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Lau SSS, Ho CCY, Pang RCK, Su S, Kwok H, Fung SF, Ho RC. Measurement of burnout during the prolonged pandemic in the Chinese zero-COVID context: COVID-19 burnout views scale. Front Public Health 2022; 10:1039450. [PMID: 36438233 PMCID: PMC9686433 DOI: 10.3389/fpubh.2022.1039450] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/11/2022] [Indexed: 11/11/2022] Open
Abstract
Burnout is an important public health issue at times of the COVID-19 pandemic. Current measures which focus on work-based burnout have limitations in length and/or relevance. When stepping into the post-pandemic as a new Norm Era, the burnout scale for the general population is urgently needed to fill the gap. This study aimed to develop a COVID-19 Burnout Views Scale (COVID-19 BVS) to measure burnout views of the general public in a Chinese context and examine its psychometric properties. A multiphase approach including literature review, expert consultation, and pilot testing was adopted in developing the scale. The scale was administered to a sample of 1,078 of the general public in Hong Kong with an average age of 34.45 years (SD = 12.47). Exploratory and Confirmatory Factor Analyses suggested a 5-item unidimensional model of COVID-19 BVS. The CFA results indicated that the COVID-19 BVS had a good model fit, as χ2 (10.054)/5 = 2.01, SRMR = 0.010, CFI = 0.998, RMSEA = 0.031. Five items were maintained in EFA with high internal consistency in terms of Cronbach's α of 0.845 and McDonald's ω coefficient of 0.87, and the corrected item-to-total correlations of 0.512 to 0.789 are way above the acceptable range. The KMO values of 0.841 and Bartlett's Test of Sphericity (p < 0.01) verified the normal distribution of the EFA and the adequacy of the EFA sampling. The analyses suggest that the COVID-19 BVS is a promising tool for assessing burnout views on the impacts of the epidemic on the Chinese general populations.
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Affiliation(s)
- Sam S. S. Lau
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,College of International Education, Hong Kong Baptist University, Hong Kong, China,Institute of Bioresources and Agriculture, Hong Kong Baptist University, Hong Kong, China,*Correspondence: Sam S. S. Lau
| | - Cherry C. Y. Ho
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Division of Nursing Education, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China
| | - Rebecca C. K. Pang
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Division of Nursing Education, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China
| | - Susan Su
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,College of International Education, Hong Kong Baptist University, Hong Kong, China
| | - Heather Kwok
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Hong Kong, China,College of International Education, Hong Kong Baptist University, Hong Kong, China
| | - Sai-fu Fung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Roger C. Ho
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
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Gangar S, Sivakumaran S, Anderson AN, Shaw KR, Estrela LA, Kwok H, Davies RC, Tong A, Salbach NM. Optimizing falls risk prediction for inpatient stroke rehabilitation: A secondary data analysis. Physiother Theory Pract 2022:1-12. [PMID: 35262449 DOI: 10.1080/09593985.2022.2043498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Identifying individuals at risk for falls during inpatient stroke rehabilitation can ensure timely implementation of falls prevention strategies to minimize the negative personal and health system consequences of falls. OBJECTIVES To compare sociodemographic and clinical characteristics of fallers and non-fallers; and evaluate the ability of the Berg Balance Scale (BBS) and Morse Falls Scale (MFS) to predict falls in an inpatient stroke rehabilitation setting. METHODS A longitudinal study involving a secondary analysis of health record data from 818 patients with stroke admitted to an urban, rehabilitation hospital was conducted. A fall was defined as having ≥1 fall during the hospital stay. Cut-points on the BBS and MFS, alone and in combination, that optimized sensitivity and specificity for predicting falls, were identified. RESULTS Low admission BBS score and admission to a low-intensity rehabilitation program were associated with falling (p < .05). Optimal cut-points were 29 for the BBS (sensitivity: 82.4%; specificity: 57.4%) and 30 for the MFS (sensitivity: 73.2%; specificity: 31.4%) when used alone. Cut-points of 45 (BBS) and 30 (MFS) in combination optimized sensitivity (74.1%) and specificity (42.7%). CONCLUSIONS A BBS cut-point of 29 alone appears superior to using the MFS alone or combined with the BBS to predict falls.
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Affiliation(s)
- Surekha Gangar
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | | | - Ashley N Anderson
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Kelsey R Shaw
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Luke A Estrela
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Heather Kwok
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Hennick Bridgepoint Hospital, Sinai Health, Toronto, ON, Canada
| | - Robyn C Davies
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Hennick Bridgepoint Hospital, Sinai Health, Toronto, ON, Canada.,Unity Health Toronto, Toronto, ON, Canada
| | - Agnes Tong
- Hennick Bridgepoint Hospital, Sinai Health, Toronto, ON, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Cai W, Sun Y, Peng K, Kwok H, Lei L, Wu S, Lam CK, Li L, Gao Y. Physical-Activity-Related Injuries and Risk Factors among Secondary School Students in Hong Kong. Int J Environ Res Public Health 2020; 17:ijerph17030747. [PMID: 31991589 PMCID: PMC7036798 DOI: 10.3390/ijerph17030747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 02/05/2023]
Abstract
Increase in physical activity (PA) might elevate risks for physical-activity-related injuries (PARIs). This study aimed to investigate the incidence rate and risk factors for PARIs among secondary school students in Hong Kong. All eligible students from three secondary schools were invited to participate in the study from November to December 2014. Information on PARI occurrences in the past 12 months, PA participation, and sociodemographics was collected. Multivariate and hierarchical logistic regression models were performed to estimate the risk of potential factors for PARIs. In total, 1916 students in forms 1-6 (aged 14.3 ± 1.7 years) completed valid questionnaires, with an overall yearly PARI incidence rate of 32.1% (boys: 34.3%; girls: 29.3%). There were sex differences in the risk factors identified, except that family size was associated with PARIs for all participants. Longer duration and higher intensity of PA increased the risk for PARI occurrences in both sexes. In conclusion, PARIs were prevalent among secondary school students in Hong Kong, and different sexes had different PARI incidence rates and were influenced by different risk factors. There is an urgent call for effective sex-specific interventions to prevent PARIs in this population.
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Affiliation(s)
- Weicong Cai
- Department of Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (W.C.); (L.L.)
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China;
| | - Yan Sun
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China; (Y.S.); (H.K.); (S.W.); (C.K.L.)
| | - Ke Peng
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia;
- School of Public Health, The University of Sydney, Sydney, NSW 2042, Australia
| | - Heather Kwok
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China; (Y.S.); (H.K.); (S.W.); (C.K.L.)
| | - Lin Lei
- Department of Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (W.C.); (L.L.)
| | - Shing Wu
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China; (Y.S.); (H.K.); (S.W.); (C.K.L.)
| | - Chi Kei Lam
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China; (Y.S.); (H.K.); (S.W.); (C.K.L.)
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China;
| | - Yang Gao
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China; (Y.S.); (H.K.); (S.W.); (C.K.L.)
- Correspondence: ; Tel.: +852-34-113-082
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Gao Y, Cai W, Gao L, Wang J, Liang J, Kwok H, Jia C, Li L. Physical activity-related injuries among university students: a multicentre cross-sectional study in China. BMJ Open 2018; 8:e021845. [PMID: 30244210 PMCID: PMC6157521 DOI: 10.1136/bmjopen-2018-021845] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/26/2018] [Accepted: 08/15/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the epidemiological characteristics and preliminarily explore possible risk factors of physical activity-related injury (PARI) occurrences among Chinese university students via a multicentre mixed survey. DESIGN Cross-sectional study. PARTICIPANTS A total of 4758 undergraduates graded 1-3 in nine universities in three Chinese cities were enrolled via cluster random sampling and completed the self-administered online questionnaires during March and April 2017. MAIN OUTCOME MEASURES PARI in the past 12 months. RESULTS Of the 4758 participants, 1081 sustained PARI in the past 12 months, with an overall PARI incidence rate of 22.7% (27.3% (367/1343) in males and 20.9%(714/3415) in females). Around one-quarter of the injured (26.4%) suffered from PARI over at least three episodes. More than half of the injured subjects experienced physical activity (PA) absenteeism and sought medical attention. All PA indicators were significantly and positively associated with PARI, with a frequency of sports and leisure-time vigorous-intensity PA (VPA) participation being the strongest (adjusted OR: 1.079, 95% CI: 1.018 to 1.144). Moreover, males (OR=1.199), Shantou students (OR=4.239), year 1 students (OR=1.287), university and other sports team members (OR=1.717-2.360) and those with insufficient sleep time (OR=1.262-1.333) were also at a higher risk of PARI. CONCLUSIONS PARI is prevalent among university students in China. The frequency of sports and leisure-time VPA participation was most strongly associated with PARI among all PA indicators. These data can inform future programmes for injury intervention among university students. Safety issues should also be emphasised when promoting PA among the public to reduce PARI.
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Affiliation(s)
- Yang Gao
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Weicong Cai
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Lijie Gao
- Department of Epidemiology, Shandong University School of Public Health, Shandong, China
| | - Jingjing Wang
- Mass Sports Research Center, China Institute of Sport Science, Beijing, China
| | - Jiehui Liang
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Heather Kwok
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Cunxian Jia
- Department of Epidemiology, Shandong University School of Public Health, Shandong, China
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Fragkos K, Kwok H, Bhakta A, Keane N, Chakraverty R, Thomson K, Rahman F, Di Caro S, Mehta S. Malabsorption and artificial nutrition in patients with gut GvHD post allogenic stem cell transplantation: Home parenteral nutrition affects survival significantly. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fragkos K, Fini L, Keane N, Kwok H, Paulon E, Barragry J, Mehta S, Rahman F, Di Caro S. SUN-P114: Home Parenteral Nutrition in Patients with Advanced Cancer: A Systematic Review. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Keane N, Fragkos K, Patel P, Murray K, Obbard S, Ajibodu S, O’callaghan S, Kwok H, Paulon E, Barragry J, Mehta S, Di Caro S, Rahman F. MON-P096: Biochemical Measurements as a Predictor of Survival in Patients with Incurable Cancers Receiving Home Parenteral Nutrition (HPN). Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fragkos KC, Fini L, Keane N, Kwok H, Paulon E, Barragry J, O’Hanlon F, Mehta S, Rahman F, Caro SD. PTU-109 Home parenteral nutrition in patients with advanced cancer: a systematic review. Nutrition 2017. [DOI: 10.1136/gutjnl-2017-314472.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tucker JA, Cheong J, Chandler SD, Lambert BH, Kwok H, Pietrzak B. Behavioral economic indicators of drinking problem severity and initial outcomes among problem drinkers attempting natural recovery: a cross-sectional naturalistic study. Addiction 2016; 111:1956-1965. [PMID: 27318078 PMCID: PMC5056809 DOI: 10.1111/add.13492] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/29/2015] [Accepted: 06/13/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Research using different behavioral economic (BE) and time perspective (TP) measures suggests that substance misusers show greater sensitivity to shorter-term contingencies than normal controls, but multiple measures have seldom been investigated together. This study evaluated the extent to which multiple BE and TP measures were associated with drinking problem severity, distinguished initial outcomes of natural recovery attempts and shared common variance. Hypotheses were (1) that greater problem severity would be associated with greater impulsivity and demand for alcohol and shorter TPs; and (2) that low-risk drinking would be associated with greater sensitivity to longer-term contingencies compared with abstinence. DESIGN Cross-sectional naturalistic field study. SETTING Southern United States. PARTICIPANTS Problem drinkers, recently resolved without treatment [n = 191 (76.44% male), mean age = 50.09 years] recruited using media advertisements. MEASUREMENTS Drinking practices, dependence levels and alcohol-related problems prior to stopping problem drinking were assessed during structured field interviews. Measures included the Zimbardo Time Perspective Inventory; BE analogue choice tasks [delay discounting (DD), melioration-maximization (MM), alcohol purchase task (APT)]; and the Alcohol-Savings Discretionary Expenditure (ASDE) index, derived from real spending on alcohol and voluntary savings during the year before problem cessation. FINDINGS Measures of demand based on real (ASDE) and hypothetical (APT) spending on alcohol were associated with problem severity (Ps < 0.05), but DD, MM and TP measures were not. More balanced pre-resolution spending on alcohol versus saving for the future distinguished low-risk drinking from abstinent resolutions (ASDE odds ratio =5.59; P < 0.001). BE measures did not share common variance. CONCLUSIONS Two behavioral assessment tools that measure spending on alcohol, the Alcohol Purchase Task and the Alcohol-Savings Discretionary Expenditure index, appear to be reliable in assessing the severity of drinking problems. The ASDE index also may aid choices between low-risk and abstinent drinking goals.
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Tucker JA, Cheong J, Chandler SD, Lambert BH, Pietrzak B, Kwok H, Davies SL. Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery. Alcohol Clin Exp Res 2016; 40:2676-2684. [PMID: 27775161 DOI: 10.1111/acer.13245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 09/23/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND As interventions have expanded beyond clinical treatment to include brief interventions for persons with less severe alcohol problems, predicting who can achieve stable moderation drinking has gained importance. Recent behavioral economic (BE) research on natural recovery has shown that active problem drinkers who allocate their monetary expenditures on alcohol and saving for the future over longer time horizons tend to have better subsequent recovery outcomes, including maintenance of stable moderation drinking. This study compared the predictive utility of this money-based "Alcohol-Savings Discretionary Expenditure" (ASDE) index with multiple BE analogue measures of behavioral impulsivity and self-control, which have seldom been investigated together, to predict outcomes of natural recovery attempts. METHODS Community-dwelling problem drinkers, enrolled shortly after stopping abusive drinking without treatment, were followed prospectively for up to a year (N = 175 [75.4% male], M age = 50.65 years). They completed baseline assessments of preresolution drinking practices and problems, analogue behavioral choice tasks (Delay Discounting, Melioration-Maximization, and Alcohol Purchase Tasks), and a Timeline Followback interview including expenditures on alcohol compared to voluntary savings (ASDE index) during the preresolution year. RESULTS Multinomial logistic regression models showed that, among the BE measures, only the ASDE index predicted stable moderation drinking compared to stable abstinence or unstable resolutions involving relapse. As hypothesized, stable moderation was associated with more balanced preresolution allocations to drinking and savings (odds ratio = 1.77, 95% confidence interval = 1.02 to 3.08, p < 0.05), suggesting it is associated with longer-term behavior regulation processes than abstinence. CONCLUSIONS The ASDE's unique predictive utility may rest on its comprehensive representation of contextual elements to support this patterning of behavioral allocation. Stable low-risk drinking, but not abstinence, requires such regulatory processes.
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Affiliation(s)
- Jalie A Tucker
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - JeeWon Cheong
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Susan D Chandler
- Department of Health Education & Behavior, University of Florida, Gainesville, Florida
| | - Brice H Lambert
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brittney Pietrzak
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Heather Kwok
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
| | - Susan L Davies
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama
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Wilmer J, Russell R, Bronstad P, Kwok H, Blokland G, Anthony S, Smoller J, Rhodes K, Germine L. Origins of ‘the eye of the beholder’: Individual differences in face attractiveness judgments are shaped primarily by environments. Personality and Individual Differences 2016. [DOI: 10.1016/j.paid.2016.05.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wilmer J, Russell R, Bronstad M, Kwok H, Anthony S, Germine L. Disagreements about the attractiveness of faces arise largely from past experiences: evidence from twins. J Vis 2013. [DOI: 10.1167/13.9.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gill H, Kwok H, To KKW, Ho PL, Mak HKF, Chim CS, Kwong YL. Positron emission tomography in the diagnosis of disseminated pyomyositis due to PVL-negative methicillin-resistant Staphylococcus aureus. QJM 2013; 106:485-6. [PMID: 22690009 DOI: 10.1093/qjmed/hcs088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Gill
- Department of Medicine, Queen Mary Hospital, Hong Kong, China
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Wilmer JB, Germine L, Ly R, Hartshorne JK, Kwok H, Pailian H, Williams MA, Halberda J. The heritability and specificity of change detection ability. J Vis 2012. [DOI: 10.1167/12.9.1275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Robinson D, Adams B, Kwok H, Peebles K, Clarke L, Funk G. Respir Res 2001; 2:P17. [DOI: 10.1186/rr133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
The phrenoesophageal ligament, attaching the esophagus to the diaphragm, has been given little emphasis in anatomy teaching. This study was undertaken to examine the macroscopic and microscopic structure of the phrenoesophageal ligament. The results indicate that the ligament is a distinct structure bridging the space between the esophageal wall and the margins of the esophageal hiatus. This ligament appears to arise from both the endothoracic fascia and the transversalis fascia and is composed of abundant collagen and elastic lamellae. Toward the wall of the esophagus, the ligament divides into a prominent upper leaf and an ill-defined lower leaf before inserting into the wall of the esophagus. Histological study reveals that the ligament has a substantial and deep insertion into the wall of the esophagus. It appears that the ligament plays an important role in anchoring the lower esophagus and maintaining gastroesophageal competence.
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Affiliation(s)
- H Kwok
- Department of Anatomy with Radiology, Faculty of Medicine and Health Science, University of Auckland, New Zealand
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Abstract
We examined developmental changes in breathing pattern and the ventilatory response to hypoxia (7.4% O(2)) in unanesthetized Swiss CD-1 mice ranging in age from postnatal day 0 to 42 (P(0)-P(42)) using head-out plethysmography. The breathing pattern of P(0) mice was unstable. Apneas were frequent at P(0) (occupying 29 +/- 6% of total time) but rare by P(3) (5 +/- 2% of total time). Tidal volume increased in proportion to body mass ( approximately 10-13 ml/kg), but increases in respiratory frequency (f) (55 +/- 7, 130 +/- 13, and 207 +/- 20 cycles/min for P(0), P(3), and P(42), respectively) were responsible for developmental increases in minute ventilation (690 +/- 90, 1,530 +/- 250, and 2,170 +/- 430 ml. min(-1). kg(-1) for P(0), P(3), and P(42), respectively). Between P(0) and P(3), increases in f were mediated by reductions in apnea and inspiratory and expiratory times; beyond P(3), increases were due to reductions in expiratory time. Mice of all ages showed a biphasic hypoxic ventilatory response, which differed in two respects from the response typical of most mammals. First, the initial hyperpnea, which was greatest in mature animals, decreased developmentally from a maximum, relative to control, of 2.58 +/- 0.29 in P(0) mice to 1. 32 +/- 0.09 in P(42) mice. Second, whereas ventilation typically falls to or below control in most neonatal mammals, ventilation remained elevated relative to control throughout the hypoxic exposure in P(0) (1.73 +/- 0.31), P(3) (1.64 +/- 0.29), and P(9) (1. 34 +/- 0.17) mice but not in P(19) or P(42) mice.
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Affiliation(s)
- D M Robinson
- Department of Physiology, Faculty of Medicine and Health Science, University of Auckland, Auckland, New Zealand
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Abstract
With the widespread introduction of preoperative radiotherapy for rectal cancer and the development of transanal endoscopic microsurgery for selected early lesions, preoperative radiological staging of these tumours has taken on increasing importance. This study is a systematic review to evaluate computed tomography (CT), endorectal sonography (ES) and magnetic resonance imaging (MRI) as preoperative staging modalities in rectal cancer. A Medline-based search identifying studies using CT, ES, or MRI in preoperative staging of rectal cancer between 1980 and 1998 was undertaken. The list of papers was supplemented by extensive cross-checking of citation lists. Studies were included if they met predetermined criteria. Data from the accepted studies were entered into pooled tables comparing radiological and pathological staging results for each modality both in determining bowel wall penetration and involvement of lymph nodes. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were determined for the pooled results. Eighty-three studies from 78 papers including 4,897 patients met the inclusion criteria. In determining the wall penetration of the tumour the values for sensitivity for CT, ES, MRI and MRI with endorectal coil were 78%, 93%, 86% and 89%; for specificity 63%, 78%, 77% and 79%; and for accuracy 73%, 87%, 82% and 84%, respectively. In determining the nodal involvement by tumour the sensitivity values for CT, ES, MRI and MRI with endorectal coil 52%, 71%, 65% and 82%; for specificity 78%, 76%, 80% and 83%; and for accuracy 66%, 74%, 74% and 82%, respectively. MRI with an endorectal coil is the single investigation that most accurately predicts pathological stage in rectal cancer.
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Affiliation(s)
- H Kwok
- University Department of Surgery, Auckland Hospital, New Zealand
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Lau F, Kwok H, Bay KS. Some computer-based decision support tools for the rehabilitation manager. Physiother Can 1993; 45:29-38. [PMID: 10124338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The recent introduction of the Management Information System (MIS) guidelines has sparked much interest among health care institutions across Canada regarding proper approaches to the recording and interpretation of various financial and workload indicators. While the benefits of the MIS guidelines are widely acknowledged, much less attention has been directed to how departmental managers can analyze and make use of the vast amount of information generated. In this paper we attempt to review some of the computer-based decision-support tools that may be useful to the manager of the rehabilitation services department in analyzing the various MIS data that are collected. The data are assumed to be available through a computerized rehabilitation information system which includes workload measures. The quantitative models reviewed in this paper include basic descriptive statistics, deviation, trend and what-if-analysis and graph-plotting. Although the use of such tools can assist the rehabilitation manager in the routine decision-making process, it is very important that we ask the right questions and employ the proper model to make the most rational and best decision. In this respect, ongoing training in general problem-solving skills, decision-making processes, and use of computer-based decision-support tools may be very beneficial.
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Affiliation(s)
- F Lau
- Department of Applied Sciences in Medicine, University of Alberta, Edmonton
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