Background Non-adherence at psychiatric out-patients clinics has serious impact on clinical and economic outcomes. It is costly to both health care systems and the patients. This study aimed to examine the predictors of treatment adherence in a group of patients with first episode psychosis in Hong Kong. Methods Thirty five patients with psychosis underwent assessment for prospective memory, insight and social support at baseline. Clinical symptoms were also measured. Linear regression was used to identify predictors of treatment adherence at baseline. Actual medication adherence was assessed three months later and multiple linear regression models were used to identify predictors of non-adherence. Results The effects of independent variables age, gender, number of psychiatric hospitalization, and prospective memory were no statistically significant to treatment adherence. But educational level, insight and social support were showed positive correlation with treatment adherence. Conclusions The study demonstrates that treatment adherence is associated with level of education, insight and social support system. These factors are important to assess when trying to estimate the degree of medication adherence and its relationship to clinical presentation. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

The primary focus of this dissertation is to examine how graffiti is emplaced in Hong Kong. Artifactual and contextual photographs have been collected of examples of graffiti and will be considered according to their place in the semiotic aggregate, the facets and foci of thirteen styles of graffiti, and as they represent the inscription site. Geosemiotics, defined as ‘signs in place’, will be utilized to analyze the transgressive nature of graffiti. Gestural routines are also studied as they relate to the body of the graffiti writer acting in space, inscribing place. The subsets of graffiti as it relates to urban and street art is weighed as well as the tools and means at its disposal. An understanding of Hong Kong’s situated cultural experience in negotiating meaning and contesting perception through inhabiting public space made cultural space will be sought in this dissertation. The way in which previous cultural understandings of rock-carving and inscription, as well as a study of the terms as used in Hong Kong can help to illuminate the background of graffiti as it has occurred within Hong Kong and China. Finally, a purposeful look at the active sight of the individual in coming to terms with the language systems in urban spaces can give a nuanced perception of how the material placement of graffiti challenges planned space and provides a ‘street-wise’ aesthetic. / published_or_final_version / English Studies / Master / Master of Arts

This field guide has been carried out to fulfil part of the requirements of my master’s degree in the field of Applied Geosciences at the University of Hong Kong. The project was mainly written from September 2012 to July 2013 under the supervision of Dr. Jason R. Ali. The objective of the study was to produce a simple, easily understood, geological guide of areas on eastern and central Lantau Island. The guide intends to introduce useful, fundamental concepts of geomorphology and geology to everyone who visits the selected study areas. Data has been obtained by a literature survey, interpretation of aerial photographs, use of geological and topographic maps and much fieldwork. The information is presented in the form of a simple field guide divided into four chapters. Chapter 1 is the introduction, while Chapter 2 presents background information of the geology of Lantau Island and Chapter 3 is the actual field guide divided into two areas, east Lantau and central Lantau. Chapter 4 concludes this dissertation. It is concluded that Lantau Island exhibits many interesting landscapes and geological features. This field guide provides convenient and easy to understand information for any person, professional or amateur, having an interest in understanding their surroundings (the physical environment) when visiting Lantau Island. / published_or_final_version / Applied Geosciences / Master / Master of Science

Ineffective and tough parenting has been associated with physical child abuse. Parenting support would be the key component to act as a preventive measure of the problem. The evidenced based parenting intervention has proved to reduce prevalence of child abuse and children behavioural and emotional problems as well. As a result, there is a marked increased international recognition of the value of Positive Parenting Program (Triple P). Triple P is developed at University of Queensland in Australia. It is based on social learning models and proved that is effective, especially on managing early onset of children’s conduct problems by enhancing parental competence. Group Triple P is an intensive level (level 4) of Triple P. It is identified as universal parenting support program. Department of Health of Hong Kong has launched Triple P in 2002. Research was carried out to prove that it was an effective parental intervention on reducing the parental stress and enhancing the martial relationship in HK. The course is delivered by nurses only, named as accredited facilitators. However both incidence rate of child abuse and nurses’ workload are increasing dramatically in recent years. Better distributing the resources should be addressed immediately. In order to enhance the efficiency of the course with limited resources, a new protocol to improving by synthesis of the high level evidenced studies should be proposed. According to the studies’ results, the program design of Group Triple P could be modify into four group sessions instead of eight by cancellation of four telephone sessions. Thus more parents would access to the course as shortening their waiting time with better utilisation of nurses’ manpower. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Psychological distress aroused by stigma may lead to impairments in attentional functioning because it calls attention to the experience of stigma-related stress. Very few studies have actually considered whether stigma could disrupt attentional functioning by serving as distractors with emotional valence in the schizophrenia spectrum, given that there is a possible dysfunctional affective system in response to processing of emotional information. This research employed the paradigm of emotional Stroop task and attentional probe task to investigate how stigma impacts on the functioning of selective attention. The primary objective of this current study was to investigate how selective attention, as measured in terms of reaction time and accuracy, can be disturbed by stigma-related stimuli in schizophrenia patients. The secondary objective of this study was to test the assumption that schizophrenic patients with higher sensitivity towards stigmatization will demonstrate higher impairment of selective attention in relation to stigma-related stimuli, since they may display more intense negative emotions than patients with lower sensitivity. For emotional Stroop task, two categories of stimuli, including stigma-related words (emotional arousing to schizophrenic patients), furniture-related words (neutral stimuli) were shown in different colors and the subjects were instructed to name the color of words as fast and as accurate as possible. For attentional probe task, a stigma-related word was paired up with a furniture-related word in each trial. Participants had to respond as soon as they detect the dot in the position previously occupied by the words. Two groups of participants, healthy controls (N = 40) and patients with schizophrenia-related disorders (N = 40) were compared regarding their performances on emotional Stroop task and attentional probe task. The patients were further split into two groups; high-sensitivity towards stigma (N = 19) and low-sensitivity towards stigma(N = 18),for comparison on various variables, like level of symptoms, depression, medical adherence and awareness of mental disorders. Based on the group comparison of performance on emotional Stoop task, schizophrenic patients exhibited significant emotional interference with the presentations of stigma-related words when compared with the healthy controls. Although the group comparison of performance on attentional probe task did not provide a significant result, schizophrenic subjects obtained higher difference scores which indicated that they were in general displayed more attentional bias towards stigma-related stimuli as compared to furniture-related stimuli. Both emotional Stroop and attentional probe task results show that schizophrenia patients in high-sensitivity subgroup demonstrated the greatest effect of emotional interference with the presentations of stigma-related words. Level of emotional interference for stigma-related stimuli in schizophrenic patients was moderately correlated with the measure of positive symptoms severity, and patients in high-sensitivity group had a significantly higher mean depressive symptoms score than patients in low-sensitivity group. Such information might help to identify potential risk factors and lead to improved treatment and prevention strategies for psychotic patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Human coronaviruses were first discovered in 1960s and believed to be the causative agents of only mild respiratory tract infections. In 2003, the worldwide outbreak of Severe Acute Respiratory Syndrome caused by SARS-CoV had greatly boosted the research interest on coronaviruses. Two more human coronaviruses – HCoV-NL63 and HCoV-HKU1 were then discovered in 2004 and 2005 respectively. Events of recombination between different genotypes had also been detected in HCoV-OC43 and HCoV-HKU1 in natural circulating strains that are causing infections. Creation of novel genotypes is resulted, which may possibly associate with more severe disease. In this study, twenty seven HCoV-NL63 strains in Hong Kong from 2004 to 2012 were included in the investigation. RNA-Dependent RNA Polymerase gene, Spike gene and the Nucleocapsid gene of these strains were sequenced, followed by phylogenetic analysis and bootscan analysis. Antigenic drift from genotype A (in 2004-2006) to B (in 2003-2010) and C (in 2009-2012) were observed. Two local strains clustered with an American strain in all three genes, which the American strain had been formed by recombination between genotype A and C. Five recent strains from 2009 to 2012, along with two Beijing strains, may belong to a potential novel genotype. Two more strains were discovered with atypical genomic profile. Complete genome sequencing would be the further work for clear investigation on their sites of recombination. No clear association between the genotypes and clinical features had been observed. / published_or_final_version / Microbiology / Master / Master of Medical Sciences

The study area of Deep Bay in the Southern China has been recognized as ecologically important site. This study presents a wetland change detection analysis incorporating both geographic information system (GIS) and remote sensing techniques. Both natural and artificial wetlands are considered as part of the Deep Bay wetland system. For instance, mangrove forests, fish ponds and shrimp ponds (gei wai) are all considered as wetlands in this study. This study is to find out how much area of the wetland system has been lost due to the conversion of land cover types in recent decades. In particular, this study uses supervised classification and change detection analysis on the satellite images which were acquired in three different time periods (1975, 1994, and 2009). It is a quantitative result which was based on the numbers of pixel changed on the images. The result shows that 39.76 % of fishpond and 20.47% of mangrove in terms of pixels have been changed to urban or residential area between 1975 and 2009. The result implies both Shenzhen and Hong Kong side of Deep Bay has significant wetland loss in recent decades. Moreover, the Deep Bay in Hong Kong includes an Aerial Photos area change analysis. This study presents three different sets of land use data which was created according to the manual interpretation of aerial photos in three different time periods (1973, 1986, and 2011). The aerial photos mainly focus on the fishpond and mangrove change in recent decades. The qualitative results show that a lot of locations were no longer mapped as wetlands in recent decades. The quantitative results illustrate the total wetland areas in the Hong Kong side of Deep Bay were continuously decreased from 1973 to 2011 by 19.06%. Additionally, the study also presents a change analysis of the nightlight imageries. Previous research found that urban development and the brightness value of nightlight imageries are highly correlated. The study uses two nightlight imageries which were acquired from 1992 and 2009 to examine whether Deep Bay has a rapid increase in urban developments. The result shows that the brightness value has continuously increased during the period with more changes in the western side of the study area. Moreover, the average brightness value of the study area has increased by 17.6%. It can show that there is an increase of urban activities in recent years. Based on the change detection analysis, it can be concluded that urban development such as reclamation is the major threat to the Deep Bay wetland system. Furthermore, there are more changes occurred in the Wetland Conservation Area and Wetland Barrier Area in Hong Kong. Both of them are either close to or around the Ramsar site. The area may not be able to support further wetland loss in the future. This study can definitely provide some information to the government and policy-makers on strategic planning of land use in Deep Bay. Sustainable development in Hong Kong is crucial in balancing the ecology and development of the city. / published_or_final_version / Environmental Management / Master / Master of Science in Environmental Management

Introduction: Sleep-related cognitive and behavioral characteristics play an important role in the maintenance of insomnia. Culture affects individuals’ belief system and behaviors, but few studies have examined how Chinese subjects describe their experiences of insomnia and how they deal with it. This study explored the topic using qualitative and quantitative approaches. Methods: Participants were recruited from the community via advertisements. Their DSMIV diagnosis of primary insomnia for at least 6 months was confirmed by a sleep specialist with the help of the Structured Clinical Interview for DSM-IV and sleep-wake questionnaires. A focus group approach was used to elicit participants’ insomnia experiences. They were also asked to keep a 1-week insomnia experience diary prior to attending the focus group and to complete a set of sleepwake questionnaires, including the 30-item Dysfunctional Beliefs and Attitudes about Sleep Scale after the group meeting. Each focus group comprised 6 to 8 participants. Discussion was led by a facilitator with a pre-determined question route and it was audiotaped, transcribed verbatim, and managed with NVivo software to facilitate coding and analysis. Focus group data collection ceased when data saturation was achieved. All data were fragmented into meaningful units, compared iteratively, and assigned with descriptive codes to condense the emerging meanings. Codes pertaining to the same phenomena were grouped together and a coding framework was built. The findings from the qualitative study were then validated in a quantitative questionnaire survey of a separate group of participants with chronic primary insomnia and good sleepers. Results: A total of 6 focus groups were arranged, involving 31 women and 12 men, with an average age of 51 years. Participants had a mean duration of insomnia of 11.81 years, and an average sleep-diary derived sleep efficiency of 70.57%. There were 16 sub-categories and 4 categories of characteristics. The 16 sub-categories could be grouped under: 1) beliefs regarding the nature and treatment of insomnia, 2) behavioral responses to insomnia, 3) cognitive-emotional and physiological arousal, and 4) emotional experiences associated with insomnia. Significant difference between primary insomniacs and good sleepers was found on 9 out of 14 items of the quantitative scale we developed based on the qualitative study results. Seven items remained significant after Bonferroni correction (p < .003), including 1) puzzlement about cause, 2) realistic sleep expectation, 3) constant search for treatment, 4) nighttime negative emotions and physiological symptoms, 5) heightened vigilance, 6) association of sleep with suffering, and 7) sleep problem not understood by others. Conclusion: The present study serves as the first to use both qualitative and quantitative approaches to identify the subjective experience of Hong Kong Chinese insomnia patients. Questionnaire study confirmed that the identified experience was also found in a separate chronic insomnia sample. It sheds light on tailoring CBT-I for the local population with chronic insomnia. Further research on the efficacy and acceptance of a tailor-made local CBT-I program is needed. / published_or_final_version / Psychiatry / Master / Master of Philosophy

This research aims at examining how the Central People’s Government’s Liaison Office (hereafter CPGLO) exercises political and ideological leadership over three pro-China youth organizations, namely the Youth Branch of the Democratic Alliance for the Betterment and Progress of Hong Kong, the Y. Elites Association and the Federation of the New Territories Youth, through its United Front work in Hong Kong. It particularly looks into how the CPGLO (1) cultivates political connections with these pro-China organizations, and (2) gains its moral and ideological appeal among members of the organizations through patriotism. It compares patriotic discourses constructed by the members of the pro-China organizations with that of the CPGLO, and seeks to show consensus, negotiations and inner contradictions between the two in giving interpretations to various political events. This thesis argues that patriotic United Front is a governing strategy employed by the CPGLO to structure its relationship with the Hong Kong society, and the pro-China organizations function as part of the United Front. Critically drawn upon Antonio Gramsci, Ernesto Laclau and Chantal Mouffe, it also argues that the political relationship between the CPGLO and the pro-China organizations can be described as a hegemonic one. It finds that the CPGLO establishes and sustains political connections with the three pro-China organizations through assisting their establishment, co-opting the core members, serving as their patrons, and so on. It also demonstrates that official patriotism wins its moral and ideological leadership by projecting a collective imaginary called “the Chinese nation”. The collective is portrayed as threatened by antagonistic forces, and it can only survive under the political order established by the Communist party. Finding shows that the respondents from the three pro-China organizations agree with official patriotism at large. They establish the principles of supporting “one-party rule”, “the Socialist road” and “territorial integrity” as the baseline for being “patriotic” in the context of Hong Kong. These political orders are seen as indispensable to the survival of the Chinese nation, and they are not conditioned by any commitment to universal values. By selective recall of myths, traditions and episodes in history, interests associated with the Communist regime are generalized into the interests of the entire nation. Despite resemblance between the patriotic discourses constructed by the respondents and those of the CPGLO, negotiations of meaning and even resistance against top-down political orders can still be observed within these organizations. On certain occasions, the respondents reference to the democratic discourses in their interpretation of specific political events and issues, though the critical elements of these discourses are dismissed at large. / published_or_final_version / Politics and Public Administration / Doctoral / Doctor of Philosophy

There has been a growing interest in promoting active transportation as an effective route to address the issues caused by the heavy reliance on motorized modes. Walking, as a unique form among all types of active transportation mode, is highly accessible and easy to be incorporated into every trip. A number of distinct benefits of walking deserve special mention. Among the whole transport system, walking is a fundamental and integral part linking various elements of trip together, irrespective of public or private modes. Besides, walking offers people an opportunity for regular physical activity that contributes to substantial health benefits. In order to identify how built and social environmental attributes influence on walking, four communities in Hong Kong with different physical and/or social characteristics were selected as case study. First hand data was collected by on-site questionnaire survey, together with objective assessments towards neighborhood walkability and condition of socio-economic disadvantage, the influences of physical and social factors on the level of walking were examined. For the study on walking intensity, individual characteristics including gender and income were found to be better predictors for the level of walking intensity. Among environmental determinants, the perceptions of pedestrians towards neighborhood walkability might be particularly important to predict one’s intensity of walking activity. Besides, positive association was observed between health condition and the level of walking activity. In terms of the study exploring the concordance between perceived and objective walkability, a moderate concordance between dual environmental measurements was found. The results of the study revealed that pedestrians’ perceptions towards neighborhood walkability might be crucial influencing one’s propensity and intensity. / published_or_final_version / Transport Policy and Planning / Master / Master of Arts in Transport Policy and Planning