Publications by authors named "Huanhuan Tong"

8 Publications

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Clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students.

Nurse Educ Pract 2021 May 16;53:103055. Epub 2021 Apr 16.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address:

Evaluation and cultivation of clinical competence in undergraduate nursing students are essential in nursing education. Self-efficacy and good clinical learning environments are expected to have a positive influence on the clinical competence of undergraduate nursing students, but few studies have focused on the relationships among clinical competence, self-efficacy, and clinical learning environments. This study aimed to examine clinical competence and its association with self-efficacy and clinical learning environments among Chinese undergraduate nursing students. A cross-sectional questionnaire survey was conducted with 1518 undergraduate nursing students being recruited from five medical colleges in China. The nursing students' clinical competence, self-efficacy, and clinical learning environments were assessed using a set of self-reported questionnaires, including Chinese versions of the Holistic Clinical Assessment Tool; General Self-Efficacy Scale; and Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale. Factors significantly associated with the clinical competence of undergraduate nursing students were professional interest, self-efficacy, and clinical learning environments, accounting for 36.1% of the total variance. Self-efficacy played a mediating role between clinical learning environments and clinical competence. The results of this study can be applied as reference for the enhancement of a nursing education program to improve the clinical competence of Chinese undergraduate nursing students.
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http://dx.doi.org/10.1016/j.nepr.2021.103055DOI Listing
May 2021

The caring experience and supportive care needs of male partners for women with gynaecologic cancer: A qualitative literature review.

J Clin Nurs 2020 Dec 19;29(23-24):4469-4481. Epub 2020 Oct 19.

Alice Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Objective: To systematically review male partners' caring experience and supportive care needs when caring for women with gynaecologic cancer.

Methods: The PRISMA guidelines were used to conduct this systematic review. We performed a comprehensive literature search in nine databases and qualitative studies published in English or Chinese from inception to January 2020. The included papers were appraised, using the Critical Appraisal Skills Program tool for qualitative research. An inductive thematic analysis method was adopted to synthesise major findings to construct core concepts and themes.

Results: Eight studies were included in this review, and four overarching themes emerged the following: the negative experience of disease, the need for supportive care to cope, adapting to a new life and post-traumatic growth.

Conclusions: This study shows that male partners had both negative and positive experiences in the caring process, and they could adjust themselves to some extent. Their perceived supportive care needs were often neglected.

Relevance To Clinical Practice: Male partners of women with gynaecologic cancer are an under-recognised group. The couple-oriented or family-oriented supportive care programmes should be implemented to meet the supportive care needs of male partners to enhance their health and well-being.
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http://dx.doi.org/10.1111/jocn.15501DOI Listing
December 2020

Multiple geophysical surveys for old landfill monitoring in Singapore.

Environ Monit Assess 2017 Jan 15;189(1):20. Epub 2016 Dec 15.

Residues and Resource Reclamation Centre (R3C), Nanyang Environment and Water Research Institute, Nanyang Technological University, 1 Cleantech Loop, CleanTech One, Singapore, 637141, Singapore.

One-dimensional boring presents limitations on mapping the refuse profile in old landfills owning to waste heterogeneity. Electrical imaging (EI) and multiple-analysis of surface wave (MASW) were hereby deployed at an old dumping ground in Singapore to explore the subsurface in relation to geotechnical analysis. MASW estimated the refuse boundary with a higher precision as compared to EI, due to its endurance for moisture variation. EI and MASW transection profiles suggested spots of interest, e.g., refuse pockets and leachate mounds. 3D inversion of EI and MASW data further illustrated the transformation dynamics derived by natural attenuation, for instance the preferential infiltration pathway. Comparison of geophysical surveys at different years uncovered the subterranean landfill conditions, indicating strong impacts induced by aging, precipitation, and settlement. This study may shed light on a characterization framework of old landfills via combined geophysical models, thriving landfill knowledge with a higher creditability.
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http://dx.doi.org/10.1007/s10661-016-5722-4DOI Listing
January 2017

Insights for transformation of contaminants in leachate at a tropical landfill dominated by natural attenuation.

Waste Manag 2016 Jul 8;53:105-15. Epub 2016 May 8.

School of Civil and Environmental Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore.

The purpose of this study was to track the long-term trends of contaminants distribution in the old landfill of Singapore through monitored natural attenuation and to explore the main parameters that rule such transition. Contaminants distribution, including dissolved organic matter (DOM), inorganic species, heavy metals, and organic compounds, was investigated via monitoring wells in the years 1997, 2004 and 2011. The data revealed that the distribution of contaminants possessed selective attention of spots associated with leachate movement. The hydrogeology of the landfill governed the fate and transportation of contaminants. More specifically, strong statistical correlations were identified between DOM and certain constituents in the leachate, suggesting enhanced mobilization potential. However, the leachate composition exhibited limited correspondence to the nearby solid waste, indicating the minor effect induced by the partitioning coefficient. The presence of sulphate unveiled air intrusion, suggesting increased stability of the landfill, where enhanced biodegradation occurred at earlier period responsible for higher BOD removal. Afterwards other parameters continued to facilitate the compounds removal resulting in overall low concentrations of the contaminants.
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http://dx.doi.org/10.1016/j.wasman.2016.04.033DOI Listing
July 2016

Influence of temperature on carbon and nitrogen dynamics during in situ aeration of aged waste in simulated landfill bioreactors.

Bioresour Technol 2015 Sep 19;192:149-56. Epub 2015 May 19.

Residues and Resource Reclamation Centre, Nanyang Environment and Water Research Institute, Nanyang Technological University, 1 Cleantech Loop, CleanTech One, Singapore 637141, Singapore; School of Civil and Environmental Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore. Electronic address:

The effect of temperature on carbon and nitrogen compounds during in situ aeration of aged waste was investigated in lab-scale simulated landfill bioreactors at 35, 45 and 55 °C, respectively. The bioreactor operated at 55 °C presented the highest carbon mineralization rate in the initial stage, suggesting accelerated biodegradation rates under thermophilic conditions. The nitrogen speciation study indicated that organic nitrogen was the dominant species of total N in aerobic bioreactors due to ammonia removal. Leachate organic nitrogen was further fractionated to elucidate the fate of individual constituent. Detailed investigation revealed the higher bioconversion rates of N-humic and N-fulvic compounds compared to hydrophilic compounds in thermophilic conditions. At the end, waste material in 55 °C bioreactor was richer in highly matured humic substances (HS) verifying the high bioconversion rates.
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http://dx.doi.org/10.1016/j.biortech.2015.05.049DOI Listing
September 2015

Monitoring transitory profiles of leachate humic substances in landfill aeration reactors in mesophilic and thermophilic conditions.

J Hazard Mater 2015 Apr 22;287:342-8. Epub 2015 Jan 22.

Residues and Resource Reclamation Centre, Nanyang Environment and Water Research Institute, Nanyang Technological University, 1 Cleantech Loop, CleanTech One, 637141, Singapore; School of Civil and Environmental Engineering, Nanyang Technological University, 50 Nanyang Avenue, 639798, Singapore. Electronic address:

The presence of humic substances (HS) in landfill leachate is of great interest because of their structural stability and potential toxicity. This study examined the effects of temperature and waste age on the transformation of HS during in situ aeration of bioreactor landfills. By establishing aerobic conditions, dissolved organic carbon (DOC) rapidly accumulated in the bioreactor leachate. Fractional analysis showed that the elevated concentration of humic acids (HAs) was primarily responsible for the increment of leachate strength. Further structural characterization indicated that the molecular weight (MW) and aromacity of HS were enhanced by aeration in conjunction with thermophilic temperature. Interestingly, elevation of HAs concentration was not observed in the aeration reactor with a prolonged waste age, as the mobility of HAs was lowered by the high MW derived from extended waste age. Based on these results, aeration may be more favorable in aged landfills, since dissolution of HAs could be minimized by the evolution to larger MW compared to young landfills. Moreover, increased operation temperature during aeration likely offers benefits for the rapid maturation of HS.
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http://dx.doi.org/10.1016/j.jhazmat.2015.01.049DOI Listing
April 2015

Effects of fulvic substances on the distribution and migration of Hg in landfill leachate.

J Environ Monit 2011 May 6;13(5):1464-9. Epub 2011 Apr 6.

The State Key Laboratory of Pollution Control and Resource Reuse, Tongji University, Shanghai 200092, China.

Mercury (Hg) distribution and migration in different landfill stabilization processes were evaluated in this study. Wide ranges of Hg concentrations were observed because of the heterogeneity and variability of landfill refuse. In addition, temporally variable conditions, including pH, organic matter, and vegetation cover, which influence Hg migration in landfills, may also affect the temporal distribution of Hg in landfill refuse. The main fraction of Hg, elemental Hg, decreased with time, while the stable fractions of Hg increased. The fulvic acid (FA) extracted from the landfill leachate had much lower overall Hg-complexation stability constants, which suggests that organic S groups might have been rapidly saturated by small amounts of Hg while leaving oxygen functional groups, such as carboxylic functional or phenolic groups, acting as the primary binding sites for Hg.
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http://dx.doi.org/10.1039/c1em10103jDOI Listing
May 2011

Abiotic association of PAEs with humic substances and its influence on the fate of PAEs in landfill leachate.

Chemosphere 2010 Mar 27;78(11):1362-7. Epub 2010 Jan 27.

The State Key Laboratory of Pollution Control and Resource Reuse, Tongji University, Shanghai, China.

An equilibrium dialysis combined with a (14)C-labeling method was used to study the abiotic association of phthalic acid esters (PAEs) with dissolved humic substances (HS) and its influence on the fate of PAEs in landfill leachate. Elemental analysis and FTIR spectral analysis were carried out on the humic acid (HA) and fulvic acid (FA) components of HS to examine the relationship between the structure of HS and the intensity of the association of the PAEs with HS (K(A)). The results show that the association intensity of HS with PAEs depends greatly on both the properties of the PAEs and the source of HS. The HS have a strong association reaction with dibutyl phthalic acid, which might explain the higher concentration of dibutyl phthalic acid detected in landfill leachate. The pH value strongly affects the K(A) of HS, and it decreases radically when the pH increase from 3.0 to 9.0. The non-specific hydrophobic interaction between HS and PAEs plays a more important role in the abiotic association of HS with PAEs. Elemental analysis and FTIR spectra suggest that the high K(A) values are related to the high aromatic content and larger molecular weight of HS.
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http://dx.doi.org/10.1016/j.chemosphere.2009.12.073DOI Listing
March 2010