Introduction: Influenza illness is considered to be associated with high mortality, morbidity and economic loss. Numerous studies and mathematical simulations are conducted to understand the disease pattern, transmission dynamics, and psychosocial response of the population; however, little is known about the health seeking behavior of patients after the onset of respiratory infection symptoms. Respiratory infections exert substantial burden on the health care system of Hong Kong, therefore in addition to detecting the disease early, it is necessary to understand health care utilization behavior of the population. This information will not only benefit to formulate public health policies, it will also improve the preparedness plan to deal with future pandemics. Objective: To examine the influence of factors such as gender, age, education and occupation on the health seeking behavior of Hong Kong citizens and to understand the magnitude of health care utilization by the patients with respiratory infections. Method: This study is based on the data from a large randomized controlled trial of 703 households comprising of 2,586 individuals. Bi-weekly telephone contact was established with these households to assess the health seeking behavioral response of the individuals with respiratory infection episodes separately for laboratory confirmed influenza, and two other clinically defined infection episodes that are influenza like illness (ILI) and acute respiratory infection (ARI) episodes. Descriptive analyses were performed to assess the health care utilization within various health care delivery institutions. Multivariable logistic regression models were applied to determine the association of demographic factors with the health seeking behavior of individuals with respiratory infection episodes. Fischer exact test was used to analyze the association of promptness of health care contact with ARI and ILI episodes. Multivariable logistic regression model was used to analyze the association of demographic factors of ILI patients with early health care contact. Results: The results showed that seeking health care varied by the severity of illness and characteristics of the patients/ parents. As compared with the patients of ARI (non-ILI) episodes, higher proportion of ILI patients sought medical care and among all the health care delivery systems, private health care delivery system was attended by majority of the patients. Individuals with ILI episodes more likely to seek health care were male patients by 66% (Crude OR 1.66; 95% CI 1.01-2.77), and children below 10 years by 219% (Crude OR 3.19; 95% CI 1.30-7.79). Within the group of laboratory confirmed influenza patients, adjusted odds ratio showed male patients 243% more likely to seek health care (Adjusted OR 3.43; 95% CI 1.01-11.63). Unemployed ILI adult patients were less likely to seek medical care (Crude OR 0.39; 95% CI 0.15-0.98), and employed ARI (non-ILI) patients were 52% more likely to attend medical care (Crude OR 1.52; 95% CI 1.10-2.08). Health care contact within 24 hours of onset of symptoms was significantly associated with ILI patients (OR 1.85; 95% CI 1.33-2.59; p-value 0.0003) showing that patients with febrile ARI were more likely to seek early health care rather than patients with afebrile ARI. Conclusion: The differences in the health seeking behavior demonstrated in this study indicate inequalities in the health care services utilization. Higher and earlier utilization of health care services by patients with ILI episodes during low influenza activity period might result in the overburdening of the health care system. In order to address these issues, policy makers should have a clear understanding of populations’ preventive and enabling factors to seek health care, perceptions of the risk of disease, self-care behaviors and health education levels. / published_or_final_version / Public Health / Master / Master of Public Health

Background: Weight misperceptions are common in adolescents and doctors’ advice may help clarify these misperceptions. Few studies have examined how common physicians assess various weight-related factors, including physical measurements, lifestyle factors, and obesity-related medical risks, based on adolescents’ reports and patient characteristics that predict such assessments. Physicians’ weight comments were associated with weight perception in overweight patients, however, such association was unclear in non-overweight adolescents. Objectives: The present study aimed to 1) examine how common adolescents received weight-related factors from private practitioners; 2) identify factors associated with these assessments; 3) assess how common adolescents received weight comments from private practitioners; 4) examine the association of body weight comments by private practitioners with weight perception in adolescents, intention to do more non-exercise physical activity (NEPA), and perceived risk of chronic disease for being overweight. Methods: In the Hong Kong Student Obesity Surveillance (HKSOS) project, 33692 students (44.9% boys; mean age 14.8, SD 1.9 years) from 42 randomly selected schools completed an anonymous questionnaire. The students were asked whether in the past 12 months any private practitioner (or their nurses) had assessed their height, weight, waist circumference (WC), blood pressure (BP), body mass index (BMI), diet, and physical activity. Students were also asked to report any weight status comments received from private practitioners. Perceived risk of chronic disease for being overweight and intention to do more NEPA were also reported. Weight status was based on self-reported weight and height. Multiple imputation was used to replace missing values. Logistic (or ordinal logistic) regression was used to assess the association between student characteristics and assessment of each weight-related factor, and the association of weight comments with adolescent weight perception, perceived risk of chronic disease, and intention to do more NEPA. Results: Among 13283 students who had doctor consultations in the past 12 months, 37.9% received physical measurements or lifestyle enquiries, with weight (20.8%), height (16.8%) and blood pressure (11.5%) being the most common, followed by diet (8.1%), BMI (6.3%), WC (4.6%), and physical activity (4.6%). In general, adolescents who were female, older, underweight or overweight/obese, had parents with higher education level, and had actively asked private practitioners for advice about weight were more likely to receive assessments of weight-related factors. Less than one-fifth (16.8%) of adolescents received height and weight or BMI assessments. Nearly 3 in 10 (28.7%) adolescents reported receiving weight status comments from private practitioners, of which 59.8% were correct. Correct weight status comments were associated with correct weight perceptions among adolescents regardless of weight status. Being told by a private practitioner that one is too fat was positively associated with perceiving higher risk of chronic disease for being overweight in normal weight and overweight adolescents, and more intention to do NEPA in all adolescents. Conclusions: Weight-related factors in adolescents were infrequently assessed by private practitioners in Hong Kong. Generally, unhealthy weight, higher parental education and advice-seeking by adolescents predicted these assessments. Receiving correct weight comments predicted correct adolescent weight perceptions. Practitioners should routinely assess and advise adolescents on weight status. / published_or_final_version / Community Medicine / Master / Master of Philosophy

While regional infrastructures are being actively pursued by the Hong Kong governments in recent years, the impacts brought by the cross-boundary infrastructures have not been comprehensively scrutinized. This study is aimed to fill in the research gap by examining the interrelationships between regional planning, transport planning and real estate economics. As concerns on accessibility and transport convenience are key factors determining the price of a flat, transport improvements made to the residential area should lead to an increase in residential property prices. On the other hand, as regional infrastructures are often justified with their impacts in fostering further economic development, retail rental prices in the service coverage areas should experience positive impacts. Therefore, changes in price gradient of residential properties, and that in transaction prices of commercial properties will be both taken into consideration in understanding the impacts of regional infrastructures. When examining these impacts, an additional dimension will be incorporated to investigate the impacts across the initial stage, planning stage, post-feasibility stage, construction stage as well as the post-project completion stage of the projects. Hedonic pricing models will be applied in this study for assessment. The empirical case will focus on the Hong Kong-Shenzhen Western Corridor (SWC) project and the associated areas of Tin Shui Wai, Yuen Long and Tusen Wan, to obtain the relevant data to understand the interrelationships across the different stages of the SWC project. In the research finding, as far as residential property sales are concerned, it is observed that a general decrease in property prices has been experienced from the commencement of the SWC, as a result of the combination of factors such as construction pollution and catchment problems. While for the retail rental prices within the study scope, a contrasting uprising trend has been instead generally observed, attributed to the differences in the accessibility to the areas and the availability of business opportunities experienced in the focus area during the various stages of the project. The empirical results reveal that cross-boundary cooperation in coordinating time of infrastructural project completion is exceptionally crucial. If the coordination of the infrastructures bridging the two sides of the borders are not coordinated well, the problem of SWC in the early stage of commissioning will happen again, causing the unavailability for areas connected to the border to enjoy the business opportunities, economic and spatial efficiency in the area. Also, the residential property prices may even be driven down by the cross-boundary infrastructure, which is considered to be strategic in fostering economic development and enhancing transport efficiency upon regional integration of the Pearl River Delta cities. Therefore, careful planning and regional coordination are needed to enhance the efficiency of the cross-boundary infrastructure, so as to achieve its objectives to facilitate economic growth, social harmony and environmental sustainability. / published_or_final_version / Urban Planning and Design / Master / Master of Science in Urban Planning

Adolescent gambling has raised concern among the public as it entails an array of significant adverse consequences. With the dramatic expansion of gambling opportunity and the wide acceptance of gambling as a harmless and entertaining activity, the number of adolescents involved with gambling activities has increased. As such, there is growing interest among researchers in studying factors that are associated with adolescents’ gambling behavior. Nevertheless, this important research area has been surprisingly under-studied in Chinese populations, particularly, with adolescent samples. Adolescent gambling has raised concern among the public as it entails an array of significant adverse consequences. With the dramatic expansion of gambling opportunity and the wide acceptance of gambling as a harmless and entertaining activity, the number of adolescents involved with gambling activities has increased. As such, there is growing interest among researchers in studying factors that are associated with adolescents‟ gambling behavior. Nevertheless, this important research area has been surprisingly under-studied in Chinese populations, particularly, with adolescent samples. Three sequential studies with mixed methods were designed to achieve the above objectives. Study I aimed to explore what Chinese adolescents think would happen if they were to gamble. Using focus group discussion, 14 adolescents were interviewed. The results identified multiple themes including material gain, social benefit, enjoyment/arousal, tension/boredom, self-enhancement, relational cost, out of control, monetary loss and behavioral problems. In addition, the item pool of the Chinese Adolescents Gambling Expectancy Scale (CAGES) was also generated from Study I. In Study II three measures were constructed and validated using 258 Chinese adolescents: the Chinese Adolescent Gambling Expectancy Scale (CAGES), the Gambling Subjective Norms Scale (GSNS) and the Chinese version of the Gamblers’ Belief Questionnaire (GBQ-C). The findings of this study indicated sound psychometric properties for all these measures in general, thus justifying their use in Study III. Study III examined the relationships among gambling outcome expectancy, subjective norms about gambling and perceived behavioral control, as proposed by the theory of planned behavior, and gambling behavior among 1218 Chinese adolescents. The findings of this study showed that gambling outcome expectancy had incremental validity to predict both gambling behavior and intention to gamble among Chinese adolescents. Two other well-known constructs, i.e. subjective norms about gambling and perceived behavioral control were also important predictors of gambling behavior as well as intention to gamble among Chinese adolescents. Compared to positive outcome expectancy, subjective norms about gambling and illusion of control, it is noteworthy that negative outcome expectancy and belief in luck/perseverance played a more pivotal role in problem gambling among Chinese adolescents. The theoretical and research contributions and practical implications of this study are discussed along with the limitations and recommendations for future studies. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Teaching competition is a common and standardized practice in mainland China, but until then it is rather new to teachers in Hong Kong. Teaching competition can have dual roles: being an activity for teacher development and as a kind of standard enforcement of teachers’ performances. The primary purpose of this dissertation was to examine the perceptions of teachers in Hong Kong towards teaching competition as a means for staff development. Both quantitative and qualitative methods were used in this research study. A questionnaire containing both multiple choices and open-ended questions was used to collect data anonymously from secondary school teachers in Hong Kong. This study also attempted to explore other areas relating to teaching competition, including teacher collaboration, teaching performance assessment, teacher identity, and teacher standards. The results of this study showed that in general Hong Kong teachers did not reject the idea of using teaching competition as a platform for sharing and developing teaching skills. However, some teachers considered that teaching competition might, to a certain extent, induce tensions among teachers and jeopardize teacher collaboration. Judging teachers’ performances in teaching competition can be considered as a process of assessment. As such, applying theories of assessment could gain better understanding of the judgment itself, maintain fairness of judgment and clear up the misunderstanding of ostentation in teaching competition and non-determinacy of teaching performance. Moreover, the results of judgments in teaching competitions must be correctly interpreted. Judgments accompanied with feedback instead of simply feedouts could serve better for teacher development purpose. Finally, teaching competition could enforce performance standards to teachers. Findings from this research study revealed that recent education reform in Hong Kong would affect teachers’ views on teaching competition. It was argued that teaching competition might be an appropriate means to help teachers establish and re-establishing their discredited professional identity under the cultural change of marketization. / published_or_final_version / Education / Master / Master of Education

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

In the recent decade or so, the phenomenon of enrollment decline of secondary schools has been clearly observed in Hong Kong. The significance of this phenomenon has grown over time such that the number of public sector schools has had to be reduced. Meanwhile, an alternative to school closure is to reduce the class size of schools which is however not less controversial. On the surface, the arguments against class size reduction include perceived extra cost per student and ineffectiveness of small class teaching in secondary schools. Hidden in the agenda of the Government could be, arguably, the political difficulty to reverse such class size reduction trend when the enrollment rebounds eventually. This dissertation reviews how the Government has reacted to the changing situation and developing public concern on the issue, and cautiously evaluates the effectiveness of the Government’s responses. Then, this dissertation explores the literature in public administration in relation to school retrenchment policies, and hence addresses the Hong Kong case accordingly. Finally, recommendations are made along with rationale for the betterment of managing enrollment decline by means of controlled class size subject to a mechanism to be agreed on. In making these recommendations, it is hoped that the policy direction should point to the future, with an aim to look for positive management opportunities while solving problematic phenomenon at the same time. / published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration