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Fong HPY, Choi SYK, Leung MKW, Lo HHM, Wang B, Wong SYS, Sit RWS. Determinants of health-related quality of life in older people with chronic musculoskeletal pain: a cross-sectional study. BMC Geriatr 2024; 24:119. [PMID: 38297217 PMCID: PMC10832201 DOI: 10.1186/s12877-024-04669-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND This study aimed to identify the significant physical, psychological, and social determinants associated with EuroQuol-5D (EQ-5D) among Chinese older people with chronic musculoskeletal pain, and to evaluate how these determinants affected the five dimensions of EQ-5D. METHOD This is a cross-sectional study. Data were collected through a cohort involving 946 community-dwelling older people aged ≥ 60 with chronic musculoskeletal pain in Hong Kong. Selected independent variables were categorized into physical, psychological, and social domains. Physical variables included age, sex, body mass index (BMI), pain severity score, number of pain regions, the most painful site, and the number of comorbidities. Psychological variables included depression level measured using the 9-question Patient Health Questionnaire (PHQ-9), and anxiety level measured using the Generalized Anxiety Disorder Assessment (GAD-7). Social variables included living, marital, and social welfare recipient's status. The dependent variables comprised the index scores and the five dimensions of the EQ-5D descriptive system. Ordinal least squares (OLS) model and logistic regression model were used for data analysis. RESULTS The mean age of the participants was 67.1 (SD = 5.1), with 77.6% being female. Higher pain severity scores (beta (β) coefficient =-0.044, P < 0.001), depression scores (β=-0.007, P < 0.001) and higher anxiety scores (β=-0.01, P < 0.001) were associated with lower EQ-5D index scores. Specifically, knee pain (β=-0.061, P < 0.001) was significantly associated with lower EQ-5D index scores. Participants with higher pain severity and depression scores were more likely to report problems in most EQ-5D dimensions. Participants with anxiety primarily faced challenges related to mood, and those with knee pain were more likely to have problems with mobility and daily activities. CONCLUSION Among the selected determinants in our study, pain intensity, depression, anxiety, and knee pain were identified as key determinants associated with reduced HRQoL in older Chinese people with chronic musculoskeletal pain. Each of these determinants showed distinct associations with different dimensions of the EQ-5D, potentially informed resource allocation and the development of targeted interventions to improve the overall HRQoL of this specific population.
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Affiliation(s)
- Hugo Pak-Yiu Fong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong
- Department of Family Medicine, New Territories East Cluster, Hospital Authority, New Territory, Hong Kong
| | - Shirley Yue-Kwan Choi
- Department of Family Medicine, New Territories East Cluster, Hospital Authority, New Territory, Hong Kong
| | - Maria Kwan-Wa Leung
- Department of Family Medicine, New Territories East Cluster, Hospital Authority, New Territory, Hong Kong
| | - Hermione Hin-Man Lo
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong
| | - Bo Wang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong
| | - Regina Wing-Shan Sit
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, New Territory, Hong Kong.
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Chung GKK, Marmot M, Ho IYY, Chan SM, Lai ETC, Wong SYS, Yeoh EK, Woo J, Chung RYN. Secular trends of life expectancy and disability-free life expectancy at age 65 and associated gender and area-level socioeconomic inequalities in Hong Kong: a serial cross-sectional study between 2007 and 2020. Lancet Reg Health West Pac 2023; 41:100909. [PMID: 37780635 PMCID: PMC10541487 DOI: 10.1016/j.lanwpc.2023.100909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/03/2023]
Abstract
Background Despite Hong Kong's world leading longevity, little is known about its associated disability burden and social patterning. Hence, this study assessed the gender-specific secular trends and area-level inequalities in life expectancy (LE) and disability-free life expectancy (DFLE) at age 65 in Hong Kong. Methods Population structure, death records, and disability data in 2007, 2013, and 2020 were retrieved from the Census and Statistics Department to estimate LE and DFLE using the Sullivan Method. District-based sociodemographic indicators were used to compare LE and DFLE across 18 districts of Hong Kong in 2013. Findings Between 2007 and 2020, LE at age 65 increased by 3.7 years (from 18.3 to 22.0) in men and by 2.1 years (from 22.7 to 24.8) in women. By contrast, DFLE increased more slowly, by 1.8 years (from 14.6 to 16.3) in men and by only 0.1 year (from 16.4 to 16.5) in women, leading to a substantial increase in proportion of life spent with disability. Results from multiple linear regression using district-based data in 2013 showed a similar extent of associations of education with LE and DFLE (mean year difference: 0.81 [95% CI: 0.14, 1.48] and 0.68 [0.10, 1.27], respectively, per 10% increase in average education level), while female gender was more strongly associated with LE (4.44 [3.56, 5.31]) than with DFLE (2.00 [1.18, 2.82]). Interpretation Expansion of disability burden and male-female health-survival paradox hold true in Hong Kong. Unlike Western countries with a stronger socioeconomic patterning of DFLE, the extent of area-level socioeconomic inequalities in LE and DFLE appears to be more comparable in Hong Kong. Funding Health and Medical Research Fund (Ref. no.: 19202031) by the Health Bureau of Hong Kong.
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Affiliation(s)
- Gary Ka-Ki Chung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Michael Marmot
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- UCL Institute of Health Equity, Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Irene Yuk-Ying Ho
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Siu-Ming Chan
- Department of Social and Behavioural Sciences, The City University of Hong Kong, Hong Kong, China
| | - Eric Tsz-Chun Lai
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Jean Woo
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
| | - Roger Yat-Nork Chung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Centre for Bioethics, The Chinese University of Hong Kong, Hong Kong, China
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Wong KYK, Hughes DA, Debski M, Latt N, Assaf O, Abdelrahman A, Taylor R, Allgar V, McNeill L, Howard S, Wong SYS, Jones R, Cassidy CJ, Seed A, Galasko G, Clark A, Wilson D, Davis GK, Montasem A, Lang CC, Kalra PR, Campbell R, Lip GYH, Cleland JGF. Effectiveness of out-patient based acute heart failure care: a pilot randomised controlled trial. Acta Cardiol 2023; 78:828-837. [PMID: 37694719 DOI: 10.1080/00015385.2023.2197834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 03/21/2023] [Accepted: 03/25/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Acute heart failure (AHF) hospitalisation is associated with 10% mortality. Outpatient based management (OPM) of AHF appeared effective in observational studies. We conducted a pilot randomised controlled trial (RCT) comparing OPM with standard inpatient care (IPM). METHODS We randomised patients with AHF, considered to need IV diuretic treatment for ≥2 days, to IPM or OPM. We recorded all-cause mortality, and the number of days alive and out-of-hospital (DAOH). Quality of life, mental well-being and Hope scores were assessed. Mean NHS cost savings and 95% central range (CR) were calculated from bootstrap analysis. Follow-up: 60 days. RESULTS Eleven patients were randomised to IPM and 13 to OPM. There was no statistically significant difference in all-cause mortality during the index episode (1/11 vs 0/13) and up to 60 days follow-up (2/11 vs 2/13) [p = .86]. The OPM group accrued more DAOH {47 [36,51] vs 59 [41,60], p = .13}. Two patients randomised to IPM (vs 6 OPM) were readmitted [p = .31]. Hope scores increased more with OPM within 30 days but dropped to lower levels than IPM by 60 days. More out-patients had increased total well-being scores by 60 days (p = .04). OPM was associated with mean cost savings of £2658 (95% CR 460-4857) per patient. CONCLUSIONS Patients with acute HF randomised to OPM accrued more days alive out of hospital (albeit not statistically significantly in this small pilot study). OPM is favoured by patients and carers and is associated with improved mental well-being and cost savings.
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Affiliation(s)
- K Y K Wong
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
- Liverpool Centre for Cardiovascular Science, Liverpool, UK
| | - D A Hughes
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - M Debski
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - N Latt
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - O Assaf
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - A Abdelrahman
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - R Taylor
- Research and Development Department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - V Allgar
- Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK
| | - L McNeill
- Accountant, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - S Howard
- Financial Information And Costing Manager, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - S Y S Wong
- Department of Care of the Older Person, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - R Jones
- Public Involvement Group, Research and Development Department, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - C J Cassidy
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - A Seed
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - G Galasko
- Department of Cardiology, Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - A Clark
- Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK
| | - D Wilson
- Department of Cardiology, Worcestershire Royal Hospital (Worcestershire Acute Hospital NHS Trust), Worcester, UK
| | - G K Davis
- Cardiorespiratory Research Centre, Edge Hill University Medical School, Ormskirk, UK
| | - A Montasem
- Institute of Life Course and Medical Sciences, School of Dental Sciences, Liverpool University Dental Hospital, University of Liverpool, Liverpool, UK
| | - C C Lang
- Department of Cardiology, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - P R Kalra
- Department of Cardiology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - R Campbell
- Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - G Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - J G F Cleland
- Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
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Wong NS, Wong BCK, Lee MP, Tsang OTY, Cheung DKF, Sit AYW, Wong SYS, Lee SS. Mpox vaccination for men who have sex with men and their differential risk of exposure and infection. Hum Vaccin Immunother 2023; 19:2252263. [PMID: 37649367 PMCID: PMC10472867 DOI: 10.1080/21645515.2023.2252263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/05/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023] Open
Abstract
Following the post-COVID-19 reopening of the society with enhanced traveling between countries, people at risk of mpox infection, notably men who have sex with men (MSM) and people living with HIV, are facing increasing threat of virus exposure. Mpox vaccination is an important public health strategy which is provided free in Hong Kong to people at higher risk of infection. Between October 2022 and January 2023, 326 and 184 MSM vaccinees from vaccination sites and HIV specialist clinics in Hong Kong, respectively, were recruited for assessing their infection risks. Apart from the urge to protect one's significant others (68%), 45% were worried about the stigmatizing mpox symptoms if infected. Compared with MSM vaccinees at vaccination site, a lower proportion of MSM vaccinees in HIV care were sexually active in the past 6 months (88% vs 97%), but a higher proportion had recent sexually transmitted infection diagnoses (19% vs 10%) and perceived considerable exposure risk in the following 6 months (40% vs 22%). There were no differences in the perceived effectiveness of mpox vaccination. If optimal supplies of mpox vaccines can be secured, a low threshold approach at vaccination site could enable MSM with different levels of behavioral risks to become protected.
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Affiliation(s)
- Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- S.H. Ho Research Centre for Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- The JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Bonnie Chun-Kwan Wong
- Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region Government, Hong Kong, China
| | - Man-Po Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Owen Tak-Yin Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Danny King Fai Cheung
- Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region Government, Hong Kong, China
| | - Alfred Yao-Wai Sit
- Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong Special Administrative Region Government, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- The JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Shui-Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
- S.H. Ho Research Centre for Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
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Wang S, Leung M, Leung SY, Han J, Leung W, Hui E, Mihailidou AS, Tsoi KKF, Wong MCS, Wong SYS, Lee EKP. Correction: Safety, Feasibility, and Acceptability of Telemedicine for Hypertension in Primary Care: A Proof-of-concept and Pilot Randomized Controlled Trial (SATE-HT). J Med Syst 2023; 47:68. [PMID: 37405511 DOI: 10.1007/s10916-023-01965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Affiliation(s)
- Shuqi Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Maria Leung
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Shuk-Yun Leung
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Jinghao Han
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Will Leung
- Cluster Services Division, Hospital Authority Head Office, Kowloon, Hong Kong
| | - Elsie Hui
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Anastasia S Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, Macquarie University, Sydney, NSW, Australia
| | - Kelvin Kam-Fai Tsoi
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Martin Chi-Sang Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
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Lai PBS, Wong GTC, Wong SYS. 'Ten Years Down the Line': a roundtable on the progress and advancement of medical education and training. Hong Kong Med J 2023. [PMID: 37286368 DOI: 10.12809/hkmj235146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Affiliation(s)
- P B S Lai
- Co-Chairmen, Organising Committee, Tripartite Medical Education Conference 2023, Hong Kong SAR, China
| | - G T C Wong
- Co-Chairmen, Organising Committee, Tripartite Medical Education Conference 2023, Hong Kong SAR, China
| | - S Y S Wong
- Co-Chairmen, Organising Committee, Tripartite Medical Education Conference 2023, Hong Kong SAR, China
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Chung RYN, Lee TTY, Chan SM, Chung GKK, Chan YH, Wong SYS, Lai E, Wong H, Yeoh EK, Marmot M, Woo J. Experience of South and Southeast Asian minority women in Hong Kong during COVID-19 pandemic: a qualitative study. Int J Equity Health 2023; 22:110. [PMID: 37268921 DOI: 10.1186/s12939-023-01922-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Hong Kong has a relatively low incidence rate of COVID-19 across the globe. Nevertheless, ethnic minorities in Hong Kong, especially South Asians (SAs) and Southeast Asians (SEAs), face numerous physical, mental, social, economic, cultural and religious challenges during the pandemic. This study explores the experiences of SA and SEA women in a predominantly Chinese metropolitan city. METHODS Ten SA and SEA women were recruited and face-to-face interviews were conducted. Questions about participants' daily life experience, physical and mental health conditions, economic situation and social interaction amid COVID-19 pandemic were asked to assess the impact of COVID-19. RESULTS SAs and SEAs have a distinctive family culture, and women experienced significant physical and mental impact of COVID-19 due to their unique gender role in the family. In addition to taking care of their family in Hong Kong, SA and SEA women also had to mentally and financially support family members residing in their home countries. Access to COVID-related information was restricted due to language barrier. Public health measures including social distancing imposed extra burden on ethnic minorities with limited social and religious support. CONCLUSIONS Even when COVID-19 incidence rate is relatively low in Hong Kong, the pandemic made life even more challenging for SAs and SEAs, which is a community already struggling with language barriers, financial woes, and discrimination. This in turn could have led to greater health inequalities. Government and civil organizations should take the social determinants of health inequalities into account when implementing COVID-19-related public health policies and strategies.
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Affiliation(s)
- Roger Yat-Nork Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China.
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
- CUHK Centre for Bioethics, The Chinese University of Hong Kong, Hong Kong, China.
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Tobey Tsz-Yan Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Siu-Ming Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Gary Ka-Ki Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Yat-Hang Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
| | - Eric Lai
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Hung Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng Kiong Yeoh
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Michael Marmot
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, United Kingdom
| | - Jean Woo
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
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Li Q, Wang X, Wong SYS, Yang X. Impacts of combined childhood exposures to poor neighborhood quality, peer friendships and family relationships on adult depression: A seven-year longitudinal study. J Affect Disord 2023:S0165-0327(23)00728-0. [PMID: 37244546 DOI: 10.1016/j.jad.2023.05.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Little is known about how multisystemic childhood exposures predict adult depression. This study aims to examine the effects of multisystemic childhood exposures on the onset and remission of adult depression. METHODS Data were drawn from the China Health and Retirement Longitudinal Survey (CHARLS) (wave 1-4), which is a nationally representative longitudinal survey of people 45 years of age or older in China. Childhood family relationships (CFR), childhood peer friendships (CPF), and childhood neighborhood quality (CNQ) scores were recoded into binary (No = 0, Yes = 1) according to the first quantile value. Participants were divided into four groups based on the total number of poor childhood exposures (group 0-3). The generalized linear mixed model was used to test the longitudinal relationship between combined poor childhood exposures and adult depression. RESULTS Of the 4696 participants (55.1 % males), 22.5 % suffered from depression at baseline. The incidence of depression increased from group0 to group3 in four waves, reaching the peak in wave 2018 (incidence of group0 to group3: 14.1 %, 18.5 %, 22.8 %, 27.4 %, p < 0.001), with declining remission rates that reached its lowest in wave 2018 (50.8 %, 41.3 %, 34.3 %, 31.7 %, p < 0.001). The persistent depression rate increased from group0 to group3 (2.7 %, 5.0 %, 8.1 %, 13.0 %, p < 0.001). The risk of depression in group1 (AOR = 1.50, 95%CI: 1.27-1.77), group2 (AOR = 2.43, 95%CI: 2.01-2.94) and group3 (AOR = 4.24, 95%CI: 3.25-5.54) were significantly higher than that in group0. LIMITATIONS Childhood histories were collected via self-reported questionnaires, and thus recall bias was inevitable. CONCLUSIONS Multisystem poor childhood exposures jointly increased the onset and persistence of adult depression, as well as reduced the remission rate of depression.
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Affiliation(s)
- Qian Li
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Xin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Yeung-Shan Wong
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
| | - Xue Yang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen 518172, China.
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Kwan TH, Chan DPC, Wong SYS, Lee SS. Implementation Cascade of a Social Network-Based HIV Self-testing Approach for Men Who Have Sex With Men: Cross-sectional Study. J Med Internet Res 2023; 25:e46514. [PMID: 37099364 PMCID: PMC10173037 DOI: 10.2196/46514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/14/2023] [Accepted: 03/16/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND HIV testing is the cornerstone of strategies for achieving the fast-track target to end the AIDS epidemic by 2030. Self-testing has been proven to be an effective health intervention for men who have sex with men (MSM). While social network-based approaches for distributing HIV self-tests are recommended by the World Health Organization, their implementation consists of multiple steps that need to be properly evaluated. OBJECTIVE This study aimed to assess the implementation cascade of a social network-based HIV self-test approach for reaching MSM who had never undergone testing in Hong Kong. METHODS This is a cross-sectional study. Seed MSM participants were recruited through different web-based channels, who in turn invited their peers to participate in this study. A web-based platform was set up to support the recruitment and referral process. Participants could request for an oral fluid or a finger-prick HIV self-test, with or without real-time support, after completing a self-administered questionnaire. Referrals could be made upon uploading the test result and passing the web-based training. Characteristics of participants completing each of these steps and their preferences for the type of HIV self-test were evaluated. RESULTS A total of 463 MSM were recruited, including 150 seeds. Participants recruited by seeds were less likely to have previously been tested for HIV (odds ratio [OR] 1.80, 95% CI 1.06-3.04, P=.03) and have lower confidence in performing self-tests (OR 0.66, 95% CI 0.45-0.99, P=.045). Almost all (434/442, 98%) MSM who completed the questionnaire requested a self-test, of whom 82% (354/434) had uploaded their test results. Participants requesting support were new to self-testing (OR 3.65, 95% CI 2.10-6.35, P<.001) and less confident in carrying out the self-test correctly (OR 0.35, 95% CI 0.22-0.56, P<.001). More than half (216/354, 61%) of the eligible participants initiated the referral process by attempting the web-based training with a passing rate of 93% (200/216). They were more likely to have sought sex partners (OR 2.20, 95% CI 1.14-4.25, P=.02), especially through location-based networking apps (OR 2.13, 95% CI 1.31-3.49, P=.002). They also gave higher usability scores along the implementation cascade (median 81 vs 75, P=.003). CONCLUSIONS The social network approach was effective in diffusing HIV self-tests in the MSM community and reaching nontesters. Support and option to choose a preferable type of self-test are essential to address users' individual needs when delivering HIV self-tests. A positive user experience throughout the processes along the implementation cascade is vital to transform a tester into a promoter. TRIAL REGISTRATION ClinicalTrials.gov NCT04379206; https://clinicaltrials.gov/ct2/show/NCT04379206.
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Affiliation(s)
- Tsz Ho Kwan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Denise Pui Chung Chan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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10
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Zhang T, Huang B, Yan Y, Lin Y, Wong H, Wong SYS, Chung RYN. Street-view and traditional greenness metrics with adults' sitting time in high-density living in Hong Kong: Comparing associations, air pollution and noise roles, and population heterogeneity. Sci Total Environ 2023; 870:161778. [PMID: 36716875 DOI: 10.1016/j.scitotenv.2023.161778] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 01/08/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Emerging evidence suggests neighborhood greenness is associated with physical activity; however, the sitting-specific associations with multi-source greenness metrics remain unclear, especially in high-density cities. OBJECTIVES This cross-sectional study examined: 1) the associations of street-view greenness (SVG) and traditional greenness metrics (i.e., Normalized Difference Vegetable Index (NDVI) and park density) with sitting time; 2) the potential moderating/mediating roles of objective/perceived air pollution and perceived roadside noise; and 3) how the associations vary by demographics and socioeconomic status. METHODS Interview survey data of 1977 adults in Hong Kong from 2014 and 2015 was linked to environmental data. Using an object-based image classification algorithm, SVG was derived from Google Street View images, capturing human-viewed street-level greenery. NDVI was derived from Landsat 8 satellite images using the normalized difference between the near-infrared and red bands. Park density was calculated by point density. In the main analyses including regressions, parallel mediation, interaction, and stratified models, the environmental metrics were measured within a 1000-m Euclidean buffer of residence. RESULTS SVG and park density were negatively associated with sitting time after adjusting for covariates including physical activity while NDVI was not significantly associated with sitting time, and results were robust with 800-1800 m Euclidean and 1400-1800 m network distance. Greenness-sitting associations were not moderated/mediated by perceived air pollution/roadside noise while SVG-sitting associations were moderated by objective NO2, O3, and PM2.5 and mediated by O3. SVG-sitting associations differed by age, having under-school-aged children, birthplace, education, and occupation type while associations between traditional greenness metrics and prolonged sitting showed no significant population heterogeneity. CONCLUSIONS SVG appears to be more accurate in estimating exposure than traditional metrics to reflect greenness-sitting associations, objective air pollution moderating and mediating roles, and population heterogeneity, which emphasizes the importance of street-level greenness planning for health promotion in terms of reducing sitting time.
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Affiliation(s)
- Ting Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, China; Institute of Space and Earth Information Science, The Chinese University of Hong Kong, 999077, Hong Kong.
| | - Bo Huang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, 999077, Hong Kong; Department of Geography and Resource Management, The Chinese University of Hong Kong, 999077, Hong Kong; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518057, China.
| | - Yizhen Yan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, 999077, Hong Kong.
| | - Yinyi Lin
- Department of Geography, The University of Hong Kong, 999077, Hong Kong.
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, 999077, Hong Kong; Institute of CUHK Institute of Health Equity, The Chinese University of Hong Kong, 999077, Hong Kong.
| | - Samuel Yeung-Shan Wong
- Institute of CUHK Institute of Health Equity, The Chinese University of Hong Kong, 999077, Hong Kong; JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 999077, Hong Kong.
| | - Roger Yat-Nork Chung
- Institute of CUHK Institute of Health Equity, The Chinese University of Hong Kong, 999077, Hong Kong; JC School of Public Health and Primary Care, The Chinese University of Hong Kong, 999077, Hong Kong.
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11
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Hu R, Hui SSC, Lee EKP, Stoutenberg M, Wong SYS, Yang YJ. Factors associated with physical activity promotion efforts in individuals with chronic diseases: A systematic review from the perspective of patients. Patient Educ Couns 2023; 109:107641. [PMID: 36724581 DOI: 10.1016/j.pec.2023.107641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/04/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To determine factors associated with healthcare provider physical activity (PA) promotion in individuals with chronic diseases from the perspective of patients. METHODS A systematic review of literature was conducted between March and April 2022 by searching five databases. Studies were included if they used survey data, published in English or Chinese, and investigated factors influencing healthcare provider PA promotion in chronic diseases from the perspective of adult patients. Retrieved factors were extracted and mapped to Anderson's Behavioral Model of Health Services Use. Quality of each study was assessed using the NIH Quality Assessment Tool. RESULTS Thirteen articles were included for final analysis. The quality of the included studies ranged from fair to good. A series of factors were positively related to healthcare provider PA promotion (e.g., having emotional support or public programs for PA). Conflicting results were found for other factors (e.g., age and gender). CONCLUSIONS A series of factors may impact the incorporation of PA promotion into clinical care. More studies with well-designed surveys using primary data collection are suggested to confirm these findings. PRACTICE IMPLICATIONS Factors identified from this review provide insights for developing of strategies related to healthcare provider PA promotion for individuals with chronic diseases.
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Affiliation(s)
- Rui Hu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region
| | - Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region.
| | - Eric Kam-Pui Lee
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Samuel Yeung-Shan Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region
| | - Yi-Jian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region
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12
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Zhu M, Dong D, Lo HHM, Wong SYS, Mo PKH, Sit RWS. Patient preferences in the treatment of chronic musculoskeletal pain: a systematic review of discrete choice experiments. Pain 2023; 164:675-689. [PMID: 36149784 PMCID: PMC10026832 DOI: 10.1097/j.pain.0000000000002775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/14/2022] [Accepted: 08/22/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Chronic musculoskeletal pain (CMP) is a preference-sensitive condition for which numerous treatment options are available, each with benefits and risks. Thus, patient preferences play a critical role in decision making. This study summarized evidence from discrete choice experiments (DCEs) to quantify patient preferences for CMP treatment and identified important treatment attributes. A systematic review of DCEs on patient preferences for CMP treatment was conducted. Studies were included if they used DCE to determine patient preferences for CMP. A previously described methodological assessment tool was used to assess the risk of bias. The treatment attributes were summarized and sorted according to the frequency of citation and relative weight. Subgroup analyses were conducted to explore the intervention-specific attributes. A total of 15 eligible studies with 4065 participants were included. We identified "capacity to realize daily life activities," "risk of adverse events," "effectiveness in pain reduction," and "out-of-pocket cost" as important attributes. Although "treatment frequency" and "onset of treatment efficacy" were less frequently mentioned, they were also important attributes. The attribute of "risk of adverse events" was especially important for drug treatment. The "out-of-pocket cost" and "treatment location and mode" were important attributes of exercise therapy. The attributes identified in this review will inform the design of future DCE studies, facilitate the translation of measurement-based care to value-based care, and provide the rationale to promote shared decision making and patient-centered care.
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Affiliation(s)
- Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dong Dong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Hermione Hin-Man Lo
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix Kit-Han Mo
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Regina Wing-Shan Sit
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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13
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Wang S, Leung M, Leung SY, Han J, Leung W, Hui E, Mihailidou A, Kam-Fai Tsoi K, Chi-Sang Wong M, Wong SYS, Lee EKP. Safety, Feasibility, and Acceptability of Telemedicine for Hypertension in Primary Care: A Proof-of-concept and Pilot Randomized Controlled Trial (SATE-HT). J Med Syst 2023; 47:34. [PMID: 36905441 PMCID: PMC10007637 DOI: 10.1007/s10916-023-01933-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
Hypertension (HT) continues to be a leading cause of cardiovascular death and an enormous burden on the healthcare system. Although telemedicine may provide improved blood pressure (BP) monitoring and control, it remains unclear whether it could replace face-to-face consultations in patients with optimal BP control. We hypothesized that an automatic drug refill coupled with a telemedicine system tailored to patients with optimal BP would lead to non-inferior BP control. In this pilot, multicenter, randomized control trial (RCT), participants receiving anti-HT medications were randomly assigned (1:1) to either the telemedicine or usual care group. Patients in the telemedicine group measured and transmitted their home BP readings to the clinic. The medications were refilled without consultation when optimal control (BP < 135/85 mmHg) was confirmed. The primary outcome of this trial was the feasibility of using the telemedicine app. Office and ambulatory BP readings were compared between the two groups at the study endpoint. Acceptability was assessed through interviews with the telemedicine study participants. Overall, 49 participants were recruited in 6 months and retention rate was 98%. Participants from both groups had similar BP control (daytime systolic BP: 128.2 versus 126.9 mmHg [telemedicine vs. usual care], p = 0.41) and no adverse events. Participants in the telemedicine group had fewer general outpatient clinic attendances (0.8 vs. 2, p < 0.001). Interviewees reported that the system was convenient, timesaving, cost saving, and educational. The system could be safely used. However, the results must be verified in an adequately powered RCT. Trial registration: NCT04542564.
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Affiliation(s)
- Shuqi Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Maria Leung
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Shuk-Yun Leung
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Jinghao Han
- General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Will Leung
- Cluster Services Division, Hospital Authority Head Office, Kowloon, Hong Kong
| | - Elsie Hui
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,General Outpatient Clinics, New Territory West Cluster, Hospital Authority, Tsuen Wan, Hong Kong
| | - Anastasia Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, and Macquarie University, Sydney, NSW, Australia
| | - Kelvin Kam-Fai Tsoi
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Martin Chi-Sang Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
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14
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Ho FF, Xu S, Kwong TMH, Li ASC, Ha EH, Hua H, Liong C, Leung KC, Leung TH, Lin Z, Wong SYS, Pan F, Chung VCH. Prevalence, Patterns, and Clinical Severity of Long COVID among Chinese Medicine Telemedicine Service Users: Preliminary Results from a Cross-Sectional Study. Int J Environ Res Public Health 2023; 20:1827. [PMID: 36767195 PMCID: PMC9914360 DOI: 10.3390/ijerph20031827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The emergence and persistence of symptoms after acute COVID-19 is expected to become a major burden on healthcare systems. We assessed the features of the post-COVID-19 Syndrome (Long COVID) burden in a cohort of COVID-19 patients during the fifth major wave in Hong Kong. METHODS A cross-sectional study of 135 patients with confirmed COVID-19 from Feb to Apr 2022 who utilized traditional Chinese medicine telemedicine services was conducted. The COVID-19 Yorkshire Rehabilitation Scale was administered using an online survey 12 weeks after the COVID-19 infection. Prevalence of symptom severity and functional impairments were assessed to identify burdens and patterns. The correlation between symptom severity, functional impairments, patient characteristics, and overall health was evaluated. RESULTS The mean age was 46.8 years, with 46 (34.1%) males. Symptoms, functional impairments, and overall health worsened significantly when compared to the status prior to the infection. More than 50% reported the following sequelae 12 weeks after the acute infection: breathlessness, laryngeal or airway complications, fatigue, weakness, sleep, cognition, and anxiety. The presence of a single symptom or functional impairment significantly correlated with at least seven other problems positively, except for pain. Severity tended to be higher among vulnerable groups, including those who were chronic disease patients, older, less well educated, female, or had incomplete COVID-19 vaccinations. CONCLUSIONS Long COVID is a significant healthcare burden among telemedicine users in Hong Kong, with complex needs for symptom and functional impairment management. Designing relevant health and rehabilitation services tailored to the needs of these patients is warranted.
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Affiliation(s)
- Fai Fai Ho
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Shanshan Xu
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Talos Ming Hong Kwong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Angus Siu-cheong Li
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Eun Hae Ha
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Heyu Hua
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Ching Liong
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Kwan Chi Leung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Ting Hung Leung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Zhixiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Chinese University of Hong Kong Chinese Medicine Specialty Clinic cum Clinical Teaching and Research Centre, School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
| | - Faming Pan
- Department of Epidemiology & Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Vincent Chi Ho Chung
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin 999077, Hong Kong
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Chu RYK, Dong D, Wong SYS, Lee EKP. Barriers and Determinants to the Underutilized Hypertension Screening in Primary Care Patients in Hong Kong: A Mixed-Method Study. Int J Environ Res Public Health 2023; 20:985. [PMID: 36673741 PMCID: PMC9859345 DOI: 10.3390/ijerph20020985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: Hypertension (HT) is the most common chronic condition, affecting approximately 1.13 billion people worldwide. Despite freely available blood pressure (BP) devices in primary care (PC) clinics, many patients do not regularly screen for HT and are untreated. (2) Methods: This study investigated the proportion of PC patients who did not screen for HT and the underlying reasons in Hong Kong. An explanatory mixed-method cross-sectional study was conducted in 2020, which included a questionnaire survey, office BP measurements, and subsequent semi-structured interviews. Adult patients who had no diagnosis of HT were recruited in a large PC clinic by convenience sampling. The relationships between not having HT screening and sociodemographic data were investigated by logistic regression. Twenty-four patients were purposefully sampled (based on demographics) and were interviewed until data saturation. (3) Results: Among 428 participants, 190 (44.4%) had not had HT screening in the last two years, but 197 (46.0%) had HT. No HT screening in the last two years or ever was associated with being male, being single, being of younger age, having no family history of HT, having no clinic visits in the last two years, employment status, and self-perceived HT condition. Most participants (77.8%) misinterpreted their BP readings. Individual, social, and healthcare service barriers were identified in patients' interviews. Many PC patients had no regular HT screening but around half had elevated BP. (4) Conclusion: The study results indicate that the barriers to HT screening were multifactorial. HT screening in PC is urgently needed.
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Affiliation(s)
- Rachel Yui-Ki Chu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518000, China
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eric Kam-Pui Lee
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Huang Y, Wei WI, Correia DF, Ma BHM, Tang A, Yeoh EK, Wong SYS, Ip M, Kwok KO. Antibiotic use for respiratory tract infections among older adults living in long-term care facilities: a systematic review and meta-analysis. J Hosp Infect 2023; 131:107-121. [PMID: 36202187 DOI: 10.1016/j.jhin.2022.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 09/22/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Antibiotics are commonly prescribed for respiratory tract infections (RTIs) among older adults in long-term care facilities (LTCFs), and this contributes to the emergence of antimicrobial resistance. The objective of this study was to determine the antibiotic prescribing rate for RTIs among LTCF residents, and to analyse the antibiotic consumption patterns with the AwaRe monitoring tool, developed by the World Health Organization. METHODS MEDLINE, EMBASE and CINAHL were searched from inception to March 2022. Original articles reporting antibiotic use for RTIs in LTCFs were included in this review. Study quality was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Data. A random-effects meta-analysis was employed to calculate the pooled estimates. Subgroup analysis was conducted by type of RTI, country, and study start year. RESULTS In total, 47 articles consisting of 50 studies were included. The antibiotic prescribing rate ranged from 21.5% to 100% (pooled estimate 69.8%, 95% confidence interval 55.2-82.6%). The antibiotic prescribing rate for lower respiratory tract infections (LRTIs) was higher than the rates for viral and general RTIs. Compared with Italy, France and the USA, the Netherlands had lower antibiotic use for LRTIs. A proportion of viral RTIs were treated with antibiotics, and all the antibiotics were from the Watch group. Use of antibiotics in the Access group was higher in the Netherlands, Norway, Switzerland and Slovenia compared with the USA and Australia. CONCLUSION The antibiotic prescribing rate for RTIs in LTCFs was high, and AWaRe antibiotic use patterns varied by type of RTI and country. Improving antibiotic use may require coordination efforts.
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Affiliation(s)
- Y Huang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - W I Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - D F Correia
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - B H M Ma
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong Special Administrative Region, China
| | - A Tang
- College of Computing and Informatics, Sungkyunkwan University, Seoul, Republic of Korea
| | - E K Yeoh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - S Y S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - M Ip
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - K O Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China; Hong Kong Institute of Asia-Pacific Studies, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
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Zhang D, Chung VCH, Chan DCC, Xu Z, Zhou W, Tam KW, Lee RCM, Sit RWS, Mercer SW, Wong SYS. Determinants of post-COVID-19 symptoms among adults aged 55 or above with chronic conditions in primary care: data from a prospective cohort in Hong Kong. Front Public Health 2023; 11:1138147. [PMID: 37213637 PMCID: PMC10196359 DOI: 10.3389/fpubh.2023.1138147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/04/2023] [Indexed: 05/23/2023] Open
Abstract
Background Primary care patients, especially those with an older age, are one of the most vulnerable populations for post-COVID-19 symptoms. Identifying predictors of post-COVID symptoms can help identify high-risk individuals for preventive care. Methods Out of 977 primary care patients aged 55 years or above with comorbid physical and psychosocial conditions in a prospective cohort in Hong Kong, 207 patients infected in the previous 5-24 weeks were included. The three most common post-COVID-19 symptoms (breathlessness, fatigue, cognitive difficulty), which lasted beyond the 4-week acute infection period, were assessed using items from the COVID-19 Yorkshire Rehabilitation Scale (C19-YRS), together with other self-reported symptoms. Multivariable analyses were conducted to identify predictors of post-acute and long COVID-19 symptoms (5-24 weeks after infection). Results The 207 participants had a mean age of 70.8 ± 5.7 years, 76.3% were female, and 78.7% had ≥2 chronic conditions. In total, 81.2% reported at least one post-COVID symptom (mean: 1.9 ± 1.3); 60.9, 56.5 and 30.0% reported fatigue, cognitive difficulty, and breathlessness respectively; 46.1% reported at least one other new symptom (such as other respiratory-related symptoms (14.0%), insomnia or poor sleep quality (14.0%), and ear/nose/throat symptoms (e.g., sore throat) (10.1%), etc.). Depression predicted post-COVID-19 fatigue. The female sex predicted cognitive difficulty. Receiving fewer vaccine doses (2 doses vs. 3 doses) was associated with breathlessness. Anxiety predicted a higher overall symptom severity level of the three common symptoms. Conclusion Depression, the female sex, and fewer vaccine doses predicted post-COVID symptoms. Promoting vaccination and providing intervention to those at high-risk for post-COVID symptoms are warranted.
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Affiliation(s)
- Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Vincent Chi-Ho Chung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dicken Cheong-Chun Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Zijun Xu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Weiju Zhou
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - King Wa Tam
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Rym Chung-Man Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Regina Wing-Shan Sit
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | | | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- *Correspondence: Samuel Yeung-Shan Wong,
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Kwan TH, Wong NS, Chan CP, Yeoh EK, Wong SYS, Lee SS. Mass Screening of SARS-CoV-2 With Rapid Antigen Tests in a Receding Omicron Wave: Population-Based Survey for Epidemiologic Evaluation. JMIR Public Health Surveill 2022; 8:e40175. [PMID: 36240027 PMCID: PMC9651000 DOI: 10.2196/40175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/17/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 Omicron BA.2 epidemic wave in Hong Kong peaked in the first quarter of 2022. Following the implementation of stringent public health measures, the daily number of reported cases fell from over 50,000 to below 2000. Although outbreaks steadily receded, the government rolled out a 3-day "voluntary universal rapid testing" campaign to invite all citizens to self-perform a rapid antigen test (RAT) daily to identify undetected prevalent infections. OBJECTIVE This study aimed to evaluate the uptake and results of RAT mass screening to estimate the population's residual epidemic burden and assess the risk of further transmission. METHODS A cross-sectional study comprising an open web-based population-based survey was conducted a week after the RAT campaign. Participants were asked to report their COVID-19 vaccination and infection history and the RAT performance and test result during the period. They were also invited to report their coliving individuals' test performance and results. Reasons for nonuptake were enquired. Testing and positive rates were age-adjusted. Determinants of undergoing RAT were identified using univariable and multivariable logistic regression models. RESULTS In total, particulars from 21,769 individuals were reported by 8338 participants. The overall age-adjusted testing rate was 74.94% (95% CI 73.71%-76.18%), with over 80% of participants in the age groups between 45-84 years having self-performed RAT during the campaign period. After age-adjustment, 1.03% (95% CI 0.86%-1.21%) of participants tested positive. The positive rates in the age groups between 20-29 years and >84 years exceeded 2%. Taking into account the positive rate and 5819 reported cases during the period, the cases identified in the campaign might account for 7.65% (95% CI 6.47%-9.14%) of all infections. Testers were more likely to be female, older, not previously diagnosed with COVID-19, and have received COVID-19 vaccination. Adjusting for the number of household members, those living with a child aged <12 years and whose household members were also tested were more likely to have self-performed an RAT. Main reasons for not performing an RAT included the absence of symptoms (598/1108, 53.97%), disbelief of the appropriateness of the campaign as an antiepidemic measure (355/1108, 32.04%), and a recent COVID-19 diagnosis (332/1108, 29.96%). CONCLUSIONS The residual population burden remained substantial in spite of the clear evidence of a receding epidemic wave. Despite caution in generalization to the Hong Kong population, the high participation rate in mass screening indicated that the voluntary RAT was well accepted, making it a feasible option for implementation as a complementary means of public health surveillance.
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Affiliation(s)
- Tsz Ho Kwan
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chin Pok Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Eng Kiong Yeoh
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong
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Xu Z, Sun W, Zhang D, Chung VCH, Wong SYS. Comparative effectiveness of non-pharmacological interventions for depressive symptoms in mild cognitive impairment: systematic review with network meta-analysis. Aging Ment Health 2022; 26:2129-2135. [PMID: 34841997 DOI: 10.1080/13607863.2021.1998356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Depressive symptoms are common among mild cognitive impairment (MCI) patients. It is unknown how different the effects on depressive symptoms are among various pharmacological MCI interventions. This systematic review aimed to evaluate the comparative effectiveness of non-pharmacological MCI interventions on depressive symptoms among MCI patients. METHODS A systematic review and network meta-analysis was conducted on randomized controlled trials (RCT) comparing the effect of different non-pharmacological MCI interventions on changes in depressive symptoms among MCI patients. RCTs were identified from MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, and PsycARTICLES. Results were summarized as standardized mean differences (SMD) and 95% confidence intervals (CI). The surface under the cumulative ranking (SUCRA) was used to rank the effect of different interventions. RESULTS Twenty-two RCTs were included in the network meta-analysis. Compared with non-active control, cognition-based intervention (SMD=-0.25, 95% CI: -0.46, -0.04) and physical exercise (SMD=-0.33, 95% CI: -0.56, -0.10) had significant positive effects to reduce depressive symptoms. Health education, psychosocial intervention, and the combination of physical exercise and cognition-based intervention had non-significant overall effects. The SUCRA demonstrated that physical exercise had the highest SUCRA for the reduction in depression symptoms (0.815). In subgroup analysis, health education, cognition-based intervention, physical exercise, and the combination of physical exercise and cognition-based intervention showed significant longer-term effects (6-12 months). CONCLUSION Physical exercise and cognition-based intervention were effective interventions for depressive symptoms in MCI patients. This study can provide additional evidence for healthcare providers to make decisions for selecting available and appropriate interventions for MCI patients.
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Affiliation(s)
- Zijun Xu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wen Sun
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chi-Ho Chung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Lee EKP, Zhu M, Chan DCC, Yip BHK, Mihailidou AS, Wong SYS. Comparing effect of definition of diurnal periods by diary, fixed periods, and actigraphy on ambulatory blood pressure parameters in a Chinese population. J Hypertens 2022; 40:1815-1821. [PMID: 35866490 PMCID: PMC9451909 DOI: 10.1097/hjh.0000000000003229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/15/2022] [Accepted: 05/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reliable measurement of daytime and night-time blood pressure (BP), and degree of BP dipping during sleep during ambulatory blood pressure monitoring (ABPM) requires an accurate definition of sleep time (diurnal definition). However, superiority of any diurnal definition on ABPM remains unclear. The present study compared mean daytime and night-time SBP and DBP using different methods for diurnal definition: patient's diary, wide-defined and narrow-defined fixed periods, and actigraphy, in a Chinese population with diagnosed essential hypertension. We hypothesize that BP values from actigraphy are different from BP obtained by other methods and associated with end-organ damage (i.e. impaired renal function, proteinuria, left ventricular hypertrophy). METHODS From April 2017 to October 2019, 203 Chinese patients diagnosed with hypertension were recruited prospectively from Lek Yuen Clinic and 179 completed a 48-h ABPM study, wearing a validated actigraph and completed a sleep diary. Presence of end-organ damage was retrieved from the computerized clinical management system. The differences in the mean BP values provided by different diurnal definition were compared using paired t tests and Bland-Altman plots. The prevalence of elevated BP, dipping status categories, overall percentage agreement and the Kappa statistic were calculated by pairwise comparisons between different diurnal definitions. The reproducibility was also estimated and logistic regression was used to examine the relationship between BP values from different diurnal definitions and end-organ damage. RESULTS Mean daytime and night-time BP values were similar regardless of the definition used (mean difference <2 mmHg). Kappa statistics and overall percentage agreement found excellent agreement between different definitions to diagnose elevated daytime BP (Kappa ranged from 0.80 to 0.91) and night-time BP (Kappa ranged from 0.74 to 0.89). Good agreement to diagnose nondipping was also detected (Kappa ranged from 0.65 to 0.78). Furthermore, ABPM values were most reproducible when diurnal periods were defined by patient's diary (intra-class correlation coefficient = 0.82-0.93). Daytime and night-time BP values obtained using different diurnal definitions did not differ in their association to end-organ damage. CONCLUSION Differing definitions of diurnal periods provide similar mean BP values among a Chinese hypertensive population and have good agreement for diagnosis of elevated BP and dipping status. In individual patients, clinicians should be aware that different definitions of diurnal periods can lead to a 3-5 mmHg difference in patient's BP values and may affect the diagnosis of elevated BP in patients with BP close to diagnostic thresholds. The current study supports using the patient's diary to define diurnal periods, which provided the best reproducibility.
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Affiliation(s)
- Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Mengting Zhu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Dicken Cheong-Chun Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Benjamin Hon-Kei Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Anastasia Susie Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital
- Macquarie University, Sydney, New South Wales, Australia
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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Chen JY, Chao D, Wong SYS, Tse TYE, Wan EYF, Tsang JPY, Leung MKW, Ko W, Li YC, Chen C, Luk W, Dao MC, Wong M, Leung WM, Lam CLK. Morbidity patterns in primary care in Hong Kong: protocol for a practice-based morbidity survey (Preprint). JMIR Res Protoc 2022; 11:e37334. [PMID: 35731566 PMCID: PMC9260520 DOI: 10.2196/37334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background Up-to-date and accurate information about the health problems encountered by primary care doctors is essential to understanding the morbidity pattern of the community to better inform health care policy and practice. Morbidity surveys of doctors allow documentation of actual consultations, reflecting the patient’s reason for seeking care as well as the doctor’s diagnostic interpretation of the illness and management approach. Such surveys are particularly critical in the absence of a centralized primary care electronic medical record database. Objective With the changing sociodemographic profile of the population and implementation of health care initiatives in the past 10 years, the aim of this study is to determine the morbidity and management patterns in Hong Kong primary care during a pandemic and compare the results with the last survey conducted in 2007-2008. Methods This will be a prospective, practice-based survey of Hong Kong primary care doctors. Participants will be recruited by convenience and targeted sampling from both public and private sectors. Participating doctors will record the health problems and corresponding management activities for consecutive patient encounters during one designated week in each season of the year. Coding of health problems will follow the International Classification of Primary Care, Second Edition. Descriptive statistics will be used to calculate the prevalence of health problems and diseases as well as the rates of management activities (referral, investigation, prescription, preventive care). Nonlinear mixed effects models will assess the differences between the private and public sectors as well as factors associated with morbidity and management patterns in primary care. Results The data collection will last from March 1, 2021, to August 31, 2022. As of April 2022, 176 doctor-weeks of data have been collected. Conclusions The results will provide information about the health of the community and inform the planning and allocation of health care resources. Trial Registration ClinicalTrials.gov NCT04736992; https://clinicaltrials.gov/ct2/show/NCT04736992 International Registered Report Identifier (IRRID) DERR1-10.2196/37334
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Affiliation(s)
- Julie Yun Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - David Chao
- The Hong Kong College of Family Physicians, Hong Kong, China (Hong Kong)
- Department of Family Medicine & Primary Health Care, Kowloon East Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Samuel Yeung-Shan Wong
- Division of Family Medicine and Primary Healthcare, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Tsui Yee Emily Tse
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Joyce Pui Yan Tsang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Maria Kwan Wa Leung
- Department of Family Medicine & Primary Health Care, New Territories East Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Welchie Ko
- Department of Family Medicine & Primary Health Care, Hong Kong West Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Yim-Chu Li
- Department of Family Medicine & Primary Health Care, Kowloon Central Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Catherine Chen
- Department of Family Medicine & Primary Health Care, Kowloon Central Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Wan Luk
- Department of Family Medicine & Primary Health Care, Kowloon West Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Man-Chi Dao
- Department of Family Medicine & Primary Health Care, Kowloon West Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Michelle Wong
- Department of Family Medicine & Primary Health Care, Hong Kong East Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Wing Mun Leung
- Department of Family Medicine & Primary Health Care, Hong Kong East Cluster, Hospital Authority, Hong Kong, China (Hong Kong)
| | - Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China (Hong Kong)
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Lee EKP, Poon P, Yu CP, Lee VWY, Chung VCH, Wong SYS. Controlled-release oral melatonin supplementation for hypertension and nocturnal hypertension: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2022; 24:529-535. [PMID: 35388609 PMCID: PMC9106086 DOI: 10.1111/jch.14482] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 12/16/2022]
Abstract
Oral melatonin is a potential alternative treatment for hypertension and nocturnal hypertension. However, high‐quality and relevant meta‐analyses are lacking. This meta‐analysis aimed to investigate whether oral melatonin supplementation reduces daytime/asleep blood pressure and cardiovascular risk, improves sleep quality, and is well‐tolerated compared with placebo. Relevant articles were searched in multiple databases, including MEDLINE, EMBASE, CINAHL Complete, and the Cochrane Library, from their inception to June 2021. The included studies were randomized controlled trials recruiting patients with hypertension, using oral melatonin as the sole intervention, and investigating its effect on blood pressure. The mean out‐of‐office (including 24‐h, daytime, and asleep) systolic and diastolic blood pressures, sleep quality, and side effects were compared between the melatonin and placebo arms using pairwise random‐effect meta‐analyses. A risk of bias assessment was performed using the Cochrane risk‐of‐bias tool. Four studies were included in the analysis and only one study was considered to have a low risk of bias. No study reported on cardiovascular risk or outcomes. Only controlled‐release melatonin (not an immediate‐release preparation) reduced asleep systolic blood pressure by 3.57 mm Hg (95% confidence interval: –7.88 to .73; I2 = 0%). It also reduced asleep and awake diastolic blood pressure, but these differences were not statistically significant. Melatonin improves sleep efficacy and total sleep time and is safe and well‐tolerated. Due to the limited number of high‐quality trials, the quality of evidence was low to very low. Therefore, adequately powered randomized controlled trials on melatonin are warranted.
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Affiliation(s)
- Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Paul Poon
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Chun-Pong Yu
- Li Ping Medical Library, The Chinese University of Hong Kong, Hong Kong
| | - Vivian Wing-Yan Lee
- the Centre for Learning Enhancement and Research, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Vincent Chi-Ho Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.,School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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23
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Zhu M, Rabago D, Chung VCH, Reeves KD, Wong SYS, Sit RWS. Effects of Hypertonic Dextrose Injection (Prolotherapy) in Lateral Elbow Tendinosis: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2022; 103:2209-2218. [PMID: 35240122 DOI: 10.1016/j.apmr.2022.01.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematic review the effectiveness of hypertonic dextrose prolotherapy (DPT) on pain intensity and physical functioning in patients with lateral elbow tendinosis (LET) compared with other active non-surgical treatments. DATA SOURCES Systematic search of CENTRAL, MEDLINE, EMBASE, Web of Science, PubMed, Dimensions, Global Health, NHS Health Technology Assessment, AMED and OVID nursing database from inception to 15 June 2021, without language restrictions. STUDY SELECTION Two reviewers independently identified parallel or cross-over RCTs that evaluated the effectiveness of DPT in LET. The search identified 245 records; data from 8 studies (354 patients) were included. DATA EXTRACTION Two reviewers independently extracted data and assessed included studies. The Cochrane Risk of Bias 2 tool was used to evaluate risk of bias. The Grading of Recommendation Assessment, Development, and Evaluation approach was used to assess quality of the evidence. DATA SYNTHESIS Pooled results favored the use of DPT in reducing tennis elbow pain intensity compared with active controls at 12 weeks post-enrollment, with standardized mean difference (SMD) of -0.44 (95% CI -0.88 to -0.01, P =0.04) and of moderate heterogeneity (I2= 49%). Pooled results also favored the use of DPT on physical functioning compared with active controls at 12 weeks, with DASH score achieving mean difference (MD) -15.04 (95% CI -20.25 to -9.82, P < 0.001) and of low heterogeneity (I2= 0.0%). No major related adverse events have been reported. CONCLUSIONS DPT is superior to active controls at 12 weeks for decreasing pain intensity and functioning by margins that meet criteria for clinical relevance in the treatment of LET. While existing studies are too small to assess rare adverse events, for LET patients, especially those refractory to first-line treatments, DPT can be considered a non-surgical treatment option in carefully selected patients. Further high-quality trials with comparison with other injection therapies are needed.
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Affiliation(s)
- Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong, China.
| | - David Rabago
- Department of Family and Community Medicine, Pennsylvania State University, United States of America.
| | - Vincent Chi-Ho Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong, China.
| | | | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong, China.
| | - Regina Wing-Shan Sit
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong, China.
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Wong ELY, Lau JYC, Chau PYK, Chung RYN, Wong SYS, Woo J, Yeoh EK. Caregivers’ Experience of End-of-Life Stage Elderly Patients: Longitudinal Qualitative Interview. IJERPH 2022; 19:ijerph19042101. [PMID: 35206288 PMCID: PMC8871572 DOI: 10.3390/ijerph19042101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/11/2022] [Accepted: 02/12/2022] [Indexed: 02/01/2023]
Abstract
Objectives: This study seeks to provide an understanding of the changing experiences in caregivers of end-of-life patients in Hong Kong through exploring their caregiving journey. Methods: Using longitudinal individual qualitative interviews, a total of 14 caregivers of community-dwelling elderly patients receiving end-of-life care were recruited between 2015 and 2016. A series of in-depth interviews and observations were conducted in 14 cases during the end-of-life journey. Results: A thematic analysis revealed four sequential experiential stages, abbreviated as “CAPE” that caregivers confronted: Stage 1 Certainty, (1a) lack of certainty regarding the progression of decline at the end-stage of life (1b) feelings of despair as patients’ function decreased; Stage 2 Ambivalence, (2a) feelings of ambivalence after decisions were made regarding EOL care, (2b) struggle over care responsibility within families; Stage 3 Perturbed, (3a) varied in quality of EOL care, (3b) depressed mood arisen from frequent exposure to the suffering of elderly patients; and Stage 4 Expectation, (4a) losing the caregiving role as patients showing signs of imminent death. Conclusions: These findings increase our understanding of caregivers’ in-depth experience over time that arise within the structural context of end-of-life care. Our data highlights the need for end of life related knowledge and information, provision of a caring atmosphere and communication, and professional-led detachment in creating caregiving-friendly service in healthcare system, thus as to provide support and alleviate stress for caregivers with their critical responsibility and role during the course of end-of-life care.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
- Correspondence:
| | - Janice Ying-Chui Lau
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Patsy Yuen-Kwan Chau
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Roger Yat-Nork Chung
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Samuel Yeung-Shan Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Jean Woo
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China;
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
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Yeung NCY, Wong ELY, Cheung AWL, Leung CSY, Yeoh EK, Wong SYS. Finding the positives from the COVID-19 pandemic: factors associated with posttraumatic growth among nurses in Hong Kong. Eur J Psychotraumatol 2022; 13:2005346. [PMID: 35145608 PMCID: PMC8823681 DOI: 10.1080/20008198.2021.2005346] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Due to active involvement with patients for COVID-19 treatments, nurses are susceptible to adverse psychological outcomes amid the COVID-19 pandemic. Despite the distress, studies have suggested that nurses are able to experience positive changes (i.e. posttraumatic growth; PTG) during the pandemic. Research on other populations has also indicated that COVID-19-specific worries and work-related coping resources are associated with people's positive changes during the pandemic. OBJECTIVE This study examined how socio-demographic characteristics, COVID-19-related worries, and work-related variables (satisfaction with work and workplace pandemic guidelines) were associated with PTG among nurses in Hong Kong. METHODS Nurses (N = 1510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between 8 August 2020 and 22 September 2020. They were invited to complete a cross-sectional survey measuring their sociodemographic characteristics, COVID-19 worries, and satisfaction with work and workplace pandemic-control measures. RESULTS Results from hierarchical regressions found that those working non-full-time (β = -0.06), affiliating with a religion (β = 0.24), having higher COVID-19-related worries and psychological distress (βs ranging from 0.12-0.15), and having higher work satisfaction (β = 0.14) were associated with higher PTG (ps < .05). Moreover, a significant interaction between psychological distress and satisfaction with workplace pandemic control guidelines emerged in explaining PTG (β = 0.08, p < .05), such that guideline satisfaction was only associated with higher PTG among those with higher distress (β = 0.09, p = .03), but not those with lower distress (β = -0.05, p > .05). CONCLUSIONS Nurses in Hong Kong did report positive changes amid the COVID-19 pandemic. Future studies could focus on the contributing factors of PTG to design for effective strategies to enhance resources for nurses to promote positive psychosocial outcomes.
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Affiliation(s)
- Nelson Chun-Yiu Yeung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cecilia Shih-Ya Leung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- The Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Lee EKP, Wong B, Chan PHS, Zhang DD, Sun W, Chan DCC, Gao T, Ho F, Kwok TCY, Wong SYS. Effectiveness of a mindfulness intervention for older adults to improve emotional well-being and cognitive function in a Chinese population: A randomized waitlist-controlled trial. Int J Geriatr Psychiatry 2022; 37. [PMID: 34415638 DOI: 10.1002/gps.5616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/05/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND To investigate the effect of a modified mindfulness-based stress reduction (mMBSR) program on mental well-being and cognitive function of older adults. METHOD Two hundred and fourty-six participants were randomly assigned to mMBSR (n = 120) group or waitlist control group which received mMBSR at 2-month (n = 123). Data collected at baseline, 2 and 4 months after recruitment. PRIMARY OUTCOME mental well-being: Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). SECONDARY OUTCOMES Five Facet Mindfulness Questionnaire Short Form, Montreal Cognitive Assessment (MOCA), Verbal Fluency Test (VFT), international shopping list test, self-compassion scale, peace of mind scale, geriatric depression scale (GDS), and Pittsburgh sleep quality index (PSQI). In modified-intention-to-treat analysis, paired t-test for within group comparison, and ANCOVA to compare group differences at 2-months with adjustment of baseline values. RESULTS Most participants were female (83.7%), living with others (67.0%), and married (50.7%). No significant difference of baseline characteristics except sleep quality. At 2 months, intervention group reported better mental well-being (0.9, 95%CI: 0.1-1.8, p = 0.025) and less depressive symptoms (-1.0; 95%CI: -1.7 to -0.3, p = 0.004). Within group at 2 months, intervention group had improvement in: mental well-being (SWEMWBS: 22.5-23.4, p = 0.011), cognitive function (MOCA: 24.6-25.8, p < 0.001; VFT: 38.7-42.1, p < 0.001), depressive symptoms (GDS: 4.1-3.1, p < 0.001), and sleep quality (PSQI: 8.3-6.7, p < 0.001). All these changes, except mental well-being, were sustained at 4 months. DISCUSSION Attrition rate was 14% and mindfulness intervention was found to be feasible and acceptable in older adults. Major limitation of the study was the absence of an active control group to control for non-specific effect.
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Affiliation(s)
- Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Bel Wong
- Jockey Club Centre for Positive Ageing, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Daisy Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wen Sun
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Dicken Cheong-Chun Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ting Gao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Florence Ho
- Jockey Club Centre for Positive Ageing, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy Chi Yui Kwok
- Jockey Club Centre for Positive Ageing, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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27
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Xu Z, Zhang D, Ding H, Zheng X, Lee RCM, Yang Z, Mo PKH, Lee EKP, Wong SYS. Association of positive and adverse childhood experiences with risky behaviours and mental health indicators among Chinese university students in Hong Kong: an exploratory study. Eur J Psychotraumatol 2022; 13:2065429. [PMID: 35646294 PMCID: PMC9135422 DOI: 10.1080/20008198.2022.2065429] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Different childhood experiences may affect adult health differently. OBJECTIVE To explore the association of different types of positive childhood experiences(PCEs) and adverse childhood experiences (ACEs) with risky behaviours and mental health indicators, andhow PCEs and ACEs are associated with health outcomes in the context of each other. METHOD This was an exploratory cross-sectional online survey including 332 university students in Hong Kong. ACEs (abuse and household challenges), PCEs (perceived safety, positive quality of life, and interpersonal support), risky behaviours (smoking, binge drinking, and sexual initiation), and mental health indicators(depression, anxiety, loneliness, self-rated health, multimorbidity, meaning in life, and life satisfaction)were measured. RESULTS The multivariable logistic regression analysis indicated cumulative effects of PCEs in lowered risks of depression, anxiety, loneliness, as well as better self-rated health, life satisfaction, and meaning in life (p < .05), after adjusting for ACEs. Results also indicated that ACEs had an increasing relationship with poorer mental health indicators, such as anxiety, loneliness, and life satisfaction (p < .05), after adjusting for PCEs. There was also an adverse association between having ≥4 ACEs with smoking and binge drinking. In addition, each type of PCE and ACE was significantly associated with one or more risky behaviours and mental health indicators. Stratified results showed that PCEs had stronger associations with mental health indicators in participants with fewer ACEs. Furthermore, ACEs had stronger associations with mental health indicators in participants with more PCEs than in those with fewer PCEs. CONCLUSIONS In this study, PCE was proven to be an independent protective factor against poor mental health after accounting for ACE. ACE was also proven to be an independent risk factor for poor mental health and risky behaviours. These findings suggest a crucial need for the active promotion of PCEs and the prevention of child maltreatment. The results of subtypes and stratifications can be taken into consideration when developing targeted interventions in the future. HIGHLIGHTS PCE is an independent protective factor against poor mental health after accounting for ACE. ACE is an independent risk factor for poor mental health and risky behaviours.PCEs and ACEs have different associations with health outcomes in the context of one another.
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Affiliation(s)
- Zijun Xu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Dexing Zhang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Hanyue Ding
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Xiaoxiang Zheng
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Rym Chung-Man Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Zuyao Yang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Phoenix Kit-Han Mo
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Eric Kam-Pui Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
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28
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Wang K, Wong ELY, Cheung AWL, Yau PSY, Chung VCH, Wong CHL, Dong D, Wong SYS, Yeoh EK. Influence of Vaccination Characteristics on COVID-19 Vaccine Acceptance Among Working-Age People in Hong Kong, China: A Discrete Choice Experiment. Front Public Health 2021; 9:793533. [PMID: 34957038 PMCID: PMC8702724 DOI: 10.3389/fpubh.2021.793533] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Along with individual-level factors, vaccination-related characteristics are important in understanding COVID-19 vaccine hesitancy. This study aimed to determine the influence of these characteristics on vaccine acceptance to formulate promotion strategies after considering differences among respondents with different characteristics. Methods: An online discrete choice experiment was conducted among people aged 18–64 years in Hong Kong, China, from 26 to 28 February 2021. Respondents were asked to make choices regarding hypothetical vaccination programmes described by vaccination-related characteristics—the attributes derived from a prior individual interview. Subgroup analysis was performed to identify the differences in vaccination-related characteristics among respondents with different personal characteristics. Results: A total of 1,773 respondents provided valid responses. The vaccine efficacy and brand were the most important factors affecting acceptance, followed by the exemption of quarantine for vaccinated travelers, safety, venue for vaccination, vaccine uptake of people in their lives, and recommendations by general physicians or government. Frequent exposure to vaccination information on social media has been associated with increasing vaccine refusal. Substantial preference heterogeneity for the attributes was found among people of different ages, incomes, chronic conditions, and previous acceptance of influenza vaccines. Conclusion: The findings provided evidence to formulate interventions to promote vaccine uptake, including the provision of vaccination at housing estate or workplaces, involvement of general physicians and interpersonal communication in vaccine promotion and information dissemination, and exemption of quarantine for vaccinated people. Moreover, social media is a significant information channel that cannot be neglected in the dissemination of official information.
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Affiliation(s)
- Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Peter Sen-Yung Yau
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chi-Ho Chung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Charlene Hoi-Lam Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Dong Dong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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29
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Hu R, Hui SSC, Lee EKP, Stoutenberg M, Wong SYS, Yang YJ. Provision of physical activity advice for patients with chronic diseases in Shenzhen, China. BMC Public Health 2021; 21:2143. [PMID: 34814878 PMCID: PMC8611940 DOI: 10.1186/s12889-021-12185-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity (PA) may best be promoted to patients during clinical consultations. Few studies investigated the practice of PA advice given by physicians, especially in China. This study aimed to investigate the prevalence and contents of PA advice given by physicians in China and its association with patients' characteristics. METHODS Face-to-face questionnaire asking the prevalence and contents of PA advice given by physicians was administered to adult patients in three major hospitals in Shenzhen, China. Attitude of compliance, stature, PA level, and socio-demographic information were also collected. Data was analyzed via descriptive statistics and binary logistic regression. RESULTS Of the 454 eligible patients (Age: 47.0 ± 14.4 years), only 19.2% (n = 87) reported receiving PA advice, whereas 21.8%, 23.0%, 32.2%, and 55.2% of patients received advices on PA frequency, duration, intensity, and type, respectively. Male patients were more likely to receive PA advice from physicians [odds ratio (OR): 1.81; 95% confidence interval (CI): 1.08-3.05], whereas patients who were unemployed (OR: 0.16; 95% CI: 0.04-0.67), and who already achieved adequate amount of PA (OR: 0.29; 95% CI: 0.12-0.71) were less likely to receive PA advice. CONCLUSIONS Prevalence of physicians providing physical activity advice to patients is low, there is a pressing need to take intervention measures to educate healthcare providers.
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Affiliation(s)
- Rui Hu
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong.
| | - Eric Kam-Pui Lee
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Mark Stoutenberg
- Department of Kinesiology, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Samuel Yeung-Shan Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Yi-Jian Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
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30
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Yeung NCY, Wong ELY, Cheung AWL, Yeoh EK, Wong SYS. Feeling Anxious Amid the COVID-19 Pandemic: Factors Associated With Anxiety Symptoms Among Nurses in Hong Kong. Front Psychol 2021; 12:748575. [PMID: 34659066 PMCID: PMC8517884 DOI: 10.3389/fpsyg.2021.748575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The coronavirus (COVID-19) pandemic has increased the burden for the medical systems around the world. In Hong Kong, the pandemic not only affects the local populations, but also the healthcare workers. Healthcare workers, especially nurses, involving in COVID-19 treatments are highly susceptible to adverse psychological outcomes (e.g., anxiety symptoms). Studies have shown that socio-demographic characteristics, COVID-19-specific worries, and work settings-related variables are associated with healthcare workers' well-being during the COVID-19 pandemic. However, relevant studies for nurses in Hong Kong are limited. This study examined the psychosocial correlates of anxiety symptoms among nurses in Hong Kong. Methods: Nurses (N = 1,510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between August 8, 2020 and September 22, 2020. They were invited to complete a cross-sectional survey measuring their anxiety symptoms, sociodemographic characteristics, COVID-19-specific worries, and satisfaction with work and workplace pandemic-control guidelines. Results: 17.2% of nurses reported moderate to severe levels of anxiety symptoms. Results from hierarchical regressions found that higher COVID-19-specific worries (contracting COVID-19, family members contracting COVID-19 due to their nursing work, insufficient protective equipment at workplace) (βs ranged from 0.07 to 0.20, ps < 0.01), higher perceived stigma of being a healthcare worker (β = 0.18, p < 0.001), and lower work satisfaction (β = −0.21, p < 0.001) were associated with higher anxiety symptoms. Conclusion: A moderate proportion of nurses in Hong Kong did report levels of anxiety symptoms amid the COVID-19 pandemic. Futures studies could focus on the contributing factors of anxiety symptoms to design for effective strategies to promote nurses' well-being during pandemic situations.
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Affiliation(s)
- Nelson Chun-Yiu Yeung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong, SAR China
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong, SAR China
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31
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Chan SM, Chung GKK, Chan YH, Woo J, Yeoh EK, Chung RYN, Wong SYS, Marmot M, Lee RWT, Wong H. The mediating role of individual-level social capital among worries, mental health and subjective well-being among adults in Hong Kong during the COVID-19 pandemic. Curr Psychol 2021; 42:10260-10270. [PMID: 34580570 PMCID: PMC8459135 DOI: 10.1007/s12144-021-02316-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic has substantially induced worries and affected individual mental health and subjective well-being. Nonetheless, a high level of social capital could potentially protect individuals who suffer from mental health problems and thus promote their subjective well-being, especially under the social distancing policies during the pandemic. To this end, based on a random sample of 1053 Hong Kong adults, structural equation modeling was applied to study the path relationships between the worries of COVID-19, social capital, mental health problems, and subjective well-being. The study found that worries during the pandemic were associated with mental health and subjective well-being, through social capital as a mediator. Moreover, social capital exhibited a stronger influence on mental health and subjective well-being in the economically inactive group than in the economically active group. This study highlights the important role of social capital during the COVID-19 pandemic. While Hong Kong’s COVID-19 response has primarily focused on disease prevention, it must be noted that social services and mutual-help activities are also crucial for people to withstand the crisis.
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Affiliation(s)
- Siu-Ming Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,Department of Social and Behavioural Sciences (Social Work), The City University of Hong Kong, Hong Kong, SAR China
| | - Gary Ka-Ki Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China
| | - Yat-Hang Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China
| | - Jean Woo
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Eng Kiong Yeoh
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Roger Yat-Nork Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR China.,School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Samuel Yeung-Shan Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Michael Marmot
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,UCL Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, London, UK
| | - Richard Wai-Tong Lee
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Hung Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, The Chinese University of Hong Kong, SAR Hong Kong, China.,Department of Social Work, The Chinese University of Hong Kong, Hong Kong, SAR China
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32
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Lee EKP, Zhang DD, Yip BHK, Cheng J, Hui SSC, Yu EYT, Leung M, Chu WCW, Mihailidou AS, Wong SYS. Exercise Intervention to Normalize Blood Pressure and Nocturnal Dipping in HyperTensive Patients (END-HT): Protocol of a Randomized Controlled Trial. Am J Hypertens 2021; 34:753-759. [PMID: 33471104 DOI: 10.1093/ajh/hpab019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Lack of decrease (≤10%) in systolic blood pressure (BP) during sleep, referred to as non-dipping (ND), independently predicts cardiovascular events and mortality. There has been no prospective and adequately powered randomized controlled trial (RCT) to determine whether exercise, when compared with standard treatment, can normalize ND in patients with hypertension (HT). Further, most patients do not sustain an exercise program by 12 months. METHODS A 2-arm, assessor-blinded RCT, involving 198 hypertensive Chinese patients who have ND will be conducted to evaluate the effectiveness of a combined exercise (aerobic exercise and resistance training) program to normalize ND. The combined exercise program, "exercise is medicine" (EIM), was developed to maintain exercise habit using a variety of techniques (e.g. 12-week exercise classes, mobile application, wrist trackers, self-scheduling, monitoring, regular feedback, and motivational interviewing). Eligible patients will be randomized to EIM plus usual care or to usual care in 1:1 ratio by stratified randomization according to age and sex. The randomization sequence is blinded to the investigators and allocation is disclosed only after valid consent. Ambulatory BP measurements will be performed at baseline, 3, and 12 months. The primary outcome is proportion of participants with ND at 3 months; secondary outcomes include proportion of participants with ND at 12 months, absolute BP values at 3 and 12 months. Exercise level will be detected by validated questionnaire and compared between 2 arms at 3 and 12 months. CONCLUSION The trial will examine the efficacy of treating ND and HT by an exercise program.
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Affiliation(s)
- Eric Kam-Pui Lee
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Daisy Dexing Zhang
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Benjamin Hon-Kei Yip
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - James Cheng
- Department of Computer Science and Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Stanley Sai-Chuen Hui
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - Maria Leung
- Department of Family Medicine, New Territory East Cluster, Hospital Authority, Hong Kong
| | - Winnie Chiu Wing Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong
| | - Anastasia Susie Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, and Macquarie University, Sydney, NSW, Australia
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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33
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Chung GKK, Chan SM, Chan YH, Yip TCF, Ma HM, Wong GLH, Chung RYN, Wong H, Wong SYS, Yeoh EK, Marmot M, Woo J. Differential Impacts of Multimorbidity on COVID-19 Severity across the Socioeconomic Ladder in Hong Kong: A Syndemic Perspective. Int J Environ Res Public Health 2021; 18:8168. [PMID: 34360461 PMCID: PMC8346110 DOI: 10.3390/ijerph18158168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/23/2022]
Abstract
The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72-3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32-2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system.
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Affiliation(s)
- Gary Ka-Ki Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
| | - Siu-Ming Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Yat-Hang Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
| | - Terry Cheuk-Fung Yip
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hon-Ming Ma
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
| | - Grace Lai-Hung Wong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
- Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Roger Yat-Nork Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hung Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng Kiong Yeoh
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Michael Marmot
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- UCL Institute of Health Equity, UCL Research Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Jean Woo
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (S.Y.-S.W.); (E.K.Y.); (M.M.); (J.W.)
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China; (T.C.-F.Y.); (H.-M.M.); (G.L.-H.W.)
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
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Xu Z, Sun W, Zhang D, Chung VCH, Sit RWS, Wong SYS. Comparative Effectiveness of Interventions for Global Cognition in Patients With Mild Cognitive Impairment: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Front Aging Neurosci 2021; 13:653340. [PMID: 34220484 PMCID: PMC8249717 DOI: 10.3389/fnagi.2021.653340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/17/2021] [Indexed: 12/13/2022] Open
Abstract
Background: There is a lack of study comprehensively comparing the effects of all existing types of interventions on global cognition among patients with mild cognitive impairment (MCI). Aims: To conduct a network meta-analysis to evaluate the effectiveness of different types of interventions in improving global cognition among MCI patients. Methods: Randomized controlled trials (RCTs) assessing the effects of pharmacological or non-pharmacological interventions on the Mini-Mental State Examination (MMSE) in MCI patients were included. Two authors independently screened the studies and extracted the data. Random-effects network meta-analysis was used to synthesize the data. Results were summarized as mean difference (MD) and corresponding 95% CIs of MMSE in forest plots. Results: Fifty RCTs with 5,944 MCI patients met the inclusion criteria and 49 were included in the network meta-analysis. Compared with the control group, cognition-based intervention (MD = 0.80, 95% CI 0.04–1.57), physical exercise (MD = 1.92, 95% CI 1.19–2.64), combined physical exercise and cognition-based intervention (MD = 1.86, 95% CI 0.60–3.12), and antioxidants (MD = 0.94, 95% CI 0.04–1.83) had positive effects on MMSE in participants with MCI. There was no significant difference between all other interventions included and the control group. Conclusions: This study suggested that cognition-based intervention, physical exercise, combined physical exercise and cognition-based intervention, and antioxidants could be among the most effective interventions on global cognition in older adults with MCI. The availability, acceptability, and cost-effectiveness of interventions should also be taken into consideration when selecting interventions. Registration: PROSPERO CRD42020171985.
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Affiliation(s)
- Zijun Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wen Sun
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Dexing Zhang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent Chi-Ho Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Regina Wing-Shan Sit
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Affiliation(s)
- P K M Poon
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - S Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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Fung ACH, Tsui BSY, Wong SYS, Tam YH. Self-inserted foreign bodies during COVID-19: two case reports. Hong Kong Med J 2021; 27:142-144. [PMID: 33824215 DOI: 10.12809/hkmj208858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- A C H Fung
- Department of Surgery, Princes of Wales Hospital, Hong Kong
| | - B S Y Tsui
- Department of Surgery, Princes of Wales Hospital, Hong Kong
| | - S Y S Wong
- Department of Surgery, Princes of Wales Hospital, Hong Kong
| | - Y H Tam
- Department of Surgery, Princes of Wales Hospital, Hong Kong
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Wong ELY, Ho KF, Dong D, Cheung AWL, Yau PSY, Chan EYY, Yeoh EK, Chien WT, Chen FY, Poon S, Zhang Q, Wong SYS. Compliance with Standard Precautions and Its Relationship with Views on Infection Control and Prevention Policy among Healthcare Workers during COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:ijerph18073420. [PMID: 33806138 PMCID: PMC8038100 DOI: 10.3390/ijerph18073420] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/23/2021] [Accepted: 03/23/2021] [Indexed: 12/20/2022]
Abstract
Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
- Correspondence: ; Tel.: +852-2252-8772
| | - Kin-Fai Ho
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (K.-F.H.); (E.Y.-Y.C.); (S.Y.-S.W.)
| | - Dong Dong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Peter Sen-Yung Yau
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Emily Ying-Yang Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (K.-F.H.); (E.Y.-Y.C.); (S.Y.-S.W.)
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (D.D.); (A.W.-L.C.); (P.S.-Y.Y.); (E.-K.Y.)
| | - Wai-Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Frank Youhua Chen
- Department of Management Sciences, College of Business, City University of Hong Kong, Hong Kong, China;
| | - Simon Poon
- School of Computer Science, Faculty of Engineering, The University of Sydney, Hong Kong, China;
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China;
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (K.-F.H.); (E.Y.-Y.C.); (S.Y.-S.W.)
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38
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Bowman L, Kwok KO, Redd R, Yi Y, Ward H, Wei WI, Atchison C, Wong SYS. Comparing Public Perceptions and Preventive Behaviors During the Early Phase of the COVID-19 Pandemic in Hong Kong and the United Kingdom: Cross-sectional Survey Study. J Med Internet Res 2021; 23:e23231. [PMID: 33539309 PMCID: PMC7942393 DOI: 10.2196/23231] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/19/2020] [Accepted: 02/01/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Given the public health responses to previous respiratory disease pandemics, and in the absence of treatments and vaccines, the mitigation of the COVID-19 pandemic relies on population engagement in nonpharmaceutical interventions. This engagement is largely driven by risk perception, anxiety levels, and knowledge, as well as by historical exposure to disease outbreaks, government responses, and cultural factors. OBJECTIVE The aim of this study is to compare psychobehavioral responses in Hong Kong and the United Kingdom during the early phase of the COVID-19 pandemic. METHODS Comparable cross-sectional surveys were administered to adults in Hong Kong and the United Kingdom during the early phase of the epidemic in each setting. Explanatory variables included demographics, risk perception, knowledge of COVID-19, anxiety level, and preventive behaviors. Responses were weighted according to census data. Logistic regression models, including effect modification to quantify setting differences, were used to assess the association between the explanatory variables and the adoption of social distancing measures. RESULTS Data from 3431 complete responses (Hong Kong, 1663; United Kingdom, 1768) were analyzed. Perceived severity of symptoms differed by setting, with weighted percentages of 96.8% for Hong Kong (1621/1663) and 19.9% for the United Kingdom (366/1768). A large proportion of respondents were abnormally or borderline anxious (Hong Kong: 1077/1603, 60.0%; United Kingdom: 812/1768, 46.5%) and regarded direct contact with infected individuals as the transmission route of COVID-19 (Hong Kong: 94.0%-98.5%; United Kingdom: 69.2%-93.5%; all percentages weighted), with Hong Kong identifying additional routes. Hong Kong reported high levels of adoption of various social distancing measures (Hong Kong: 32.6%-93.7%; United Kingdom: 17.6%-59.0%) and mask-wearing (Hong Kong: 98.8% (1647/1663); United Kingdom: 3.1% (53/1768)). The impact of perceived severity of symptoms and perceived ease of transmission of COVID-19 on the adoption of social distancing measures varied by setting. In Hong Kong, these factors had no impact, whereas in the United Kingdom, those who perceived their symptom severity as "high" were more likely to adopt social distancing (adjusted odds ratios [aORs] 1.58-3.01), and those who perceived transmission as "easy" were prone to adopt both general social distancing (aOR 2.00, 95% CI 1.57-2.55) and contact avoidance (aOR 1.80, 95% CI 1.41-2.30). The impact of anxiety on adopting social distancing did not vary by setting. CONCLUSIONS Our results suggest that health officials should ascertain baseline levels of risk perception and knowledge in populations, as well as prior sensitization to infectious disease outbreaks, during the development of mitigation strategies. Risk should be communicated through suitable media channels-and trust should be maintained-while early intervention remains the cornerstone of effective outbreak response.
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Affiliation(s)
- Leigh Bowman
- MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College, London, United Kingdom
| | - Kin On Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Shenzhen Research Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Rozlyn Redd
- Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
| | - Yuanyuan Yi
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Helen Ward
- MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College, London, United Kingdom.,Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
| | - Wan In Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Christina Atchison
- Patient Experience Research Centre, School of Public Health, Imperial College London, London, United Kingdom
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Cao L, Lou J, Zhao S, Chan RWY, Chan M, Wu WKK, Chong MKC, Zee BCY, Yeoh EK, Wong SYS, Chan PKS, Wang MH. In silico prediction of influenza vaccine effectiveness by sequence analysis. Vaccine 2021; 39:1030-1034. [PMID: 33483214 DOI: 10.1016/j.vaccine.2021.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/31/2020] [Accepted: 01/03/2021] [Indexed: 12/30/2022]
Abstract
The effectiveness of seasonal influenza vaccines varies with the matching of vaccine strains to circulating strains. Based on the genetic distance of hemagglutinin and neuraminidase gene of the influenza viruses to vaccine strains, we statistically quantified the relationship between the genetic mismatch and vaccine effectiveness (VE) for influenza A/H1N1pdm09, A/H3N2 and B. We also proposed a systematic approach to integrate multiple genes and influenza types for overall VE estimation. Evident linear relationships were identified and validated in independent data. The modelling framework may enable in silico prediction for VE on a real-time basis and inform the influenza vaccine selection strategy.
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Affiliation(s)
- Lirong Cao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK Shenzhen Research Institute, Shenzhen, China.
| | - Jingzhi Lou
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK Shenzhen Research Institute, Shenzhen, China.
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK Shenzhen Research Institute, Shenzhen, China.
| | - Renee W Y Chan
- Department of Pediatrics, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK-UMCU Joint Research Laboratory of Respiratory Virus & Immunobiology, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - Martin Chan
- Department of Microbiology, Stanley Ho Centre for Emerging Infectious Diseases, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - William K K Wu
- CUHK Shenzhen Research Institute, Shenzhen, China; Department of Anesthesia and Intensive Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - Marc Ka Chun Chong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK Shenzhen Research Institute, Shenzhen, China.
| | - Benny Chung-Ying Zee
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK Shenzhen Research Institute, Shenzhen, China.
| | - Eng Kiong Yeoh
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - Paul K S Chan
- Department of Microbiology, Stanley Ho Centre for Emerging Infectious Diseases, Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region.
| | - Maggie Haitian Wang
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, N.T., Hong Kong Special Administrative Region; CUHK Shenzhen Research Institute, Shenzhen, China.
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Bo Y, Kwok KO, Chu KKY, Leung EYH, Yu CP, Wong SYS, Lee EKP. Comparison Between Automated Office Blood Pressure Measurements and Manual Office Blood Pressure Measurements-Implications in Individual Patients: a Systematic Review and Meta-analysis. Curr Hypertens Rep 2021; 23:4. [PMID: 33452580 PMCID: PMC7810619 DOI: 10.1007/s11906-020-01118-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/02/2022]
Abstract
Purpose of Review Automated office blood pressure (AOBP) measurements may provide more accurate estimation of blood pressure (BP) than manual office blood pressure (MOBP) measurements. This systematic review investigated the diagnostic performance of AOBP and MOBP using ambulatory blood pressure measurement (ABPM) as reference. Several databases including MEDLINE, Embase, Scopus, and China Academic Journals were searched. Data were extracted, double-checked by two investigators, and were analysed using a random effects model. Recent Findings A total of 26 observational studies were included. The mean systolic/diastolic BP obtained by AOBP was not significantly different from that obtained by ABPM. The sensitivity and specificity of AOBP to detect elevated BP were approximately 70%. Fewer participants had white-coat hypertension on AOBP measurement than on MOBP measurement (7% versus 14%); however, about 13% had masked hypertension on AOBP measurement. The width of the limit of agreement comparing (i) AOBP and ABPM and (ii) MOBP and ABPM was comparable. Summary AOBP may reduce the rate of the observed white-coat effect but undermine masked hypertension. The current recommendation, however, is limited by the absence of high-quality studies and the high heterogeneity of our results. More high-quality studies using different AOBP machines and in different population are therefore needed. Supplementary Information The online version contains supplementary material available at 10.1007/s11906-020-01118-1.
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Affiliation(s)
- Yacong Bo
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kin-On Kwok
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kareen Ka-Yin Chu
- Department of Continuing Education, University of Oxford, Oxford, UK
| | - Eppie Yu-Han Leung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun Pong Yu
- Li Ping Medical Library, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. .,Room 402, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong.
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Bo Y, Kwok KO, Chung VCH, Yu CP, Tsoi KKF, Wong SYS, Lee EKP. Short-term reproducibility of ambulatory blood pressure measurements: a systematic review and meta-analysis of 35 observational studies. J Hypertens 2020; 38:2095-2109. [PMID: 32555001 PMCID: PMC7575032 DOI: 10.1097/hjh.0000000000002522] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/11/2020] [Accepted: 04/30/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A systematic review on the reproducibility of ambulatory blood pressure measurements (ABPM) has not yet been conducted. This meta-analysis compared 24-h/daytime/night-time SBP and DBP mean values and SBP/DBP nocturnal dipping status from ABPMs in participants with or without hypertension. METHODS Ovid MEDLINE, EMBASE, and CINAHL Complete databases were searched for articles published before 3 May 2019. Eligible studies reporting a 24-h ABPM repeated at least once within 1 month were included. The mean daytime/night-time/24-h BP values, percentage of nocturnal dipping, and proportion of nondippers were compared between the first and second day of measurements, and the proportion of participants with inconsistent dipping status were estimated using a random effect model. RESULTS Population-based analysis found a 0-1.1 mmHg difference between the first and second ABPM for 24-h/daytime/night-time SBP and DBP and 0-0.5% for percentage of SBP/DBP nocturnal dipping. The proportion of non-dippers was not different between the first and second ABPM. Intra-individual analysis found that the 95% limit of agreements (LOA) for SBP/DBP were wide and the 95% LOA for daytime SBP, common reference to diagnose hypertension, ranged -16.7 to 18.4 mmHg. Similarly, 32% of participants had inconsistent nocturnal dipping status. CONCLUSION ABPM had excellent reproducibility at the population level, favouring its application for research purposes; but reproducibility of intra-individual BP values and dipping status from a 24-h ABPM was limited. The available evidence was limited by the lack of high-quality studies and lack of studies in non-Western populations.
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Affiliation(s)
- Yacong Bo
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine
| | - Kin-On Kwok
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine
| | | | - Chun-Pong Yu
- Li Ping Medical Library, The Chinese University of Hong Kong, Hong Kong
| | | | | | - Eric Kam-Pui Lee
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine
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Dong D, Xu RH, Wong ELY, Hung CT, Feng D, Feng Z, Yeoh EK, Wong SYS. Public preference for COVID-19 vaccines in China: A discrete choice experiment. Health Expect 2020; 23:1543-1578. [PMID: 33022806 PMCID: PMC7752198 DOI: 10.1111/hex.13140] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 01/12/2023] Open
Abstract
Background As the coronavirus disease 2019 (COVID‐19) pandemic is sweeping across the globe, there is an urgent need to develop effective vaccines as the most powerful strategy to end the pandemic. This study aimed to examine how factors related to vaccine characteristics, their social normative influence and convenience of vaccination can affect the public's preference for the uptake of the COVID‐19 vaccine in China. Methods An online discrete choice experiment (DCE) survey was administered to a sample of China's general population. Participants were asked to make a series of hypothetical choices and estimate their preference for different attributes of the vaccine. A mixed logit regression model was used to analyse the DCE data. Willingness to pay for each attribute was also calculated. Results Data of 1236 participants who provided valid responses were included in the analysis. There was strong public preference for high effectiveness of the vaccine, followed by long protective duration, very few adverse events and being manufactured overseas. Price was the least important attribute affecting the public preference in selecting the COVID‐19 vaccine. Conclusions The strong public preferences detected in this study should be considered when developing COVID‐19 vaccination programme in China. The results provide useful information for policymakers to identify the individual and social values for a good vaccination strategy. Patient or Public Contribution The design of the experimental choices was fully based on interviews and focus group discussions participated by 26 Chinese people with diverse socio‐economic backgrounds. Without their participation, the study would not be possible.
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Affiliation(s)
- Dong Dong
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Richard Huan Xu
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi-Tim Hung
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Da Feng
- School of Pharmacy, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health & Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kwok KO, Lai FYL, Wei VWI, Tsoi MTF, Wong SYS, Tang JWT. Comparing the impact of various interventions to control the spread of COVID-19 in twelve countries. J Hosp Infect 2020; 106:214-216. [PMID: 32619456 PMCID: PMC7326439 DOI: 10.1016/j.jhin.2020.06.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/22/2020] [Indexed: 11/16/2022]
Affiliation(s)
- K O Kwok
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China; Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, China.
| | - F Y L Lai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - V W I Wei
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - M T F Tsoi
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - S Y S Wong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - J W T Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
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Li X, Leung CHY, Gao T, Chung VCH, FWP Y, Wong SYS, Lam TP, Cheng JCY, Yip BHK. The use of mindfulness-based intervention to improve bracing compliance for AIS patients. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Despite good bracing compliance is crucial to prevent curve progression among braced AIS patients, only few interventions were suggested to improve bracing compliance. This study examined the effect of MBI on bracing compliance for AIS patients.
Methods
116 eligible AIS patients were randomized and 86 participants were enrolled in intervention. Patients in the MBI group joint weekly sessions, which is an adapted version of mindfulness-based stress reduction (MBSR) program, for 8 weeks. Control group consisted of an 8-week PE intervention that is recommended according to the SOSORT 2011 guideline. The primary outcome is the 6-month post-intervention bracing compliance. The secondary outcomes include quality of life and psychosocial measurements. Primary analysis was ANCOVA with treatment as covariate. Trend analysis was conducted using Linear Mixed effect model.
Results
At the end of intervention, intention-to-treat analysis improved bracing compliance by1.24h/day and 0.08h/day for MBI and PE respectively. MBI group presented an increase in emotional regulation than baseline (ERQ-CCA) (1.92, p = 0.01), especially in Cognitive reappraisal sub-scale (1.00, p = 0.05). Bracing Specific Quality of Life (SRS-22) reduced significantly in both groups, but MBI group decreased less (MBI: -3.08, p = 0.00, PE -4.47, p = 0.00). Effect at six months for compliance progressed negatively but favoured MBI group (MBI: -1.16, p = 0.13, PE: -1.84, p = 0.06) although there was no significant difference between groups (p = 0.78). The Perception of stress (PSS) decreased significantly in PE group (-3,53, p = 0.01) rather than MBI (1.53, p = 0.22), however the between-group difference isn't significant (p = 0.62).
Conclusions
It is alarming that patients in both interventions group progressed with poorer compliance and worsen QoL. These progressions were less severe in the MBI group than in the PE group, but the differences did not reach statistical significant.
Key messages
Both groups decreased in compliance and QoL but MBI group reduced less. MBI wasn't more effective in improving participants’ compliance and other measurements.
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Affiliation(s)
- X Li
- School of Public Health, CUHK, Hongkong, China
| | - C H Y Leung
- School of Public Health, CUHK, Hongkong, China
| | - T Gao
- School of Public Health, CUHK, Hongkong, China
| | - V C H Chung
- School of Public Health, CUHK, Hongkong, China
| | - Yu FWP
- Department of Orthopaedics and Traumatology, CUHK, Hongkong, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, CUHK, Hongkong, China
- Joint Scoliosis Research Center of the Chinese University of, CUHK, Hongkong, China
| | - S Y S Wong
- School of Public Health, CUHK, Hongkong, China
| | - T P Lam
- Department of Orthopaedics and Traumatology, CUHK, Hongkong, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, CUHK, Hongkong, China
- Joint Scoliosis Research Center of the Chinese University of, CUHK, Hongkong, China
| | - J C Y Cheng
- Department of Orthopaedics and Traumatology, CUHK, Hongkong, China
- SH Ho Scoliosis Research Laboratory, Faculty of Medicine, CUHK, Hongkong, China
- Joint Scoliosis Research Center of the Chinese University of, CUHK, Hongkong, China
| | - B H K Yip
- School of Public Health, CUHK, Hongkong, China
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Kim JH, Wong SYS, Chan R, Chan RY, Sumerlin TS, Chan LY. Acceptability of assisted reproductive technologies in Hong Kong, a very low fertility Asian city. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although advances in medical technologies now allow greater reproductive options, the social acceptance of assisted reproductive technologies (ART) has not been examined in East Asian countries which currently have the lowest fertility rates in the world and highly prohibitive regulations.
Methods
A cross-sectional telephone surveys interviewed 990 among Hong Kong Chinese adults (>18 years of age) in 2015 who were asked about their knowledge and attitudes towards various ART and their inclination to use ART. A focus group was conducted (n = 30) on physicians to examine the perceived barriers and benefits of integrating ART as routine offerings.
Results
Although nearly all adults (>92.0%) were familiar with ART procedures such as in vitro fertilization, sperm banking, and gestational surrogacy, attitudes supporting the use of these services and the inclination to use these services varied widely by socio-demographic attributes. Nearly one-third (31.5%) of women said that they would consider cryopreservation of their oocytes or embryos if they could afford it and 21.9% would encourage their female family members to do so. Although respondents considered sperm donation and embryo preservation to be well-accepted practices, support for these services was noticeably lower than in Western countries for unmarried individuals and homosexuals. Also, the vast majority of respondents were much more disinclined to use anonymous donor gametes than in Western countries. Among medical practitioners, the primary barriers to routine offering of these services to their clients was the perceived lack of cultural acceptance of these types of services.
Conclusions
Public support of assisted reproductive services for genetic offspring is well-accepted for heterosexual couples. Main Messages: Asian countries with sub-replacement fertility levels may consider integrating ART into their mainstream health services and updating their regulatory frameworks.
Key messages
Public support for assisted reproductive technologies is high for married couples only in Hong Kong. Given the sub-replacement fertility levels, cities in East Asia should consider updating regulatory frameworks to allow expansion of ART services.
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Affiliation(s)
- J H Kim
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - S Y S Wong
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - R Chan
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - R Y Chan
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - T S Sumerlin
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - L Y Chan
- Hong Kong Reproductive Medicine Centre, Hong Kong, China
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Wong ELY, Ho KF, Wong SYS, Cheung AWL, Yau PSY, Dong D, Yeoh EK. Views on Workplace Policies and its Impact on Health-Related Quality of Life During Coronavirus Disease (COVID-19) Pandemic: Cross-Sectional Survey of Employees. Int J Health Policy Manag 2020; 11:344-353. [PMID: 32772010 PMCID: PMC9278481 DOI: 10.34172/ijhpm.2020.127] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/08/2020] [Indexed: 11/09/2022] Open
Abstract
Background: This study explored the degree of views towards supportive workplace policies among employees during coronavirus disease 2019 (COVID-19) pandemic and its association with health-related quality of life (HRQoL) in Hong Kong.
Methods: A cross-sectional study was conducted in 1049 employees using online self-administered questionnaire. Views on workplace policies were measured in term of agreement on its comprehensiveness, timeliness and transparency whereas HRQoL was measured using EQ-5D-5L Hong Kong version. Univariate estimates on the impact of HRQoL from views of measures in workplace was done. Qualitative comments on the suggestions to strengthen workplace measures were collected and presented descriptively.
Results: Of 1048 respondents, 16% reported that no workplace measures nor guidelines were existed in their company related to the COVID-19 pandemics. Those who reported having workplace policy were not satisfied with the arrangement in term of comprehensiveness (36%), timeliness (38%), and transparency (63%). Regarding to the policy measure, only 68% respondents reported that their workplace supplied face masks to them. The health index was 0897, which was lower than the norm of 0.924. 64% of respondents reported having a health problem in at least 1 of 5 dimension of EQ-5D-5L with the highest proportion of having problem in anxiety/depression (55%). In addition, the workplace policy and measure had a direct effect of 0.131 on health outcome. Perception of infection risk had a direct effect of 0.218 on health outcome and partly mediated the relationship between workplace policy and measure and health outcome (0.066).
Conclusion: The study highlighted the workplace policy and measure is an important mean to minimize infection risk at workplace so as to reduce tremendous stress and health outcome caused by a COVID-19 pandemic. Workplace measures related to COVID-19 pandemic should be further strengthen to mitigate the risk of infection and protect employee’s health.
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Affiliation(s)
- Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kai-Fai Ho
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Samuel Yeung-Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Peter Sen-Yung Yau
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dong Dong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Chung GKK, Chung RYN, Chan DCC, Lai FTT, Wong H, Lau MKW, Wong SYS, Yeoh EK. The independent role of deprivation in abdominal obesity beyond income poverty. A population-based household survey in Chinese adults. J Public Health (Oxf) 2020; 41:476-486. [PMID: 30215743 DOI: 10.1093/pubmed/fdy161] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/13/2018] [Accepted: 08/27/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Individual-level deprivation takes into account the non-monetary aspects of poverty that neither income poverty nor socio-economic factors could fully capture; however, it has rarely been considered in existing studies on social inequality in obesity. Therefore, we examined the associations of deprivation, beyond income poverty, with both general and abdominal obesity. METHODS A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed via face-to-face household interviews between 2014 and 2015. Deprivation was assessed by a Deprivation Index specific to the Hong Kong population. General obesity was defined as body mass index (BMI) ≥ 25 kg/m2, while abdominal obesity was defined as waist circumference (WC) ≥ 90 cm/80 cm for male/female. Multivariable binary logistic regressions were performed. RESULTS Deprivation was independently associated with abdominal obesity (odds ratios (OR) = 1.68; 95% confidence intervals (CI): 1.27-2.22); however, no significant association was found with general obesity (OR=1.03; CI: 0.77-1.38). After additional adjustment for BMI, deprivation remained strongly associated with abdominal obesity (OR=2.00; CI: 1.41-2.83); and after further adjustment for WC, deprivation had a marginal inverse association with general obesity (OR=0.72; CI: 0.51-1.01). CONCLUSIONS Deprivation is an important risk factor of abdominal obesity and plays a critical role in capturing the preferential abdominal fat deposition beyond income poverty.
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Affiliation(s)
- Gary Ka-Ki Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Roger Yat-Nork Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Dicken Cheong-Chun Chan
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Francisco Tsz-Tsun Lai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Maggie Ka-Wai Lau
- Asia-Pacific Institute of Ageing Studies, Lingnan University, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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Yu EYT, Leung WLH, Wong SYS, Liu KSN, Wan EYF. How are family doctors serving the Hong Kong community during the COVID-19 outbreak? A survey of HKCFP members. Hong Kong Med J 2020; 26:176-183. [PMID: 32475841 DOI: 10.12809/hkmj208606] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION This study evaluated the preparedness of family doctors during the early phase of the coronavirus disease 2019 (COVID-19) outbreak in Hong Kong. METHODS All members of the Hong Kong College of Family Physicians were invited to participate in a cross-sectional online survey using a 20-item questionnaire to collect information on practice preparedness for the COVID-19 outbreak through an email followed by a reminder SMS message between 31 January 2020 and 3 February 2020. RESULTS Of 1589 family doctors invited, 491 (31%) participated in the survey, including 242 (49%) from private sector. In all, 98% surveyed doctors continued to provide clinical services during the survey period, but reduced clinic service demands were observed in 45% private practices and 24% public clinics. Almost all wore masks during consultation and washed hands between or before patient contact. Significantly more private than public doctors (80% vs 26%, P<0.001) experienced difficulties in stocking personal protective equipment (PPE); more public doctors used guidelines to manage suspected patients. The main concern of the respondents was PPE shortage. Respondents appealed for effective public health interventions including border control, quarantine measures, designated clinic setup, and public education. CONCLUSION Family doctors from public and private sectors demonstrated preparedness to serve the community from the early phase of the COVID-19 outbreak with heightened infection control measures and use of guidelines. However, there is a need for support from local health authorities to secure PPE supply and institute public health interventions.
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Affiliation(s)
- E Y T Yu
- The Hong Kong College of Family Physicians, Hong Kong.,Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - W L H Leung
- The Hong Kong College of Family Physicians, Hong Kong.,Department of Family Medicine and Primary Health Care, Kowloon West Cluster, Hospital Authority, Hong Kong
| | - S Y S Wong
- The Hong Kong College of Family Physicians, Hong Kong.,The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - K S N Liu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong
| | - E Y F Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong.,Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
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Wong SYS, Kwok KO. Role of computed tomography imaging in identifying COVID-19 cases. Hong Kong Med J 2020; 26:167-168. [PMID: 32525100 DOI: 10.12809/hkmj205099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- S Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
| | - K O Kwok
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
- Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong
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50
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Cheung WKW, Wu IXY, Sit RWS, Ho RST, Wong CHL, Wong SYS, Chung VCH. Low-level laser therapy for carpal tunnel syndrome: systematic review and network meta-analysis. Physiotherapy 2020; 106:24-35. [PMID: 32026843 DOI: 10.1016/j.physio.2019.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Splinting is recommended by various organisations as a non-surgical first-line treatment for carpal tunnel syndrome (CTS), despite the limited evidence supporting its effectiveness. Previous studies on the effectiveness of low-level laser therapy (LLLT) have reported mixed results, and this systematic review aimed to resolve this controversy. OBJECTIVE To perform a network meta-analysis (NMA) for evaluating the effectiveness of LLLT compared with other conservative treatments for CTS. METHODS Eighteen electronic databases were searched for potential randomised controlled trials (RCTs). RCTs evaluating LLLT or other non-surgical treatments as an add-on to splinting were included. Included RCTs measured at least one of the following three outcomes with validated instruments: pain, symptom severity and functional status. RESULTS Six RCTs (418 patients) were included. NMA suggested that LLLT plus splinting has the highest probability (75%) of pain reduction, compared with sham laser plus splinting (61%), ultrasound plus splinting (57%) and splinting alone (8%). However, while LLLT plus splinting is significantly more effective than sham laser plus splinting for pain reduction, the magnitude is not clinically significant (Visual Analogue Scale mean difference -0.53cm, 95% confidence interval -1.01 to -0.05cm; P=0.03, I2=25%). The effect of LLLT plus splinting on symptom severity and functional status was not superior to splinting alone. CONCLUSION The use of LLLT in addition to splinting for the management of CTS is not recommended, as LLLT offers limited additional benefits over splining alone in terms of pain reduction, reduction of symptom severity or improved functional status. PROSPERO for systematic reviews and meta-analyses registration number CRD42017082650.
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Affiliation(s)
- W K W Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - I X Y Wu
- Xiang-Ya School of Public Health, Central South University, Changsha, China
| | - R W S Sit
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - R S T Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - C H L Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - V C H Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
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