The practice firm concept: a competency approach to teach key business skills

Whether it is called “Core Skills (UK)”; “Employability Skills (Canada)”; “Essential Skills (New Zealand)”; “Workplace Know-how (USA)” or “Project and Transfer Oriented Training (Germany)”, globally we have been concerned with integrating key competencies with learning outcomes to provide the workforce with potential employees that are employable in day one. The Department of Business Administration, HKIVE (Tsing Yi) supports this view by incorporating “the Practice Firm Concept” into course delivery, with the belief that it enhances the quality of teaching and fosters life-long learning skills. The purpose of this paper is to illustrate how this Concept has been developed and incorporated in our business curriculum

The use of average Pavlov ratio to predict the risk of post operative upper limb palsy after posterior cervical decompression

STUDY DESIGN: A retrospective study was conducted to study the post operative upper limb palsy after laminoplasty for cervical myelopathy. OBJECTIVE: To identify a reliable and simple preoperative radiological parameter in predicting the risk of post operative upper limb palsy. BACKGROUND: Post operative upper limb palsy is one of the causes of patient dissatisfaction after surgery. There had been no simple, standard preoperative radiological parameters reliably predict the occurrence of this problem. MATERIALS AND METHODS: Seventy-four patients received posterior cervical decompression from 1998 to 2008. Medical record and preoperative radiological information were evaluated. Clinical presentations of the palsy were described. The relationship between the occurrence of palsy and different preoperative radiological information is analyzed. RESULTS: Eighteen patients (24.3%) presented with post operative upper limb palsy. Majority of patients presented with dysesthesia (17/18) and with deficit of the C5 segment (17/18). Ten patients presented with pure dysesthesia and 8 patients presented with mixed motor-sensory deficit and dysesthesia. Multilevel involvement was exclusively presented in patients with motor weakness. A longer duration of symptom (16.7 Vs 57.2 days) was noticed in patients in the motor deficit group. Average Pavlov ratio less then 0.65 (P = 0.027, Odds Ratio = 3.68) and compression at the C3/4 in preoperative MRI image (P = 0.025, Odds Ratio = 6) were significant risk factors for development of this problem. CONCLUSION: Post operative upper limb palsy is not uncommon and thorough preoperative explanation is important. There is a spectrum of clinical presentation and patients with multi-level involvement and motor deficit are associated with poorer prognosis. Average Pavlov ratio < 0.65 and compression at C3/4 segment on preoperative MRI image are simple and reliable preoperative predictor for the development of this problem

La promotion de la santé dans l’apprentissage par le service communautaire : le regard des organismes partenaires

Background: Health advocacy is a core competency for physicians, which can be developed through community-based service-learning (CBSL). This exploratory study investigated the experiences of community partner organizations (CPOs) participating in CBSL in the context of health advocacy. Methods: A qualitative study was conducted. Nine CPOs at a medical school participated in interviews on topics pertaining to CBSL and health advocacy. Interviews were recorded, transcribed, and coded. Major themes were identified. Results: CPOs perceived a positive impact from CBSL through student activities and connecting with the medical community. There was no unifying definition of health advocacy. Advocacy activities varied depending on the individual’s role (i.e., CPO, physician, and student), which encompassed providing patient care or services, raising awareness of healthcare issues, and influencing policy changes. CPOs had different perceptions of their role in CBSL from facilitating service-learning opportunities to teaching students in CBSL, while a few desired to be involved in curriculum development. Conclusion: This study provides further insight into health advocacy from the lens of CPOs, which may inform changes to health advocacy training and the CanMEDS Health Advocate Role to better align with the values of community organizations. Engaging CPOs in the broader medical education system may improve health advocacy training and ensure a positive bidirectional impact.Contexte : Compétence fondamentale pour les médecins, la participation à la promotion de la santé peut être développée dans le cadre de l’apprentissage par le service communautaire (ASC). Cette étude exploratoire examine les expériences des organismes communautaires partenaires (OCP) participant à l’ASC en ce qui concerne le volet promotion de la santé. Méthodes : Dans le cadre d’une étude qualitative, neuf OCP d’une faculté de médecine ont participé à des entretiens sur des sujets liés à l’ASC et à la promotion de la santé. Les entretiens ont été enregistrés, transcrits et codés, et les thèmes principaux en ont été extraits. Résultats : Les OCP ont perçu un effet positif de l’ASC, notamment par le biais des activités étudiantes et des liens établis avec la communauté médicale. Nous n’avons pas relevé de définition commune de la promotion de la santé. Les activités s’y rapportant varient selon le rôle de la personne (OCP, médecin ou étudiant) et comprennent la prestation de soins ou de services aux patients, la sensibilisation aux enjeux de santé et la promotion de changements d’orientations politiques. Les divers OCP avaient des perceptions différentes de leur rôle dans l’ASC, allant de l’offre de possibilités d’apprentissage par le service à l’enseignement aux étudiants en ASC, certains exprimant le désir de participer à l’élaboration des programmes d’études. Conclusion : Cette étude permet de mieux saisir le point de vue des OCP sur la promotion de la santé. Elle peut ainsi éclairer les révisions du rôle CanMEDS de promoteur de la santé et de la formation en la matière de façon à les aligner davantage sur les valeurs des organismes communautaires. L’intégration des OCP à la formation médicale au sens large pourrait contribuer à améliorer le volet promotion de la santé de cette dernière et profiter aux partenaires de part et d’autre

Study protocol for "Moving bright, eating smart"- a phase 2 clinical trial on the acceptability and feasibility of a diet and physical activity intervention to prevent recurrence in colorectal cancer survivors

Background: Colorectal cancer is the second most common cancer and cancer-killer in Hong Kong with an&nbsp;alarming increasing incidence in recent years. The latest World Cancer Research Fund report concluded that foods&nbsp;low in fibre, and high in red and processed meat cause colorectal cancer whereas physical activity protects againstcolon cancer. Yet, the influence of these lifestyle factors on cancer outcome is largely unknown even though&nbsp;cancer survivors are eager for lifestyle modifications. Observational studies suggested that low intake of a&nbsp;Western-pattern diet and high physical activity level reduced colorectal cancer mortality. The Theory of PlannedBehaviour and the Health Action Process Approach have guided the design of intervention models targeting a&nbsp;wide range of health-related behaviours.Methods/design: We aim to demonstrate the feasibility of two behavioural interventions intended to improve&nbsp;colorectal cancer outcome and which are designed to increase physical activity level and reduce consumption of a&nbsp;Western-pattern diet. This three year study will be a multicentre, randomised controlled trial in a 2x2 factorialdesign comparing the &ldquo;Moving Bright, Eating Smart&rdquo; (physical activity and diet) programme against usual care.&nbsp;Subjects will be recruited over a 12-month period, undertake intervention for 12 months and followed up for a&nbsp;further 12 months. Baseline, interim and three post-intervention assessments will be conducted.&nbsp;Two hundred and twenty-two colorectal cancer patients who completed curative treatment without evidence of&nbsp;recurrence will be recruited into the study. Primary outcome measure will be whether physical activity and dietary&nbsp;targets are met at the end of the 12-month intervention. Secondary outcome measures include the magnitude andmechanism of behavioural change, the degree and determinants of compliance, and the additional health benefits&nbsp;and side effects of the intervention.Discussion: The results of this study will establish the feasibility of targeting the two behaviours (diet and physical activity) and demonstrate the magnitude of behaviour change. The information will facilitate the design of a further&nbsp;larger phase III randomised controlled trial with colorectal cancer outcome as the study endpoint to determine&nbsp;whether this intervention model would reduce colorectal cancer recurrence and mortality

Advocacy in community-based service learning: perspectives of community partner organizations

Background: Health advocacy is a core competency for physicians, which can be developed through community-based service-learning (CBSL). This exploratory study investigated the experiences of community partner organizations (CPOs) participating in CBSL in the context of health advocacy. Methods: A qualitative study was conducted. Nine CPOs at a medical school participated in interviews on topics pertaining to CBSL and health advocacy. Interviews were recorded, transcribed, and coded. Major themes were identified. Results: CPOs perceived a positive impact from CBSL through student activities and connecting with the medical community. There was no unifying definition of health advocacy. Advocacy activities varied depending on the individual’s role (i.e., CPO, physician, and student), which encompassed providing patient care or services, raising awareness of healthcare issues, and influencing policy changes. CPOs had different perceptions of their role in CBSL from facilitating service-learning opportunities to teaching students in CBSL, while a few desired to be involved in curriculum development. Conclusion: This study provides further insight into health advocacy from the lens of CPOs, which may inform changes to health advocacy training and the CanMEDS Health Advocate Role to better align with the values of community organizations. Engaging CPOs in the broader medical education system may improve health advocacy training and ensure a positive bidirectional impact

A qualitative study of the views of patients with long-term conditions on family doctors in Hong Kong

&lt;b&gt;Background&lt;/b&gt; Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government policy aims to enhance the management of LTCs in primary care possibly based on a 'family doctor' model. Patients' views on this are not well documented and the aim of the present study was to explore the views of patients with LTCs on family doctors in Hong Kong.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; The views of patients (with a variety of LTCs) on family doctors in Hong Kong were explored. Two groups of participants were interviewed; a) those who considered themselves as having a family doctor, b) those who considered themselves as not having a family doctor (either with a regular primary care doctor but not a family doctor or with no regular primary care doctor). In-depth individual semi-structured interviews were carried out with 28 participants (10 with a family doctor, 10 with a regular doctor, and 8 with no regular doctor) and analysed using the constant comparative method.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; Participants who did not have a family doctor were familiar with the concept but regarded it as a 'luxury item' for the rich within the private healthcare system. Those with a regular family doctor (all private) regarded having one as important to their and their family's health. Participants in both groups felt that as well as the more usual family medicine specialist or general practitioner, traditional Chinese medicine practitioners also had the potential to be family doctors. However most participants attended the public healthcare system for management of their LTCs whether they had a family doctor or not. Cost, perceived need, quality, trust, and choice were all barriers to the use of family doctors for the management of their LTCs.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; Important barriers to the adoption of a 'family doctor' model of management of LTCs exist in Hong Kong. Effective policy implementation seems unlikely unless these complex barriers are addressed

Physical activity for cancer survivors: meta-analysis of randomised controlled trials

Objective To systematically evaluate the effects of physical activity in adult patients after completion of main treatment related to cancer

Physical activity intervention in cancer survivors : a systematic review and meta-analysis of randomized controlled trials

Proffered paper session: Information, patients and the public/ Survivorship and end of life careBackground The aim was to systematically review all published randomized controlled trials (RCTs) which tested the effect of a physical activity intervention in adult cancer survivors after the main cancer treatment. Method Relevant RCTs were located by: (1) systematic searching of electronic databases (PUBMED and Google Scholar) using cancer-related and exercise-related search terms; and (2) scanning the references of retrieved RCTs and relevant reviews. All relevant RCTs were retrieved and assessed to determine if they met the selection criteria. Data extraction was independently performed by two investigators and followed by a discussion to reach consensus. The main outcome measures were cancer outcome (survival and recurrence), quality of life (QoL), body composition and functional capacity. Results A total of 2,447 citations were identified of which 170 potentially relevant ones were examined in detail. Forty-five papers met the selection criteria of which 41 reported data on at least one relevant outcome. These encompassed 18 papers not included in previously published reviews. Twenty-six papers (63.4%) were on breast cancers and the remaining papers were on other cancers. There was a paucity of published data on the effects of physical activity interventions on cancer outcome. Various instruments were used to assess the other outcomes (QoL and functional capacity) limiting the pooling of data for meta-analysis. Estimates of the effects of physical activity interventions on QoL, body composition and functional capacity were determined. Potential determinants of the effect heterogeneity across studies were evaluated. Conclusion Moderately-strong-to-strong evidence was found for a positive effect of physical activity interventions on QoL of adult cancer survivors following main cancer treatment. Clinically meaningful associations were identified between such interventions and improved functional capacity. The observed heterogeneity in study design and outcome parameters highlighted the need for the development of a standardized protocol to facilitate meta-analysis on the effects of physical activity in cancer survivors. Acknowledgements This study has been supported by WCRF UK, WCRF International and WCRF Hong Kong

Risk of peanut- and tree-nut-induced anaphylaxis during Halloween, Easter and other cultural holidays in Canadian children.

BACKGROUND: It is not established whether the risk of anaphylaxis induced by peanuts or tree nuts in children increases at specific times of the year. We aimed to evaluate the risk of peanut-and tree-nut-induced anaphylaxis during certain cultural holidays in Canadian children. METHODS: We collected data on confirmed pediatric cases of anaphylaxis presenting to emergency departments in 4 Canadian provinces as part of the Cross-Canada Anaphylaxis Registry. We assessed the mean number of cases per day and incidence rate ratio (IRR) of anaphylaxis induced by unknown nuts, peanuts and tree nuts presenting during each of 6 holidays (Halloween, Christmas, Easter, Diwali, Chinese New Year and Eid al-Adha) versus the rest of the year. We estimated IRRs and 95% confidence intervals (CIs) using Poisson regression. RESULTS: Data were collected for 1390 pediatric cases of anaphylaxis between 2011 and 2020. Their median age was 5.4 years, and 864 (62.2%) of the children were boys. During Halloween and Easter, there were higher rates of anaphylaxis to unknown nuts (IRR 1.66, 95% CI 1.13-2.43 and IRR 1.71, 95% CI 1.21-2.42, respectively) and peanuts (IRR 1.86, 95% CI 1.12-3.11 and IRR 1.57, 95% CI 0.94-2.63, respectively) compared to the rest of the year. No increased risk of peanut- or tree-nut-induced anaphylaxis was observed during Christmas, Diwali, Chinese New Year or Eid al-Adha. Anaphylaxis induced by unknown nuts, peanuts and tree nuts was more likely in children aged 6 years or older than in younger children. INTERPRETATION: We found an increased risk of anaphylaxis induced by unknown nuts and peanuts during Halloween and Easter among Canadian children. Educational tools are needed to increase awareness and vigilance in order to decrease the risk of anaphylaxis induced by peanuts and tree nuts in children during these holidays