Lee Tze-fan, Diana. / "April 2000." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 243-266). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Yeung Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 125-138). / Abstracts in English and Chinese; questionnaires also in Chinese. / Acknowledgement --- p.iii / Declaration --- p.iv / List of Tables --- p.v / List of Figures --- p.viii / Abstract --- p.ix / Abbreviation --- p.xiv / Chapter Chapter One --- Introduction / Background --- p.1 / Chapter 1.1 --- Definition / Chapter 1.2 --- Disease Prevalence / Chapter 1.3 --- Associated Disability / Chapter 1.4 --- Treatment-effectiveness / Chapter 1.5 --- Rehabilitation / Chapter Chapter Two --- Hong Kong Situation --- p.56 / Chapter 2.1 --- What is known --- Hong Kong elderly population database / Chapter 2.2 --- Service provision for the elderly in Hong Kong / Chapter Chapter Three --- Methodology --- p.68 / Chapter 3.1 --- Aims / Chapter 3.2 --- Subject and methodology / Chapter Chapter Four --- Results --- p.93 / Chapter 4.1 --- Results at baseline / Chapter 4.2 --- "Trend with time (0,12,48 weeks) between the exercise group and the control group" / Chapter 4.3 --- Results at first follow up (12 weeks) / Chapter 4.4 --- Results at second follow up (48 weeks) / Chapter 4.5 --- Results from baseline to second follow up within the exercise group or within the control group / Chapter Chapter Five --- Discussion --- p.113 / Chapter 5.1 --- Short-term efficacy of pulmonary program / Chapter 5.2 --- Long-term efficacy of pulmonary program / Chapter 5.3 --- The characteristics of pulmonary program / Chapter Chapter Six --- Conclusion --- p.124 / Reference --- p.125 / Appendix The Questionnaire Used in Interviews --- p.139

Background & Objective: Acute gastroenteritis (AG) outbreak in elderly homes is common in Hong Kong, especially during the winter. Although mainly a self-limiting condition, the associated short-term as well as long-term medical and social costs can be extensive. This case-control study aims to investigate the hygienic risk factors related to infectious AG in elderly homes at both institutional and individual levels. Predictor variables under investigation include hand wash practice, infection control practice, routine institutional hygienic practice, food handling practice, and environmental factors such as the home setting, ventilation measures and isolation room setting. / Conclusions: This study found that 'sometimes or never wash hands after toilet' was a significant personal hygienic risk factor for AG transmission. This indicated that toilet may be the most susceptible place and hands are the most susceptible vehicle for AG transmission in Hong Kong elderly homes. A higher percentage of the NOHs had a more frequent routine cleaning practice than the OHs, demonstrating that routine cleaning practice may be an economical and an effective way to prevent AG infection. / Methods: All the elderly homes in the New Territories East were invited to take part in the study. A total of 34 homes and 2,995 residents were recruited in the study sample. The data collection period was from Dec 2007 to May 2009. Cases were notified within one week after a reported AG case, either by a report from the elderly home in question, the weekly check up with the New Territories East Community Geriatric Assessment Teams (NTE CGATs), regular contact with the elderly homes by the research assistant and case referrals from the Accident and Emergency Department from the Prince of Wales Hospital (PWH). One hundred and forty cases and 280 matched controls were recruited. For every AG case reported, two sex and age (within 5 years) and elderly home matched controls were selected. Structured questionnaires were conducted in face-to-face interviews in the elderly homes by trained interviewers. Information about the ventilation and the environmental hygiene of the elderly homes was collected by observation from the research team at the beginning of the study. Descriptive analysis was performed for the characteristics of cases and controls. Multivariate and multilevel logistic regression models were applied and odds ratios (ORs) were calculated for the potential hygienic risk factors. / Results: Multiple conditional logistic regression analysis revealed 'sometimes or never wash hands after toilet' OR:3.09 (95%CI: 1.28 -- 7.42) [ref gp: wash hands every time after toilet] was the major significant risk factor for AG in elderly homes, indicating the possible route of person-to-person transmission. Other significant risk factors included: Self-nutrition evaluation as 'not enough' (OR: 2.07; 95%CI: 1.05 -- 4.06), 'Being hospitalized in past month before the interview' (OR: 2.86; 95%CI: 1.16 -- 7.05), 'Simplified Barthel Index scored <15" (OR: 2.63; 1.06 -- 6.53), and 'Alzheimer's' (OR: 2.75; 95% 1.18 -- 6.40). The institutional hygiene factors were investigated based on the descriptive analysis between the outbreak homes (OHs) and the non-outbreak homes (NOHs). The results indicated that the health worker (HW) to resident ratio was much lower in OHs than NOHs (50% OHs: 1:30-55 vs > 80% NOHs:1:10-29), and a higher percentage of the NOHs had a more frequent routine cleaning practice than the OHs. / Fung, Pui Kwan. / Adviser: Ho Suzanne Sutying. / Source: Dissertation Abstracts International, Volume: 73-02, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 182-206). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

CONCLUSION: A multi-faceted hand hygiene intervention with pocket-sized containers of alcohol-based hand rub was effective in increasing hand rubbing compliance and reducing incidence of total infections requiring hospitalization in elderly LTCFs. Its effect on outbreaks still needs further investigations. The questionnaire developed in this study may be a simple and effective method to assess the attitude and compliance change of the HCWs after implementing a hand hygiene programme. / DESIGN: Clustered randomized controlled trial / INTERVENTIONS: After a 3-month run-in period, we randomized three LTCFs to the treatment and three to the control group. The treatment group received pocket-sized containers of alcohol-based hand rub, education and reminding materials. The control group received basic life support education and workshops. They were followed up for another seven months. We measured the hand hygiene compliance of the HCWs by direct observation and recorded the incidence of infections of the residents from their hospital discharge summaries. / OBJECTIVE: To investigate the effectiveness of a multi-faceted hand hygiene programme with pocket-sized containers of alcohol-based hand rub for infection control in elderly long-term care facilities (LTCFs) / OUTCOMES & DATA ANALYSIS: Primary outcomes were direct observed compliances of hand washing and antiseptic hand rubbing of the HCWs, incidence of infections requiring hospitalization and death rate due to infection of the residents, and outbreaks of the LTCFs. Secondary outcomes were change in hand hygiene attitude and self-reported compliance. / PARTICIPANTS: All health care workers (HCWs) of the LTCFs recruited by snowball sampling. Their job categories were nurses, nursing assistants and physiotherapists. / RESULTS: In the treatment group, the compliance of alcohol-based hand rubbing increased significantly from 1.5% (5/333) to 15.9% (233/1465) (p=0.001) and total compliance increased from 25.8% (86/333) to 33.3% (488/1465) (p=0.01) after intervention. Total incidence of infections decreased from 31 cases in 21,862 resident days (1.42 per 1,000 resident-day (rd)) to 33 cases in 50,441 resident days (0.65 per 1,000 resident-day) (p=0.002) and death rate due to infection decreased from 8 cases in 21,862 resident days (0.37 per 1,000 rd) to 5 cases in 50,441 resident days (0.1 per 1,000 rd) in the treatment group (p=0.01). Pneumonia significantly decreased by 0.63 per 1000 rd (p=0.001). In the control group, there were no changes in both antiseptic hand rubbing and hand washing. The total incidence of infections increased from 0.49 to 1.04 per 1000 rd (p=0.004) and no change in death rate due to infection (p=0.45). No outbreaks of influenza and norovirus occurred during the whole study in both groups. / SETTING: Six LTCFs for the elderly / The attitude of antiseptic hand rubbing on infection control increased significantly in the treatment group but there was no change under different situations in the control group. The self-reported compliance of antiseptic hand rubbing increased significantly in the treatment group. There were no changes on the self-reported compliances in the control group. The agreement of the direct observed results and the self-reported compliances was 75% (kappa coefficient = 0.5). / Yeung, Wing Kin. / Adviser: Tze Wai Wong. / Source: Dissertation Abstracts International, Volume: 73-06, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 100-106). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.