Search results for: Chin Sai Wong

Authors: Nakul V. Naphade, Sandra G. L. Persiani, Yew Wah Wong, Pramod S. Kamath, Avinash H. Anantharam, Hui Ling Aw, Yann Grynberg

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Achieving zero-energy targets in existing buildings is known to be a difficult task requiring important cuts in the building energy consumption, which in many cases clash with the functional necessities of the building wherever the on-site energy generation is unable to match the overall energy consumption. Between the building’s consumption optimization limit and the energy, target stretches a case-specific optimization grey zone, which requires tailored intervention and enhanced user’s commitment. In the view of the future adoption of more stringent energy-efficiency targets in the context of hot-humid tropical climates, this study aims to define the energy optimization grey zone by assessing the energy-efficiency limit in the state-of-the-art typical mid- and high-rise full AC office buildings, through the integration of currently available technologies. Energy models of two code-compliant generic office-building typologies were developed as a baseline, a 20-storey ‘high-rise’ and a 7-storey ‘mid-rise’. Design iterations carried out on the energy models with advanced market ready technologies in lighting, envelope, plug load management and ACMV systems and controls, lead to a representative energy model of the current maximum technical potential. The simulations showed that ZEB targets could be achieved in fully AC buildings under an average of seven floors only by compromising on energy-intense facilities (as full AC, unlimited power-supply, standard user behaviour, etc.). This paper argues that drastic changes must be made in tropical buildings to span the energy optimization grey zone and achieve zero energy. Fully air-conditioned areas must be rethought, while smart technologies must be integrated with an aggressive involvement and motivation of the users to synchronize with the new system’s energy savings goal.

Keywords: energy simulation, office building, tropical climate, zero energy buildings

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Authors: G. Alston Rush, Gus A. Rush III, M. F. Horstemeyer

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This study compares the shell-facemask responses of four commonly used American football helmets, under the National Operating Committee on Standards for Athletic Equipment (NOCSAE) drop impact test method, to show that the test standard would more accurately simulate in-use conditions by modification to include the facemask. In our study, the need for a more vigorous systematic approach to football helmet testing procedures is emphasized by comparing the Head Injury Criterion (HIC), the Gadd Severity Index (SI), and peak acceleration values for different helmets at different locations on the helmet under modified NOCSAE standard drop tower tests. Drop tests were performed on the Rawlings Quantum Plus, Riddell 360, Schutt Ion 4D, and Xenith X2 helmets at eight impact locations, impact velocities of 5.46 and 4.88 meters per second, and helmet configurations with and without facemasks. Analysis of NOCSAE drop test results reveal significant differences (p < 0.05) for when the facemasks were attached to helmets, as compared to the NOCSAE Standard, without facemask configuration. The boundary conditions of the facemask attachment can have up to a 50% decrease (p < 0.001) in helmet performance with respect to peak acceleration. While generally, all helmets with the facemasks gave greater HIC, SI, and acceleration values than helmets without the facemasks, significant helmet dependent variations were observed across impact locations and impact velocities. The variations between helmet responses could be attributed to the unique design features of each helmet tested, which include different liners, chin strap attachments, and faceguard attachment systems. In summary, these comparative drop test results revealed that the current NOCSAE standard test methods need improvement by attaching the facemasks to helmets during testing. The modified NOCSAE football helmet standard test gives a more accurate representation of a helmet’s performance and its ability to mitigate the on-field impact.

Keywords: football helmet testing, gadd severity index, head injury criterion, mild traumatic brain injury

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Authors: Mei Sze Wong, Huanyu Mou, Wai-Tong Chien

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Background: Breastmilk is the most nutritious food for infants to support their growth and protect them from infection. Therefore, breastfeeding promotion is an important topic for infant health; whereas, different educational and supportive approaches to interventions have been prompted and targeted at antenatal, postnatal, or both periods to promote and sustain exclusive breastfeeding. This systematic review aimed to identify the effective approaches of educational and supportive interventions to improve breastfeeding. Outcome measures were exclusive breastfeeding, partial breastfeeding, and breastfeeding self-efficacy, being analyzed in terms of ≤ 2 months, 3-5 months, and ≥ 6 months postpartum. Method: Eleven electronic databases and the reference lists of eligible articles were searched. English or Chinese articles of randomized controlled trials on educational and supportive intervention with the above breastfeeding outcomes over recent 20 years were searched. Quality appraisal and risk of bias of the studies were checked by Effective Public Health Practice Project tool and Revised Cochrane risk-of-bias tool, respectively. Results: 13 articles that met the inclusion criteria were included; and they had acceptable quality and risk of bias. The optimal structure, format, and delivery of the interventions significantly increased exclusive breastfeeding rate at ≤ 2 months and ≥ 6 months and breastfeeding self-efficacy at ≤ 2 months included: (a) delivering from antenatal to postnatal period, (b) multicomponent involving antenatal group education, postnatal individual breastfeeding coaching and telephone follow-ups, (c) both individual and group basis, (d) being guided by self-efficacy theory, and (e) having ≥ 3 sessions. Conclusion: The findings showed multicomponent theory-based interventions with ≥ 3 sessions that delivered across antenatal and postnatal period; using both face-to-face teaching and telephone follow-ups can be useful to enhance exclusive breastfeeding rate for more than 6 months and breastfeeding self-efficacy over the first two months of postpartum.

Keywords: breastfeeding self-efficacy, education, exclusive breastfeeding, primiparous, support

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Authors: Julia Wong, Hua Beng Lim, Petrina Goh, Johanna Foo, Caleb Ng, Nurul ‘Aqilah Bte Mohd Taufek

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Animal-assisted therapy (AAT) utilizes human-animal interaction to achieve specific therapeutic goals, and its efficacy has been demonstrated across various settings overseas. The use of AAT in Singapore, however, is still limited. Ang Mo Kio-Thye Hua Kwan (AMKH) is one of the first community hospitals in Singapore to use AAT to complement its occupational therapy services with elderly patients. This study explored the perspectives of AMKH’s occupational therapists (OTs) in relation to AAT to understand barriers and enablers in implementing and practising AAT. We also examined how OTs at-large across practice settings perceive AAT. A mixed method design was used. 64 OTs at-large participated in on online survey, and 7 AMKH OTs were interviewed individually via Zoom. Survey results were analysed with descriptive and Mann-Whitney U tests. Interviews were thematically analysed. AMKH OTs perceived various benefits of AAT articulated in overseas studies in domains such as motivation and participation, emotional, social interaction, sensory tactile stimulation, and cognition. Interestingly, this perception was also supported by 67% of OTs who had responded to the survey, even though most of the OTs who had participated in the survey had no experience in AAT. Despite the perceived benefits of AAT, both OTs from AMKH and those at-large articulated concerns on risks pertaining to AAT (e.g., allergies, unexpected animal behaviour, infections, etc). However, AMKH OTs shared several ways to mitigate these risks, demonstrating their ability to develop a safe program. For e.g., volunteers and their dogs must meet specific recruitment criteria, stringent protocols are used to screen and match dogs with patients, and there are strict exclusion criteria for patients participating in AAT. AMKH OTs’ experience suggests that additional skills and knowledge are required to implement AAT, therefore, healthcare institutions should first consider improving their staff training and risk mitigation knowledge before implementing AAT. They can also refer to AMKH’s AAT protocols and those found in overseas studies, but institutions must adapt the protocols to fit their institutional settings and patients’ profiles.

Keywords: animal-assisted therapy, dog-assisted therapy, occupational therapy, complementary therapy

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Authors: Louis Ngai Yuen Wong, Varun Maruvanchery

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The Bukit Timah Granite, which is a major rock formation in Singapore, encompasses different rock types such as granite, adamellite, and granodiorite with various hybrid rocks. The present study focuses on the Central Singapore Granite found in the Mandai area. Even within this small aerial extent, lithological variations with respect to the composition, texture as well as the grain size have been recognized in this igneous body. Over the years, the research effort on the Bukit Timah Granite has been focused on achieving a better understanding of its engineering properties in association with civil engineering projects. To our best understanding, a few types of research attempted to systematically investigate the influence of grain size, mineral composition, texture etc. on the strength of Bukit Timah Granite rocks in a comprehensive manner. In typical local industry practices, the different lithological varieties are not differentiated, but all are grouped under Bukit Timah Granite during core logging and the subsequent determination of engineering properties. To address such a major gap in the local engineering geological practice, a preliminary study is conducted on the variations of uniaxial compressive strength (UCS) in seven distinctly different lithological varieties found in the Bukit Timah Granite. Other physical properties including Young’s modulus, P-wave velocity and dry density determined from laboratory testing will also be discussed. The study is supplemented by a petrographical thin section examination. In addition, the specimen failure mode is classified and further correlated with the lithological varieties by carefully observing the details of crack initiation, propagation and coalescence processes in the specimens undergoing loading tests using a high-speed camera. The outcome of this research, which is the first of its type in Singapore, will have a direct implication on the sampling and design practices in the field of civil engineering and particularly underground space development in Singapore.

Keywords: Bukit Timah Granite, lithological variety, thin section study, high speed video, failure mode

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Authors: Chin-Tsu Ma, Yi-Jhen Wu, Hsia Ying Cheng, Han Hsiang Huang, Shyh Ming Kuo

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The use of specific molecules including nutrients and pharmacological agents has been tried in modulation of stem cells differentiation (MSCs) to insulin producing cells. The aim of this study is to investigate the ability of nano collagen molecules (nutrient or scaffold) to enhance the MSCs differentiation into insulin-producing cells in combination with nicotinamide and exendin-4 (pharmacological agents) in vitro and in vivo. The results demonstrated that the cells exhibit morphologically islet-like clusters after treatment with nano collagen molecules, nicotinamide and exendin-4. MSCs extra treated with nano collagen molecules showed significant increases in Nkx6.1 and insulin mRNA expression at 14-d and 21-d culture compared with those merely treated with nicotinamide and exendin-4. Early 7-day elevation in PDX-1 mRNA expression was observed. Furthermore, the MSCs exposed to nano collagen molecules produced the highest secretion of insulin (p ＜ 0.05). Type-2 diabetes induced by high-fat diet and low dose of streptozotocin in rat model was built in this study. This rat exhibited higher food intake, water intake, lower glucose tolerance, lower-insulin tolerance, and higher HbA1C (significant increases, p ＜ 0.01) as compared with the normal rat that demonstrated the model of type-2 diabetes was successfully built. Biopsy examinations also showed that obvious destruction of islet. After injection of differentiated MSCs into the destructed pancreas of diabetes rat, more regenerated islet were observed at the rats that treated with nano collagen molecules and exhibited much lower HbA1C as compared with the normal rat and diabetes rat after 4 weeks (significant deceases, p ＜ 0.001). These results indicate that the culturing MSCs with nano collagen molecules, nicotinamide, and exendin-4 are beneficial for MSCs differentiation into islet-like cells. These nano collagen molecules may lead to alternations or up-regulation of gene expression and influence the differentiated outcomes induced by nicotinamide and exendin-4.

Keywords: nano collagen molecules, nicotinamide, MSCs, diabetes

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Authors: Kuo-Wei Hsu, Wei-Chin Lo

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In these years, urban agriculture development has been wide spreading all over the world. The development of urban agriculture is an evolution process of highly urbanization, as well as an agricultural phenomenon closely related to the development of economy, society and culture in urban areas. It provides densely populated areas with multi-functional uses of land, impacting strategic development of both large and small towns in the area. In addition, the participation of social enterprises keeps industrial competitiveness and makes gains when facing rapid transformation of industrial structures and new patterns of lifestyles in urban areas. They create better living conditions as well as protect the environment with innovative business beliefs, which give new ways for development of urban agriculture. Also, through building up the value chain, these social enterprises are capable of creating value for urban agriculture. Most of research regarding to social enterprises currently explore the relationship between corporate responsibilities and its role play, operational mode and performance and organizational patterns. Merely some of them discuss the function of social entrepreneurship in the development of urban agriculture. Moreover, none of them have explored the value creation for development of urban agriculture processed by social enterprises, as well as how social enterprises operate to increase competitive advantages, which make it possible to achieve industrial innovation, increase corporate value and even provide services with value creation. Therefore, this research mainly reviews current business patterns and operational conditions of social enterprises. This research endowed social responsibilities, and discusses current development process of urban agriculture. This research adopts Value Chain perspective to discuss key factors for value creation with respect to the development of urban agriculture processed by social enterprises. Thereby after organization and integration this research develops the prospect of value creation referring to urban agriculture processed by social enterprises and builds the value chain for urban agriculture. In conclusion, this research explored the relationship between value chain and value creation, which relates to values of customer, enterprise, society and economy referring to the development of urban agriculture uniquely, in consideration of the participation of social enterprises, and hence built the connection between value chain and value creation in the development of urban agriculture by social enterprises. The research found, social enterprises help to enhance the connection between the enterprise value and society value, mold corporate image with social responsibility and create brand value, and therefore impact the increase of economic value.

Keywords: urban agriculture development, value chain, social enterprise, urban systems

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Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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Authors: Renzo Munoz-Najar, Cristina Wong, Daniel De La Torre Ugarte

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The literature on price transmission usually deals with asymmetries related to different commodities and/or the short and long term. The role of domestic regional differences and the relationship with asymmetries within a country are usually left out. This paper looks at the asymmetry in the transmission of rice prices from the international price to the farm gate prices in four northern regions of Peru for the last period 2001-2016. These regions are San Martín, Piura, Lambayeque and La Libertad. The relevance of the study lies in its ability to assess the need for policies aimed at improving the competitiveness of the market and ensuring the benefit of producers. There are differences in planting and harvesting dates, as well as in geographic location that justify the hypothesis of the existence of differences in the price transition asymmetries between these regions. Those differences are due to at least three factors geography, infrastructure development, and distribution systems. For this, the Threshold Vector Error Correction Model and the Autoregressive Vector Model with Threshold are used. Both models, collect asymmetric effects in the price adjustments. In this way, it is sought to verify that farm prices react more to falls than increases in international prices due to the high bargaining power of intermediaries. The results of the investigation suggest that the transmission of prices is significant only for Lambayeque and La Libertad. Likewise, the asymmetry in the transmission of prices for these regions is checked. However, these results are not met for San Martin and Piura, the main rice producers nationwide. A significant price transmission is verified only in the Lambayeque and La Libertad regions. San Martin and Piura, in spite of being the main rice producing regions of Peru, do not present a significant transmission of international prices; a high degree of self-sufficient supply might be at the center of the logic for this result. An additional finding is the short-term adjustment with respect to international prices, it is higher in La Libertad compared to Lambayeque, which could be explained by the greater bargaining power of intermediaries in the last-mentioned region due to the greater technological development in the mills.

Keywords: asymmetric price transmission, rice prices, price transmission, regional economics

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Authors: Caspar S. Carson, Gabriel W. Prather, Nicholas E. Wong, Jeffery R. Anton, William H. McCoy

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Cutibacterium acnes is a commensal bacterium found on human skin that has been linked to acne. C. acnes can also be an opportunistic pathogen when it infiltrates the body during surgery. This pathogen can cause dangerous infections of medical implants, such as shoulder replacements, leading to life-threatening blood infections. Compounding this issue, C. acnes resistance to many antibiotics has become an increasing problem worldwide, creating a need for special forms of treatment. C. acnes expresses the protein RoxP, and it requires this protein to colonize human skin. Though this protein is required for C. acnes skin colonization, its function is not yet understood. Inhibition of RoxP function might be an effective treatment for C. acnes infections. To develop such reagents, the McCoy Laboratory generated four unique anti-RoxP antibodies. Preliminary studies in the McCoy Lab have established that each antibody binds a distinct site on RoxP. To assess the potential of these antibodies as therapeutics, it is necessary to specifically characterize these antibody epitopes and evaluate them in assays that assess their ability to inhibit RoxP-dependent C. acnes growth. To provide material for these studies, an antibody expression construct, Fv-clasp(v2), was adapted to encode anti-RoxP antibody sequences. The author hypothesizes that this expression strategy can produce sufficient amounts of >95% pure antibody fragments for further characterization of these antibodies. Four anti-RoxP Fv-clasp(v2) expression constructs (pET vector-based) were transformed into E. coli BL21-Gold(DE3) cells and a small-scale expression and purification trial was performed for each construct to evaluate anti-RoxP Fv-clasp(v2) yield and purity. Successful expression and purification of these antibody constructs will allow for their use in structural studies, such as protein crystallography and cryogenic electron microscopy. Such studies would help to define the antibody binding sites on RoxP, which could then be leveraged in the development of certain methods to treat C. acnes infection through RoxP inhibition.

Keywords: structural biology, protein expression, infectious disease, antibody, therapeutics, E. coli

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Authors: Anna Ching-Yu Wong

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This study aims to identify the quality and effectiveness of the adult programs provided by the public library using the ServQUAL Method and the National Library Public Programs Assessment guidelines (NIPPA, June 2019). ServQUAl covers several variables, namely: tangible, reliability, responsiveness, assurance, and empathy. NIPPA guidelines focus on program characteristics, particularly on the outcomes – the level of satisfaction from program participants. The reached populations were adults who participated in library adult programs at a small-town public library in Kansas. This study was designed as quantitative evaluative research which analyzed the quality and effectiveness of the library adult programs by analyzing the role of each factor based on ServQUAL and the NIPPA's library program assessment guidelines. Data were collected from November 2019 to January 2020 using a questionnaire with a Likert Scale. The data obtained were analyzed in a descriptive quantitative manner. The impact of this research can provide information about the quality and effectiveness of existing programs and can be used as input to develop strategies for developing future adult programs. Overall the result of ServQUAL measurement is in very good quality, but still, areas need improvement and emphasis in each variable: Tangible Variables still need improvement in indicators of the temperature and space of the meeting room. Reliability Variable still needs improvement in the timely delivery of the programs. Responsiveness Variable still needs improvement in terms of the ability of the presenters to convey trust and confidence from participants. Assurance Variables still need improvement in the indicator of knowledge and skills of program presenters. Empathy Variable still needs improvement in terms of the presenters' willingness to provide extra assistance. The result of program outcomes measurement based on NIPPA guidelines is very positive. Over 96% of participants indicated that the programs were informative and fun. They learned new knowledge and new skills and would recommend the programs to their friends and families. They believed that together, the library and participants build stronger and healthier communities.

Keywords: ServQual model, ServQual in public libraries, library program assessment, NIPPA library programs assessment

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Authors: Jovian Cheung, Thomas Kwok, Victor Wong

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Buildings are entwined with smart city developments. Building performance relies heavily on electrical and mechanical (E&M) systems and services accounting for about 40 percent of global energy use. By cohering the advancement of technology as well as energy and operation-efficient initiatives into the buildings, people are enabled to raise building performance and enhance the sustainability of the built environment in their daily lives. Digital transformation in the buildings is the profound development of the city to leverage the changes and opportunities of digital technologies To optimize the building performance, intelligent power quality and energy management system is developed for transforming data into actions. The system is formed by interfacing and integrating legacy metering and internet of things technologies in the building and applying big data techniques. It provides operation and energy profile and actionable insights of a building, which enables to optimize the building performance through raising people awareness on E&M services and energy consumption, predicting the operation of E&M systems, benchmarking the building performance, and prioritizing assets and energy management opportunities. The intelligent power quality and energy management system comprises four elements, namely the Integrated Building Performance Map, Building Performance Dashboard, Power Quality Analysis, and Energy Performance Analysis. It provides predictive operation sequence of E&M systems response to the built environment and building activities. The system collects the live operating conditions of E&M systems over time to identify abnormal system performance, predict failure trends and alert users before anticipating system failure. The actionable insights collected can also be used for system design enhancement in future. This paper will illustrate how intelligent power quality and energy management system provides operation and energy profile to optimize the building performance and actionable insights to revitalize an existing building into a smart building. The system is driving building performance optimization and supporting in developing Hong Kong into a suitable smart city to be admired.

Keywords: intelligent buildings, internet of things technologies, big data analytics, predictive operation and maintenance, building performance

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Authors: Turki J. Alharbi, Jencia Wong, Dennis Yue, Tania P. Markovic, Julie Hetherington, Ted Wu, Belinda Brooks, Radhika Seimon, Alice Gibson, Stephanie L. Silviera, Amanda Sainsbury, Tanya J. Little

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Fasting has been practiced for centuries and is incorporated into the practices of different religions including Islam, whose followers intermittently fast throughout the month of Ramadan. Thus, Ramadan presents a unique model of prolonged intermittent fasting (IF). Despite a growing body of evidence for a cardio-metabolic and endocrine benefit of IF, detailed studies of the effects of IF on these indices in type 2 diabetes are scarce. We studied 5 subjects with type 2 diabetes (T2DM) and 7 healthy controls (C) at baseline (pre), and in the last week of Ramadan (post). Fasting circulating levels of glucose, HbA1c and lipids, as well as body composition (with DXA) and resting energy expenditure (REE) were measured. Plasma gut hormone levels and appetite responses to a mixed meal were also studied. Data are means±SEM. Ramadan decreased total fat mass (-907±92 g, p=0.001) and trunk fat (-778±190 g, p=0.014) in T2DM but not in controls, without any reductions in lean mass or REE. There was a trend towards a decline in plasma FFA in both groups. Ramadan had no effect on body weight, glycemia, blood pressure, or plasma lipids in either group. In T2DM only, the area under the curve for post-meal plasma ghrelin concentrations increased after Ramadan (pre:6632±1737 vs. post:9025±2518 pg/ml.min-1, p=0.045). Despite this increase in orexigenic ghrelin, subjective appetite scores were not altered by Ramadan. Meal-induced plasma concentrations of the satiety hormone pancreatic polypeptide did not change during Ramadan, but were higher in T2DM compared to controls (post: C: 23486±6677 vs. T2DM: 62193±6880 pg/ml.min-1, p=0.003. In conclusion, Ramadan, as a model for IF appears to have more favourable effects on body composition in T2DM, without adverse effects on metabolic control or subjective appetite. These data suggest that IF may be particularly beneficial in T2DM as a nutritional intervention. Larger studies are warranted.

Keywords: type 2 diabetes, obesity, intermittent fasting, appetite regulating hormones

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Authors: Emni Omar Daw Hussin, Pathmawathi Subramanian, Wong Li Ping

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Background: To provide quality care at the end of life, nurses should possess knowledge and skills to provide effective end-of-life care, as well as develop the attitudes and interpersonal competence to provide compassionate care. Aim: This study aimed to assess nurses’ knowledge and attitude towards end of life care and caring for terminal ill patients and to examine relationships among demographic variables and nurse’s knowledge and attitudes toward end of life care and caring for terminal ill patients. Method: a cross-sectional study was conducted at 1 tertiary hospital located in Kuala Lumpur, Malaysia. Self-administrative questionnaire was used to collect data from 553 nurses from over all departments except emergency department, operation theater and outpatient clinic. Two tools were used in this study, the Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale to assess the nurses’ attitude and End of Life Knowledge Assessment to assess the nurses’ knowledge. Result: the result of this study yielded that, the majority of participants (54.8%) and (54.4%) have less positive attitude and knowledge towards end of life care and caring for terminal ill patients respectively. As well as there is no significant relationship were found between nurses’ ethnicity, religion, and the total score of FATCOD scale; End of Life Knowledge Assessment score. On other hand there is significant relationship among nurses’ age, working experience, level of education, attending any post basic courses and the total score of both FATCOD scale and End of Life Knowledge Assessment. Conclusion: A lack of education and experience and post basic course about end of life care and palliative care may contribute to the negative attitudes and poor knowledge regarding end of life care. Providing sufficient courses about end of life care could enhance the nurses’ knowledge towards end of life care, as well as providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implication for Practice: This study elaborates the need for further research to develop an effective educational programs to enhance nurses’ knowledge and to promote positive attitude towards death and dying, as well as enhance communication skills, and coping strategies.

Keywords: knowledge, attitude, nurse, end of life care

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Jularat Chumnaul

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In forensic science, corpses from various homicides are different; there are both complete and incomplete, depending on causes of death or forms of homicide. For example, some corpses are cut into pieces, some are camouflaged by dumping into the river, some are buried, some are burned to destroy the evidence, and others. If the corpses are incomplete, it can lead to the difficulty of personally identifying because some tissues and bones are destroyed. To specify gender of the corpses from skeletal remains, the most precise method is DNA identification. However, this method is costly and takes longer so that other identification techniques are used instead. The first technique that is widely used is considering the features of bones. In general, an evidence from the corpses such as some pieces of bones, especially the skull and pelvis can be used to identify their gender. To use this technique, forensic scientists are required observation skills in order to classify the difference between male and female bones. Although this technique is uncomplicated, saving time and cost, and the forensic scientists can fairly accurately determine gender by using this technique (apparently an accuracy rate of 90% or more), the crucial disadvantage is there are only some positions of skeleton that can be used to specify gender such as supraorbital ridge, nuchal crest, temporal lobe, mandible, and chin. Therefore, the skeletal remains that will be used have to be complete. The other technique that is widely used for gender specifying in forensic science and archeology is skeletal measurements. The advantage of this method is it can be used in several positions in one piece of bones, and it can be used even if the bones are not complete. In this study, the classification and cluster analysis are applied to this technique, including the Kth Nearest Neighbor Classification, Classification Tree, Ward Linkage Cluster, K-mean Cluster, and Two Step Cluster. The data contains 507 particular individuals and 9 skeletal measurements (diameter measurements), and the performance of five methods are investigated by considering the apparent error rate (APER). The results from this study indicate that the Two Step Cluster and Kth Nearest Neighbor method seem to be suitable to specify gender from human skeletal remains because both yield small apparent error rate of 0.20% and 4.14%, respectively. On the other hand, the Classification Tree, Ward Linkage Cluster, and K-mean Cluster method are not appropriate since they yield large apparent error rate of 10.65%, 10.65%, and 16.37%, respectively. However, there are other ways to evaluate the performance of classification such as an estimate of the error rate using the holdout procedure or misclassification costs, and the difference methods can make the different conclusions.

Keywords: skeletal measurements, classification, cluster, apparent error rate

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Authors: Eugene Y. C. Wong, Daniel Y. W. Mo, Cosmo T. Y. Ng, Jessica K. Y. Chan, Leith K. Y. Chan, Henry Y. K. Lau

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The real-time planning visualisation, precise allocation and loading optimisation in air cargo load planning operations are increasingly important as more considerations are needed on dangerous cargo loading, locations of lithium batteries, weight declaration and limited aircraft capacity. The planning of the unit load devices (ULD) can often be carried out only in a limited number of hours before flight departure. A dynamic air cargo load planning system is proposed with the optimisation of cargo load plan and visualisation of planning results in virtual reality systems. The system aims to optimise the cargo load planning and visualise the simulated loading planning decision on air cargo terminal operations. Adopting simulation tools, Cave Automatic Virtual Environment (CAVE) and virtual reality technologies, the results of planning with reference to weight and balance, Unit Load Device (ULD) dimensions, gateway, cargo nature and aircraft capacity are optimised and presented. The virtual reality system facilities planning, operations, education and training. Staff in terminals are usually trained in a traditional push-approach demonstration with enormous manual paperwork. With the support of newly customized immersive visualization environment, users can master the complex air cargo load planning techniques in a problem based training with the instant result being immersively visualised. The virtual reality system is developed with three-dimensional (3D) projectors, screens, workstations, truss system, 3D glasses, and demonstration platform and software. The content will be focused on the cargo planning and loading operations in an air cargo terminal. The system can assist decision-making process during cargo load planning in the complex operations of air cargo terminal operations. The processes of cargo loading, cargo build-up, security screening, and system monitoring can be further visualised. Scenarios are designed to support and demonstrate the daily operations of the air cargo terminal, including dangerous goods, pets and animals, and some special cargos.

Keywords: air cargo load planning, optimisation, virtual reality, weight and balance, unit load device

Procedia PDF Downloads 345

Authors: Eric A. Morris, Xia Liu, Yee Ka Wong, Greg J. Evans, Jeff R. Brook

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Air quality monitoring stations tend to be widely distributed and are often located far from major roadways, thus, determining where, when, and which traffic-related air pollutants (TRAPs) have the greatest impact on public health becomes a matter of extrapolation. Compact, multipollutant sensor systems are an effective solution as they enable several TRAPs to be monitored in a geospatially dense network, thus filling in the gaps between conventional monitoring stations. This work describes two applications of one such system named AirSENCE for gathering actionable air quality data relevant to smart city infrastructures. In the first application, four AirSENCE devices were co-located with traffic monitors around the perimeter of a city block in Oshawa, Ontario. This study, which coincided with the COVID-19 outbreak of 2020 and subsequent lockdown measures, demonstrated a direct relationship between decreased traffic volumes and TRAP concentrations. Conversely, road construction was observed to cause elevated TRAP levels while reducing traffic volumes, illustrating that conventional smart city sensors such as traffic counters provide inadequate data for inferring air quality conditions. The second application used two AirSENCE sensors on opposite sides of a major 2-way commuter road in Toronto. Clear correlations of TRAP concentrations with wind direction were observed, which shows that impacted areas are not necessarily static and may exhibit high day-to-day variability in air quality conditions despite consistent traffic volumes. Both of these applications provide compelling evidence favouring the inclusion of air quality sensors in current and future smart city infrastructure planning. Such sensors provide direct measurements that are useful for public health alerting as well as decision-making for projects involving traffic mitigation, heavy construction, and urban renewal efforts.

Keywords: distributed sensor network, continuous ambient air quality monitoring, Smart city sensors, Internet of Things, traffic-related air pollutants

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Authors: Eugene Y. C. Wong

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The increased market competition, customer expectation, and warehouse operating cost in third-party logistics have motivated the continuous exploration in improving operation efficiency in warehouse logistics. Cargo tracing in ordering picking process consumes excessive time for warehouse operators when handling enormous quantities of goods flowing through the warehouse each day. Internet of Things (IoT) with mobile cargo tracing apps and database management systems are developed this research to facilitate and reduce the cargo tracing time in order picking process of a third-party logistics firm. An operation review is carried out in the firm with opportunities for improvement being identified, including inaccurate inventory record in warehouse management system, excessive tracing time on stored products, and product misdelivery. The facility layout has been improved by modifying the designated locations of various types of products. The relationship among the pick and pack processing time, cargo tracing time, delivery accuracy, inventory turnover, and inventory count operation time in the warehouse are evaluated. The correlation of the factors affecting the overall cycle time is analysed. A mobile app is developed with the use of MIT App Inventor and the Access management database to facilitate cargo tracking anytime anywhere. The information flow framework from warehouse database system to cloud computing document-sharing, and further to the mobile app device is developed. The improved performance on cargo tracing in the order processing cycle time of warehouse operators have been collected and evaluated. The developed mobile voice picking and tracking systems brings significant benefit to the third-party logistics firm, including eliminating unnecessary cargo tracing time in order picking process and reducing warehouse operators overtime cost. The mobile tracking device is further planned to enhance the picking time and cycle count of warehouse operators with voice picking system in the developed mobile apps as future development.

Keywords: warehouse, order picking process, cargo tracing, mobile app, third-party logistics

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Authors: Wong Yat Cheung Maggie

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Occupational Safety and Health Ordinance (OS&HO) (Chap 509) was enacted in 1997, OHS in HK should be growing and maturing, with a holistic approach to occupational health and safety in the workplace including physical, mental, social and spiritual well-being. The question is “How effective are OHSPs in meeting the current needs of HK health workers?” This study was designed to explore the issue for the first time, to empirically analyse the views of those who work in the system. The study employed a mixed method approach to collect various data from Occupational Health Service Providers (OHSPs), Occupational Health Service Consumers (OHSC): Registered nurses working in the hospital setting. This study was designed in two phases and two stages. Phase I Stage I was a paper survey to collect the data on OHSP. Then Phase I Stage II was a follow-up interview. Phase II Stage I was a paper survey to collect the data on OHSC. Then Phase II Stage II was a follow-up focus group study on OHSC for further clarification of the Phase II and Stage I result. The Phase I result reflects HK OHSPs point of view and their experience in the existing OHS practice in the local hospitals. It reflects various styles of reporting systems, staff profiles background and resource in providing OHS in HK hospitals. However, the basic OHS concern is similar between hospitals. In general, the OHS policies and procedures are available on site even though they may have different foci. The Phase II result is reflecting the HKs OHSCs echoes the OHSP feedback at providing of OHS, OHS concern and related policies and procedure are available on site. However, the most significant feedback from the OHSC at Phase II Stage II shows, nurses experienced various OHS concern most commonly work stress, workplace harassment and back strain without formal or official report to the related parties. The lack of reporting was due to the management handling attitude, stakeholders’ compliance and term of definition still have room to be improved even the related policies and procedures are available on site.

Keywords: occupational health service, registered nurse, Hong Kong hospital, mixed method

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Authors: Shashwat, Sandra G. L. Persiani, Yew Wah Wong, Pramod S. Kamath, Avinash H. Anantharam, Hui Ling Aw, Yann Grynberg

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Achieving zero-energy targets in existing buildings is known to be a difficult task, hence targets are addressed at new buildings almost exclusively. Although these ultra-efficient case-studies remain essential to develop future technologies and drive the concepts of Zero-energy, the immediate need to cut the consumption of the existing building stock remains unaddressed. This work aims to present a reliable and straightforward methodology for assessing the potential of energy-efficient upgrading in existing buildings. Public Singaporean school buildings, characterized by low energy use intensity and large roof areas, were identified as potential objects for conversion to highly-efficient buildings with a positive energy balance. A first study phase included the development of a detailed energy model for two case studies (a primary and a secondary school), based on the architectural drawings provided, site-visits and calibrated using measured end-use power consumption of different spaces. The energy model was used to demonstrate compliances or predict energy consumption of proposed changes in the two buildings. As complete energy monitoring is difficult and substantially time-consuming, short-term energy data was collected in the schools by taking spot measurements of power, voltage, and current for all the blocks of school. The figures revealed that the bulk of the consumption is attributed in decreasing order of magnitude to air-conditioning, plug loads, and lighting. In a second study-phase, a number of energy-efficient technologies and strategies were evaluated through energy-modeling to identify the alternatives giving the highest energy saving potential, achieving a reduction in energy use intensity down to 19.71 kWh/m²/y and 28.46 kWh/m²/y for the primary and the secondary schools respectively. This exercise of field evaluation and computer simulation of energy saving potential aims at a preliminary assessment of the positive-energy feasibility enabling future implementation of the technologies on the buildings studied, in anticipation of a broader and more widespread adoption in Singaporean schools.

Keywords: energy simulation, school building, tropical climate, zero energy buildings, positive energy

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Authors: Malcolm Dinovitzer, Calvin Miller, Adam Hacker, Gabriel Wong, Zach Annen, Padmassun Rajakareyar, Jordan Mulvihill, Mostafa S.A. ElSayed

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The research work presented in this paper is developed by the Blended Wing Body (BWB) Unmanned Aerial Vehicle (UAV) team, a fourth-year capstone project at Carleton University Department of Mechanical and Aerospace Engineering. Here, a clean sheet UAV with BWB configuration is designed and optimized using Multiscale Design Optimization (MSDO) approach employing lattice materials taking into consideration design for additive manufacturing constraints. The BWB-UAV is being developed with a mission profile designed for surveillance purposes with a minimum payload of 1000 grams. To demonstrate the design methodology, a single design loop of a sample rib from the airframe is shown in details. This includes presentation of the conceptual design, materials selection, experimental characterization and residual thermal stress distribution analysis of additively manufactured materials, manufacturing constraint identification, critical loads computations, stress analysis and design optimization. A dynamic turbulent critical load case was identified composed of a 1-g static maneuver with an incremental Power Spectral Density (PSD) gust which was used as a deterministic design load case for the design optimization. 2D flat plate Doublet Lattice Method (DLM) was used to simulate aerodynamics in the aeroelastic analysis. The aerodynamic results were verified versus a 3D CFD analysis applying Spalart-Allmaras and SST k-omega turbulence to the rigid UAV and vortex lattice method applied in the OpenVSP environment. Design optimization of a single rib was conducted using topology optimization as well as MSDO. Compared to a solid rib, weight savings of 36.44% and 59.65% were obtained for the topology optimization and the MSDO, respectively. These results suggest that MSDO is an acceptable alternative to topology optimization in weight critical applications while preserving the functional requirements.

Keywords: blended wing body, multiscale design optimization, additive manufacturing, unmanned aerial vehicle

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Authors: En-Tzu Wang, Ting-Ann Wang, Yi-Hui Shen, Yu-Min Chou, Chi-Tai Fang, Chin-Hui Yang

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Background and purpose: A mass varicella immunization program was established to provide free 1-dose vaccination for all 1-year-old children throughout Taiwan since 2004. The epidemiological characteristics and disease burden of varicella from 2000 to 2012 was investigated and the results will be essential to refine the national immunization policy. Method: We included patients (n = 17,838–164,245) with ICD-9-CM codes 052 (chickenpox) from the 2000 to 2012 National Health Insurance Database. The age, period, and cohort-specific incidence of varicella were calculated. The hospital admission rate, medical costs and indirect costs from the societal perspective of varicella including travel costs to the medical facility, registration fee, productivity losses of the patients and caregivers were also estimated. Result: There were 979,252 patients for medical treatment due to varicella from 2000 to 2012 in Taiwan. The implementation of a routine childhood varicella vaccination program has resulted in 87% decline in morbidity (881.49 to 115.17 per 100,000). The average age of patients increased from 7.9 years to 16.3 years. The overall varicella-related hospital admission rate was 15.5 per 1000 patients, and peaked in the groups of infants younger than 1 year, adults aged from 20 to 39 years and elders over 70 years. Among patients admitted to hospital, 33.5% of them had one or more complications. Patients with underlying diseases had higher admission rate (241.6 per 1,000) and longer duration of hospital stay (6.61 days vs. 4.76 days). The annual varicella-related medical expense declined after 2002 and the proportion of medical costs for admission has increased to 42%. The annual indirect costs from the societal perspective of varicella were 5.29 to 9.63 times higher than varicella-related medical costs. Every one dollar invested in the varicella immunization program, 2.97 dollars of medical and social costs were saved on average. Conclusion: The dramatic decline in morbidity, hospitalization, medical and social costs of varicella can be directly attributed to the implementation of the mass immunization program. Two-dose vaccination is recommended for both children with underlying diseases and susceptible adults to prevent serious complications and hospitalizations.

Keywords: disease burden, epidemiology, medical and social costs, varicella, varicella vaccine

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Authors: Maria Lopez-Ibarra, Ana Velazquez-Wong, Lucelli Yañez-Gutierrez, Maria Araujo-Solis, Fabio Salamanca-Gomez, Alfonso Mendez-Tenorio, Haydeé Rosas-Vargas

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Congenital heart diseases (CHD) are the most common congenital abnormalities. These conditions can occur as both an element of distinct chromosomal malformation syndromes or as non-syndromic forms. Their etiology is not fully understood. Genetic variants such copy number variants have been associated with CHD. The aim of our study was to analyze these genomic variants in peripheral blood from Mexican children diagnosed with non-syndromic CHD. We included 16 children with atrial and ventricular septal defects and 5 healthy subjects without heart malformations as controls. To exclude the most common heart disease-associated syndrome alteration, we performed a fluorescence in situ hybridization test to identify the 22q11.2, responsible for congenital heart abnormalities associated with Di-George Syndrome. Then, a microarray based comparative genomic hybridization was used to identify global copy number variants. The identification of copy number variants resulted from the comparison and analysis between our results and data from main genetic variation databases. We identified copy number variants gain in three chromosomes regions from pediatric patients, 4q13.2 (31.25%), 9q34.3 (25%) and 20q13.33 (50%), where several genes associated with cellular, biosynthetic, and metabolic processes are located, UGT2B15, UGT2B17, SNAPC4, SDCCAG3, PMPCA, INPP6E, C9orf163, NOTCH1, C20orf166, and SLCO4A1. In addition, after a hierarchical cluster analysis based on the fluorescence intensity ratios from the comparative genomic hybridization, two congenital heart disease groups were generated corresponding to children with atrial or ventricular septal defects. Further analysis with a larger sample size is needed to corroborate these copy number variants as possible biomarkers to differentiate between heart abnormalities. Interestingly, the 20q13.33 gain was present in 50% of children with these CHD which could suggest that alterations in both coding and non-coding elements within this chromosomal region may play an important role in distinct heart conditions.

Keywords: aCGH, bioinformatics, congenital heart diseases, copy number variants, fluorescence in situ hybridization

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Authors: Yu-Wen Lin, Chin-Sheng Tang, Wan-Yi Chen

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Various biological specimens, drugs, and chemicals exist in the hospital. The medical staffs and hypersensitive inpatients expose might expose to multiple hazards while they work or stay in the hospital. Therefore, the indoor air quality (IAQ) of the hospital should be paid more attention. Respiratory care wards (RCW) are responsible for caring the patients who cannot spontaneously breathe without the ventilators. The patients in RCW are easy to be infected. Compared to the bacteria concentrations of other hospital units, RCW came with higher values in other studies. This research monitored the IAQ of the RCW and checked the compliances of the indoor air quality standards of Taiwan Indoor Air Quality Act. Meanwhile, the influential factors of IAQ and the impacts of ventilator modules, with humidifier or with filter, were investigated. The IAQ of two five-bed wards and one nurse station of a RCW in a regional hospital were monitored. The monitoring was proceeded for 16 hours or 24 hours during the sampling days with a sampling frequency of 20 minutes per hour. The monitoring was performed for two days in a row and the AIQ of the RCW were measured for eight days in total. The concentrations of carbon dioxide (CO₂), carbon monoxide (CO), particulate matter (PM), nitrogen oxide (NOₓ), total volatile organic compounds (TVOCs), relative humidity (RH) and temperature were measured by direct reading instruments. The bioaerosol samples were taken hourly. The hourly air change rate (ACH) was calculated by measuring the air ventilation volume. Human activities were recorded during the sampling period. The linear mixed model (LMM) was applied to illustrate the impact factors of IAQ. The concentrations of CO, CO₂, PM, bacterial and fungi exceeded the Taiwan IAQ standards. The major factors affecting the concentrations of CO, PM₁ and PM₂.₅ were location and the number of inpatients. The significant factors to alter the CO₂ and TVOC concentrations were location and the numbers of in-and-out staff and inpatients. The number of in-and-out staff and the level of activity affected the PM₁₀ concentrations statistically. The level of activity and the numbers of in-and-out staff and inpatients are the significant factors in changing the bacteria and fungi concentrations. Different models of the patients’ ventilators did not affect the IAQ significantly. The results of LMM can be utilized to predict the pollutant concentrations under various environmental conditions. The results of this study would be a valuable reference for air quality management of RCW.

Keywords: respiratory care ward, indoor air quality, linear mixed model, bioaerosol

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Authors: Duangchai Sookchaloem, Sutida Maneeanakekul

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Araceous plant or Araceae is a monocotyledon family having numerous potential useful plants. Two hundred and ten species of Araceae were reported in Thailand, of which 43 species were reported as threatened plants. Fifty percent of endemic status and rare status plants were recorded in limestone areas. Currently, these areas are seriously threatened by land-use changes. The study on taxonomy of Araceous plants was carried out in Lop Buri and Saraburi limestone mountains from February 2011 to May 2015. The purposes of this study were to study species diversity, taxonomic character and ecological habitat. 55 specimens collected from various limestone areas including Pra Phut Tabat National forest (Pra Phut Tabat Mountain, Khao Pra Phut Tabat Noi Mountains, Wat Thum Krabog Mountain), Tab Khwang and Muak Lek Natinal forest (Pha Lad mountain, and Muak Lek waterfall) in Saraburi province ,and Wang Plaeng Ta Muang and Lumnarai National forest (Wat Thum chang phuk mountain), Panead National forest (Wat Khao Samo Khon Mountain), Lan Ta Ridge National forest (Khao Wong Prachan mountain, Wat Pa Chumchon) in Lop Buri province. Twenty species of Araceous plants were identified using characteristics of underground stem, phyllotaxis and leaf blade, spathe and spadix. Species list are Aglaonema cochinchinense, A. simplex, Alocasia acuminata, Amorphophallus paeoniifolius, A. albispathus, A. saraburiensis, A. pseudoharmandii, Pycnospatha arietina, Hapaline kerri, Lasia spinosa, Pothos scandens, Typhonium laoticum, T. orbifolium, T. saraburiense, T. trilobatum, T. sp.1, T. sp. 2, Cryptocoryne crispatula var. balansae, Scindapsus sp., and Rhaphidophora peepla. Five species are new locality records. One species (Typhonium sp.1) is considered as a new species. Seven species were reported as threatened plants in Thailand Red Data Book. Taxonomic features were used for key to species constructions. Araceous specimens were found in mixed deciduous forests, dry evergreen forests with 50-470 m. elevation. New ecological habitat of Typhonium laoticum, T. orbifolium, and T. saraburiense were reported in this study.

Keywords: ecology, limestone mountains, Lopburi and Saraburi provinces, species diversity, taxonomic character

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Authors: Leei Wong

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Changes in globalized contexts precipitate changing perceptions concerning linguistic politeness practices. Within these changing contexts, misunderstanding or stereotypification of politeness norms may lead to negative consequences such as hostility or even communication breakdown. With China’s rising influence, the country is offering a vast potential market for global economic development and diplomatic relations and opportunities for intercultural interaction, and many outside China are subsequently learning Chinese. These trends bring both opportunities and pitfalls for intercultural communication, including within the important field of politeness awareness. One internationally recognized benchmark for the study and classification of languages – the updated 2018 CEFR (Common European Framework of Reference for Language) Companion Volume New Descriptors (CEFR/CV) – classifies politeness as a B1 (or intermediate) level descriptor on the scale of Politeness Conventions. This provides some indication of the relevance of politeness awareness within new globalized contexts for fostering better intercultural communication. This study specifically examines Bald on record politeness strategies presented in current beginner TCAL textbooks used in Australian tertiary education through content-analysis. The investigation in this study involves the purposive sampling of commercial textbooks published in America and China followed by interpretive content analysis. The philosophical position of this study is therefore located within an interpretivist ontology, with a subjectivist epistemological perspective. It sets out with the aim to illuminate the characteristics of Chinese Bald on record strategies that are deemed significant in the present-world context through Chinese textbook writers and curriculum designers. The data reveals significant findings concerning politeness strategies in beginner stage curriculum, and also opens the way for further research on politeness strategies in intermediate and advanced level textbooks for additional language learners. This study will be useful for language teachers, and language teachers-in-training, by generating awareness and providing insights and advice into the teaching and learning of Bald on record politeness strategies. Authors of textbooks may also benefit from the findings of this study, as awareness is raised of the need to include reference to understanding politeness in language, and how this might be approached.

Keywords: linguistic politeness, higher education, Chinese language, additional language

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Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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Authors: Wing Chi Wong

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Globally, studying parents caring for children with attention deficit/ hyperactivity disorder (ADHD) is valuable in order to design measures in supporting those parents by health care providers and government. Such parents in Hong Kong seem to encounter detrimental stress and enormous difficulties which are exacerbated by the traditional Chinese culture, exclusion from social members and fiercely competitive educational system. However, seldom studies scrutinize this issue in Hong Kong. This article aims to review the literature regarding parents caring offsprings with ADHD in Hong Kong. Criteria were set for searching among published studies listed in various databases, including MEDLINE, CINCAHL, PsycINFO, ProQuest, Embase, Cochrane Library and Springer Link. Articles with words 'Attention Deficit Hyperactivity Disorder', 'parenting', 'parent', 'family', 'father', 'mother', 'care' in titles and abstracts were identified. Articles with all types of research designs and methods, regardless in English or Chinese, were included. They were limited to years between January 2008 and September 2018. Four relevant studies have resulted. Of them, two were exploratory studies, one was a qualitative study, and one was a survey. Samples were recruited from child psychiatric clinic, Child and Adolescent Mental Health Unit, or multiple family group therapy centres. Authors proclaimed that quality of life of those parents was usually low; particularly mothers perceived a higher stress than fathers; parenting barriers existed; conflicts were commonly raised in parent-child relationship resulting in probable maltreatment to children. Previous studies generally suggested the potential negative outcomes of parents caring children with ADHD. The types and effectiveness of interventions to those parents on relieving their tortures under Hong Kong context had not been explored and systematically evaluated. The scanty studies and existing understanding could not give a promising conclusion pertaining to the appropriate family intervention to parents living with children with ADHD. A stringent research design is necessary to establish evidence on the effectiveness of interventions for those families.

Keywords: attention deficit/ hyperactivity disorder, Hong Kong, parents, interventions

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Authors: Huei Jiun Chen, Hui Mei Huan

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Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.

Keywords: pain assessment, elderly, gender, education

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