Triad influence on the detection of crime in Hong Kong.

We use bootstrap data envelopment analysis, adjusting for endogeneity, to examine police efficiency in detecting crime in Hong Kong. We address the following: (i) is there a correlation between the detection of crime and triad influence? (ii) does the level of triad influence affect the efficiency in translating inputs (police strength) into outputs (crime detection)? and (iii) how can the allocation of policing resources be adjusted to improve crime detection? We find that nighty-eight percent of Hong Kong police districts in our sample were found to be inefficient in the detection of crime. Variation was found across districts regarding the detection of violent, property and other crimes. Most inefficiencies and potential improvements in the detection of crime were found in the categories violent and other crimes. We demonstrate how less efficient police districts can modify police resourcing decisions to better detect certain crime types while maintaining current levels of resourcing. Finally, we highlight how the method we outline improves efficiency estimation by adjusting for endogeneity and measuring the conditional efficiency of each district (i.e. the efficiency of crime detection taking the instrumental variables (e.g. influence of triads) into consideration). The use of frontier models to assist in evaluating policing performance can lead to improved efficiency, transparency, and accountability in law enforcement, ultimately resulting in better public safety outcomes and publicly funded resource allocation.

Understanding the life experiences of elderly in social isolation from the social systems perspective: using Hong Kong as an illustrating example.

Aim: The elderly in social isolation often referred to as older people who experience social alienation with little social support from their family, peers, and community suffer from a poor quality of life and well-being. Since their life experiences are affected by a range of factors from different levels, this study seeks to investigate their current life situations and experiences from a social systems perspective. Methods: A qualitative study was conducted to enrich the understanding of their current life situations and experiences and to generate corresponding practice implications. In this study, there were 13 elderly participants in social isolation, which were users of a social service agency in Hong Kong. They took part in a semi-structured individual interview, sharing their life stories about their daily lives, social relationships, and sense of well-being. Qualitative results were analyzed based on these dimensions. Results: Results showed that the elderly participants in social isolation had a low level of social support and participation in social activities. Their life experiences and situations were affected by multiple levels of factors that were interrelated. Conclusion: The results support the application of the social systems perspective in investigating the living conditions of the elderly in social isolation. The corresponding practice implications were also discussed.

Young people's perceptions of the challenges and opportunities during the Mainland China-Hong Kong convergence.

Since the handover of the sovereignty of Hong Kong from Britain to China in 1997, convergence between Mainland China and Hong Kong has gradually emerged. During this process, young people have engaged in demonstrations to express their dissatisfaction with government policies and limited socio-economic progression. However, the underlying reasons for their dissatisfaction have not been fully investigated. This study investigates their perceived challenges and opportunities during the convergence, with the objective of identifying the factors affecting the Mainland China-Hong Kong convergence and examining young people's perceived challenges and opportunities during the convergence. Mixed research methods of focus groups and a survey were adopted. Ten focus groups with 83 participants were conducted to collect qualitative data on the factors relating to convergence. Based on the qualitative data, a questionnaire was constructed to investigate young people's perceived challenges and opportunities during the convergence, using a sample of 1253 young people. Ordinary least-squares regression was applied to analyse the relationships among identified factors. The study found that Hong Kong's youth tended to regard the Mainland China-Hong Kong convergence as an opportunity for socio-economic progression, and they identified three challenges during the convergence. It also revealed that young people's higher education, perceived housing challenges, and perceived socio-economic challenges are negatively related to the convergence, whereas their perceived challenges associated with entrepreneurship and innovation are positively related to the convergence. The development of more well-balanced and mutually beneficial policies that satisfy the needs of young people will lead to a higher acceptance of the convergence. As such, young people will be more willing to embrace the opportunities and face the challenges brought about by the convergence, resulting in a more harmonious society and socio-economic progression.

Use of theatresports to promote positive education among youth participants.

BACKGROUND: Due to the scarcity of research on the benefits of theatresports for youth, this study examined the outcomes of theatresports as a means to implement positive education in youth work settings. METHODS: To this end, qualitative research was conducted with 92 participants in a theatresports program. Thematic analysis was applied to analyze the participants' experiences of the program, using the framework of positive education. RESULTS: Results showed that the processes and practices of the theatresports program helped the participants achieved well-being in terms of various domains namely positive emotions, positive health, positive relationships, positive engagement, positive accomplishment, and positive meaning. These capabilities and qualities acquired helped them achieve well-being, and the learning acquired from the program could even be applied to daily life situations and deal with the challenges. CONCLUSIONS: This shows that the theatresports program manifests the benefits of positive education. Corresponding implications were discussed.

Development and validation of the caregiver needs and resources assessment.

Introduction: Existing caregiver assessment tools were long criticized for focusing on the needs and burden while neglecting the importance of the resources. The current study aimed to develop a multidimensional and time-effective assessment tool that measures both needs and resources of non-paid family caregivers of older adults for screening and service-matching purposes. Methods: Items of the Caregiver Needs and Resources Assessment (CNRA) were developed from extensive literature reviews and focus group interviews of family caregivers and social workers in the field. In addition, we collected 317 valid responses from family caregivers of older adults from local non-government organizations in examining the psychometric properties of the CNRA. Results: The results revealed a 12-factor structure that fitted nicely into the conceptual frame of needs and resources domains. Need factors were positively associated with mental health symptoms, while resource factors were positively associated with peace in mind, meaning-making, and personal gain measures. The 36-item CNRA revealed good internal reliability and convergent validity. Discussion: The CNRA has the potential to be used as a compact yet balanced assessment tool for understanding both the needs and resources of caregivers for human service professionals.

Reporting unit context data to stakeholders in long-term care: a practical approach.

BACKGROUND: The importance of reporting research evidence to stakeholders in ways that balance complexity and usability is well-documented. However, guidance for how to accomplish this is less clear. We describe a method of developing and visualising dimension-specific scores for organisational context (context rank method). We explore perspectives of leaders in long-term care nursing homes (NHs) on two methods for reporting organisational context data: context rank method and our traditionally presented binary method-more/less favourable context. METHODS: We used a multimethod design. First, we used survey data from 4065 healthcare aides on 290 care units from 91 NHs to calculate quartiles for each of the 10 Alberta Context Tool (ACT) dimension scores, aggregated at the care unit level based on the overall sample distribution of these scores. This ordinal variable was then summed across ACT scores. Context rank scores were assessed for associations with outcomes for NH staff and for quality of care (healthcare aides' instrumental and conceptual research use, job satisfaction, rushed care, care left undone) using regression analyses. Second, we used a qualitative descriptive approach to elicit NH leaders' perspectives on whether the methods were understandable, meaningful, relevant, and useful. With 16 leaders, we conducted focus groups between December 2017 and June 2018: one in Nova Scotia, one in Prince Edward Island, and one in Ontario, Canada. Data were analysed using content analysis. RESULTS: Composite scores generated using the context rank method had positive associations with healthcare aides' instrumental research use (p < .0067) and conceptual research use and job satisfaction (p < .0001). Associations were negative between context rank summary scores and rushed care and care left undone (p < .0001). Overall, leaders indicated that data presented by both methods had value. They liked the binary method as a starting point but appreciated the greater level of detail in the context rank method. CONCLUSIONS: We recommend careful selection of either the binary or context rank method based on purpose and audience. If a simple, high-level overview is the goal, the binary method has value. If improvement is the goal, the context rank method will give leaders more actionable details.

Vaginal delivery of second twins: factors predictive of failure and adverse perinatal outcomes.

INTRODUCTION: This study was performed to explore factors associated with adverse perinatal outcomes for second twins and to identify predictive factors for successful vaginal delivery of the second twin after vaginal delivery of the first twin. METHODS: This 10-year retrospective study included 231 cases of twin pregnancies in which vaginal delivery of the second twin was attempted after vaginal delivery of the first twin. The relationships of obstetric characteristics with the composite adverse perinatal outcome of the second twin were analysed. Predictive factors for successful vaginal delivery of the second twin were also explored. RESULTS: Gestational age <32 weeks was the only independent risk factor for the composite adverse perinatal outcome and neonatal intensive care unit admission for the second twin. A longer inter-twin delivery interval was associated with greater risk of caesarean delivery of the second twin, but it did not increase the risk of an adverse perinatal outcome. Non-vertex presentation of the second twin at delivery was independently associated with caesarean delivery (9.0% vs 2.0%, P=0.03). For second twins in breech presentation, caesarean delivery was associated with the presence of less experienced birth attendants. CONCLUSION: Among second twins born to mothers who had attempted vaginal delivery, adverse perinatal outcomes were mainly related to prematurity. The presence of more experienced birth attendants may contribute to successful vaginal delivery of the second twin, particularly for twins in non-vertex presentation.

Quantitative detection of seizures with minimal-density EEG montage using phase synchrony and cross-channel coherence amplitude in critical care.

Seizures frequently occur in paediatric emergency and critical care, with up to 74% being sub-clinical seizures making detection difficult. Delays in seizure detection and treatment worsen the neurological outcome of critically-ill patients. Gold-standard seizure detections using multi-channels electroencephalograms (EEG) require trained clinical physiologists to apply scalp electrodes and highly specialised neurologists to interpret and identify seizures. In this study, we extracted phase synchrony and cross-channel coherence amplitude across 4 and 8 pre-selected scalp EEG signals. Binary classification is used to determine whether the signal segment is seizure or non-seizure, and the predictions were compared against the gold-standard seizure onset markings. The application of the algorithm on a cohort of forty routinely collected EEGs from paediatric patients showed an average accuracy of 77.2 % and 76.5% using 4 and 8 channels, respectively. Clinical Relevance- This work demonstrates the feasibility of seizure detection with pre-defined 4 and 8 EEG electrodes with an average accuracy of 77%. This means for the first time seizure detection is possible using an EEG montage that can be applied readily at the bedside independent of expert input.

Proactive Criminal Thinking and Restrictive Deterrence: A Pathway to Future Offending and Sanction Avoidance.

Perceived crime benefit and criminal thinking are essential factors in predicting future offending. However, less is known about how the interaction of the two influences individuals' perception and cognition of crime. This study explores whether proactive criminal thinking mediates the effect of perceived crime benefit, and tests whether restrictive deterrence influences these pathways. Using a drug dealer sample that was drawn from the Second RAND Inmate Survey, this paper finds that proactive criminal thinking significantly mediates the effect of perceived crime benefit on future offending, criminal self-efficacy, and future sanction avoidance. Mediation pathways are enhanced when taking a heterogeneous crime strategy as a moderator, but only in the experienced drug dealer subsample. These results suggest that proactive criminal thinking is a route for channeling the effects of perceived crime benefit, and an amplifier for bringing restrictive deterrence into play. Both roles apply to experienced offenders rather than less-experienced offenders. Integrating restrictive deterrence with individuals' perception and cognition of crime is a meaningful attempt to fit restrictive deterrence into a broader theoretical map.

Prisoners' Perceived Violence and Hair Regulation in Hong Kong Prisons: Gender-Based Differences.

Hair regulation is an essential policy for maintaining hygiene, security, and discipline in correctional institutions. However, the implementation of any hair-regulating policy should include a consideration of gender needs and differences. This study investigated Chinese prisoners' perceived influence of hairstyles on their behavioral responses. Data were collected by means of a self-administered questionnaire survey from 500 male and 500 female prisoners in 11 correctional institutions of Hong Kong, China. Descriptive analyses and chi-square tests were used to explore the perceived violence of prisoners and gender differences. Mediation analysis was adopted to examine the prisoners' perceived behavioral responses and mental and psychological well-being under different hairstyle situations, using self-esteem, procedural fairness, and negative emotional responses as mediators. The study found that male prisoners are inherently more tensive than the female group in terms of violent proclivities. In addition, perceived violent behavior is associated with hairstyle, and the influence path is gender related. Restrictive hair regulations that do not address unique social and cultural meanings and gender differences would decrease male prisoners' self-esteem, while increasing all prisoners' negative emotional responses and reducing their perceived procedural fairness. To maintain security inside institutions, we recommend short hair for male prisoners and long hair for female prisoners in Chinese prisons. Given that many prisons in Asian and African nations have an authoritarian style of governance similar to that of China, this study is of considerable international relevance.

Non-visualisation of fetal gallbladder in a Chinese cohort.

INTRODUCTION: Non-visualisation of fetal gallbladder (NVFGB) is associated with chromosomal abnormalities, biliary atresia, cystic fibrosis, and gallbladder agenesis in Caucasian fetuses. We investigated the outcomes of fetuses with NVFGB in a Chinese cohort. METHODS: This retrospective analysis included cases of NVFGB among Chinese pregnant women at five public fetal medicine clinics in Hong Kong from 2012 to 2019. We compared the incidences of subsequent gallbladder visualisation, chromosomal abnormalities, biliary atresia, cystic fibrosis, and gallbladder agenesis between cases of isolated NVFGB and cases of non-isolated NVFGB. RESULTS: Among 19 cases of NVFGB detected at a median gestational age of 21.3 weeks (interquartile range, 20.0-22.3 weeks), 10 (52.6%) were isolated and nine (47.4%) were non-isolated. Eleven (58.0%) cases had transient non-visualisation, four (21.0%) had gallbladder agenesis, three (15.8%) had chromosomal abnormalities (trisomy 18, trisomy 21, and 22q11.2 microduplication), one (5.2%) had biliary atresia, and none had cystic fibrosis. The incidence of serious conditions was significantly higher in the non-isolated group than in the isolated group (44.4% vs 0%; P=0.029); all three cases with chromosomal abnormalities and the only case of biliary atresia were in the non-isolated group, while all four cases with gallbladder agenesis were in the isolated group. The incidences of transient non-visualisation were similar (55.6% vs 60.0%; P=1.000). CONCLUSION: Isolated NVFGB is often transient or related to gallbladder agenesis. While investigations for chromosomal abnormalities and biliary atresia are reasonable in cases of NVFGB, testing for cystic fibrosis may be unnecessary in Chinese fetuses unless the NVFGB is associated with consistent ultrasound features, significant family history, or consanguinity.

An Innovative Model of Positive Education with Traditional Chinese Moral Values: An Evaluation of Project Bridge.

Project Bridge, as a new, contextualized positive education program, is designed to enhance university students' character strengths and moral development, resulting in the promotion of their psychological wellbeing. Taking into account the differences between Western and Chinese cultures, the project integrated both Western and Asian concepts and values in the delivery of university education that would likely bring about optimal outcomes. In the evaluation, mixed methods were applied to demonstrate the outcomes of this newly developed positive education program. Pre- and post-test, as well as reflective writing, were adopted to measure the outcomes. Both quantitative and qualitative results demonstrated satisfying outcomes. Implications and future developments are discussed in the conclusion.

Family caregiving during the COVID-19 pandemic: factors associated with anxiety and depression of carers for community-dwelling older adults in Hong Kong.

BACKGROUND: The COVID-19 pandemic disrupts the daily routine and increases the caregiving load of the family carers of older adults. This study examined how the pandemic may impact mental health and investigated the prevalence of anxiety and depressive symptoms in family carers of older people. METHODS: Two hundred and thirty-six family carers of older adults participated in this cross-sectional survey study. Outcome measures included their symptoms of anxiety and depression, pandemic-related psychosocial factors, external factors, and the practice of preventive behaviours. RESULTS: Caseness prevalence of anxiety and depression among family carers was 25 and 56% respectively. Working carers were more depressed than non-working, while younger carers reported more anxiety and depression symptoms than older. Hand hygiene and getting drugs from the hospital positively predicted depression while healthy lifestyle negatively predicted depression. These variables, together with perceived risk and severity and the worry of getting infected, predicted anxiety. CONCLUSIONS: The prevalence of mental health symptoms was alarming. Telemedicine practice, including online pharmaceutical services and the Internet Hospital plus Drug Delivery platform, could be a solution in alleviating the burden and worry of infection of family carers. Tailored-made interventions by age and working status of the family carers are recommended.

An Inquiry into the Relationship between Drug Users' Psychological Situations and Their Drug-Taking Behaviour.

In view of the research gap whereby few studies have investigated the inner psychological situations underlying continuous drug use, this study used the Soulmate Scale to investigate the relationship between soulmate experience and drug-taking behaviour. Overall, 276 participants took part in this study. Results showed that soulmate experience was negatively related to drug-taking behaviour, which means that being psychologically attached to drugs and receiving comfort from them encourages dependency and a higher level of difficulty in quitting drugs. In addition, soulmate experience significantly mediated the effect of meaning of life and social isolation on drugs, suggesting that when such psychological bonding and sustenance can be developed in interpersonal relationships instead of drugs, drug users are likely to develop the meaning of life and a lower sense of social isolation, and are more likely to quit drugs. The corresponding implications were discussed.

Restrictive Deterrence in Drug Offenses: A Systematic Review and Meta-Synthesis of Mixed Studies.

Deterrence by punishment aims to prevent a crime; however, it is not always successful. Restrictive deterrence explains the continuous criminal activities that occur despite deterrence; offenders enact various strategies to avoid detection, which is more typical among drug offenders given that they have a high frequency of offending and exposure to punishment. This systematic review provides an in-depth understanding of restrictive deterrence of drug offenders. Two prominent themes, "restrictive deterrence strategy" and "deterrability and restrictive deterrence," depict drug offenders' restrictive deterrence and effectively fit within the certainty-severity framework of punishment. Future studies should investigate restrictive deterrence strategies in the after-arrest context, the facilitative effect of perception of risk on strategy development, and facilitators or inhibitors affecting the diffusion of restrictive deterrence strategies.

Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies.

OBJECTIVE: To investigate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and infection-to-delivery interval with maternal and cord serum concentrations of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies and transplacental transfer ratio in pregnant women with active or recovered SARS-CoV-2 infection. METHODS: This was a prospective case series of consecutive pregnant women with laboratory-confirmed SARS-CoV-2 infection between 27 March 2020 and 24 January 2021. We collected information regarding deep throat saliva or nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) test results, serial cycle threshold (Ct) values at and after diagnosis, demographic, clinical and outcome data, and neonatal NPS RT-PCR results. Qualitative and quantitative analysis of IgG and immunoglobulin M (IgM) antibodies against SARS-CoV-2 was performed in maternal and cord blood serum samples obtained at delivery. Correlation of maternal Ct values, infection-to-delivery interval, infection duration and viral load area under the curve (AUC) with gestational age (GA) at diagnosis, maternal and cord serum IgG concentrations and transplacental transfer ratio of IgG were evaluated using Pearson's correlation. RESULTS: Twenty pregnant women who consented to participate and who had delivered their babies by 31 January 2021 were included in the study, comprising 14 who had recovered from coronavirus disease 2019 (COVID-19) and six with active infection at delivery. The median GA at clinical manifestation was 32.7 (range, 11.9-39.4) weeks. The median infection-to-delivery interval and infection duration were 41.5 (range, 2-187) days and 10.0 (range, 1-48) days, respectively. The median GA at delivery was 39.1 (range, 32.4-40.7) weeks and the median seroconversion interval was 14 (range, 1-19) days. Of 13 neonates born to seropositive mothers with recovered infection at delivery, 12 tested positive for anti-SARS-CoV-2 IgG. All neonatal NPS samples were negative for SARS-CoV-2 and all cord sera tested negative for IgM. The median transplacental transfer ratio of IgG was 1.3 (interquartile range, 0.9-1.6). There was a negative correlation between infection-to-delivery interval and anti-SARS-CoV-2 IgG concentrations in maternal (r = -0.6693, P = 0.0087) and cord (r = -0.6554, P = 0.0068) serum and a positive correlation between IgG concentration in maternal serum and viral load AUC (r = 0.5109, P = 0.0310). A negative correlation was observed between transfer ratio and viral load AUC (r = -0.4757, P = 0.0409). CONCLUSIONS: In pregnant women who have recovered from COVID-19, anti-SARS-CoV-2 IgG concentrations at delivery increased with increasing viral load during infection and decreased with increasing infection-to-delivery interval. The median transplacental transfer ratio of IgG was 1.3 and it decreased with increasing viral load during infection. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Hong Kong Geriatrics Society and Hong Kong Urological Association consensus on personalised management of male lower urinary tract symptoms in the era of multiple co-morbidities and polypharmacy.

Lower urinary tract symptoms (LUTS) are common complaints of adult men. Benign prostatic hyperplasia (BPH) represents the most common underlying cause. As the incidence of BPH increases with age, and pharmacological treatment is a major part of the disease's management, the majority of patients with LUTS are managed by primary care practitioners. There are circumstances in which specialist care by urologists or geriatricians is required, such as failure of medical treatment, adverse effects from medical treatment, or complications from BPH. Referral choices can be confusing to patients and even practitioners in different specialties under such circumstances. There is currently no local consensus about the diagnosis, medical management, or referral mechanism of patients with BPH. A workgroup was formed by members of The Hong Kong Geriatrics Society (HKGS) and the Hong Kong Urological Association (HKUA) to review evidence for the diagnosis and medical treatment of LUTS. A consensus was reached by HKGS and HKUA on an algorithm for the flow of male LUTS care and the use of uroselective alpha blockers, antimuscarinics, beta-3 adrenoceptor agonists, and 5α-reductase inhibitors in the primary care setting. This consensus by HKGS and HKUA provides a new management paradigm of male LUTS.

Outcome and Cost of Optimal Control of Dyslipidemia in Adults With High Risk for Cardiovascular Disease.

BACKGROUND: We assessed the impact of optimal dyslipidemia control on mortality and costs in adults at high risk for cardiovascular disease (HRCVD). METHODS: We linked Alberta health databases to identify patients aged ≥ 18 years with HRCVD between April 2012 and March 2017. The first HRCVD event was considered the index event. Patients were categorized into (1) optimal control and (2) suboptimal control of dyslipidemia based on biomarkers and lipid-lowering therapy during the year post-index event. We measured the association between optimal dyslipidemia control and mortality and health care costs using difference-in-difference and propensity score-matching methods. RESULTS: The study included 459,739 patients with HRCVD (43,776 [9.5%] optimal patients). The optimal patients were older (median age = 62 vs 55 years; P < 0.001), included fewer female patients (37.7% vs 52%; P < 0.001), and featured a higher proportion of secondary prevention patients (15.7% vs 1.7%; P < 0.001). Compared with suboptimal patients, the optimal patients had lower adjusted mortality (0.7% vs 1.9% at 1-year and 2.9% vs 5.1% at 3-year post-index event; both P < 0.001), and higher adjusted health care costs (CA$3758 and CA$6844 at 1-year and 3-year post-index event, respectively; both P < 0.001). Among the secondary prevention group, the optimal patients had lower adjusted mortality (2.4% and 5% absolute reduction at 1-year and 3-year post-index event, respectively; both P < 0.001) at no additional costs. The results were robust across 5 definitions of optimal dyslipidemia control. CONCLUSIONS: Patients with optimal dyslipidemia control have lower mortality and incur modestly higher costs. However, secondary prevention patients experience lower mortality at no additional costs.

Is there a difference between the thicknesses of the rami in mandibular asymmetry?

The purpose of this retrospective study was to investigate whether the thicknesses of the two rami differ in patients with mandibular asymmetry. Preoperative cone beam computed tomography scans of 78 patients with mandibular asymmetry were assessed for ramus thickness, mandibular length, and mandibular shift. The results showed that the ramus was thinner on the longer side than on the shorter side in 85.9% of the patients. On average, the longer side of the mandible was 2.74mm longer (range 0.07-9.90mm, standard deviation 1.92mm) and 0.55mm thinner (range -0.61 to 2.02mm, standard deviation 0.59mm) than the shorter side (both P<0.001). This study indicates a trend in the discrepancy in ramus thickness between the longer and shorter side of about 8% of the mean thickness of the ramus. Regression analysis showed that for every 1-mm increase in the length of the mandible, the thickness of the superior aspect of the ramus was reduced by 0.041 mm (P=0.009) and the anterior aspect by 0.125 mm (P=0.001). Age and sex did not have a significant influence on the thickness of the mandible. It is concluded that the longer side of the mandible tends to be thinner at the ramus than the shorter side in patients with mandibular asymmetry. The implication of this finding could be important in relation to the sagittal split ramus osteotomy.