Translocal imagination of Hong Kong connections: the shifting of Chow Yun-Fat's star image since 1997

Anyone who is interested in Hong Kong cinema must be familiar with one name: Chow Yun-fat (b. 1955). He rose to film stardom in the 1980s when Hong Kong cinema started to attract global attention beyond East Asia. During his early screen career, Chow established a star image as an urban citizen of modern Hong Kong through films such as A Better Tomorrow/Yingxiong bense (John Woo, 1986), City on Fire/Longhu fengyun (Ringo Lam, 1987), All About Ah-Long/A Lang de gushi (Johnnie To, 1989), God of Gamblers/Du shen (Wong Jing, 1989), and Hard Boiled/Lashou shentan (John Woo, 1992)

Factors Associated with Pharmaceutical Venous Thromboembolism Prophylaxis in Hospitalized Surgical Patients.

Despite evidence that venous thromboembolism (VTE) is one of the most preventable causes of death, pharmaceutical prophylaxis is underused. It is unclear why such evidence-based risk assessment and treatment is often omitted or delayed. One unexamined factor is nursing’s role in the administration of prophylaxis, and the nursing work environment. This study applied a theoretical framework of situational awareness, recognized by high reliability organizations (HROs) as a critical component in daily operations, to an important problem: VTE prophylaxis. This retrospective cohort study, utilizing data from the Michigan Surgical Quality Collaborative (MSQC), the electronic medical record, and the staffing system, aimed to examine environmental factors associated with 1) the administration of pharmaceutical VTE prophylaxis, 2) VTE occurrences, and 3) other postoperative occurrences. The sample included patients from a single institution in the MSQC database who were hospitalized for at least 24 hours and remained on the same unit (N=1,370). Correlations and logistic regressions were used to analyze the data. Nearly one-third of patients experienced an error. Significant predictors included VTE risk score, the difference between actual and budgeted RN hours per patient day (RN HPPD), census, workload, education, and unit type, all in expected directions. As the gap in RN HPPD decreased, patients were 12.4% more likely to receive prophylaxis. Patients were less likely to receive prophylaxis as nursing workload increased. The more baccalaureate-prepared nurses on the unit, the more likely patients received prophylaxis; a 1% increase corresponded to a 4% decrease in patients not receiving necessary prophylaxis. Patients admitted to surgical units were four times more likely to receive the prophylaxis. Patients who received prophylaxis were less likely to have a VTE occurrence. This is the first study to examine the environmental factors of situational awareness and patient outcomes. Situational awareness is recognized as a contributing factor in HROs to manage and reduce risk. Future work is needed to extend this research and contribute to an understanding of how the nursing work environment impacts patient outcomes in a high reliability organization. The findings from this study have potential to extend our understanding of the complex work in nursing.PhDNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/120647/1/arenard_1.pd

Citizen science for observing and understanding the Earth

Citizen Science, or the participation of non-professional scientists in a scientific project, has a long history—in many ways, the modern scientific revolution is thanks to the effort of citizen scientists. Like science itself, citizen science is influenced by technological and societal advances, such as the rapid increase in levels of education during the latter part of the twentieth century, or the very recent growth of the bidirectional social web (Web 2.0), cloud services and smartphones. These transitions have ushered in, over the past decade, a rapid growth in the involvement of many millions of people in data collection and analysis of information as part of scientific projects. This chapter provides an overview of the field of citizen science and its contribution to the observation of the Earth, often not through remote sensing but a much closer relationship with the local environment. The chapter suggests that, together with remote Earth Observations, citizen science can play a critical role in understanding and addressing local and global challenges

Situational awareness within objective structured clinical examination stations in undergraduate medical training - a literature search

Background: Medical students may not be able to identify the essential elements of situational awareness (SA) necessary for clinical reasoning. Recent studies suggest that students have little insight into cognitive processing and SA in clinical scenarios. Objective Structured Clinical Examinations (OSCEs) could be used to assess certain elements of situational awareness. The purpose of this paper is to review the literature with a view to identifying whether levels of SA based on Endsley's model can be assessed utilising OSCEs during undergraduate medical training. Methods: A systematic search was performed pertaining to SA and OSCEs, to identify studies published between January 1975 (first paper describing an OSCE) and February 2017, in peer reviewed international journals published in English. PUBMED, EMBASE, PsycINFO Ovid and SCOPUS were searched for papers that described the assessment of SA using OSCEs among undergraduate medical students. Key search terms included "objective structured clinical examination", "objective structured clinical assessment" or "OSCE" and "non-technical skills", "sense-making", "clinical reasoning", "perception", "comprehension", "projection", "situation awareness", "situational awareness" and "situation assessment". Boolean operators (AND, OR) were used as conjunctions to narrow the search strategy, resulting in the limitation of papers relevant to the research interest. Areas of interest were elements of SA that can be assessed by these examinations. Results: The initial search of the literature retrieved 1127 publications. Upon removal of duplicates and papers relating to nursing, paramedical disciplines, pharmacy and veterinary education by title, abstract or full text, 11 articles were eligible for inclusion as related to the assessment of elements of SA in undergraduate medical students. Discussion: Review of the literature suggests that whole-task OSCEs enable the evaluation of SA associated with clinical reasoning skills. If they address the levels of SA, these OSCEs can provide supportive feedback and strengthen educational measures associated with higher diagnostic accuracy and reasoning abilities. Conclusion: Based on the findings, the early exposure of medical students to SA is recommended, utilising OSCEs to evaluate and facilitate SA in dynamic environment

Racial, Ethnic, and Sex Diversity in Academic Medical Leadership

IMPORTANCE: For the past 50 years, significant gaps have existed in gender and racial diversity across various medical specialties, despite the many benefits of a diverse physician workforce. One proposed approach to increasing diversity is top-down diversification, in which diverse leadership results in increased minority and female workforce representation. OBJECTIVE: To investigate the changes in academic medical leadership diversity from 2007 to 2019 and to assess the recent leadership diversity of various specialties compared with the averages across all specialties. DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional analysis of physicians in varying academic roles in 2007, 2019, and 2020. Demographic data were collected via specialized reports from the Association of American Medical Colleges. Included were 4 primary care specialties (internal medicine, family medicine, pediatrics, obstetrics/gynecology [OB/GYN] and 4 surgical specialties (orthopedic surgery, neurologic surgery, otolaryngology [ENT], general surgery). Study participants were faculty, program directors, and chairpersons. Data were analyzed for the years 2007, 2019, and 2020. INTERVENTION: Self-reporting of demographic information to residency programs collected via the Graduate Medical Education Track Survey. MAIN OUTCOMES AND MEASURES: Proportions of each race/ethnicity and sex among cohorts of participants and comparisons between them. RESULTS: The total number of individuals investigated included 186 210 faculty from 2019 (79 441 female [42.7%]), 6417 program directors from 2020 (2392 female [37.3%]), 1016 chairpersons from 2007 (89 female [8.8%]), and 2424 chairpersons from 2019 (435 female [17.9%]). When comparing chairperson diversity from 2007 to 2019, only internal medicine and general surgery experienced significant increases in minority (aggregate category used throughout the investigation to refer to anyone who self-identified as anything other than non-Hispanic White) representation (90% increase [11.7 percentage points, from 13.0% in 2007 to 24.7% in 2019]; P = .01 and 96% increase [13.0 percentage points, from 13.5% in 2007 to 26.5% in 2019]; P \u3c .001), respectively; meanwhile, several specialties saw significant increases in female representation during this period (family medicine by 107.4%, P =.002; pediatrics by 83.1%, P =.006; OB/GYN by 53.2%, P =.045; orthopedic surgery by +4.1 percentage points, P =.04; general surgery by 226.9%, P =.005). In general, surgical specialties had lower leadership diversity than the average diversity of all residency programs, whereas primary care specialties had similar or increased diversity. CONCLUSIONS AND RELEVANCE: Study results suggest that some specialties have made significant contributions toward bridging diversity gaps whereas others continue to lag behind. Our recommendations to improve academic medical leadership diversity include programs and institutions (1) publishing efforts and outcomes of diversity representation, (2) incorporating a representative demographic for leadership selection committees, and (3) actively promoting the importance of diversity throughout the selection process

Exploring Ethical Development from Standard Instruction in the Contexts of Biomedical Engineering and Earth Science

Ethics continues to be required in the accreditation of engineers. However, ethics is seldom the core focus of departmental instruction. Yet, standard instruction may have myriad impacts on students' ethical development. This study explores students’ ethical formation when ethics is a peripheral or non-intentional aspect of instruction in departmental courses in Biomedical Engineering and Earth Science. The research question that we seek to address is, “In what different ways and to what extent does participation in departmental engineering and science courses cultivate STEM students’ ethical formation?” To address our research question, we disseminated a survey to students before (pre) and after (post) their participation in one of 12 courses offered in Earth Science or Biomedical Engineering during the Fall 2017 or Spring 2018. The survey included four instruments: (1) the Civic-Minded Graduate scale; (2) the Interpersonal Reactivity Index; (3) two relational constructs developed by the authors; and (4) the Defining Issues Test-2. Results suggest that current Earth Science curriculum, overall, positively contributes to students' ethical growth. However, the Biomedical Engineering courses showed no evidence of change. As the Earth Science courses do not explicitly focus on ethics, one potential explanation for this trend is the community-engaged nature of the Earth Science curriculum. These findings will be beneficial locally to help direct improvements in departmental STEM instruction. In addition, these findings pave the way for future comparative analyses exploring how variations in ethical instruction contribute to students' ethical and professional formation. © 2019 American Society for Engineering Educatio

Heart rate and swimming activity as indicators of post-surgical recovery time of Atlantic salmon (Salmo salar)

BackgroundFish telemetry using electronic transmitter or data storage tags has become a common method for studying free-swimming fish both in the wild and in aquaculture. However, fish used in telemetry studies must be handled, anaesthetised and often subjected to surgical procedures to be equipped with tags, processes that will shift the fish from their normal physiological and behavioural states. In many projects, information is needed on when the fish has recovered after handling and tagging so that only the data recorded after the fish has fully recovered are used in analyses. We aimed to establish recovery times of adult Atlantic salmon (Salmo salar) after an intraperitoneal tagging procedure featuring handling, anaesthesia and surgery.ResultsBased on ECG and accelerometer data collected with telemetry from nine individual Atlantic salmon during the first period after tagging, we found that heart rate was initially elevated in all fish and that it took an average of approximate to 4 days and a maximum of 6 days for heart rate to return to an assumed baseline level. One activity tag showed no consistent decline in activity, and two others did not show strong evidence of complete recovery by the end of the experiment: baseline levels of the remaining tags were on average reached after approximate to 3.3 days.ConclusionOur findings showed that the Atlantic salmon used in this study required an average of approximate to 4 days, with a maximum interval of 6 days, of recovery after tagging before tag data could be considered valid. Moreover, the differences between recovery times for heart rate and activity imply that recovery time recommendations should be developed based on a combination of indicators and not just on e.g. behavioural observations

Environmental aspects of the transuranics: a selected, annotated bibliography

This bibliography of 500 references is compiled from the Data Base on the Environmental Aspects of the Transuranics built to provide information support to the Nevada Applied Ecology Group (NAEG) of ERDA`s Nevada Operations Office. The general scope is environmental aspects of uranium and the transuranic elements, with emphasis on plutonium. Laboratory and field studies dealing with the effects of plutonium-239 on animals are highlighted in this bibliography. Supporting information on ecology of the Nevada Test Site and reviews on the effects of other radionuclides upon man and his environment has been included at the request of the NAEG. The references are arranged by subject category with first authors appearing alphabetically in each category. Indexes are given for author, geographic location, keywords, taxons, permuted title and publication description

Traditions of research into interruptions in healthcare: A conceptual review

Background Researchers from diverse theoretical backgrounds have studied workplace interruptions in healthcare, leading to a complex and conflicting body of literature. Understanding pre-existing viewpoints may advance the field more effectively than attempts to remove bias from investigations. Objective To identify research traditions that have motivated and guided interruptions research, and to note research questions posed, gaps in approach, and possible avenues for future research. Methods A critical review was conducted of research on interruptions in healthcare. Two researchers identified core research communities based on the community’s motivations, philosophical outlook, and methods. Among the characteristics used to categorise papers into research communities were the predominant motivation for studying interruptions, the research questions posed, and key contributions to the body of knowledge on interruptions in healthcare. In cases where a paper approached an equal number of characteristics from two traditions, it was placed in a blended research community. Results A total of 141 papers were identified and categorised; all papers identified were published from 1994 onwards. Four principal research communities emerged: epidemiology, quality improvement, cognitive systems engineering (CSE), and applied cognitive psychology. Blends and areas of mutual influence between the research communities were identified that combine the benefits of individual traditions, but there was a notable lack of blends incorporating quality improvement initiatives. The question most commonly posed by researchers across multiple communities was: what is the impact of interruptions? Impact was measured as a function of task time or risk in the epidemiology tradition, situation awareness in the CSE tradition, or resumption lag (time to resume an interrupted task) in the applied cognitive psychology tradition. No single question about interruptions in healthcare was shared by all four of the core communities. Conclusions Much research on workplace interruptions in healthcare can be described in terms of fundamental values of four distinct research traditions and the communities that bring the values and methods: of those research traditions to their investigations. Blends between communities indicate that mutual influence has occurred as interruptions research has progressed. It is clear from this review that there is no single or privileged perspective to study interruptions. Instead, these findings suggest that researchers investigating interruptions in healthcare would benefit from being more aware of different perspectives from their own, especially when they consider workplace interventions to reduce interruptions