Open space office: A review of the literature and Hong Kong case studies.

BACKGROUND: Open plan or open space office has become increasingly popular but those who promote the concept seldom refer to health studies or workers' perceptions of a change in office layout towards an open space arrangement. OBJECTIVE: To review the literature on open plan or open space office layouts in terms of facilities management (FM) with users' perceptions in mind and to obtain opinions of users of open space offices for a better appreciation of the FM issues. METHODS: A literature search of research papers from 2007 in journals using the keywords "open plan office" and "open space office" plus "health", first in the titles then in the text, was carried out. Thirty-two of those papers, accessible by the authors' institutions, were consulted together with 5 other works in the Harvard Business Review. The review consulted but excluded papers and reports published or sponsored by commercial firms that were in favour of open space layouts. Case studies were conducted by face to face meetings in confidence with workers in the middle managements of twelve Hong Kong organisations known as friends to two of the authors. Problems as seen by staff are reported and discussed. RESULTS: The literature review reveals that apart from writing that promotes the use of an open plan office layout, a host of scientific works point to the problems of perceived dissatisfaction with such a layout, the nature of the dissatisfaction tending to depend on the actual design. Most workers interviewed disliked the new style open plan layouts, which points to the necessity of consulting workers when such changes are contemplated, as well as monitoring the results of the change once it is in place whether against workers' wishes or with their support. There is a need for a number of facility arrangements in making a change to open plan that ensures that worker needs for proper lighting, privacy, and indoor health will be met. CONCLUSIONS: If the aim of a change to an open plan arrangement is to promote collegial communications in office, the study sheds light on the extent to which such arrangements may not in practice be suitable for achieving the aim. It follows that further, more specifically sociological studies of workers' job satisfaction and emotional health in open plan office settings would be worth doing.

Persistent organic pollution characterization of sediments in Pearl River estuary.

As a byproduct of rapid urbanization and industrial development in the Pearl River estuary of South China, excessive release of various types of persistent toxic substances were conveyed from agricultural, industrial and municipal discharges at upstream section down into the estuary largely via various river outlets. In this paper, a persistent organic pollution (POP) characterization of sediments in the estuary is undertaken. More than one bioavailable toxicants are detected to play active roles in causing toxicity of marine sediments in the estuary. POPs may be transported for long distances to the downstream end of the Pearl River delta region. The data suggests that DDT might still be applied illegally within the region recently and that the prevalent levels of DDTs and HCHs in sediments are likely to pose detrimental biological effects on benthic organisms. The findings have significant implications in order to understand the environmental changes, to determine reasonable ways for future development, and to maintain a sustainable environment in the Pearl River estuary region.

Characterization of transboundary POP contamination in aquatic ecosystems of Pearl River delta.

During the past two decades, the rapid development of the Pearl River delta leads to substantial accumulation of various toxic organic compounds. This study aims to give a preliminary characterization of the existing state of contamination in this region and to provide insight into the possible fate of persistent organic pollutants (POPs) in this estuary. The available data on POPs in water, river, estuarine sediments, soil, and marine organisms within the Pearl River delta are compiled. It is shown that it may lead to transboundary POP pollution problems at both Hong Kong and Macau Special Administration Regions located at the downstream end of the region. It is noted that the levels of DDTs and HCHs in various environmental media are at alerting levels and that fresh DDT might still be applied illegally within the region. A systematic research is required to determine both the temporal and spatial variations of all POPs in various carrying media of the Pearl River delta as a whole.

An unsteady three-dimensional eutrophication model in Tolo harbour, Hong Kong.

The eutrophication phenomenon often leads to undesirable water quality. This paper delineates an unsteady three-dimensional finite difference numerical model for eutrophication dynamics in the coastal waters of Tolo harbour, Hong Kong, employing the numerically generated, boundary-fitted, orthogonal curvilinear grid system as well as a grid "block" technique. It models the transport and interaction of nine water quality constituents. Adjustments of values of some kinetic coefficients in the model are effected through calibration with field data. It is demonstrated that the model can reasonably reproduce the interactions amongst all the water quality constituents, the eutrophication processes and, in particular, the featured bottom water anoxic condition during the summer in Tolo harbour.

Investigation on effects of aggregate structure in water and wastewater treatment.

The fractal structure and particle size of flocs are generally recognized as the two most crucial physical properties having impact on the efficiency of operation of several unit processes in water and wastewater treatment. In this study, an experimental investigation is undertaken on the effect of aggregate structure in water and wastewater treatment in Hong Kong. The fractal dimension of the resulting aggregate is employed as a measure of the aggregate structure. Small angle light scattering technique is used here. Different amounts of polymers are mixed to bacterial suspensions and the resulting structures are examined. The addition of polymer may foster aggregate formation by neutralization of the bacterial surface charge and enhance inter-particle bridging. The aggregation behavior may affect the efficiency of certain water and wastewater treatment processes such as dewatering and coagulation. The impacts of aggregate structure on two representative processes, namely, ultra-filtration membrane fouling and pressure filter dewatering efficiency, are studied. It is found that the looser flocs yield a more porous cake and less tendency to foul whilst more porous filter cakes yield more ready biosolids dewatering.

Simulation of transboundary pollutant transport action in the Pearl River delta.

The rapid economic development in The Pearl River delta region (PRDR) has exerted serious potential pollution threats to areas in the vicinity, which have complicated the task of environmental protection in Hong Kong and Macau. In this paper, a three-dimensional numerical pollutant transport model coupled with a synchronised numerical hydrodynamic model, is developed and employed to simulate the unsteady transport of a representative water quality variable chemical oxygen demand in The Pearl River Estuary. It is demonstrated that there exists a transboundary pollutant transport action between Guangdong Province and Hong Kong for the pollutants in the wastewater discharged from PRDR.

Clinical risk factors for obstructive sleep apnoea in children.

OBJECTIVE: To identify the clinical factor(s) that identify obstructive sleep apnoea syndrome (OSAS) in children. METHODS: A prospective study of children referred to the sleep clinic of the paediatric department was conducted in a public non-teaching regional hospital in Hong Kong. A standard questionnaire was administered and overnight sleep polysomnography was performed in a consecutive series of patients. Logistic regression analysis was performed to obtain significant risk factors for prediction of OSAS in this series of patients. RESULTS: Sixty-two children were enrolled into the study and 22 were diagnosed to have OSAS. Logistic regression analysis showed that, among all the answers, 'snoring every night' is the single most significant risk factor (p<0.0001) to predict OSAS. 'Snoring every night' has a sensitivity of 91% and specificity of 75% for OSAS patients. It also has a positive predictive value of 67% and negative predictive value of 94%. CONCLUSION: Snoring every night is an important risk factor in identifying OSAS in children. Priority for an overnight sleep polysomnogram should be given to those with this symptom.

Two-layered, 2D unsteady eutrophication model in boundary-fitted coordinate system.

The decline of water quality in Tolo Harbour in recent years is an example of eutrophication. This paper delineates a robust unsteady two-layered, 2D finite difference numerical model for eutrophication in coastal waters. The modelling is based upon the numerically generated boundary-fitted orthogonal curvilinear grid system and integrated with a hydrodynamic model. It simulates the transport and transformation of nine water quality constituents associated with eutrophication in the waters, i.e. three organic parameters (carbon, nitrogen and phosphorus), four inorganic parameters (dissolved oxygen, ammonia, nitrite + nitrate and orthophosphate), and two biological constituents (phytoplankton and zooplankton). Key kinetic coefficients are calibrated with the field data. The hydrodynamic, pollution source and solar radiation data in the model are real-time simulated. The computational results show that the present model mimic the stratification tendency for eutrophication phenomena during summer time in the Tolo Harbour successfully. The model running time for the long-term simulation is not excessive and it can be run on a microcomputer.

Three-dimensional pollutant transport model for the Pearl River Estuary.

In this paper, the development and implementation of a three-dimensional, numerical pollutant transport model, which is based on an orthogonal curvilinear coordinate system in the horizontal direction and a sigma coordinate system in the vertical direction, is delineated. An efficient as well as simple open boundary condition is employed for pollutant transport in this mathematical model. It is then applied to model the distribution and transport of Chemical Oxygen Demand in the Pearl River Estuary. The results from the numerical simulations illustrate that the transboundary or inter-boundary effects of pollutants, between the Guangdong Province and the Hong Kong Special Administrative Region due to the wastewater discharged from the Pearl River Delta Region, are quite strong.

Habitual snoring and sleep bruxism in a paediatric outpatient population in Hong Kong.

OBJECTIVE: To determine the prevalence of habitual snoring and sleep bruxism in children attending the out-patient clinics of a paediatric department. METHODOLOGY: A cross-sectional survey of parents was conducted with questionnaire administered by paediatric nurses. Parents were recruited when they brought their children to the out-patient clinics. Sex and age were recorded. Presence and absence of habitual snoring and sleep bruxism were noted. Types of diseases that brought the children to the out-patient clinics were also noted. RESULTS: Twenty-nine of the 200 recruited children were noted to have habitual snoring (14.5%, 95% C.I. 10%-20%). The mean age of these habitual snorers was 6.2 +/- 3.1 years. For habitual snorers, male to female ratio was 1.4 to 1. Sixteen of these 28 children accepted a sleep polysomnographic examination. Eleven children were found to have snoring during the night of study. Two were found to have obstructive sleep apnoea syndrome. Sleep bruxism was found in 17 children (8.5%, 95% C.I.5%-13%). Sleep bruxism was closely related to habitual snoring as 16 out of the 17 children with sleep bruxism were also habitual snorers (p < 0.0001). CONCLUSION: Habitual snoring and sleep bruxism were commonly found in children attending paediatric clinics. Paediatricians should be aware of these problems and be prepared to deal with them. Habitual snoring and sleep bruxism were closely related. Further studies into this relationship is needed.

Nocturnal enuresis and obstructive sleep apnoea in two children.

Nocturnal enuresis was a symptom of childhood obstructive sleep apnoea, OSAS. We reported two children with secondary nocturnal enuresis which disappeared after tonsillectomy and adenoidectomy for proven OSAS. Pathogenesis of secondary nocturnal enuresis in OSAS was discussed.

The architectural transcription factor high mobility group I(Y) participates in photoreceptor-specific gene expression.

The nonhistone chromosomal proteins high mobility group I(Y) [HMG I(Y)] have been shown to function as architectural transcription factors facilitating enhanceosome formation on a variety of mammalian promoters. Specifically, they have been shown to act as a "molecular glue" mediating protein-protein and protein-DNA contacts within the enhanceosome complex. HMG I(Y) proteins are expressed at high levels in embryonic and transformed cells and have been implicated in transcriptional regulation in these cells. Terminally differentiated cells, however, have been reported to express only minimal, if any, HMG I(Y). In contrast to these observations, we show here that adult mouse retinal photoreceptors, which are terminally differentiated cells, express high levels of these proteins. Using retinoblastoma cells as an approximate model, we further demonstrate in transiently transfected cells that inhibition of HMG I(Y) expression and mutation of HMG I(Y) binding sites significantly reduce rhodopsin promoter activity. DNase I footprint analysis indicates that HMG I protein interacts with a discrete site within the rhodopsin proximal promoter. This site overlaps with the binding site for Crx, a paired-like homeodomain transcription factor that is essential for photoreceptor functioning and that when mutated causes several forms of human photoreceptor degeneration. Both biochemical and functional experiments demonstrate that HMG I(Y) physically associate with Crx and that their interaction with DNA is required for high-level transcription of the rhodopsin gene. These data provide the first demonstration that HMG I(Y) can be important for gene activation in terminally differentiated cells.

A randomized controlled trial of azithromycin and amoxycillin/clavulanate in the management of subacute childhood rhinosinusitis.

OBJECTIVE: Subacute childhood rhinosinusitis is a disorder commonly seen in children with allergic rhinitis. Antibiotics have been recommended as a major component of the treatment regime. The objective of the present study was to compare the effectiveness of a 3-day course of azithromycin and a 2-week course of amoxycillin/clavulanate in the treatment of subacute childhood rhinosinusitis. METHODOLOGY: A randomized single-blinded control study of subacute rhinosinusitis was conducted, comparing a 3-day course of azithromycin and a 2-week course of amoxycillin/clavulanate. Inclusion criteria were children aged between 5 and 16 years, duration of nasal blockage or discharge between 30 and 120 days, and abnormal sinus radiographs. All enrolled children were prescribed budesonide nasal spray (Rhinocort Aqua Nasal Spray, Astra Pharmaceuticals, Sodertalje, Sweden) as adjuvant treatment. RESULTS: Forty-two children were recruited into the study and one defaulted on follow-up. Failure occurred in 6 of 20 for the azithromycin group and 5 of 21 for the amoxycillin/clavulanate group. The odds ratio was 1.46 (95%CI 0.37-5. 80, P = 0.73). No relapse occurred in azithromycin group and 5 of 21 in amoxycillin/clavulanate group. The odds ratio was 0.16 (95%CI 0. 017-1.51, P = 0.18). Both antibiotics were well tolerated, however, two children, one from each group, complained of mild transient epigastric discomfort. CONCLUSIONS: This small study did not provide evidence of a difference between 14 days of amoxycillin/clavulanate and 3 days of azithromycin. Larger studies will be needed to determine which, if any, antibiotic regimen should be used in treating subacute childhood rhinosinusitis.

Use of montelukast in the treatment of early childhood wheezing from clinical experience with three cases.

Leukotrienes were found to be raised in respiratory syncytial virus bronchiolitis. Montelukast is a cysteinyl leukotrienes antagonist. We report our experience with the use of montelukast in three young children from 5-months to 20-months old. The first case was a 5-month-old boy with previous good health. He had prolonged respiratory distress secondary to adenovirus type 3 infection. The second case was a 20-month-old boy with bronchopulmonary dysplasia. He had respiratory syncytial virus and an adenovirus type 3 infection leading to prolonged wheeze. The third case was a 20-month-old girl with chronic lung disorder after an episode of severe E. coli pneumonia at 1 month old. She developed acute virus-negative severe wheeze after a few days of running nose and low-grade fever. All three cases responded poorly to inhaled steroids and bronchodilators. Addition of montelukast was associated with marked clinical improvement within 1 week. The three cases were very heterogeneous and differed from usual simple virus-induced acute bronchiolitis. The use of multiple drugs including montelukast did not enable any definite conclusions; however, the addition of montelukast was closely related to clinical improvement. Further studies in the use of montelukast in severe virus-induced bronchiolitis are warranted.

Neonatal Marfan syndrome: a case report.

A case of neonatal Marfan syndrome is presented. The patient was noted to have cardiomegaly and tricuspid regurgitation on antenatal ultrasound scan. She was born with long, slender fingers and toes, an aged appearance and non-paralytic hypotonia. Echocardiogram revealed a dilated right atrium, right ventricle, dysplastic tricuspid valve and severe tricuspid regurgitation. She subsequently died of severe heart failure. Post-mortem examination showed the pathological features of lobar emphysema and cystic medial necrosis of the aorta. These features supported the diagnosis of neonatal Marfan syndrome. Nucleotide sequencing showed substitution of G by A at codon 1032 in exon 25 located in the long arm of chromosome 15. This resulted in the substitution of a cysteine by a tyrosine. A de novo mutation is suggested by the absence of affected family members.