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VR training system for older adults with cognitive frailty

Cognitive frailty is characterised by the presence of both physical frailty and cognitive impairment, which is a common clinical syndrome among community-dwelling older people. To help those older adults maintain their cognitive functions and simultaneously improve their motor abilities for carrying out activities of daily living, Dr Rick Kwan (principal Investigator) and his team* collaborated with Pok Oi Hospital to develop the Virtual Reality (VR) Motor-Cognitive Game-based Training System and a study was carried out to evaluate its effectiveness. The VR system was funded by the Innovation and Technology Fund for Better Living, the Innovation and Technology Bureau with HK$ 2.9 million. The system provides virtual space mimicking real environments, such as simulated road conditions in Hong Kong. When users put on the wireless VR headset, they are taken on a journey to complete tasks of activities of daily living. Following the on-screen instructions and by riding on the ergometer exercise bike, players ‘walk’ around streets to reach a shop or a supermarket to buy daily commodity by themselves, or ‘walk’ to a bus stop and travel to different destinations. The VR training system provides 16 levels of tasks with increasing difficulties to enhance the cognitive functions of players. The resistance level of the ergometer exercise bike can also be adjusted corresponding to the training need. Players have to attend two (30-minute each) VR sessions per week for a total of eight-week for achieving health benefits. Seventeen older adults with cognitive frailty from one elderly centre under Pok Oi Hospital were recruited to participate in the pilot study. Those in the intervention group receiving the VR training showed a significant improvement in cognitive function, including calculation, memory, reaction and attention, than their controlled counterparts, who received motor and cognitive training separately (each session included a 15-minute cycling and 15-minute cognitive tablet games or newspaper reading). ‘The players can apply the skills they have learnt in the VR game to their daily lives,’ said Dr Kwan. The research team aims at applying the VR system to a total of 648 elderly by the end of next year (2022). They also hope to develop a multiplayer mode that includes more tasks such as babysitting their grandchildren. Click here to see the demonstration of our VR motor-cognitive training system. *Co-investigators include Prof. Kenneth Fong, Professor, PolyU’s Department of Rehabilitation Sciences; Dr Justina Liu, Dr Harry Qin, Associate Professors, and Dr Claudia Lai, Honorary Professor; Ms Lydia Suen and Ms Man-kei Tse, Research Associates, School of Nursing, PolyU. 

8 Sep, 2021

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New AI system provides a convenient way to detect dementia risk

Dr Thomas Choi, Professor, (Principle Investigator) and his team* announced to the public the development of an artificial intelligence (AI) system that automates the assessment of the risk of dementia with an average precision of up to 88% at a press conference held in May. Prof Choi and Dr Xiao Shen, (Postdoctoral Fellow, left the School in 2021) a key developer of the AI algorithm, have applied a patent for the system in the United States. Currently about 35% of dementia cases are attributed to risk factors, such as hypertension, obesity, depression, and smoking. Dementia risk is also associated with many non-cognitive conditions, such as cardiovascular conditions, nutrition, mobility, and depression. Early detection of people with high risk of dementia enables early modification of lifestyle, timely diagnosis and intervention. Health care professionals around the globe commonly use the Mini-Mental State Examination (MMSE), a cognitive screening tool to identify people with cognitive impairment, however, it has some limitations. Using the MMSE at the asymptomatic stage of dementia or repeated use of the questionnaire may lead to a “practice effect” that degrades its effectiveness. Supported by HK$ 3.2 million from the Innovation and Technology Fund, Innovation and Technology Commission (ITC) of the HK Government, the research team has developed an AI assessment system that uses health data of older adults, which are routinely and vastly obtained from elderly care facilities or community centers to detect dementia risk. From 2008 to 2018, the team collected basic profile and health data (including age, gender, blood pressure, teeth condition and nutritional assessment) from over 2,000 older adults, who were aged 77 on average for the AI assessment. The average precision of AI screening of dementia reached 88%. This reliable tool makes early detection of cognitive impairment and prediction of high-risk dementia cases at the asymptomatic stage possible. It also facilitates follow-up or a detailed diagnosis by healthcare professionals. Dr Rick Kwan, said, ‘We used the existing data for predicting the risk of dementia, which was probably a new approach. After seeking their clients’ consent, staff of the participating community centres for older adults can upload the health data of their clients (the research participants) to the system to get the assessment results.’ According to Prof. Choi, the research team is planning to apply the Public Sector Trial Scheme under the ITC and use the funding for developing the AI system for implementing in local elderly service centres as well as conducting more trials to further test its effectiveness. *Team members: Dr Rick Kwan, PolyU’s School of Nursing; Dr Xiao Shen, Associate Professor of the School of Computer Science and Technology at Hainan University, Mainland China (She obtained a PhD degree at PolyU’s Department of Computing in 2019); Dr Guanjin Wang, Lecturer in information technology, Murdoch University, Western Australia, Australia (She obtained a joint PhD degree from PolyU and University of Technology Sydney in 2018. Dr Thomas Choi was her chief supervisor during her PhD study).

3 May, 2021

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VR games to enhance students’ understanding and empathy towards the needs of older people with cognitive problems

The School’s Gerontological Nursing Laboratory offers a new way for students of health care disciplines to experience physical and cognitive challenges associated with ageing. Two virtual reality (VR) games were developed by Dr Justina Liu, Associate Professor (& Principal Investigator of the project) and her team** to deliver experiences of ‘losing spatial reference and wandering in streets and visual hallucinations, which are disorders experienced by older adults with cognitive problems. Funded by the Larger-scale Collaborative Project, Learning and Teaching Committee, PolyU and the School (Matching Fund), this VR games allow students to visualise abstract concepts, such as Delirium, a common syndrome affecting many elderly patients in geriatric wards and the community. When students put on the wireless VR headset, they are taken on a journey to a hospital ward to experience cognition changes that lead to hallucinations, which involve distorted visual images and perception. The game gives vivid but creepy images that allow students to immerse in an experience of sensory misperception to understand what it is like to have a delirium. Another game ‘Get lost’ sets in a local community in Hong Kong. Users are required to find the way to a supermarket. While ‘walking’ around the streets, users find themselves unable to identify directions and may get lost in a familiar surroundings. ‘These VR games play a unique role in addressing challenges associated with ageing and they are useful tools for experiential learning. Through the “hands-on” experiences, we expect that students will increase their understanding and develop empathy towards older people, which is essential for quality elderly care,’ said Dr Justina Liu. Students are also expected to apply their knowledge gained through the VR training to propose solutions or care plans targeted older people with cognitive impairment and disabilities. **Dr Rick Kwan, Dr Patrick Kor, Dr Daphne Cheung, Dr Mimi Tse, Dr Xue Bai (Associate Professor, PolyU’s Department of Applied Social Sciences), Prof. Kenneth Fong (Professor, PolyU’s Department of Rehabilitation Sciences), and Dr Tulio Pereira dos Santos Maximo (Assistant Professor, PolyU’s School of Design).

2 May, 2021

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Virtual Hospital

Dr Kitty Chan, Senior Teaching Fellow of the School of Nursing (& Principal Investigator of the project) and her team* has developed the Virtual Hospital that use virtual reality technology to offer an innovative experiential learning solution to nursing students, amid suspension of face-to-face teaching and clinical placements in hospitals and clinics. Under the COVID-19 situation, the Nursing Council of Hong Kong has allowed a certain percentage of simulated learning to substitute clinical practice experience. The Virtual Hospital is an alternative means that helps students develop competence to bridge their learning gap in practicum. Set in a general ward of a hospital, the system randomly generates simulated scenarios that focus on three themes: patient safety, priority of care, handling of unexpected incidents/multiple events. Players are expected to identify settings in the ‘hospital’ that may cause safety problems, complete nursing tasks within a limited time or prioritise tasks. Players’ ability to prevent errors while handling unexpected incidents/multiple events is also tested through the VR games. A special feature of the Virtual Hospital is its flexibility to be used together with a plasma TV and tablets, which allows players’ responses and decisions to be shown in the plasma TV for whole group participation. Players’ communication with the virtual patients is recorded for review. With the tablets, other students are not passive observers, and they can engage in the scenarios and respond to the situations by answering the multiple choice questions together with the players. Another uniqueness lies in its strength to generate multiple medical events that cause distractions to players. ‘The Virtual Hospital provides students collaborative case-based problem-solving opportunities. They will engage in medical events that distract them from care delivery. Through the VR experiential learning, debriefing and group discussion, students share different ideas or solutions and learn how to act appropriately while being distracted, communicate effectively, and make clinical decisions,’ said Dr Kitty Chan. Dr Kitty Chan expected that the Virtual Hospital supplements our current practice on patient simulators or simulated patients and helps students enhance their ability to apply knowledge, improve clinical reasoning, therapeutic communications skills, critical thinking skills, and reduce errors in actual clinical situations. The game data and the automated assessment function of the system also provide conveniences to teachers in tracking students’ progress and evaluating learning outcomes. The School has developed eight Virtual Hospital systems and they will be used in the Nursing Therapeutics subjects starting from next semester (September 2021) . *Team members: Dr Rick Kwan (Co-Principal Investigator), Dr Kin Cheung, Dr Justina Liu, Mr Timothy Lai. The Virtual Hospital is funded by the PolyU Large Equipment Fund.

1 May, 2021

SN researchers among world’s top 2% of scientists on Stanford University list

Prof. Alex Molasiotis, Head of the School, and Prof. Frances Wong, Professor and Associate Dean (PolyU’s Faculty of Health and Social Sciences), have been listed among the world’s most cited researchers and those who are among the top 2% scientists within their specialty areas, released by Stanford University. A total of 163 PolyU scholars where five of them are SN scholars (including those who had left the School and retired) were named in the ranking of 2% of the best scientists whose publications are most frequently cited by other authors across the globe. PolyU has the second highest number of scientists included on the list among Hong Kong universities. The ranking method is based on standardized citation metrics developed by a group of scientists led by John PA Ioannidis##, a statistician at Stanford University. The scientists were grouped into 22 subject fields and 176 sub-fields using the indicators, which included information on citations, an individual’s scientific research output, co-authorship and a composite indicator for career-long citation impact up to the end of 2019. SN Researcher in the list Subject Field Rank in Field Field Size Prof. Alex Molasiotis Oncology & Carcinogenesis 1,197 230,678 Prof. Frances Wong Nursing 485 35,893 Dr Lorna Suen* Complementary & Alternative Medicine 145 9,518 Dr Paul Lee** General & Internal Medicine 933 106,795 Dr Esther Mok# Nursing 644 35,893 *Associate Professor before she left the School in 2021. ** Assistant Professor before he left the School in 2021. # Professor and Associate Head (Postgraduate Education) of the School before her retirement in 2014. ## The study was published in the journal Public Library of Science Biology, click here to view.

1 Apr, 2021

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PolyU School of Nursing launches Youth Quitline run by nursing students

The Hong Kong Polytechnic University (PolyU) announced the launch of student-run “Youth Quitline” service from the School of Nursing (SN), and a kick-off ceremony was held recently. The service provides free telephone counselling for young people who want to quit smoking, while nursing students are also given clinical placement opportunities to serve the youth under the pandemic, where they can learn to work in a community setting to benefit people in need. The "Youth Quitline" is funded by the Tobacco and Alcohol Control Office of the Department of Health. Trained nursing students from PolyU are responsible for providing essential information to young people aged 25 or below, educating them about the health hazards and misconceptions associated with smoking (including emerging tobacco products), as well as offering assessments of nicotine dependence, formulating smoking cessation plans, suggesting various methods to control smoking addiction and providing free auricular cessation services, so as to help young people develop good lifestyle habits. Referrals can also be made for other appropriate smoking cessation services when needed. “Currently, training on smoking cessation counselling is not covered in most undergraduate nursing curricula. In view of this, PolyU's School of Nursing decided to train students in smoking cessation counselling skills and help them put their learning into practice. They will thus not only be equipped with professional knowledge, but also with essential hands-on experience,” said Professor David Shum, Yeung Tsang Wing Yee and Tsang Wing Hing Professor in Neuropsychology, Chair Professor of Neuropsychology and Dean of the Faculty of Health and Social Sciences of PolyU. He added that due to the pandemic situation, many clinical placements originally planned at various hospitals have been suspended. With the launch of the “Youth Quitline”, the School of Nursing will provide training to its Year 3 students to serve as peer counsellors, preparing them to offer smoking cessation counselling and health education to the public in their future capacity as professional nurses. The “Youth Quitline” has successfully served over 70 young smokers since its launch. Professor Alex Molasiotis, Angel S.P. Chan Lau Professor in Health and Longevity, Chair Professor of Nursing and Head of the School of Nursing, said, “By February next year, PolyU's School of Nursing is expected to have trained nearly 300 nursing students who are able to provide smoking cessation counselling. This will ensure sufficient manpower in expanding clinical and community-based services to quit smoking and hence better promote the benefits of quitting smoking to the general public.” To learn more about the “Youth Quitline” operated by PolyU, please visit: https://www.polyuyql.com/

26 Feb, 2021

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The 9th Cross-Border Elderly Care Seminar - Opportunities and Challenges of Ageing in Greater Bay Area: Cross-border Services Amid of Covid-19

The 9th Cross-Border Elderly Care Seminar, themed “Opportunities and Challenges of Ageing in Greater Bay Area: Cross-border Services Amid of Covid-19” was held online on 22 January 2021. The seminar, jointly organised by eight local research institutes/societies and associations, attracted 270 participants to attend, including elderly care professionals and people who are interested in cross-border elderly care. Organisers of the seminar included: the Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University (PolyU); PolyU’s Department of Applied Social Sciences and Institute of Active Ageing ; Sau Po Centre on Ageing, The University of Hong Kong (HKU); Asia-Pacific Institute of Ageing Studies, Lingnan University; Hong Kong Association of Gerontology; Helping Hand;, and Hong Kong Society for Rehabilitation. This seminar gave an opportunity for participants to learn more about elderly care services across the border. It also aimed to urge the Hong Kong government and the elderly care sector to support cross-border elderly care so that older adults in Hong Kong can plan ahead to age in the Greater Bay area (GBA). Prof. Wen Zhuoyi Vincent, Research Assistant Professor, Asia-Pacific Institute of Ageing Studies, Lingnan University, moderated the seminar. Dr Justina Liu, Associate Professor and Deputy Director of the Centre for Gerontological Nursing, School of Nursing, PolyU, said in her welcoming speech that the provision of medical services and social resources in the GBA are the key elements in promoting cross-border ageing. Mr Yuen Man Chung, Commissioner for the Development of the Guangdong-Hong Kong-Macao Greater Bay Area, delivered a keynote speech to review the government’s measures in promoting Hong Kong older adults ageing in the GBA and overview policies announced by the central government and the ministries and commissions of Guangdong Province on living or ageing in the GBA. Prof. Chung-Mau Lo, Hospital Chief Executive, University of Hong Kong-Shenzhen Hospital [also Chin Lan Hong Professor and Chair of Hepatobiliary and Pancreatic Surgery; Chief of Division of Liver Transplantation, HKU/Queen Mary Hospital], talked about the development of the University of Hong Kong-Shenzhen Hospital in the past nine years and how to innovate cross-border medical service and promote the integration of medical services in the GBA. Mr Jacob Wong, Councilor of Life Insurance Council and Member of Task Force on Greater China Affairs, The Hong Kong Federation of Insurers, outlined the needs and considerations of retirees, and introduced the retirement protection in Hong Kong as well as the retirement protection and medical insurance plans in the in the GBA. Dr Lou Wei Qun, Vivian, the Director of Sau Po Centre on Ageing, HKU, moderated the panel discussion. Dr Leung Pui-Yu Pamela, Chief Executive Officer of the Hong Kong Society for Rehabilitation, talked about the challenges in operating the Hong Kong Jockey Club Yee Hong Height, a rehabilitation and elderly care centre in Shenzhen during the COVID-19 pandemic, such as limitations on transporting medical supplies and the telemedicine system, border restrictions hindering residents returning to Hong Kong to attend medical consultations. She also talked about the supportive measures from the Hong Kong and Shenzhen governments during the pandemic. Mr Colman Wong, Chief Executive Officer, Helping Hand, shared how their elderly home in Zhaoqing operated during the pandemic and talked about their administrative arrangements, infection control measures, and entertainment and recreational activities for their residents. Ms. Zhou Xiao-yan, President, Guangdong Professional Social Workers Association, spoked about the practice of social work for older adults in the GBA and introduced the institutional elderly care service and ageing in place in Guangdong Province. Dr Leung Man Fuk Edward, President, Hong Kong Association of Gerontology, gave a closing remarks to conclude the seminar.

22 Jan, 2021

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Knowledge Transfer: PolyU new N95 respirators-Patent filed and debuted in palliative care centre

PolyU has filed a patent at the Patents Registry, Intellectual Property Department, HK Government, for the unique ‘adjustable elastic straps’ of the new N95 surgical particulate respirators, developed and validated by Dr Simon Lam and his team* (filer’s ref: HK32020021992.3) and a license agreement was signed on 11 January 2021 between PolyU Technology and Consultancy Company Ltd. and Vannex International Limited, which sets the ground for bulk manufacturing of the respirators for commercial and clinical uses. Traditional N95 respirators have non-adjustable stripes and do not fit well on Chinese people. During the COVID-19 pandemic, shortage in the supply of traditional N95 respirators has turned healthcare workers to spend long hours in wearing N95 nano-fiber masks, particularly those with ear loops and clips to protect themselves against the novel virus. These tight fitted masks have left many healthcare workers with pain, pressure sores or bruises. Dr Lam had the same experience in the battle against SARS in 2003 when he was a nurse on the coronavirus frontline. Determined to find the solution, Dr Lam led our team of nursing and infection control experts to develop new N95 respirators. The uniqueness of our new respirators lies in their innovative PVC (synthetic rubber) adjustable elastic straps that allow users to fit the respirators according to their facial contour and head size to optimise fit rates. All models of our new N95 respirators are certificated with FFP3 or FFP2 standards (highest respirator standards-at least 99% or 94% filter capacity in removing of all particles that are 0.3/0.4 microns in diameter or larger). Our new N95 respirators were debuted in the Haven of Hope Sister Annie Skau Holistic Care Centre (基督教靈實協會靈實司務道寧養院), a centre providing palliative and elderly care, and have received very positive feedback. Dr Lam and his team performed fit tests with the new respirators on over 100 centre’s staff and the new N95 respirators were proven outstanding. ‘The fit rates of traditional N95 respirators are about 60% for Chinese people. The two models of new respirators obtained very good fit rates at 87% and 88%,’ said Dr Simon Lam. Dr Paul Wong, Deputy Medical Superintendent of the holistic care centre commented in a letter of appreciation to the School that ‘the usability of these respirators, e.g., optimal tightness, comfort level and prolonged usage, were all satisfactory and better than any conventional model.’ Meanwhile, Dr Lam’s team has provided samples of the new respirators to the Hospital Authority (HA) Head Office, hospitals under HA, and some private hospitals for trial and examination. ‘The new respirators will certainly play an important role in protecting ten thousands of our healthcare professionals in hospitals and clinics, as well as healthcare workers in the community, ‘said Dr Simon Lam. *Dr Simon Lam (Principle Investigator and Deputy Director of the School’s Squina International Centre for Infection Control) and our team of nursing and infection control experts including: Dr Lorna Suen, Dr Sukki Ho, Ms Ka-Yan Ko, Mr Timothy Lai, Mr Keith Fung, and Ms Wing-sum Ng.

11 Jan, 2021

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Conference on Credit Transfer Practices in Higher Education: Partnership for Success

On 27 November, PolyU collaborated with Hong Kong Council for Accreditation of Academic and Vocational Qualifications (HKCAAVQ) and Federation for Self-financing Tertiary Education (FSTE) to organise an online conference themed “Credit Transfer Practices in Higher Education: Partnership for Success”, with Education Bureau (EDB) as the supporting organization. This conference aimed at advancing local credit transfer practices with streamlined programme articulation and transparent information, exploring the integration of recognized overseas systems into the local education context and promoting a cross-institutional collaborative culture among sending and receiving institutions for the better learning experience of Senior Year Admitted (SYA) students. Attracting more than 300 officials, academics and administrators from 55 organisations including government, sub-degree, self-financed and UGC-funded institutions and professional accreditation bodies. This conference offered a platform for local and overseas experts from Canada, Netherlands, USA to share valuable experiences in the development of, challenges on and support to credit transfer practices in higher education. The engaging interaction contributed to fruitful discussions which have given inspirational feedback to both audiences and speakers. The conference was organized by the UGC-funded Teaching and Learning Project “Enriching Senior Year Places Students' Learning Experience through Curricular and Co-curricular Activities in Hong Kong's Universities” (The SYA Project) led by Dr Kin CHEUNG, Associate Professor of School of Nursing. City University of Hong Kong (Dr Bin Li as a co-leader), Hong Kong Baptist University (Prof Peter Benz as a co-leader), and the Chinese University of Hong Kong (Prof Ka Ming Chow as a co-leader) are the partnering institutions of the SYA Project and the co-organizers of the conference. For more details of the project, please click HERE.

27 Nov, 2020

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PolyU’s School of Nursing re-designated as a World Health Organization Collaborating Centre for Community Health Services

(23 November 2020) The School of Nursing at The Hong Kong Polytechnic University (PolyU) was re-designated by the World Health Organization (WHO) as a WHO Collaborating Centre (WHO CC) for Community Health Services for a period of four years to the end of 2023. Established since 2007, the Centre is the first and only WHO Collaborating Centre in Healthy Ageing in the Asia Pacific. Its missions include taking on a proactive role in promoting the implementation of WHO’s strategic initiatives, as well as supporting them in developing healthy ageing policies and recommendations across the Western Pacific region. A re-designation ceremony was held on 20 November, officiated by Prof. Sophia Chan, JP, Secretary for Food and Health, HKSAR Government; and Dr Hiromasa Okayasu, Coordinator, Healthy Ageing Data, Strategy and Innovation (DSI), WHO Regional Office for the Western Pacific. The ceremony also had representatives from PolyU, including Prof. David Shum, Yeung Tsang Wing Yee and Tsang Wing Hing Professor in Neuropsychology, Chair Professor of Neuropsychology and Dean of the Faculty of Health and Social Sciences; and Prof. Alex Molasiotis, Angel S.P. Chan Lau Professor in Health and Longevity, Chair Professor of Nursing, Head of the School of Nursing and Director of the WHO CC for Community Health Services. During the 4-year designation period, the Centre will work towards the goals of identifying key indicators of ageing and health in the region, actively promoting and implementing the WHO Guidelines on Integrated Care for Older People (ICOPE), and providing a platform for inter-disciplinary collaborations among health care professionals and academia for initiating projects on healthy ageing. Prof David Shum said, “The Centre has always been very active in promoting various healthy ageing related issues in the region. It also serves as a common ground to draw upon the readily available expertise and collaborative opportunities within the University to help carry out the mission of the Centre. I am confident that members of the Centre will continue to work closely with the WHO to make a positive difference to the health services in our community.” Prof. Alex Molasiotis is pleased that the Centre received re-designation from the WHO, stating, “Since established, the Centre has been actively involved in various community health initiatives. Going forward, the Centre will step up its efforts in developing a series of work plans, including collaborative research projects, roundtable sessions and training workshops on healthy ageing, in response to the WHO’s Decade of Healthy Ageing. Furthermore, we will continue our role in assisting the WHO’s Western Pacific Regional Office to roll out its strategic initiatives on ageing for the region, in the hope of improving the health and wellbeing of older people and their families.” For more details about the WHO Collaborating Centre for Community Health Services, please visit: https://sn.polyu.edu.hk/whocc/en/index.html

20 Nov, 2020

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