In patients with a foreign body seen on plain cervical radiography, presentation delayed for more than 2 days after ingestion, and foreign body impacted at the level of the cricopharyngeus or oesophagus there is a high degree of correlation with the occurrence of complications. Awareness should be raised when these risk factors are present.
Severe acute respiratory syndrome (SARS) is a highly infectious disease, with high potential for transmission to close contacts, particularly among healthcare workers. This is the first systematic study investigating hospital nurses' physical and psychological health status and the kinds of healthcare used-stratified by the level of contact with SARS patients-during the 2003 outbreak in Hong Kong. Nurses in moderate-risk areas appeared to have more stress symptoms than those working in high-risk areas. It is essential to design hospital support systems and occupational health policy to promote the psychological well-being of nurses during future outbreaks of emerging infections.
Hong Kong is one of the most densely built-up and populated cities in the world. An adequate air ventilation at pedestrian level would ease the thermal stress in its humid subtropical climate, but the high-density city severely reduces the natural ventilation. This case study investigates pedestrian level ventilation in two neighbourhoods in Kowloon, downtown Hong Kong using the parallelized large-eddy-simulation (LES) model PALM. The LES technique is chosen here for a city quarter scale pedestrian comfort study despite of its high computational cost. The aims of the paper are a) to get a comprehensive overview of pedestrian level ventilation and a better understanding of the ventilation processes in downtown Hong Kong, b) to test the LES technique on this urban scale compared to the wind tunnel and c) to investigate how numerical/physical parameters influence ventilation. This case study is restricted to neutral stratification in order to allow a direct comparison with the wind tunnel. A sensitivity study quantifies the dependence of site-averaged ventilation on numerical and physical parameters and determines an appropriate urban LES setup for two 1 km 2 neighbourhoods in Kowloon (Tsim Sha Tsui, Mong Kok) that are investigated for prevailing E and SW wind. The results reveal the critical dependence of ventilation on the urban morphology. Air paths, street orientations, ground coverage, sites fronting the water, inter connectivity of spaces, building podium size and building heights can all affect the pedestrian wind environment. Isolated tall buildings may have a pronounced impact on ventilation both locally and downstream.
Enhanced podcasts increase learning, but evidence is lacking on how they should be designed to optimize their effectiveness. This study assessed the impact two learning instructional design methods (mental practice and modeling), either on their own or in combination, for teaching complex cognitive medical content when incorporated into enhanced podcasts. Sixty-three medical students were randomised to one of four versions of an airway management enhanced podcast: (1) control: narrated presentation; (2) modeling: narration with video demonstration of skills; (3) mental practice: narrated presentation with guided mental practice; (4) combined: modeling and mental practice. One week later, students managed a manikin-based simulated airway crisis. Knowledge acquisition was assessed by baseline and retention multiple-choice quizzes. Two blinded raters assessed all videos obtained from simulated crises to measure the students' skills using a key-elements scale, critical error checklist, and the Ottawa global rating scale (GRS). Baseline knowledge was not different between all four groups (p = 0.65). One week later, knowledge retention was significantly higher for (1) both the mental practice and modeling group than the control group (p = 0.01; p = 0.01, respectively) and (2) the combined mental practice and modeling group compared to all other groups (all ps = 0.01). Regarding skills acquisition, the control group significantly under-performed in comparison to all other groups on the key-events scale (all ps ≤ 0.05), the critical error checklist (all ps ≤ 0.05), and the Ottawa GRS (all ps ≤ 0.05). The combination of mental practice and modeling led to greater improvement on the key events checklist (p = 0.01) compared to either strategy alone. However, the combination of the two strategies did not result in any further learning gains on the two other measures of clinical performance (all ps > 0.05). The effectiveness of enhanced podcasts for knowledge retention and clinical skill acquisition is increased with either mental practice or modeling. The combination of mental practice and modeling had synergistic effects on knowledge retention, but conveyed less clear advantages in its application through clinical skills.
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