1
|
Yao XI, Tong X, Shen C, Song Y, Sun S, Chen K, Shen H. Green space, genetic susceptibility, and risk of osteoporosis:a cohort study from the UK Biobank. Chemosphere 2024; 353:141632. [PMID: 38442776 DOI: 10.1016/j.chemosphere.2024.141632] [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: 11/13/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE This study aimed to investigate the effect of residential exposure to green space on the incident osteoporosis and further explore the modification effect of genetic susceptibility. METHODS Participants from the UK Biobank were followed from 2006 to 2010 (baseline) to December 31st, 2022. Using land use coverage, we evaluated exposure to residential surrounding green space, natural environment, and domestic gardens. We used the Cox regression to examine the association between the residential environment and incident osteoporosis. The interactive effects between polygenic risk score (PRS) of osteoporosis and residential environments on incident osteoporosis were investigated. RESULTS This study included 292,662 participants. Over a median follow-up period of 13.65 years, we documented 9177 incidents of osteoporosis. Per interquartile (IQR) increase in greenness and natural environment at a 300 m buffer was associated with a 4% lower risk of incident osteoporosis [HR = 0.96 (95% CI: 0.93, 0.99)] and [HR = 0.96 (95% CI: 0.93, 0.98)], respectively. We did not identify any interactive effects between genetic risk and residential environment on incident osteoporosis. CONCLUSIONS This study found that public greenness and natural environments could reduce the risk of incident osteoporosis regardless of genetic predisposition. Developing sustainable and publicly accessible natural environments might benefit populations' bone health.
Collapse
Affiliation(s)
- Xiaoxin I Yao
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, PR China
| | - Xinning Tong
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China
| | - Chen Shen
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK; National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, UK
| | - Yichang Song
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China
| | - Shengzhi Sun
- School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
| | - Keng Chen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China.
| | - Huiyong Shen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, PR China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, PR China.
| |
Collapse
|
2
|
Chen K, Wang T, Tong X, Song Y, Hong J, Sun Y, Zhuang Y, Shen H, Yao XI. Osteoporosis is associated with depression among older adults: a nationwide population-based study in the USA from 2005 to 2020. Public Health 2024; 226:27-31. [PMID: 37988825 DOI: 10.1016/j.puhe.2023.10.022] [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: 06/01/2023] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES The global prevalence of osteoporosis is rising, yet it is unclear whether people with osteoporosis have a higher risk of depression than those without osteoporosis. STUDY DESIGN A cross-sectional study. METHODS We used nationally representative data from the US National Health and Nutrition Examination Survey (NHANES) in 2005-2006, 2007-2008, 2009-2010, 2013-2014, and 2017-2020. The diagnosis of osteoporosis was based on the bone mineral density of the femoral neck measured by dual-energy X-ray absorptiometry. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9), with a score ≥5 as depressive symptoms and a score ≥10 as probable depression. We used logistic regression models to evaluate the association between osteoporosis and depressive symptoms and probable depression. RESULTS We included 11,603 adults (aged 50 years and older, 52.3% male) and observed 5.2% of them had osteoporosis. 31.9% of these osteoporotic people had depressive symptoms, and 10.0% had probable depression. Compared to participants without osteoporosis, those with osteoporosis were 1.73 times more likely to experience depressive symptoms (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.20-2.50) and 1.91 times more likely to experience probable depression (OR = 1.91, 95% CI 1.02-3.59), after adjusting for sex, age, race/ethnicity, education, marital status, family income, body mass index, smoking, physical activity, and alcohol abuse. Moderate-to-vigorous activities mediated the associations between osteoporosis and depression and depressive symptoms. CONCLUSIONS Osteoporosis is an independent risk factor for depression. This study highlights the need to evaluate the mental well-being of patients with osteoporosis in clinical and primary health care.
Collapse
Affiliation(s)
- K Chen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - T Wang
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - X Tong
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - Y Song
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - J Hong
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - Y Sun
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Y Zhuang
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - H Shen
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| | - X I Yao
- Department of Orthopaedics, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China; Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, 3025 Shennan Road, Shenzhen 518000, PR China.
| |
Collapse
|
3
|
Han L, Shi H, Li Y, Qi H, Wang Y, Gu J, Wu J, Zhao S, Cao P, Xu L, Deng X, Yao XI, Ran J. Excess Deaths of Gastrointestinal, Liver, and Pancreatic Diseases During the COVID-19 Pandemic in the United States. Int J Public Health 2023; 68:1606305. [PMID: 37649691 PMCID: PMC10462779 DOI: 10.3389/ijph.2023.1606305] [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: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
Objectives: To evaluate excess deaths of gastrointestinal, liver, and pancreatic diseases in the United States during the COVID-19 pandemic. Methods: We retrieved weekly death counts from National Vital Statistics System and fitted them with a quasi-Poisson regression model. Cause-specific excess deaths were calculated by the difference between observed and expected deaths with adjustment for temporal trend and seasonality. Demographic disparities and temporal-spatial patterns were evaluated for different diseases. Results: From March 2020 to September 2022, the increased mortality (measured by excess risks) for Clostridium difficile colitis, gastrointestinal hemorrhage, and acute pancreatitis were 35.9%; 24.8%; and 20.6% higher than the expected. For alcoholic liver disease, fibrosis/cirrhosis, and hepatic failure, the excess risks were 1.4-2.8 times higher among younger inhabitants than older inhabitants. The excess deaths of selected diseases were persistently observed across multiple epidemic waves with fluctuating trends for gastrointestinal hemorrhage and fibrosis/cirrhosis and an increasing trend for C. difficile colitis. Conclusion: The persistently observed excess deaths of digestive diseases highlights the importance for healthcare authorities to develop sustainable strategies in response to the long-term circulating of SARS-CoV-2 in the community.
Collapse
Affiliation(s)
- Lefei Han
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haoting Shi
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongxuan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongchao Qi
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Yuhua Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiawei Gu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayin Wu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi Zhao
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Peihua Cao
- Clinical Research Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Lan Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaobei Deng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoxin I. Yao
- Department of Clinical Research, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
4
|
Ni MY, Canudas-Romo V, Shi J, Flores FP, Chow MSC, Yao XI, Ho SY, Lam TH, Schooling CM, Lopez AD, Ezzati M, Leung GM. Understanding longevity in Hong Kong: a comparative study with long-living, high-income countries. Lancet Public Health 2021; 6:e919-e931. [PMID: 34774201 DOI: 10.1016/s2468-2667(21)00208-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Since 2013, Hong Kong has sustained the world's highest life expectancy at birth-a key indicator of population health. The reasons behind this achievement remain poorly understood but are of great relevance to both rapidly developing and high-income regions. Here, we aim to compare factors behind Hong Kong's survival advantage over long-living, high-income countries. METHODS Life expectancy data from 1960-2020 were obtained for 18 high-income countries in the Organisation for Economic Co-operation and Development from the Human Mortality Database and for Hong Kong from Hong Kong's Census and Statistics Department. Causes of death data from 1950-2016 were obtained from WHO's Mortality Database. We used truncated cross-sectional average length of life (TCAL) to identify the contributions to survival differences based on 263 million deaths overall. As smoking is the leading cause of premature death, we also compared smoking-attributable mortality between Hong Kong and the high-income countries. FINDINGS From 1979-2016, Hong Kong accumulated a substantial survival advantage over high-income countries, with a difference of 1·86 years (95% CI 1·83-1·89) for males and 2·50 years (2·47-2·53) for females. As mortality from infectious diseases declined, the main contributors to Hong Kong's survival advantage were lower mortality from cardiovascular diseases for both males (TCAL difference 1·22 years, 95% CI 1·21-1·23) and females (1·19 years, 1·18-1·21), cancer for females (0·47 years, 0·45-0·48), and transport accidents for males (0·27 years, 0·27-0·28). Among high-income populations, Hong Kong recorded the lowest cardiovascular mortality and one of the lowest cancer mortalities in women. These findings were underpinned by the lowest absolute smoking-attributable mortality in high-income regions (39·7 per 100 000 in 2016, 95% CI 34·4-45·0). Reduced smoking-attributable mortality contributed to 50·5% (0·94 years, 0·93-0·95) of Hong Kong's survival advantage over males in high-income countries and 34·8% (0·87 years, 0·87-0·88) of it in females. INTERPRETATION Hong Kong's leading longevity is the result of fewer diseases of poverty while suppressing the diseases of affluence. A unique combination of economic prosperity and low levels of smoking with development contributed to this achievement. As such, it offers a framework that could be replicated through deliberate policies in developing and developed populations globally. FUNDING Early Career Scheme (RGC ECS Grant #27602415), Research Grants Council, University Grants Committee of Hong Kong.
Collapse
Affiliation(s)
- Michael Y Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China; Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Vladimir Canudas-Romo
- School of Demography, College of Arts and Social Sciences, The Australian National University, Canberra, ACT, Australia
| | - Jian Shi
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Francis P Flores
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Mathew S C Chow
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiaoxin I Yao
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Orthopedics, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Sai Yin Ho
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tai Hing Lam
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - C Mary Schooling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Alan D Lopez
- Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | - Majid Ezzati
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK; Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Gabriel M Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science Park, Hong Kong Special Administrative Region, China
| |
Collapse
|
5
|
Ni MY, Yao XI, Cheung F, Wu JT, Schooling CM, Pang H, Leung GM. Determinants of physical, mental and social well-being: a longitudinal environment-wide association study. Int J Epidemiol 2021; 49:380-389. [PMID: 31872233 DOI: 10.1093/ije/dyz238] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 10/25/2019] [Accepted: 11/13/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Although the World Health Organization (WHO) has defined health as a state of physical, mental and social well-being, public health strategies have primarily focused on one domain of well-being. We sought to systematically and simultaneously identify and validate associations of behavioural patterns, psychosocial factors, mental and physical health conditions, access to and utilization of health care and anthropometrics with physical, mental and social well-being. METHODS We conducted a longitudinal environment-wide association study (EWAS) with a training and testing set approach, accounting for multiple testing using a false discovery rate control. We used multivariate multilevel regression to examine the association of each exposure at wave 1 with the three outcomes at wave 2 in the Hong Kong FAMILY Cohort (n = 10 484). RESULTS Out of 194 exposures, we identified and validated 14, 5 and 5 exposures that were individually associated with physical, mental and social well-being, respectively. We discovered three factors, namely depressive symptoms, life satisfaction and happiness, that were simultaneously associated with the three domains that define health. CONCLUSIONS These associations, if verified to be causal, could become intervention targets to holistically improve population health. Our findings provide empirical support for placing mental health at the forefront of the public health agenda, and also support recent calls to use life satisfaction and happiness to guide public policy.
Collapse
Affiliation(s)
- Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiaoxin I Yao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Felix Cheung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Joseph T Wu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China.,Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| |
Collapse
|
6
|
Ni MY, Yang L, Leung CMC, Li N, Yao XI, Wang Y, Leung GM, Cowling BJ, Liao Q. Mental Health, Risk Factors, and Social Media Use During the COVID-19 Epidemic and Cordon Sanitaire Among the Community and Health Professionals in Wuhan, China: Cross-Sectional Survey. JMIR Ment Health 2020; 7:e19009. [PMID: 32365044 PMCID: PMC7219721 DOI: 10.2196/19009] [Citation(s) in RCA: 227] [Impact Index Per Article: 56.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/04/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The mental health consequences of the coronavirus disease (COVID-19) pandemic, community-wide interventions, and social media use during a pandemic are unclear. The first and most draconian interventions have been implemented in Wuhan, China, and these countermeasures have been increasingly deployed by countries around the world. OBJECTIVE The aim of this study was to examine risk factors, including the use of social media, for probable anxiety and depression in the community and among health professionals in the epicenter, Wuhan, China. METHODS We conducted an online survey via WeChat, the most widely used social media platform in China, which was administered to 1577 community-based adults and 214 health professionals in Wuhan. Probable anxiety and probable depression were assessed by the validated Generalized Anxiety Disorder-2 (cutoff ≥3) and Patient Health Questionnaire-2 (cutoff ≥3), respectively. A multivariable logistic regression analysis was used to examine factors associated with probable anxiety and probable depression. RESULTS Of the 1577 community-based adults, about one-fifth of respondents reported probable anxiety (n=376, 23.84%, 95% CI 21.8-26.0) and probable depression (n=303, 19.21%, 95% CI 17.3-21.2). Similarly, of the 214 health professionals, about one-fifth of surveyed health professionals reported probable anxiety (n=47, 22.0%, 95% CI 16.6-28.1) or probable depression (n=41, 19.2%, 95% CI 14.1-25.1). Around one-third of community-based adults and health professionals spent ≥2 hours daily on COVID-19 news via social media. Close contact with individuals with COVID-19 and spending ≥2 hours daily on COVID-19 news via social media were associated with probable anxiety and depression in community-based adults. Social support was associated with less probable anxiety and depression in both health professionals and community-based adults. CONCLUSIONS The internet could be harnessed for telemedicine and restoring daily routines, yet caution is warranted toward spending excessive time searching for COVID-19 news on social media given the infodemic and emotional contagion through online social networks. Online platforms may be used to monitor the toll of the pandemic on mental health.
Collapse
Affiliation(s)
- Michael Y Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong.,Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong, Hong Kong
| | - Lin Yang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Candi M C Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Na Li
- Department of Anaesthesiology, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Xiaoxin I Yao
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Yishan Wang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Gabriel M Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.,World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Benjamin J Cowling
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.,World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Qiuyan Liao
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
7
|
Yao XI, Ni MY, Cheung F, Wu JT, Schooling CM, Leung GM, Pang H. Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts. CMAJ 2020; 191:E753-E760. [PMID: 31285378 DOI: 10.1503/cmaj.181583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although the association of moderate alcohol consumption with specific disorders, such as cardiovascular disease and cancers, has been well documented, the evidence of the broader impact of alcohol consumption on health-related quality of life is less clear. Our objective was to examine the association of drinking patterns with changes in physical and mental well-being across populations. METHODS We conducted a multilevel analysis with multivariate responses in the population-representative FAMILY Cohort in the Hong Kong Special Administrative Region, China, to examine the association between alcohol drinking patterns across 2 waves (2009-2013) (i.e., quitters, initiators, persistent drinkers, persistent former drinkers and lifetime abstainers) and changes in physical and mental well-being (Physical and Mental Component Summary of the 12-Item Short Form Health Survey [SF-12]). Analyses were stratified by sex. We validated findings using a nationally representative cohort in the United States, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2005). RESULTS In the FAMILY Cohort (n = 10 386; median follow-up 2.3 yr), the change in mental well-being was more favourable in female quitters than in lifetime abstainers (β = 1.44, 95% confidence interval [CI] 0.43 to 2.45; mean score change of +2.0 for quitters and +0.02 for lifetime abstainers). This association was validated in the NESARC (n = 31 079; median follow-up 3.1 yr) (β = 0.83, 95% CI 0.08 to 1.58; mean score change of -1.1 for quitters and -1.6 for lifetime abstainers). INTERPRETATION The change in mental well-being was more favourable in female quitters, approaching the level of mental well-being of lifetime abstainers within 4 years of quitting in both Chinese and American populations.
Collapse
Affiliation(s)
- Xiaoxin I Yao
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Michael Y Ni
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Felix Cheung
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Joseph T Wu
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of Medicine (Yao, Ni, Cheung, Wu, Schooling, Leung, Pang), and The State Key Laboratory of Brain and Cognitive Sciences (Ni), The University of Hong Kong, Hong Kong Special Administrative Region, China; Graduate School of Public Health and Health Policy (Schooling), City University of New York, New York, NY
| |
Collapse
|
8
|
Ni MY, Yao XI, Leung KSM, Yau C, Leung CMC, Lun P, Flores FP, Chang WC, Cowling BJ, Leung GM. Depression and post-traumatic stress during major social unrest in Hong Kong: a 10-year prospective cohort study. Lancet 2020; 395:273-284. [PMID: 31928765 DOI: 10.1016/s0140-6736(19)33160-5] [Citation(s) in RCA: 137] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/08/2019] [Accepted: 12/13/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hong Kong has been embroiled in increasingly violent social unrest since June, 2019. We examined the associated population mental health burden, risk factors, and health-care needs. METHODS In a population-based prospective cohort, adult participants aged 18 years or older were assessed at nine timepoints from 2009. Probable depression was measured using the Patient Health Questionnaire-9 (score ≥10) and suspected post-traumatic stress disorder (PTSD) by the PTSD Checklist-Civilian Version (score ≥14), plus direct exposure to traumatic events related to the ongoing social unrest. We used multivariable logistic regression to identify factors associated with both outcomes, adjusting for doctor-diagnosed depression or anxiety disorders before the unrest. On the basis of routine service statistics and respondents' intention to seek professional care, we projected the number of additional ambulatory specialist psychiatric visits required. FINDINGS After the two baseline surveys, we followed up random subsets of 1213-1736 adults at each timepoint. Probable depression was reported by 11·2% (95% CI 9·8-12·7) of participants in 2019, compared with 1·9% (1·6-2·1) during 2009-14 and 6·5% (5·3-7·6) in 2017 after the Occupy Central Movement and before the current unrest. Prevalence of suspected PTSD in 2019 was estimated to be 12·8% (11·2-14·4). Age, sex, educational attainment, or household income were not associated with either outcome, whereas heavy social media use (≥2 h per day) was associated with both. Political attitude or protest participation was not associated with probable depression, but neutrality towards the extradition bill approximately halved the risk of suspected PTSD. Family support mitigated against probable depression. We estimated that the mental health burden identified would translate into roughly an excess 12% service requirement to the public sector queue or equivalent. INTERPRETATION We have identified a major mental health burden during the social unrest in Hong Kong, which will require substantial increases in service surge capacity. Health-care and social care professionals should be vigilant in recognising possible mental health sequelae. In a world of increasing unrest, our findings might have implications for service planning to better protect population mental health globally. FUNDING Research Grants Council, University Grants Committee of Hong Kong, Hong Kong Jockey Club Charities Trust.
Collapse
Affiliation(s)
- Michael Y Ni
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China; Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Xiaoxin I Yao
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kathy S M Leung
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Cynthia Yau
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Candi M C Leung
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Phyllis Lun
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Francis P Flores
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Wing Chung Chang
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Benjamin J Cowling
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Gabriel M Leung
- School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China.
| |
Collapse
|
9
|
Yao XI, Wang X, Speicher PJ, Hwang ES, Cheng P, Harpole DH, Berry MF, Schrag D, Pang HH. Reporting and Guidelines in Propensity Score Analysis: A Systematic Review of Cancer and Cancer Surgical Studies. J Natl Cancer Inst 2017; 109:3078530. [PMID: 28376195 DOI: 10.1093/jnci/djw323] [Citation(s) in RCA: 226] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/06/2016] [Indexed: 12/15/2022] Open
Abstract
Background : Propensity score (PS) analysis is increasingly being used in observational studies, especially in some cancer studies where random assignment is not feasible. This systematic review evaluates the use and reporting quality of PS analysis in oncology studies. Methods : We searched PubMed to identify the use of PS methods in cancer studies (CS) and cancer surgical studies (CSS) in major medical, cancer, and surgical journals over time and critically evaluated 33 CS published in top medical and cancer journals in 2014 and 2015 and 306 CSS published up to November 26, 2015, without earlier date limits. The quality of reporting in PS analysis was evaluated. It was also compared over time and among journals with differing impact factors. All statistical tests were two-sided. Results More than 50% of the publications with PS analysis from the past decade occurred within the past two years. Of the studies critically evaluated, a considerable proportion did not clearly provide the variables used to estimate PS (CS 12.1%, CSS 8.8%), incorrectly included non baseline variables (CS 3.4%, CSS 9.3%), neglected the comparison of baseline characteristics (CS 21.9%, CSS 15.6%), or did not report the matching algorithm utilized (CS 19.0%, CSS 36.1%). In CSS, the reporting of the matching algorithm improved in 2014 and 2015 ( P = .04), and the reporting of variables used to estimate PS was better in top surgery journals ( P = .008). However, there were no statistically significant differences for the inclusion of non baseline variables and reporting of comparability of baseline characteristics. Conclusions The use of PS in cancer studies has dramatically increased recently, but there is substantial room for improvement in the quality of reporting even in top journals. Herein we have proposed reporting guidelines for PS analyses that are broadly applicable to different areas of medical research that will allow better evaluation and comparison across studies applying this approach.
Collapse
Affiliation(s)
- Xiaoxin I Yao
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - Xiaofei Wang
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Paul J Speicher
- Duke University Medical Center and Duke Cancer Institute, Durham, NC, USA
| | - E Shelley Hwang
- Duke University Medical Center and Duke Cancer Institute, Durham, NC, USA
| | - Perry Cheng
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China
| | - David H Harpole
- Duke University Medical Center and Duke Cancer Institute, Durham, NC, USA
| | - Mark F Berry
- Stanford University Medical Center, Stanford, CA, USA
| | | | - Herbert H Pang
- School of Public Health, Li Ka Shing Faculty of Medicine, Hong Kong SAR, China.,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
10
|
Soudeyns H, Yao XI, Gao Q, Belleau B, Kraus JL, Nguyen-Ba N, Spira B, Wainberg MA. Anti-human immunodeficiency virus type 1 activity and in vitro toxicity of 2'-deoxy-3'-thiacytidine (BCH-189), a novel heterocyclic nucleoside analog. Antimicrob Agents Chemother 1991; 35:1386-90. [PMID: 1929298 PMCID: PMC245177 DOI: 10.1128/aac.35.7.1386] [Citation(s) in RCA: 194] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
We describe a novel nucleoside analog, 2'-deoxy-3'-thiacytidine (BCH-189), in which the 3' carbon of the ribose ring of 2'-deoxycytidine has been replaced by a sulfur atom. In MT-4 T cells, this compound had significant time- and dose-dependent antiviral activity against five different strains of human immunodeficiency virus type 1 (HIV-1) (mean 50% inhibitory dose, 0.73 microM); known 3'-azido-3'-deoxythymidine (AZT)-resistant HIV-1 variants did not exhibit cross-resistance to it. BCH-189 also suppressed HIV-1 replication in the U937 monocytoid cell line as well as in primary cultures of human peripheral blood mononuclear cells; in these latter systems, suppression was fuller and longer lasting than that induced by AZT. Moreover, BCH-189 was less toxic than AZT in cell culture. BCH-189 may be a promising drug for the treatment of HIV-1-associated disease.
Collapse
Affiliation(s)
- H Soudeyns
- Lady Davis Institute-Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | | | | | | | | | | |
Collapse
|