.Comment: 6 pages, 7 figure

Intergeneration perception toward happiness in elderly life

According to the latest statistics released by the Census and Statistics Department, the Hong Kong population aged 65 and over was 829,300 at the end of 2004. The number of persons aged 65 or older is projected to increase by 17.9% to 978,000, representing 13.2% of population in 2013. This increase in the number and proportion of elderly will intensify the challenges of ageing, which will put further pressure on the government and the society at large. In response to Hong Kong\u27s rapid aging population and in line with the concept of active and successful ageing, the question of how to assist the elderly to achieve a happy elder life has become a very important issue. According to World Health Organization (WHO), healthy” is defined as having good physical, psychological, and social status. Therefore, having a happy elder life means not only having good physical health, but also good psychological state and social status. In the past, studies on understanding the happiness of the elderly were scarce in Hong Kong. The survey on “How to lead a Happy Elder Life” conducted by Hong Kong Christian Service and Elderly Council (2001) was one of the first local study on elderly’s perception about happiness. Similar to other studies overseas (Kehn 1995; Ikels 1994), it was found that “good health status”, “good social relationship”, “stable financial situation”, and “good living arrangement” were the key factors affecting the well-being of the elderly. In addition, some scholars found that the involvement and participation across the generations is also an important element that determines well-being and happiness among the elderly (Hareven 1996). According to Sellars (1998), the collaboration between teenagers and elderly in daily life or school life would not only improve the relationship and understanding among two generations, but would also improve the self-worth of the elderly giving rise to a more fulfilling elder life. In addition, it was found that the quality of care provided by mid-aged adults (such as care givers for the elderly) was another factor affecting the life satisfaction level of the elderly (Hareven and Adams 1996; Hogan, Eggebeen and Snaith 1996). Based on the findings of these studies, it is believed that having a happy elder life requires the mutual effort of and contribution from different generations. In order to assist the elderly people to lead a happy elder life, the Elderly Commission has been promoting the concept of “Healthy Ageing” in Hong Kong since 2001. The aim of the campaign of Healthy Aging was to create a sustained healthy living environment and to allow the citizens to enjoy their elder life autonomously (Department of Health and Elderly Commission 2001). In response to this campaign, Hong Kong Christian Service combine the concepts of “Healthy Aging” and “Happy Elder Life” 3 to conduct an elderly survey on “how to lead a happy elder life” in 2001 (Hong Kong Christian Service 2001). A second study was conducted four years later. The main objectives of this survey remain the same, they are to find out the happiness index in 2005 compared with the 2001 survey and to understand how people of different age groups perceive the question of “How to lead a Happy Elder Life”. The findings of the study serve as useful inputs for promoting mutual understanding, care, and love among the different generations in Hong Kong

Diagnostic accuracy of mediastinal width measurement on posteroanterior and anteroposterior chest radiographs in the depiction of acute nontraumatic thoracic aortic dissection

We aimed to explore the diagnostic accuracy of various mediastinal measurements in determining acute nontraumatic thoracic aortic dissection with respect to posteroanterior (PA) and anteroposterior (AP) chest radiographs, which had received little attention so far. We retrospectively reviewed 100 patients (50 PA and 50 AP chest radiographs) with confirmed acute thoracic aortic dissection and 120 patients (60 PA and 60 AP chest radiographs) with confirmed normal aorta. Those who had prior history of trauma or aortic disease were excluded. The maximal mediastinal width (MW) and maximal left mediastinal width (LMW) were measured by two independent radiologists and the mediastinal width ratio (MWR) was calculated. Statistical analysis was then performed with independent sample t test. PA projection was significantly more accurate than AP projection, achieving higher sensitivity and specificity. LMW and MW were the most powerful parameters on PA and AP chest radiographs, respectively. The optimal cutoff levels were LMW = 4.95 cm (sensitivity, 90 %; specificity, 90 %) and MW = 7.45 cm (sensitivity, 90 %; specificity, 88.3 %) for PA projection and LMW = 5.45 cm (sensitivity, 76 %; specificity, 65 %) and MW = 8.65 cm (sensitivity, 72 %; specificity, 80 %) for AP projection. MWR was found less useful and less reliable. The use of LMW alone in PA film would allow more accurate prediction of aortic dissection. PA chest radiograph has a higher diagnostic accuracy when compared with AP chest radiograph, with negative PA chest radiograph showing less probability for aortic dissection. Lower threshold for proceeding to computed tomography aortogram is recommended however, especially in the elderly and patients with widened mediastinum on AP chest radiograph