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Chong KC, Chan PKS, Lee TC, Goggins WB, Wu P, Lai CKC, Fung KSC. Meteorologically favourable zones for seasonal influenza A and B in Hong Kong: abridged secondary publication. Hong Kong Med J 2023; 29 Suppl 3:19-22. [PMID: 37357586] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Affiliation(s)
- K C Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P K S Chan
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - T C Lee
- Hong Kong Observatory, Hong Kong SAR, China
| | - W B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - P Wu
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C K C Lai
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - K S C Fung
- Department of Pathology, United Christian Hospital, Hong Kong SAR, China
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Ho JY, Shi Y, Lau KKL, Ng EYY, Ren C, Goggins WB. Urban heat island effect-related mortality under extreme heat and non-extreme heat scenarios: A 2010-2019 case study in Hong Kong. Sci Total Environ 2023; 858:159791. [PMID: 36328261 DOI: 10.1016/j.scitotenv.2022.159791] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 08/04/2022] [Revised: 10/02/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
The urban heat island (UHI) effect exacerbates the adverse impact of heat on human health. However, while the UHI effect is further intensified during extreme heat events, prior studies have rarely mapped the UHI effect during extreme heat events to assess its direct temperature impact on mortality. This study examined the UHI effect during extreme heat and non-extreme heat scenarios and compared their temperature-mortality associations in Hong Kong from 2010 to 2019. Four urban heat island degree hour (UHIdh) scenarios were mapped onto Hong Kong's tertiary planning units and classified into three levels (Low, Moderate, and High). We assessed the association between temperature and non-external mortality of populations living in each UHIdh level for the extreme heat/non-extreme heat scenarios during the 2010-2019 hot seasons. Our results showed substantial differences between the temperature-mortality associations in the three levels under the UHIdh extreme heat scenario (UHIdh_EH). While there was no evidence of increased mortality in Low UHIdh_EH areas, the mortality risk in Moderate and High UHIdh_EH areas were significantly increased during periods of hot temperature, with the High UHIdh_EH areas displaying almost double the risk (RR: 1.08, 95%CI: 1.03, 1.14 vs. RR: 1.05, 95 % CI: 1.01, 1.09). However, other non-extreme heat UHI scenarios did not demonstrate as prominent of a difference. When stratified by age, the heat effects were found in Moderate and High UHIdh_EH among the elderly aged 75 and above. Our study found a difference in the temperature-mortality associations based on UHI intensity and potential heat vulnerability of populations during extreme heat events. Preventive measures should be taken to mitigate heat especially in urban areas with high UHI intensity during extreme heat events, with particular attention and support for those prone to heat vulnerability, such as the elderly and poorer populations.
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Affiliation(s)
- Janice Y Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuan Shi
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China; Department of Geography and Planning, School of Environmental Sciences, University of Liverpool, United Kingdom
| | - Kevin K L Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China; Department of Civil, Environmental and Natural Resources Engineering, Luleå University of Technology, Sweden
| | - Edward Y Y Ng
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong, China; School of Architecture, The Chinese University of Hong Kong, Hong Kong, China
| | - Chao Ren
- Division of Landscape Architecture, Department of Architecture, Faculty of Architecture, The University of Hong Kong, Hong Kong, China.
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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Ho JY, Lam HYC, Huang Z, Liu S, Goggins WB, Mo PKH, Chan EYY. Factors affecting outdoor physical activity in extreme temperatures in a sub-tropical Chinese urban population: an exploratory telephone survey. BMC Public Health 2023; 23:101. [PMID: 36641429 PMCID: PMC9840260 DOI: 10.1186/s12889-022-14788-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/29/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Physical activity (PA) can be affected by extreme temperatures, however fewer studies have identified factors impacting this relationship. This study sought to identify factors associated with changes of outdoor PA during extreme cold/heat events in a sub-tropical Chinese urban population, including factors of sociodemographic, health conditions, temperature-related awareness and attitude, and protective behaviours. METHODS Two telephone surveys were conducted a week after extreme cold/heat events in 2016 and 2017 among a cohort of Hong Kong residents over age 15. Data was collected on self-reported changes in outdoor PA level during the periods of extreme temperatures, health status, comorbidities, sociodemographic, and temperature-related awareness, and behavioural variables. We conducted multivariable logistic regression analyses to assess predictors of change in outdoor PA over the two extreme temperature events. RESULTS AND CONCLUSION Among 435 participants (42.8% response rate), over a third of the participants reported decreased outdoor PA level in extreme temperature events, while 10% reported an increase in extreme heat. Self-reported cardiovascular diseases were associated with decreased PA level in extreme cold, while hypertension was associated with unchanged/increased PA level in extreme heat. These results suggest physical activity to be an important consideration in the understanding of climate change-and-health pathways and meriting further research.
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Affiliation(s)
- Janice Y. Ho
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly Y. C. Lam
- grid.7445.20000 0001 2113 8111Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Zhe Huang
- grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China
| | | | - William B. Goggins
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K. H. Mo
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y. Y. Chan
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China ,grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China ,GX Foundation, Hong Kong, China ,grid.4991.50000 0004 1936 8948Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Wang P, Tong HW, Lee TC, Goggins WB. Projecting future temperature-related mortality using annual time series data: An example from Hong Kong. Environ Res 2022; 212:113351. [PMID: 35490827 DOI: 10.1016/j.envres.2022.113351] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous studies projecting future temperature-related mortality under climate change have mostly used short-term temperature-mortality associations based on daily time series data. The present study aimed to project mortality under different Representative Concentration Pathways (RCPs) in 21st century in Hong Kong by using analysis of annual data during 1976-2018. METHODS We employed a degree-days approach, calculating the sum of daily degrees above or below certain temperature threshold within a relevant historical year. The yearly age-standardized mortality rates (ASMRs) were regressed on annual hot and cold degree-days in quasi-Poisson generalized additive models to assess the exposure-response function that was subsequently used to calculate future changes in ASMR. The projection was performed without and with certain human adaptation assumed. RESULTS ASMRs were projected to have net increases under RCPs 4.5, 6.0, and 8.5, with increased mortality attributable to excess hot days exceeding decreases attributable to excess cold days. The average net changes under RCP8.5 was estimated to be 0.12%, 12.44%, 38.99%, and 89.25% during 2030s, 2050s, 2070s, and 2090s, respectively. Higher projected ASMRs were estimated for those aged over 75 years and for cardiovascular deaths. When human adaptation was considered, slope reduction alone under RCP4.5 and 6.0 and all adaptation assumptions under RCP8.5 might still not offset its corresponding adverse impact. CONCLUSIONS The projected decreases in cold-related mortality do not compensate for projected increases in heat-related mortality in Hong Kong. Better public adaptations strategies are warranted for coping with the adverse health impacts of climate change on a local scale.
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Affiliation(s)
- Pin Wang
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | | | | | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Sumerlin TS, Kwok TCY, Goggins WB, Yuan J, Kwong EMS, Leung J, Kim JH. The effect of subjective social status on health-related quality of life decline in urban Chinese older adults: a four-year longitudinal study from Hong Kong. BMC Geriatr 2022; 22:619. [PMID: 35883050 PMCID: PMC9316660 DOI: 10.1186/s12877-022-03314-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/14/2022] [Indexed: 11/15/2022] Open
Abstract
Background Improving health-related quality of life (HRQOL) is becoming a major focus of old age care and social policy. Researchers have been increasingly examining subjective social status (SSS), one’s self-perceived social position, as a predictor of various health conditions. SSS encompasses not only concrete socio-economic (SES) factors but also intangible aspects of status. This study’s main objective was to examine the association between SSS and long-term change in HRQOL in older Chinese adults. Methods A longitudinal Hong Kong study recruited 2934 community-dwelling adults (age > 65 years). Participants completed SF-12 physical health (PCS) and mental health (MCS) HRQOL scales. This study analyzed baseline SSS-Society (self-perceived social status within Hong Kong) and SSS-Community (self-perceived status within one’s own social network) as predictors of long-term HRQOL decline. After stratifying for sex, multiple-linear-regression was performed on 4-year follow-up SF-12 PCS and MCS scores after adjusting for baseline SF-12 scores, traditional SES indicators, demographic variables, clinical conditions, and lifestyle variables. Results In the multivariable analyses, lower SSS-Society was associated with declines in MCS in males (βstandardized = 0.08, p = 0.001) and declines in PCS (βstandardized = 0.07, p = 0.006) and MCS (βstandardized = 0.12, p < 0.001) in females. SSS-Community was associated with declines in PCS in males (βstandardized = 0.07, p = 0.005) and MCS in females (βstandardized = 0.14, p < 0.001). Conclusions SSS may be a useful supplementary tool for predicting risk of long-term HRQOL decline in older Chinese adults. Strategies to reduce perceived social inequalities may improve HRQOL in older adults.
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Affiliation(s)
- Timothy S Sumerlin
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
| | - Timothy C Y Kwok
- Faculty of Medicine Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
| | - Jinqiu Yuan
- Clinical Research Center, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Elizabeth M S Kwong
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
| | - Jason Leung
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
| | - Jean H Kim
- Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China.
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Ho JY, Goggins WB, Mo PKH, Chan EYY. The effect of temperature on physical activity: an aggregated timeseries analysis of smartphone users in five major Chinese cities. Int J Behav Nutr Phys Act 2022; 19:68. [PMID: 35701809 PMCID: PMC9195465 DOI: 10.1186/s12966-022-01285-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity is an important factor in premature mortality reduction, non-communicable disease prevention, and well-being protection. Climate change will alter temperatures globally, with impacts already found on mortality and morbidity. While uncomfortable temperature is often perceived as a barrier to physical activity, the actual impact of temperature on physical activity has been less well studied, particularly in China. This study examined the associations between temperature and objectively measured physical activity among adult populations in five major Chinese cities. Methods Aggregated anonymized step count data was obtained between December 2017-2018 for five major Chinese cities: Beijing, Shanghai, Chongqing, Shenzhen, and Hong Kong. The associations of temperature with daily aggregated mean step count were assessed using Generalized Additive Models (GAMs), adjusted for meteorological, air pollution, and time-related variables. Results Significant decreases in step counts during periods of high temperatures were found for cold or temperate climate cities (Beijing, Shanghai, and Chongqing), with maximum physical activity occurring between 16 and 19.3 °C. High temperatures were associated with decreases of 800-1500 daily steps compared to optimal temperatures. For cities in subtropical climates (Shenzhen and Hong Kong), non-significant declines were found with high temperatures. Overall, females and the elderly demonstrated lower optimal temperatures for physical activity and larger decreases of step count in warmer temperatures. Conclusions As minor reductions in physical activity could consequentially affect health, an increased awareness of temperature’s impact on physical activity is necessary. City-wide adaptations and physical activity interventions should seek ways to sustain physical activity levels in the face of shifting temperatures from climate change. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01285-1.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China. .,Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Yu J, Dong D, Sumerlin TS, Goggins WB, Feng Q, Kim JH. Selling World Health Organization's Alcohol “Best Buys” and Other Recommended Interventions in an Urban Chinese Population: Public Acceptability of Alcohol Harms Reduction Strategies in Hong Kong. Front Public Health 2022; 10:855416. [PMID: 35530734 PMCID: PMC9068987 DOI: 10.3389/fpubh.2022.855416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background To counter the harms caused by alcohol use, the World Health Organization (WHO) outlined a series of evidence-based recommendations, including the highly cost-effective “Best Buys” recommendations. While many Western countries have been actively introducing alcohol harms reduction strategies, it is unclear whether these cost-effective policies would be publicly acceptable in Asian regions with traditionally low alcohol consumption. This study examines the public acceptability of WHO-recommended alcohol harms reduction strategies in an Asian city with few extant alcohol regulations. Methods A cross-sectional telephone survey of Hong Kong Chinese residents aged 18–74 (n = 4,000) was conducted from January to August 2018. Respondents were asked about their perceptions of various WHO-recommended strategies and consequences of their implementation. After reducing the strategies into several policy categories by principal component analysis, multivariable linear regression was performed to identify factors associated with endorsement of the various policies. Results Among the “Best Buys”, introduction of moderate beer/wine taxes (68.7%) and shortened alcohol retail hours (51.9%) were the most supported while bans on event sponsorships (19.5%) and public drinking events (17.7%) were the least popular. Strategies targeting young drinkers were particularly highly supported. Males, younger adults, Non-abstainers, and those who believed in drinking's social benefits were less likely to endorse stringent control measures (p < 0.05). Adults with higher household income were less supportive, partially due to concerns about infringements on local economy, lifestyles, and economic freedom. Women and older people were generally more supportive, partially because they perceived these policies would lower alcohol-related harms. Conclusion In order to reduce barriers to implementing WHO-recommended strategies in the region, it is imperative to increase awareness of alcohol-related harms and to strengthen beliefs in the effectiveness of these countermeasures, especially among men, young adults, and drinkers.
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Affiliation(s)
- Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Timothy S. Sumerlin
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - William B. Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Qi Feng
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jean H. Kim
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- *Correspondence: Jean H. Kim
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Fung E, Lui LT, Huang L, Cheng KF, Lau GHW, Chung YT, Ahmadabadi BN, Xie S, Lee JSW, Hui E, So WY, Sung JJY, King I, Goggins WB, Chan Q, Järvelin MR, Ma RCW, Chow E, Kwok T. Characterising frailty, metrics of continuous glucose monitoring, and mortality hazards in older adults with type 2 diabetes on insulin therapy (HARE): a prospective, observational cohort study. The Lancet Healthy Longevity 2021; 2:e724-e735. [DOI: 10.1016/s2666-7568(21)00251-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/26/2022]
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Kim JH, Sumerlin TS, Goggins WB, Kwong EMS, Leung J, Yu B, Kwok TCY. Does Low Subjective Social Status Predict Cognitive Decline in Chinese Older Adults? A 4-Year Longitudinal Study From Hong Kong. Am J Geriatr Psychiatry 2021; 29:1140-1151. [PMID: 33563520 PMCID: PMC8298609 DOI: 10.1016/j.jagp.2021.01.014] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Subjective social status (SSS), one's self-perceived social position, encompasses not only concrete socio-economic (SES) factors (e.g., income) but also intangible aspects of status (e.g., social capital). In recent years, there has been increasing research interest in SSS as a predictor of a vast array of health outcomes but very few studies examining effects on cognitive functioning. This study's main objective was to examine the association between SSS and long-term cognitive decline in older Chinese adults. DESIGN A 4-year longitudinal study. SETTING Hong Kong, China. PARTICIPANTS Chinese adults (aged ≥65) (n = 3,153). MEASUREMENTS This study analyzed baseline SSS-Hong Kong (self-perceived social status within Hong Kong) and SSS-Community (self-perceived status within one's own social network) as predictors of long-term cognitive decline. Multiple-linear-regression was performed on 4-year follow-up Mini-Mental-Status-Examination (MMSE) cognitive function score (score range: 0-30) after adjusting for baseline MMSE scores, traditional SES indicators (e.g., education), demographic variables (e.g., sex), clinical conditions (e.g., stroke history, depression), and lifestyle variables (e.g., physical activity levels). RESULTS Lower SSS-Community but not SSS-Hong Kong was associated with greater cognitive decline (unstandardized coefficient (95% CI) = 0.13 (0.07, 0.19) standardized β-coefficient = 0.08, after adjusting for objective SES measures and other background and clinical factors. The standardized β-coefficients for the SSS-Community variable were similar in magnitude to those for depression and diabetes. CONCLUSION Cognitive decline is influenced by self-perceived rank in proximal reference groups rather than socioeconomic comparison with society at-large. SSS-Community is a useful, single-item supplementary instrument to improve prediction of cognitive decline in elderly Chinese.
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Affiliation(s)
- Jean H. Kim
- The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China
| | - Timothy S. Sumerlin
- The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China
| | - William B. Goggins
- The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China
| | - Elizabeth M. S. Kwong
- The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China
| | - Jason Leung
- The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China
| | - Blanche Yu
- The Chinese University of Hong Kong, Jockey Club School of Public Health and Primary Care Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China
| | - Timothy C. Y. Kwok
- The Chinese University of Hong Kong Faculty of Medicine Department of Medicine and Therapeutics, Prince of Wales Hospital Shatin, The New Territories, Hong Kong, China,Corresponding author’s
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Yu J, Sumerlin TS, Goggins WB, Dong D, Chung RYN, Kim JH. First- and second-hand alcohol-related harms among urban Chinese: A population-based study from Hong Kong. Drug Alcohol Rev 2021; 41:208-220. [PMID: 34184790 DOI: 10.1111/dar.13339] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Alcohol consumption has been steadily increasing in East Asia, however, there is comparatively little regional data of alcohol-related harms. This study examines the alcohol-related harms prevalence and risk factors in Hong Kong, a high population density city with limited alcohol regulation. METHODS A cross-sectional telephone survey was conducted in 2019 on Chinese adults aged 18-74 (n = 3200). Respondents were asked about various past-year first-hand drinking harms (after one's own drinking), second-hand harms (harms from other people's drinking) and views of neighbourhood alcohol outlet regulation. RESULTS Of drinkers, 21.1% reported first-hand alcohol harms, with physical/mental health harms (15.7%) most commonly reported. Younger-aged drinkers (adjusted odds ratios [AOR] 2.64, 95% confidence interval [CI] 1.63, 4.48) and heavy drinkers (AOR 2.34, 95% CI 1.55, 3.55) were more likely to report first-hand harms. Of the sample, 18.2% experienced past-year second-hand harms, with public harms (12.9%) most commonly reported. Young age (AOR 1.88, 95% CI 1.43, 2.49), higher education (AOR 1.44, 95% CI 1.13, 1.83), past-year binge drinking (AOR 4.29, 95% CI 3.04, 6.05) and communal living (AOR 2.04, 95% CI 1.13, 3.75) predicted greater likelihood of second-hand alcohol harms. Higher neighbourhood alcohol outlet density was not associated with any first-hand harms and only significantly predicted being inconvenienced by drinkers. Although victims of second-hand alcohol harms were more supportive of regulating outlet density, 93.3% of respondents were opposed to such policies. DISCUSSION AND CONCLUSIONS Although high levels of alcohol-related harms were not reported by Hong Kong adults, regulations should target young drinkers and binge drinkers who are most likely to experience drinking-related harms.
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Affiliation(s)
- Jiazhou Yu
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Timothy S Sumerlin
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Roger Yat-Nork Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,CUHK Institute of Health Equality, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Jean H Kim
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
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Wang P, Goggins WB, Shi Y, Zhang X, Ren C, Ka-Lun Lau K. Long-term association between urban air ventilation and mortality in Hong Kong. Environ Res 2021; 197:111000. [PMID: 33745928 DOI: 10.1016/j.envres.2021.111000] [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: 06/28/2020] [Revised: 02/17/2021] [Accepted: 03/05/2021] [Indexed: 06/12/2023]
Abstract
While associations between population health outcomes and some urban design characteristics, such as green space, urban heat islands (UHI), and walkability, have been well studied, no prior studies have examined the association of urban air ventilation and health outcomes. This study used data from Hong Kong, a densely populated city, to explore the association between urban air ventilation and mortality during 2008-2014. Frontal area density (FAD), was used to measure urban ventilation, with higher FAD indicating poorer ventilation, due to structures blocking wind penetration. Negative binomial regression models were constructed to regress mortality counts for each 5-year age group, gender, and small area group, on small area level variables including green space density, population density and socioeconomic indicators. An interquartile range increase in FAD was significantly associated with a 10% (95% confidence interval (CI) 2%-19%, p = 0.019) increase in all-cause mortality and a 21% (95% CI: 2%-45%, p = 0.030) increase in asthma mortality, and non-significantly associated with a 9% (95% CI: 1%-19%, p = 0.073) in cardio-respiratory mortality. Better urban ventilation can help disperse vehicle-related pollutants and allow moderation of UHIs, and for a coastal city may allow moderation of cold temperatures. Urban planning should take ventilation into account. Further studies on urban ventilation and health outcomes from different settings are needed.
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Affiliation(s)
- Pin Wang
- School of Public Health, Yale University Address: P.O. Box 208034, 60 College Street, New Haven, CT, 06520-0834, USA
| | - William B Goggins
- Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong.
| | - Yuan Shi
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR, China, Room 406B, Wong Foo Yuan Building, Chung Chi College, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Xuyi Zhang
- Faculty of Architecture, The University of Hong Kong, Hong Kong SAR, China, 4/F, Knowles Building, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Chao Ren
- Faculty of Architecture, The University of Hong Kong, Hong Kong SAR, China, 4/F, Knowles Building, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR, China, Room 406B, Wong Foo Yuan Building, Chung Chi College, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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12
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Ho JY, Zijlema WL, Triguero-Mas M, Donaire-Gonzalez D, Valentín A, Ballester J, Chan EYY, Goggins WB, Mo PKH, Kruize H, van den Berg M, Gražuleviciene R, Gidlow CJ, Jerrett M, Seto EYW, Barrera-Gómez J, Nieuwenhuijsen MJ. Does surrounding greenness moderate the relationship between apparent temperature and physical activity? Findings from the PHENOTYPE project. Environ Res 2021; 197:110992. [PMID: 33705766 DOI: 10.1016/j.envres.2021.110992] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/21/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Physical activity can be affected by both meteorological conditions and surrounding greenness, but few studies have evaluated the effects of these environmental factors on physical activity simultaneously. This multi-city comparative study aimed to assess the synergetic effects of apparent temperature and surrounding greenness on physical activity in four European cities. Specifically, we aimed to identify an interaction between surrounding greenness and apparent temperature in the effects on physical activity. METHODS Data were collected from 352 adult residents of Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands), and Kaunas (Lithuania) as part of the PHENOTYPE study. Participants wore a smartphone for seven consecutive days between May-December 2013 and provided additional sociodemographic survey data. Hourly average physical activity (Metabolic Equivalent of Task (MET)) and surrounding greenness (NDVI) were derived from the Calfit mobile application collecting accelerometer and location data. Hourly apparent temperature was calculated from temperature and relative humidity, which were obtained from local meteorological stations along with other meteorological covariates (rainfall, windspeed, and sky darkness). We assessed the interaction effects of apparent temperature and surrounding greenness on hourly physical activity for each city using linear mixed models, while adjusting for meteorological, demographic, and time-related variables. RESULTS We found significant interactions between apparent temperature and surrounding greenness on hourly physical activity in three of four cities, aside from the coastal city of Barcelona. Significant quadratic effects of apparent temperature were found in the highest level of surrounding greenness for Stoke-on-Trent and Doetinchem, with 4% decrease in median MET observed for a 10°C departure from optimal temperature (15.2°C and 14.6°C, respectively). Significant linear effects were found for higher levels of surrounding greenness in Kaunas, whereby an increase of 10°C was associated with ∼4% increase in median MET. CONCLUSION Apparent temperature and surrounding greenness interacted in the effect on hourly physical activity across three of four European cities, with varying effect between cities. While quadratic effects of temperature suggest diminishing levels of physical activity in the highest greenness levels in cities of temperate climates, the variation in surrounding greenness between cities could be further explored, particularly by looking at indoor-outdoor locations. The study findings support the need for evidence-based physical activity promotion and urban design.
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Affiliation(s)
- Janice Y Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilma L Zijlema
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Margarita Triguero-Mas
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Institute for Environmental Science and Technology, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Barcelona Lab for Urban Environmental Justice and Sustainability, Barcelona, Spain
| | - David Donaire-Gonzalez
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia; Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands
| | - Antònia Valentín
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Joan Ballester
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain
| | - Emily Y Y Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Hanneke Kruize
- Centre for Sustainability, Environment and Health, RIVM, Bilthoven, the Netherlands
| | | | | | - Christopher J Gidlow
- Centre for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Edmund Y W Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Barrera-Gómez
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- Instituto de Salud Global Barcelona (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Yu Q, Li X, Fan M, Qiu H, Wong AYS, Tian L, Chui CSL, Li PH, Lau LKW, Chan EW, Goggins WB, Ip P, Lum TY, Hung IFN, Cowling BJ, Wong ICK, Jit M. The impact of childhood pneumococcal conjugate vaccine immunisation on all-cause pneumonia admissions in Hong Kong: A 14-year population-based interrupted time series analysis. Vaccine 2021; 39:2628-2635. [PMID: 33858719 DOI: 10.1016/j.vaccine.2021.03.090] [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: 10/06/2020] [Revised: 03/25/2021] [Accepted: 03/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Nine years after the introduction of pneumococcal conjugate vaccine (PCV) in the United States, Hong Kong (HK) introduced the vaccine to its universal childhood immunisation programme in 2009. We aimed to assess the impact of childhood PCV immunisation on all-cause pneumonia (ACP) admissions among the overall population of HK. METHODS In this population-based interrupted time series analysis, we used territory-wide population-representative electronic health records in HK to evaluate the vaccine impact. We identified hospitalised patients with a diagnosis of pneumonia from any cause between 2004 and 2017. We applied segmented Poisson regression to assess the gradual change in the monthly incidence of ACP admissions between pre- and post-vaccination periods. Negative outcome control, subgroup and sensitivity analyses were used to test the robustness of the main analysis. FINDINGS Over the 14-year study period, a total of 587,607 ACP episodes were identified among 357,950 patients. The monthly age-standardised incidence of ACP fluctuated between 33.42 and 87.44 per 100,000-persons. There was a marginal decreasing trend in pneumonia admissions after PCV introduction among overall population (incidence rate ratio [IRR]: 0·9965, 95% confidence interval [CI]: 0·9932-0·9998), and older adults (≥65 years, IRR: 0·9928, 95% CI: 0·9904-0·9953) but not in younger age groups. INTERPRETATION There was a marginally declining trend of overall ACP admissions in HK up to eight years after childhood PCV introduction. The significance disappeared when fitting sensitivity analyses. The results indicate the complexities of using non-specific endpoints for measuring vaccine effect and the necessity of enhancing serotype surveillance systems for replacement monitoring. FUNDING Health and Medical Research Fund, Food and Health Bureau of the Government of Hong Kong (Reference number: 18171272).
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Affiliation(s)
- Qiuyan Yu
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health (D²4H), Hong Kong, China
| | - Xue Li
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D²4H), Hong Kong, China.
| | - Min Fan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China
| | - Angel Y S Wong
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Celine S L Chui
- Laboratory of Data Discovery for Health (D²4H), Hong Kong, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Philip H Li
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Lauren K W Lau
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Esther W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health (D²4H), Hong Kong, China
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Terry Y Lum
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China; Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
| | - Ivan F N Hung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Benjamin J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Laboratory of Data Discovery for Health (D²4H), Hong Kong, China; Research Department of Policy and Practice, University College London School of Pharmacy, London, UK
| | - Mark Jit
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; Centre for Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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14
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Wang P, Zhang X, Hashizume M, Goggins WB, Luo C. A systematic review on lagged associations in climate-health studies. Int J Epidemiol 2021; 50:1199-1212. [PMID: 33448301 DOI: 10.1093/ije/dyaa286] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 12/18/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lagged associations in climate-health studies have already been ubiquitously acknowledged in recent years. Despite extensive time-series models having proposed accounting for lags, few studies have addressed the question of maximum-lag specification, which could induce considerable deviations of effect estimates. METHODS We searched the PubMed and Scopus electronic databases for existing climate-health literature in the English language with a time-series or case-crossover study design published during 2000-2019 to summarize the statistical methodologies and reported lags of associations between climate variables and 14 common causes of morbidity and mortality. We also aggregated the results of the included studies by country and climate zone. RESULTS The associations between infectious-disease outcomes and temperatures were found to be lagged for ∼1-2 weeks for influenza, 3-6 weeks for diarrhoea, 7-12 weeks for malaria and 6-16 weeks for dengue fever. Meanwhile, the associations between both cardiovascular and respiratory diseases and hot temperatures lasted for <5 days, whereas the associations between cardiovascular diseases and cold temperatures were observed to be 10-20 days. In addition, rainfall showed a 4- to 10-week lagged association with infectious diarrheal diseases, whereas the association could be further delayed to 8-12 weeks for vector-borne diseases. CONCLUSION Our findings indicated some general patterns for possible lagged associations between some common health outcomes and climatic exposures, and suggested a necessity for a biologically plausible and reasonable definition of the effect lag in the modelling practices for future environmental epidemiological studies.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xuyi Zhang
- Faculty of Architecture, The University of Hong Kong, Hong Kong, China
| | | | - William B Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Chao Luo
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
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15
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Wang P, Goggins WB, Zhang X, Ren C, Lau KKL. Association of urban built environment and socioeconomic factors with suicide mortality in high-density cities: A case study of Hong Kong. Sci Total Environ 2020; 739:139877. [PMID: 32534310 DOI: 10.1016/j.scitotenv.2020.139877] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/08/2020] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 05/23/2023]
Abstract
Population ageing, climate change and urbanization have been occurring rapidly globally. Evidence-based healthy city development is required to improve living quality and mitigate the adverse impact of city living on both physical and mental health. We took a high-density city as an example to explore the association of built environment and suicide mortality and preferably to offer some implications for better future city development. Poisson generalized linear models with generalized estimation equations were employed to regress suicide mortality rate on four urban built environment variables (frontal area density (FAD), sky view factor (SVF), ground coverage ratio (GCR), and street coverage ratio (SCR)), as well as socioeconomic factors, population density, and greenery. The association for different causes of death and within different subgroups was also investigated. Generally, higher FAD and GCR were associated with higher suicide mortality while higher SVF and SCR were associated with lower suicide mortality. Age was a significant effect modifier. An interquartile range increase in FAD, SVF, and GCR was associated with 0.81 (95% confidence interval (CI) 0.71-0.92), 1.41 (95% CI 1.04-1.91), and 0.70 (95% CI 0.50-0.98) times the risk of suicide among the people aged over 70, respectively. Higher population density and unmarried status were generally associated with higher suicide rate whereas higher education level was associated with a decreased risk. Unfavorable built environment could increase risks for successful suicide attempts. Better urban development with morphological control mitigating intensifying urban heat island and other micro-environment changes are warranted to promote not only physical but psychological health.
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Affiliation(s)
- Pin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China.
| | - Xuyi Zhang
- Faculty of Architecture, The University of Hong Kong, 4/F, Knowles Building, Pokfulam Road, Hong Kong, China
| | - Chao Ren
- Faculty of Architecture, The University of Hong Kong, 4/F, Knowles Building, Pokfulam Road, Hong Kong, China
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, Chung Chi College, The Chinese University of Hong Kong, Room 406B, Wong Foo Yuan Building, Shatin, New Territories, Hong Kong, China
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16
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Kwong E, Kwok TTY, Sumerlin TS, Goggins WB, Leung J, Kim JH. Does subjective social status predict depressive symptoms in Chinese elderly? A longitudinal study from Hong Kong. J Epidemiol Community Health 2020; 74:882-891. [PMID: 32631845 DOI: 10.1136/jech-2019-212451] [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] [Received: 03/29/2019] [Revised: 10/28/2019] [Accepted: 06/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Subjective social status (SSS), one's self-perceived social status, has been gaining interest among researchers as a risk/protective factor of many health outcomes. SSS encompasses both socio-economic factors (eg, income) and intangible aspects of status (eg, esteem from peers). This study's main objective was to examine the association between SSS and future risk of depression in elderly Chinese. METHODS Using data from the ongoing Mr/Mrs Os study, a longitudinal study of Hong Kong Chinese elderly, this study analysed baseline SSS-Hong Kong (self-perceived social status within Hong Kong) and SSS-Community (self-perceived status within one's own social network) as predictors of Geriatric Depression Scale (GDS) score at year 4 (n=3153). The models adjusted for baseline depression scores, socio-economic status indicators, demographic variables, clinical conditions and functional status variables. RESULTS Higher depression scores at follow-up were independently associated with lower SSS-Hong Kong (standardised β-coefficient= -0.040, p=0.017), lower SSS-Community (standardised β-coefficient= -0.057, p=0.001), in addition to older age, female gender and stroke history. After stratifying by dementia status, higher baseline SSS was associated with less depressive symptoms only in the non-dementia group. In the multivariable models that included both SSS variables, only SSS-Community was significantly associated with year 4 GDS score. However, both SSS variables were independently associated with year 4 depression status in the logistic regression analysis. CONCLUSION In Chinese elderly, SSS captures aspects of social status that are not captured by traditional socio-economic indicators. SSS can be a useful supplementary tool for assessing future risk of developing mental health conditions.
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Affiliation(s)
- Elizabeth Kwong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Timothy T Y Kwok
- Faculty of Medicine Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Timothy S Sumerlin
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Jason Leung
- Faculty of Medicine Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Jean H Kim
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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17
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Rainer TH, Hung KKC, Yeung JHH, Cheung SKC, Leung YK, Leung LY, Goggins WB, Ho HF, Kam CW, Cheung NK, Graham CA. Trajectory of functional outcome and health status after moderate-to-major trauma in Hong Kong: A prospective 5 year cohort study. Injury 2019; 50:1111-1117. [PMID: 30827704 DOI: 10.1016/j.injury.2019.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/05/2018] [Revised: 02/01/2019] [Accepted: 02/21/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Trauma care systems in Asia have been developing in recent years, but there has been little long-term outcome data from injured survivors. This study aims to evaluate the trajectory of functional outcome and health status up to five years after moderate to major trauma in Hong Kong. METHODS We report the five year follow up results of a multicentre, prospective cohort from the trauma registries of three regional trauma centres in Hong Kong. The original cohort recruited 400 adult trauma patients with ISS ≥ 9. Telephone follow up was conducted longitudinally at seven time points, and the extended Glasgow Outcome Scale (GOSE) and Short-Form 36 (SF36) were tracked. RESULTS 119 out of 309 surviving patients (39%) completed follow up after 5 years. The trajectory of GOSE, PCS and MCS showed gradual improvements over the seven time points. 56/119 (47.1%) patients reported a GOSE = 8 (upper good recovery), and the mean PCS and MCS was 47.8 (95% CI 45.8, 49.9) and 55.8 (95% CI 54.1, 57.5) respectively at five years. Univariate logistic regression showed change in PCS - baseline to 1 year and 1 year to 2 years, and change in MCS - baseline to 1 year were associated with GOSE = 8 at 5 years. Linear mixed effects model showed differences in PCS and MCS were greatest between 1-month and 6-month follow up. CONCLUSIONS After injury, the most rapid improvement in PCS and MCS occurred in the first six to 12 months, but further recovery was still evident for MCS in patients aged under 65 years for up to five years.
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Affiliation(s)
- T H Rainer
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; School of Medicine, Cardiff University, United Kingdom
| | - K K C Hung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong
| | - J H H Yeung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong
| | - S K C Cheung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong
| | - Y K Leung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong
| | - L Y Leung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong
| | - W B Goggins
- JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong
| | - H F Ho
- Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong
| | - C W Kam
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Accident and Emergency Department, Tuen Mun Hospital, Hong Kong
| | - N K Cheung
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong
| | - C A Graham
- Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong.
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18
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Li AM, Fung CKC, Yu ITS, Goggins WB, Chan GYS, Chan CK, Lau APS, Leung JOS. Associations of wheeze during the first 18 months of life with indoor nitrogen dioxide, formaldehyde, and family history of asthma: a prospective cohort study. Hong Kong Med J 2019; 25 Suppl 3:20-23. [PMID: 30792368] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Affiliation(s)
- A M Li
- The Chinese University of Hong Kong
| | | | - I T S Yu
- The Chinese University of Hong Kong
| | | | | | - C K Chan
- Hong Kong University of Science and Technology
| | - A P S Lau
- Hong Kong University of Science and Technology
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19
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Wang P, Goggins WB, Chan EYY. A time-series study of the association of rainfall, relative humidity and ambient temperature with hospitalizations for rotavirus and norovirus infection among children in Hong Kong. Sci Total Environ 2018; 643:414-422. [PMID: 29940452 DOI: 10.1016/j.scitotenv.2018.06.189] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 04/26/2018] [Revised: 06/08/2018] [Accepted: 06/15/2018] [Indexed: 04/13/2023]
Abstract
BACKGROUND Rotavirus and norovirus are infectious pathogens primarily affecting children under 5 years old. The impact of rainfall on diarrheal diseases remains inconclusive. This study aimed to evaluate the association between short-term variation in rainfall, temperature and humidity, and rotavirus and norovirus hospitalizations among young children in Hong Kong. METHODS Generalized additive negative binomial regression models with distributed lag non-linear terms, were fit with daily counts of hospital admissions due to rotavirus and norovirus infection as the outcomes and daily total rainfall and other meteorological variables as predictors, adjusting for seasonality and trend. RESULTS Generally, greater rainfall was associated with fewer rotavirus, but more norovirus hospitalizations. Extreme precipitation (99.5 mm, 99th percentile) was found to be associated with 0.40 (95% confidence interval (CI) 0.20-0.79) and 1.93 (95% CI 1.21-3.09) times the risk of hospitalization due to rotavirus and norovirus infection respectively, relative to trace rainfall. Stronger associations were observed in winter for rotavirus and in summer for norovirus. The duration of association with rotavirus was notably longer than norovirus. Higher temperatures were found to be associated with fewer hospitalizations for both rotavirus and norovirus infection, while higher relative humidity was generally associated with more norovirus, but fewer rotavirus, hospitalizations. CONCLUSIONS Both rotavirus and norovirus hospitalizations were strongly associated with recent precipitation variation but in opposite directions. With the introduction of the rotavirus vaccine norovirus is likely to become a greater threat than rotavirus and thus greater precipitation may become more clearly associated with more childhood diarrhea.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Wang P, Goggins WB, Chan EYY. Associations of Salmonella hospitalizations with ambient temperature, humidity and rainfall in Hong Kong. Environ Int 2018; 120:223-230. [PMID: 30103121 DOI: 10.1016/j.envint.2018.08.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 05/10/2018] [Revised: 07/04/2018] [Accepted: 08/02/2018] [Indexed: 05/26/2023]
Abstract
BACKGROUND Little is known about the relationship between Salmonella infection and meteorological parameters other than air temperature. This study aimed to explore associations of Salmonella hospitalizations with temperature, relative humidity (RH) and rainfall. METHODS With negative binomial distribution assumed, time-series regression model adjusting for season and time trend were constructed employing distributed lag non-linear models and generalized additive models. Meteorological variables including mean temperature, RH, and daily total rainfall as well as indicator variables including day of the week and public holiday were incorporated in the models. RESULTS Higher temperature was strongly associated with more hospitalizations over the entire range of temperatures observed. There was a net 6.13 (95%Confidence Interval (CI) 3.52-10.67) relative risk of hospitalization at a temperature of 30.5 °C, relative to 13 °C, lag 0-16 days. Positive associations were found for RH above 60% and rainfall between 0 and 0.14 mm. Extreme high humidity (96%) and trace rainfall (0.02 mm) were associated with 2.06 (95%CI 1.35-3.14), lag 0-17 day, and 1.30 (95%CI 1.01-1.67), lag 0-26 days, relative risks of hospitalizations, relative to 60% and no rain, respectively. CONCLUSIONS High temperatures, high RH and light rainfall are positively associated with Salmonella hospitalizations. The very strong association with temperatures implies that hotter days will lead to increases in Salmonella morbidity in the absence of other changes, and the public health implications of this could be exacerbated by global climate change.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - William B Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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21
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Wong EC, Kim JH, Goggins WB, Lau J, Wong SYS, Griffiths SM. Chinese Women’s Drinking Patterns Before and After the Hong Kong Alcohol Policy Changes. Alcohol Alcohol 2018; 53:477-486. [DOI: 10.1093/alcalc/agy010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 02/02/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- Eugene C Wong
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jean H Kim
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
| | - William B Goggins
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
| | - Joseph Lau
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
| | - Samuel Y S Wong
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
| | - Sian M Griffiths
- The School of Public Health & Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR
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22
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Wong MCS, Fung FDH, Leung C, Cheung WWL, Goggins WB, Ng CF. The global epidemiology of bladder cancer: a joinpoint regression analysis of its incidence and mortality trends and projection. Sci Rep 2018; 8:1129. [PMID: 29348548 PMCID: PMC5773684 DOI: 10.1038/s41598-018-19199-z] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 12/19/2017] [Indexed: 12/29/2022] Open
Abstract
We tested the hypotheses that the global incidence of bladder cancer was increasing but its mortality was reducing and its incidence was positively correlated with country-specific socioeconomic development. We retrieved data on age-standardized incidence and mortality rates/100,000 from the GLOBOCAN database in 2012. Temporal patterns were examined for 39 countries from the Cancer Incidence in Five Continents volumes I-X and other national registries. We evaluated the correlation between the incidence/mortality rates and Human Development Index (HDI)/ logarithmic values of Gross Domestic Product per capita (GDP). The average annual percent change of the incidence and mortality rates in the most recent 10 years was examined by joinpoint regression analysis. The highest incidence rates were observed in Southern Europe, Western Europe and North America. The mortality rates were the highest in Western Asia and Northern Africa. The incidence was positively correlated with HDI (r = 0.66 [men]; r = 0.50 [women]) and to a lesser extent logarithmic values of GDP per capita (r = 0.60 [men]; r = 0.50 [women], all p < 0.01). Many European countries experienced incidence rise. A substantial mortality reduction was observed in most countries, yet increases in mortality rates were observed in the Philippines and Iceland. These findings identified countries where more preventive actions are required.
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Affiliation(s)
- Martin C S Wong
- Division of Family Medicine and Primary Healthcare, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China. .,Family Medicine and Primary Health Care, Hospital Authority, Hong Kong, China.
| | - Franklin D H Fung
- Division of Family Medicine and Primary Healthcare, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - Colette Leung
- Division of Family Medicine and Primary Healthcare, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - Wilson W L Cheung
- Division of Family Medicine and Primary Healthcare, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - William B Goggins
- Division of Biostatistics, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - C F Ng
- Division of Urology, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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23
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Wang P, Zhao H, You F, Zhou H, Goggins WB. Seasonal modeling of hand, foot, and mouth disease as a function of meteorological variations in Chongqing, China. Int J Biometeorol 2017; 61:1411-1419. [PMID: 28188360 DOI: 10.1007/s00484-017-1318-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 08/01/2016] [Revised: 01/11/2017] [Accepted: 01/27/2017] [Indexed: 06/06/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is an enterovirus-induced infectious disease, mainly affecting children under 5 years old. Outbreaks of HFMD in recent years indicate the disease interacts with both the weather and season. This study aimed to investigate the seasonal association between HFMD and weather variation in Chongqing, China. Generalized additive models and distributed lag non-linear models based on a maximum lag of 14 days, with negative binomial distribution assumed to account for overdispersion, were constructed to model the association between reporting HFMD cases from 2009 to 2014 and daily mean temperature, relative humidity, total rainfall and sun duration, adjusting for trend, season, and day of the week. The year-round temperature and relative humidity, rainfall in summer, and sun duration in winter were all significantly associated with HFMD. An inverted-U relationship was found between mean temperature and HFMD above 19 °C in summer, with a maximum morbidity at 27 °C, while the risk increased linearly with the temperature in winter. A hockey-stick association was found for relative humidity in summer with increasing risks over 60%. Heavy rainfall, relative to no rain, was found to be associated with reduced HFMD risk in summer and 2 h of sunshine could decrease the risk by 21% in winter. The present study showed meteorological variables were differentially associated with HFMD incidence in two seasons. Short-term weather variation surveillance and forecasting could be employed as an early indicator for potential HFMD outbreaks.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Han Zhao
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Fangxin You
- Chongqing Jiangbei District Center for Disease Control and Prevention, Chongqing, China
| | - Hailong Zhou
- Chongqing Jiangbei District Center for Disease Control and Prevention, Chongqing, China
| | - William B Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
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24
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Wong MCS, Jiang JY, Goggins WB, Liang M, Fang Y, Fung FDH, Leung C, Wang HHX, Wong GLH, Wong VWS, Chan HLY. International incidence and mortality trends of liver cancer: a global profile. Sci Rep 2017; 7:45846. [PMID: 28361988 PMCID: PMC5374459 DOI: 10.1038/srep45846] [Citation(s) in RCA: 141] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/03/2017] [Indexed: 12/13/2022] Open
Abstract
We examined the global incidence and mortality rates of liver cancer, and evaluated the association between incidence/mortality and socioeconomic development (Human Development Index [HDI] and Gross Domestic Product [GDP]) using linear regression analysis. The average annual percent change (AAPC) of the trends was evaluated from join-point regression analysis. The global incidence of liver cancer varied widely by nine-fold, and was negatively correlated with HDI (men: r = −0.232, p = 0.003; women: r = −0.369, p < 0.001) and GDP per capita (men: r = −0.164, p = 0.036; women: r = −0.212, p = 0.007). Its mortality showed a similarly negative correlation with both indices. The greatest incidence rise in men was observed in Poland (AAPC = 17.5, 95% C.I. = 5.6, 30.9) and Brazil (AAPC = 13.2, 95% C.I. = 5.9, 21.0), whereas Germany (AAPC = 6.6, 95% C.I = 2.0, 11.5) and Norway (AAPC = 6.5, 95% C.I. = 3.2, 10.0) had the greatest increase in women. The mortality rates paralleled the incidence rates in most countries. For mortality, Malta (AAPC = 11.5, 95% C.I. = 3.9, 19.8), Australia (AAPC = 6.8, 95% C.I. = 2.2, 11.5) and Norway (APCC = 5.6, 95% C.I. = 2.8, 8.5) reported the biggest increase among men; whilst Australia (AAPC = 13.4, 95% C.I. = 7.8, 19.4) and Singapore (AAPC = 7.7, 95% C.I. = 4.1, 11.5) showed the most prominent rise among women. These epidemiological data identified countries with potentially increasing trends of liver cancer for preventive actions.
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Affiliation(s)
- Martin C S Wong
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong.,Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Johnny Y Jiang
- Peking Union School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, China
| | - William B Goggins
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Miaoyin Liang
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Yuan Fang
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Franklin D H Fung
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Colette Leung
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Harry H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, P.R. China.,General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 9LX, UK
| | - Grace L H Wong
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Vincent W S Wong
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
| | - Henry L Y Chan
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong
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25
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Wang P, Goggins WB, Chan EYY. Hand, Foot and Mouth Disease in Hong Kong: A Time-Series Analysis on Its Relationship with Weather. PLoS One 2016; 11:e0161006. [PMID: 27532865 PMCID: PMC4988669 DOI: 10.1371/journal.pone.0161006] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022] Open
Abstract
Background Hand, foot and mouth disease (HFMD) is an emerging enterovirus-induced infectious disease for which the environmental risk factors promoting disease circulation remain inconclusive. This study aims to quantify the association of daily weather variation with hospitalizations for HFMD in Hong Kong, a subtropical city in China. Methods A time series of daily counts of HFMD public hospital admissions from 2008 through 2011 in Hong Kong was regressed on daily mean temperature, relative humidity, wind speed, solar radiation and total rainfall, using a combination of negative binomial generalized additive models and distributed lag non-linear models, adjusting for trend, season, and day of week. Results There was a positive association between temperature and HFMD, with increasing trends from 8 to 20°C and above 25°C with a plateau in between. A hockey-stick relationship of relative humidity with HFMD was found, with markedly increasing risks over 80%. Moderate rainfall and stronger wind and solar radiation were also found to be associated with more admissions. Conclusions The present study provides quantitative evidence that short-term meteorological variations could be used as early indicators for potential HFMD outbreaks. Climate change is likely to lead to a substantial increase in severe HFMD cases in this subtropical city in the absence of further interventions.
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Affiliation(s)
- Pin Wang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - William B. Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- * E-mail:
| | - Emily Y. Y. Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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26
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Lee KL, Chan YH, Lee TC, Goggins WB, Chan EYY. The development of the Hong Kong Heat Index for enhancing the heat stress information service of the Hong Kong Observatory. Int J Biometeorol 2016; 60:1029-39. [PMID: 26546311 DOI: 10.1007/s00484-015-1094-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 07/15/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 05/26/2023]
Abstract
This paper presents a study to develop a heat index, for use in hot and humid sub-tropical climate in Hong Kong. The study made use of hospitalization data and heat stress measurement data in Hong Kong from 2007 to 2011. The heat index, which is called Hong Kong Heat Index (HKHI), is calculated from the natural wet bulb temperature, the globe temperature, and the dry bulb temperature together with a set of coefficients applicable to the high humidity condition in the summer of Hong Kong. Analysis of the response of hospitalization rate to variation in HKHI and two other heat indices, namely Wet Bulb Globe Temperature (WBGT) and Net Effective Temperature (NET), revealed that HKHI performed generally better than WBGT and NET in reflecting the heat stress impact on excess hospitalization ratio in Hong Kong. Based on the study results, two reference criteria of HKHI were identified to establish a two-tier approach for the enhancement of the heat stress information service in Hong Kong.
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Affiliation(s)
- K L Lee
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China
| | - Y H Chan
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China.
| | - T C Lee
- Hong Kong Observatory, 134A Nathan Road, Tsim Sha Tsui, Kowloon, Hong Kong, China
| | - William B Goggins
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Emily Y Y Chan
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
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27
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Kim JH, Chung CH, Lau CH, Goggins WB, Lau JTF, Griffiths SM. Adverse events and poisoning from over-the-counter traditional Chinese medicine: a population-based survey. Hong Kong Med J 2016; 22 Suppl 2:S23-S28. [PMID: 26908339] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
- J H Kim
- The Jockey Club School of Public Health & Primary Care, The Chinese University of Hong Kong
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28
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Goggins WB, Yang C, Hokama T, Law LSK, Chan EYY. Using Annual Data to Estimate the Public Health Impact of Extreme Temperatures. Am J Epidemiol 2015; 182:80-7. [PMID: 26009315 DOI: 10.1093/aje/kwv013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 01/15/2015] [Indexed: 11/13/2022] Open
Abstract
Short-term associations between both hot and cold ambient temperatures and higher mortality have been found worldwide. Few studies have examined these associations on longer time scales. Age-standardized mortality rates (ASMRs) were calculated for 1976-2012 for Hong Kong SAR, People's Republic of China, defining "annual" time periods in 2 ways: from May through April of the following year and from November through October. Annual frequency and severity of extreme temperatures were summarized by using a degree-days approach with extreme heat expressed as annual degree-days >29.3°C and cold as annual degree-days <27.5°C. For example, a day with a mean temperature of 25.0°C contributes 2.5 cold degree-days to the annual total. Generalized additive models were used to estimate the association between annual hot and cold degree-days and the ASMR, with adjustment for long-term trends. Increases of 10 hot or 200 cold degree-days in an annual period, the approximate interquartile ranges for these variables, were significantly (all P's ≤ 0.011) associated with 1.9% or 3.1% increases, respectively, in the annual ASMR for the May-April analyses and with 2.2% or 2.8% increases, respectively, in the November-October analyses. Associations were stronger for noncancer and elderly mortality. Mortality increases associated with extreme temperature are not simply due to short-term forward displacement of deaths that would have occurred anyway within a few weeks.
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29
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Ip WY, Epstein JB, Lee V, Yuen HL, Li R, Thompson DR, Goggins WB, Cheng KKF. Oral mucositis in paediatric patients after chemotherapy for cancer. Hong Kong Med J 2014; 20 Suppl 7:4-8. [PMID: 25647816] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- W Y Ip
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
| | - J B Epstein
- Oral Medicine, Division of Otolaryngology, Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, USA & Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - V Lee
- Children's Cancer Centre, Department of Paediatrics, Prince of Wales Hospital
| | - H L Yuen
- Department of Paediatrics, Queen Elizabeth Hospital
| | - R Li
- Department of Paediatrics, Tuen Mun Hospital
| | - D R Thompson
- Department of Health Sciences & Department of Cardiovascular Sciences, University of Leicester, United Kingdom
| | - W B Goggins
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong
| | - K K F Cheng
- Alice Centre for Nursing Studies, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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30
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Ho SSM, Choi KC, Wong CL, Chan CWH, Chan HYL, Tang WPY, Lam WWT, Shiu ATY, Goggins WB, So WKW. Uptake of breast screening and associated factors among Hong Kong women aged ≥50 years: a population-based survey. Public Health 2014; 128:1009-16. [PMID: 25443128 DOI: 10.1016/j.puhe.2014.09.001] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 05/23/2014] [Accepted: 09/03/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the uptake of breast screening and its associated factors among Hong Kong Chinese women aged ≥50 years. STUDY DESIGN Cross-sectional population-based survey. METHODS A sample of Hong Kong Chinese women was recruited through telephone random-digit dialling. The survey consisted of six sections: perceived health status, use of complementary medicine, uptake of breast screening, perceived susceptibility to cancer, family history of cancer and demographic data. The factors associated with uptake of breast screening were analysed using logistic regression analysis. RESULTS In total, 1002 women completed the (anonymous) telephone survey. The mean age was 63.5 (standard deviation 10.6) years. The uptake rate of breast screening among Hong Kong Chinese women aged ≥50 years was 34%. The primary reasons for undertaking breast screening were as part of a regular medical check-up (74%), prompted by local signs and symptoms (11%) and a physician's recommendation (7%). Higher educational level, married or cohabiting, family history of cancer, frequent use of complementary therapies, regular visits to a doctor or Chinese herbalist, and the recommendation of a health professional were all independently and significantly associated with increased odds of having had a mammogram. CONCLUSIONS This study provides community-based evidence of the need for public health policy to promote broader use of mammography services among this target population, with emphasis on the active involvement of health care professionals, through the development and implementation of appropriate evidence-based and resource-sensitive strategies.
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Affiliation(s)
- S S M Ho
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - K C Choi
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - C L Wong
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - C W H Chan
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - H Y L Chan
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - W P Y Tang
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - W W T Lam
- Centre for Psycho-oncology Research and Training, School of Public Health, The University of Hong Kong, Sassoon Road, Hong Kong, China
| | - A T Y Shiu
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - W B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China
| | - W K W So
- Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
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31
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So WKW, Choi KC, Tang WPY, Lee PCW, Shiu ATY, Ho SSM, Chan HYL, Lam WWT, Goggins WB, Chan CWH. Uptake of prostate cancer screening and associated factors among Chinese men aged 50 or more: a population-based survey. Cancer Biol Med 2014; 11:56-63. [PMID: 24738039 PMCID: PMC3969801 DOI: 10.7497/j.issn.2095-3941.2014.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 02/05/2014] [Indexed: 01/07/2023] Open
Abstract
Objective To investigate the uptake rate of prostate specific antigen (PSA) testing among Hong Kong Chinese males aged 50 or above, and identify factors associated with the likelihood of undergoing a PSA test. Methods A population-based telephone survey was conducted in Hong Kong in 2007. The survey covered demographic information, perceived health status, use of complementary therapy, cancer screening behavior, perceived susceptibility to cancer and family history of cancer. Descriptive statistics, percentages and logistic regression analysis were used for data analysis. Results A total of 1,002 men aged 50 or above took part in the study (response rate =67%), and the uptake rate of PSA testing was found to be 10%. Employment status, use of complementary therapy, perceiving regular visits to a doctor as good for health and the recommendations of health professionals were significant factors associated with PSA testing. Conclusion The uptake rate of PSA testing in the study population was very low. Among all the factors identified, recommendations from health professionals had the strongest association with the uptake of PSA testing, and they should therefore take an active role in educating this population about cancer prevention and detection.
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Affiliation(s)
- Winnie K W So
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kai Chow Choi
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Winnie P Y Tang
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Paul C W Lee
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ann T Y Shiu
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Simone S M Ho
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Helen Y L Chan
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wendy W T Lam
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - William B Goggins
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Carmen W H Chan
- 1 The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China ; 2 Department of Community Medicine, The University of Hong Kong, Hong Kong SAR, China ; 3 The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Ho SW, Tsui YTC, Wong TT, Cheung SKK, Goggins WB, Yi LM, Cheng KK, Baum L. Effects of 17-allylamino-17-demethoxygeldanamycin (17-AAG) in transgenic mouse models of frontotemporal lobar degeneration and Alzheimer's disease. Transl Neurodegener 2013; 2:24. [PMID: 24344631 PMCID: PMC3878847 DOI: 10.1186/2047-9158-2-24] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 12/13/2013] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD), the most common dementia, is characterized by potentially neurotoxic aggregation of Aβ peptide and tau protein, and their deposition as amyloid plaques and neurofibrillary tangles (NFTs). Tau aggregation also occurs in other common neurodegenerative diseases. Frontotemporal dementia (FTD) can be caused by tau mutations that increase the susceptibility of tau to hyperphosphorylation and aggregation, which may cause neuronal dysfunction and deposition of NFTs. 17-allylamino-17-demethoxygeldanamycin (17-AAG) is a potent inhibitor of heat shock protein 90 (Hsp90), a cytosolic chaperone implicated in the proper folding and functions of a repertoire of client proteins. 17-AAG binds to Hsp90 and enhances degradation of Hsp90 client protein. We sought to determine whether 17-AAG can reduce Aβ and tau pathology in the brains of AD and FTD model mice expressing Aβ or P301L mutant tau, respectively. Mice were randomized to receive 25, 5, or 0 mg/kg 17-AAG thrice weekly from age eight to 11 months. Analysis was performed by rotarod test on motor function, on the area occupied by plaques in hippocampus or NFTs in medulla tissue sections, and on mortality. A high dose of 17-AAG tended to decrease NFTs in male mice (p = 0.08). Further studies are required to confirm the effect of 17-AAG in diseases of tau aggregation.
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Affiliation(s)
| | | | | | | | | | | | | | - Larry Baum
- School of Pharmacy, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
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Kim JH, Kwong EMS, Chung VCH, Lee JCO, Wong T, Goggins WB. Acute adverse events from over-the-counter Chinese herbal medicines: a population-based survey of Hong Kong Chinese. BMC Complement Altern Med 2013; 13:336. [PMID: 24279604 PMCID: PMC4222756 DOI: 10.1186/1472-6882-13-336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 10/30/2013] [Indexed: 12/02/2022]
Abstract
Background Although over-the-counter traditional Chinese herbal medicine (COTC) is commonly used to treat everyday illness in many parts of the world, no population-based study has been done to examine the prevalence and factors associated with COTC-related adverse events. Methods A cross-sectional telephone survey was conducted among Hong Kong Chinese adults in 2011 (n = 1100) with informed verbal consent. Stepwise logistic regression of demographic, attitudinal and behavioral variables was used to determine factors associated with past-year adverse events. Results Of study respondents, 71.7% (789/1100) reported past-year COTC use and 2.3% (25/1100) reported at least one COTC-related adverse event in the past year. Of the 27 adverse events cases reported among COTC users, the most common were allergic reactions (n = 11) dizziness (n = 5), and gastro-intestinal problems (n = 4). Pills/capsules were the dosage form that caused the highest proportion of adverse events (n = 10), followed by plasters (n = 7), creams/ointments (n = 5), and ingestible powders (n = 2). Although COTC users reporting adverse events were more likely to report greater practices to avoid adverse events (OR = 6.47; 95% CI: 1.38-30.3); they were also more likely to possess lower education levels (OR = 9.64, 95% CI: 2.20-42.3) and to have received COTC information from non-reliable, mass-media information sources such as magazines (OR = 3.32; 95% CI: 1.01-8.50) or television (OR = 2.93; 95% CI: 1.03-10.7). Package labels were also felt to be unclear by 42.9% of COTC users. A large proportion of COTC users demonstrated low levels of COTC-related knowledge, while the main impediment to greater information-seeking was the belief that reliable COTC information is not obtainable from Western health professionals. Conclusions Despite global movements toward more stringent complementary medicine regulation, the limited accessibility of reliable information and widespread misperceptions among consumers present major challenges for the safe use of complementary medicine.
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Goggins WB, Ren C, Ng E, Yang C, Chan EYY. Effect modification of the association between meteorological variables and mortality by urban climatic conditions in the tropical city of Kaohsiung, Taiwan. Geospat Health 2013; 8:37-44. [PMID: 24258881 DOI: 10.4081/gh.2013.52] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A deeper understanding of extreme hot weather are needed in cities sensitive to heat effects, an investigation was done in the tropical town of Kaohsiung in Taiwan. Its 11 districts were divided into three climatic classes varying from high urban heat, low levels of green space and lack of proximity to water bodies to low urban heat, adequate green space and proximity to water bodies. Daily data on natural mortality, meteorological variables, and pollutants from May-October 1999-2008 were analysed using generalised additive models for the time-series data. Subgroup analyses were conducted, stratifying decedents according to the level of planning activity required in order to mitigate adverse heat effects in their residential areas, classifying districts as "level 1" for those requiring a high level of mitigation action; "level 2" for those requiring some action; and "level 3" for those that need only preserve existing conditions. Stratified analyses showed that mortality increases per 1 °C rise on average, either on the same day or in the previous 4 days (lags 0-4), were associated with 2.8%, 2.3% and -1.3% for level 1, 2 and 3 districts, respectively. The slope describing the association between temperature and mortality was higher above 29.0 °C resulting in corresponding increases of 4.2%, 5.0% and 0.3% per per 1 °C rise in temperature, respectively. Other meteorological variables were not significantly associated with mortality. It is concluded that hot season mortality in Kaohsiung is only sensitive to heat effects in districts classified as having unfavourably climatic conditions and requiring mitigation efforts in city planning. Urban planning measures designed to improve climatic conditions could reduce excess mortality resulting from extreme hot weather.
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Choi KC, Chan HY, Chan DN, Lam WW, Chan CW, Ho SS, Cheng KK, Goggins WB, Shiu AT, So WK. The mediating role of health professionals' recommendation in the uptake of colorectal cancer testing among older Chinese adults. Int J Nurs Pract 2013; 20:170-178. [PMID: 24118258 DOI: 10.1111/ijn.12118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/17/2022]
Abstract
The purpose of this study is to examine the mediating effect of health professionals' recommendations on the relationship between the characteristics of older Chinese adults and the use of colorectal cancer testing. This was a cross-sectional population-based telephone survey. A total of 2004 Chinese adults aged 50 or above were recruited between 2 and 28 May 2007 to complete an anonymous telephone survey. The survey covered demographics, perceived health status and susceptibility to cancer, utilization of complementary medicine, family history of cancer, and cancer screening behaviour. The uptake of flexible sigmoidoscopy/colonoscopy was 12%, of which only 3.4% had been recommended by health professionals. The effects of gender, a history of serious disease, perceptions related to health status and visiting doctor regularly on the flexible sigmoidoscopy/colonoscopy uptake were mediated by a health professional's recommendation. A health professional's recommendation can be a catalyst for the decision of undergoing a colorectal cancer screening test in older adult people, in particular for those who are more health-conscious. As health professionals can play a crucial role in the development of successful population-based colorectal cancer screening program, efforts should be made to facilitate them in making recommendations for colorectal cancer screening to targeted high-risk group.
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Affiliation(s)
- Kai-Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
| | - Helen Yl Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
| | - Dorothy Ns Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
| | - Wendy Wt Lam
- Department of Community Medicine, The University of Hong Kong, HKSAR, China
| | - Carmen Wh Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
| | - Simone Sm Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
| | - Karis Kf Cheng
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
| | - William B Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Ann Ty Shiu
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
| | - Winnie Kw So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, HKSAR, China
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Goggins WB, Chan EYY, Yang C, Chong M. Associations between mortality and meteorological and pollutant variables during the cool season in two Asian cities with sub-tropical climates: Hong Kong and Taipei. Environ Health 2013; 12:59. [PMID: 23870087 PMCID: PMC3733824 DOI: 10.1186/1476-069x-12-59] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [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: 03/04/2013] [Accepted: 07/15/2013] [Indexed: 05/23/2023]
Abstract
BACKGROUND Numerous studies have found associations between extreme temperatures and human mortality but relatively few studies have been done in sub-tropical and tropical cities, especially in Asia. In this study we examine the impact of cold temperatures, cold waves and other meteorological and environmental variables on cool season mortality in 2 subtropical Asian cities. METHODS Separate analysis of daily mortality time-series from Hong Kong and Taipei using Generalized Additive Models with natural mortality as the outcome daily mean temperature as the main explanatory variable and relative humidity, solar radiation, wind speed, pollutants (nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), respirable suspended particulates (PM(10)), ozone (O(3)), seasonality and day of the week controlled as potential confounders. Lags up to 35 days were considered for temperature, and distributed lag models were used to determine the number of lags for final models. Subgroup analyses were also done by gender, age group, cause of death and geographical area of residence. RESULTS Cold temperatures were strongly associated with higher mortality with lagged effects persisting up to 3 weeks in Hong Kong and 2 weeks in Taipei. Cold effects were much stronger for deaths among older people and non-cancer deaths. Prolonged cold spells modestly but significantly raised mortality after accounting for the effects of individual cold days. Higher daily ozone levels were also strongly associated with higher short-term mortality in Taipei and Hong Kong, while relative humidity and solar radiation were weakly and inconsistently associated with mortality. CONCLUSIONS Cold temperatures and cold spells substantially increase short-term mortality in sub-tropical Asian cities particularly among the elderly. Greater attention needs to be paid to the adverse health effects of cold temperatures. Interventions including provisions of shelters, cold weather warnings and education about the possible health effects of cold temperature should be carried out in sub-tropical areas.
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Affiliation(s)
- William B Goggins
- Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Emily YY Chan
- Division of Family Medicine, School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chunyuh Yang
- Institute of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Marc Chong
- Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong
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Kim JH, Wong AH, Goggins WB, Lau J, Griffiths SM. Drink driving in Hong Kong: the competing effects of random breath testing and alcohol tax reductions. Addiction 2013; 108:1217-28. [PMID: 23316754 DOI: 10.1111/add.12116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 09/27/2012] [Accepted: 01/08/2013] [Indexed: 11/26/2022]
Abstract
AIMS To investigate the competing effects of increased anti-drink driving legislation and the recent elimination of excise taxes on wine and beer. DESIGN Serial cross-sectional telephone surveys were conducted in 2006 (n = 9860) and 2011 (n = 4800). SETTING Hong Kong, China. PARTICIPANTS Chinese adults (≥18 years of age). MEASUREMENTS Respondents were asked about their drinking patterns, past-year experience of driving within 2 hours of drinking, drinking-related attitudes and reported deterrents to drink driving. FINDINGS Following the legislative changes, the age-standardized past-year prevalence of drink driving decreased significantly from 5.2 to 2.8% (P < 0.001) among all males, from 9.0 to 4.4% (P < 0.001) among male past-year drinkers and from 13.7 to 8.5% (P < 0.01) among male weekly drinkers. The past-year prevalence of drink driving in 2011 among all females (0.08%), female past-year drinkers (1.6%), male binge drinkers (12.5%), female weekly drinkers (4.7%) and female binge drinkers (7.9%) were not significantly different from 2006. Drink driving was associated independently with business sector employment [odds ratio (OR) = 2.47], past-month binge drinking (OR = 6.08) and beliefs in the benefits to one's wellbeing of drinking (OR = 2.62) among males and past-month binge drinking (OR = 5.57), belief in the social benefits of drinking (OR = 5.66) and being unmarried (OR = 3.00) in females (P < 0.05). The most commonly reported drink driving deterrents were concerns about random breath tests (93.8%) and the potential legal consequences of conviction (93.6-96.5%). CONCLUSIONS Despite greater alcohol consumption in Hong Kong, the current anti-drink driving strategy appears to reduce drink driving in males and prevent increased levels among females. Binge drinkers, however, remain a high-risk group that should be monitored continually.
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Affiliation(s)
- Jean H Kim
- The Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, , The Chinese University of Hong Kong, New Territories, Hong Kong SAR
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Chan EYY, Goggins WB, Yue JSK, Lee P. Hospital admissions as a function of temperature, other weather phenomena and pollution levels in an urban setting in China. Bull World Health Organ 2013; 91:576-84. [PMID: 23940405 DOI: 10.2471/blt.12.113035] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 04/18/2013] [Accepted: 04/23/2013] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To explore the relationship between weather phenomena and pollution levels and daily hospital admissions (as an approximation to morbidity patterns) in Hong Kong Special Administrative Region (SAR), China, in 1998-2009. METHODS Generalized additive models and lag models were constructed with data from official sources on hospital admissions and on mean daily temperature, mean daily wind speed, mean relative humidity, daily total global solar radiation, total daily rainfall and daily pollution levels. FINDINGS During the hot season, admissions increased by 4.5% for every increase of 1 °C above 29 °C; during the cold season, admissions increased by 1.4% for every decrease of 1 °C within the 8.2-26.9 °C range. In subgroup analyses, admissions for respiratory and infectious diseases increased during extreme heat and cold, but cardiovascular disease admissions increased only during cold temperatures. For every increase of 1 °C above 29 °C, admissions for unintentional injuries increased by 1.9%. During the cold season, for every decrease of 1 °C within the 8.2-26.9 °C range, admissions for cardiovascular diseases and intentional injuries rose by 2.1% and 2.4%, respectively. Admission patterns were not sensitive to sex. Admissions for respiratory diseases rose during hot and cold temperatures among children but only during cold temperatures among the elderly. In people aged 75 years or older, admissions for infectious diseases rose during both temperature extremes. CONCLUSION In Hong Kong SAR, hospitalizations rise during extreme temperatures. Public health interventions should be developed to protect children, the elderly and other vulnerable groups from excessive heat and cold.
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Affiliation(s)
- Emily Y Y Chan
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, 3/F, School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, NT, Hong Kong Special Administrative Region (SAR), China.
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Choi KC, So WKW, Chan DNS, Shiu ATY, Ho SSM, Chan HYL, Lam WWT, Cheng KKF, Goggins WB, Chan CWH. Gender differences in the use of colorectal cancer tests among older Chinese adults. Eur J Oncol Nurs 2013; 17:603-9. [PMID: 23462304 DOI: 10.1016/j.ejon.2013.01.004] [Citation(s) in RCA: 6] [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: 05/15/2012] [Revised: 12/20/2012] [Accepted: 01/05/2013] [Indexed: 01/15/2023]
Abstract
PURPOSE The study aimed to explore the gender difference in using colorectal cancer (CRC) tests among Chinese aged 50 years or over. METHODS A cross-sectional study was conducted in 2004 Chinese older adults through anonymous telephone survey which covered socio-demographic variables, health status, use of complementary therapy, health-related perceptions and use of CRC tests. RESULTS The uptake rate of flexible sigmoidoscopy (FS)/colonoscopy was 14% for males and 10% for females, with males significantly more likely to have had the test after adjusting for their differences in socio-demographics, health status, use of complementary therapies, health-related perceptions and recommendation received from health professionals (adjusted OR = 1.5, 95% CI: 1.1-2.0, p = 0.005). The uptake of fecal occult blood test was nearly the same (19%) for both genders. Further interaction analyses indicates that the effect of a family history of cancer on the uptake of a FS/colonoscopy is significantly weaker in males than in females (the interaction odds ratio = 0.4, 95% CI: 0.2-0.8, p = 0.011), whereas a male perceived that visiting a doctor is good for health will be more likely to have an uptake of a FS/colonoscopy than a female with such perception (the interaction odds ratio = 2.1, 95% CI: 1.1-3.8, p = 0.018). CONCLUSIONS The uptake of CRC tests was low in this average-risk population. More effort is needed to educate the public about the importance and benefits of CRC tests. In view of the gender differences in some determinants of FS/colonoscopy uptake, particular attention should be given to develop gender-specific strategies to improve the rate.
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Affiliation(s)
- Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Goggins WB, Chan EYY, Yang CY. Weather, pollution, and acute myocardial infarction in Hong Kong and Taiwan. Int J Cardiol 2012; 168:243-9. [PMID: 23041014 DOI: 10.1016/j.ijcard.2012.09.087] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 06/28/2012] [Accepted: 09/15/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several previous studies examined the association between acute myocardial infarction (AMI) incidence and temperature and/or air pollution. Results of these studies have been inconsistent and few studies have been done in cities with sub-tropical or tropical climates. METHODS Daily data on AMI hospitalizations, mean temperature and humidity, and pollutants, were collected for 2000-2009 for three warm-climate Asian cities. Poisson Generalized Additive Models were used to regress daily AMI counts on temperature, humidity, and pollutants while controlling for day of the week, long-term trends and seasonal effects. Smoothing splines allowing non-linear associations were used for temperature and humidity while pollutants were modeled as linear terms. RESULTS A 1°C drop below a threshold temperature of 24°C was significantly (p<.0001) associated with AMI hospitalization increases of 3.7% (average lag 0-13 temperature) in Hong Kong, 2.6% (average lag 0-15) in Taipei, and 4.0% (average lag 0-11) in Kaohsiung. No significant heat effects were observed. Among pollutants same day nitrogen dioxide (NO2) levels were the strongest predictors in all three cities, with a 10mg/m(3) increase in NO2 being associated with a 1.1% rise in AMI hospitalization in Hong Kong, and a 10 ppb rise being associated with 4.4% and 2.6% rises in Taipei and Kaohsiung, respectively. CONCLUSIONS Cool temperatures and higher NO2 levels substantially raised AMI risk in these warm-climate cities and the effect sizes we observed were stronger than those found in previous studies. More attention should be paid to the health dangers of cold weather in warm-climate cities.
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Affiliation(s)
- William B Goggins
- Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong.
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Goggins WB, Woo J, Ho S, Chan EYY, Chau PH. Weather, season, and daily stroke admissions in Hong Kong. Int J Biometeorol 2012; 56:865-72. [PMID: 21915799 DOI: 10.1007/s00484-011-0491-9] [Citation(s) in RCA: 71] [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] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 08/22/2011] [Accepted: 08/22/2011] [Indexed: 05/24/2023]
Abstract
Previous studies examining daily temperature and stroke incidence have given conflicting results. We undertook this retrospective study of all stroke admissions in those aged 35 years old and above to Hong Kong public hospitals from 1999 through 2006 in order to better understand the effects of meteorological conditions on stroke risk in a subtropical setting. We used Poisson Generalized Additive Models with daily hemorrhagic (HS) and ischemic stroke (IS) counts separately as outcomes, and daily mean temperature, humidity, solar radiation, rainfall, air pressure, pollutants, flu consultation rates, day of week, holidays, time trend and seasonality as predictors. Lagged effects of temperature, humidity and pollutants were also considered. A total of 23,457 HS and 107,505 IS admissions were analyzed. Mean daily temperature had a strong, consistent, negative linear association with HS admissions over the range (8.2-31.8°C) observed. A 1°C lower average temperature over the same day and previous 4 days (lags 0-4) being associated with a 2.7% (95% CI: 2.0-3.4%, P < .0.0001) higher admission rate after controlling for other variables. This association was stronger among older subjects and females. Higher lag 0-4 average change in air pressure from previous day was modestly associated with higher HS risk. The association between IS and temperature was weaker and apparent only below 22°C, with a 1°C lower average temperature (lags 0-13) below this threshold being associated with a 1.6% (95% CI:1.0-2.2%, P < 0.0001) higher IS admission rate. Pollutant levels were not associated with HS or IS. Future studies should examine HS and IS risk separately.
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Affiliation(s)
- William B Goggins
- Division of Biostatistics, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Goggins WB, Chan EYY, Ng E, Ren C, Chen L. Effect modification of the association between short-term meteorological factors and mortality by urban heat islands in Hong Kong. PLoS One 2012; 7:e38551. [PMID: 22761684 PMCID: PMC3382248 DOI: 10.1371/journal.pone.0038551] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 05/09/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Prior studies from around the world have indicated that very high temperatures tend to increase summertime mortality. However possible effect modification by urban micro heat islands has only been examined by a few studies in North America and Europe. This study examined whether daily mortality in micro heat island areas of Hong Kong was more sensitive to short term changes in meteorological conditions than in other areas. METHOD An urban heat island index (UHII) was calculated for each of Hong Kong's 248 geographical tertiary planning units (TPU). Daily counts of all natural deaths among Hong Kong residents were stratified according to whether the place of residence of the decedent was in a TPU with high (above the median) or low UHII. Poisson Generalized Additive Models (GAMs) were used to estimate the association between meteorological variables and mortality while adjusting for trend, seasonality, pollutants and flu epidemics. Analyses were restricted to the hot season (June-September). RESULTS Mean temperatures (lags 0-4) above 29 °C and low mean wind speeds (lags 0-4) were significantly associated with higher daily mortality and these associations were stronger in areas with high UHII. A 1 °C rise above 29 °C was associated with a 4.1% (95% confidence interval (CI): 0.7%, 7.6%) increase in natural mortality in areas with high UHII but only a 0.7% (95% CI: -2.4%, 3.9%) increase in low UHII areas. Lower mean wind speeds (5(th) percentile vs. 95(th) percentile) were associated with a 5.7% (95% CI: 2.7, 8.9) mortality increase in high UHII areas vs. a -0.3% (95% CI: -3.2%, 2.6%) change in low UHII areas. CONCLUSION The results suggest that urban micro heat islands exacerbate the negative health consequences of high temperatures and low wind speeds. Urban planning measures designed to mitigate heat island effects may lessen the health effects of unfavorable summertime meteorological conditions.
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Affiliation(s)
- William B Goggins
- Division of Biostatistics, School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong.
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Chor JSY, Pada SK, Stephenson I, Goggins WB, Tambyah PA, Medina M, Lee N, Leung TF, Ngai KLK, Law SK, Rainer TH, Griffiths S, Chan PKS. Differences in the compliance with hospital infection control practices during the 2009 influenza H1N1 pandemic in three countries. J Hosp Infect 2012; 81:98-103. [PMID: 22560251 DOI: 10.1016/j.jhin.2012.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 04/03/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND In December 2009, the World Health Organization (WHO) issued updated guidelines on the prevention of H1N1 influenza virus in healthcare settings. In 2010, the WHO pandemic influenza alert level was still at phase 6. AIM To study the practice of infection control measures during the 2009 influenza H1N1 pandemic among healthcare workers (HCWs) in three countries. METHODS A standardized, self-administered anonymous questionnaire survey was conducted in 2010 among doctors, nurses and allied HCWs in 120 hospital-based clinical departments in Hong Kong, Singapore and the UK. Questions were asked on demographics; previous experience and perceived severity of influenza; infection control practices; uptake of seasonal influenza vaccination and H1N1 vaccination. Multiple logistic regression was used to test the independent association with different factors. FINDINGS A total of 2100 HCWs in the three countries participated. They reported high compliance (>80%) with infection control procedures regarded as standard for droplet-transmitted infections including wearing and changing gloves, and washing hands before and after patient contact. However, the reported use of masks with indirect or direct patient contact (surgical or N95 as required by their hospital) varied considerably (96.4% and 70.4% for Hong Kong; 82.3% and 87.7% for Singapore; 25.3% and 62.0% for the UK). Reported compliance was associated with job title, number of patient contacts and perceived severity of pandemics. There was no association between the uptake for seasonal or 2009 H1N1 vaccines and compliance. CONCLUSIONS Compliance with infection control measures for pandemic influenza appears to vary widely depending on the setting.
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Affiliation(s)
- J S Y Chor
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
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Kim JH, Lo FK, Cheuk KK, Kwong MS, Goggins WB, Cai YS, Lee SS, Griffiths S. Knowledge of avian influenza (H5N1) among poultry workers, Hong Kong, China. Emerg Infect Dis 2012; 17:2319-21. [PMID: 22172127 PMCID: PMC3311183 DOI: 10.3201/eid1712.110321] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2009, a cross-sectional survey of 360 poultry workers in Hong Kong, China, showed that workers had inadequate levels of avian influenza (H5N1) risk knowledge, preventive behavior, and outbreak preparedness. The main barriers to preventive practices were low perceived benefits and interference with work. Poultry workers require occupation-specific health promotion.
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Affiliation(s)
- Jean H Kim
- The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
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45
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Huang SP, Bao BY, Wu MT, Choueiri TK, Goggins WB, Liu CC, Huang CY, Pu YS, Yu CC, Wu TT, Huang CN, Huang CH, Wu WJ. Significant associations of prostate-specific antigen nadir and time to prostate-specific antigen nadir with survival in prostate cancer patients treated with androgen-deprivation therapy. Aging Male 2012; 15:34-41. [PMID: 21615239 DOI: 10.3109/13685538.2011.580398] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The influence of prostate-specific antigen (PSA) kinetics on the outcome of metastatic prostate cancer (PCa) after androgen-deprivation therapy (ADT) remains poorly characterised. We evaluated the prognostic significance of PSA nadir and time to PSA nadir as well as their interactive effect on prostate cancer-specific mortality (PCSM) and all-cause mortality (ACM) after ADT. METHODS A total of 650 men with advanced or metastatic PCa treated with ADT were studied. The prognostic significance of PSA nadir and time to PSA nadir on PCSM and ACM were analysed using Kaplan-Meier analysis and the Cox regression model. RESULTS On multivariate analysis, clinical M1 stage, Gleason Score 8-10, PSA nadir ≥ 0.2 ng/ml and time to PSA nadir < 10 months were independent predictors of PCSM and ACM. The combined analysis showed that patient with higher PSA nadir and shorter time to PSA nadir had significantly higher risk of PCSM and ACM compared to those with lower PSA nadir and longer time to PSA nadir (hazard ratios = 6.30 and 4.79, respectively, all P < 0.001). CONCLUSIONS Our results suggest that higher PSA nadir level and faster time to reach PSA nadir after ADT were associated with shorter survival for PCa.
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Affiliation(s)
- Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Taiwan.
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46
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So WKW, Choi KC, Chan DNS, Chan CWH, Shiu ATY, Ho SSS, Chan HYL, Lam WWT, Cheng KKF, Goggins WB. Colorectal cancer testing and associated factors among older Chinese adults. Prev Med 2012; 54:104-5. [PMID: 22033064 DOI: 10.1016/j.ypmed.2011.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 09/12/2011] [Accepted: 09/12/2011] [Indexed: 10/16/2022]
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47
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Chau PH, Woo J, Goggins WB, Wong M, Chan KC, Ho SC. Analysis of spatio-temporal variations in stroke incidence and case-fatality in Hong Kong. Geospat Health 2011; 6:13-20. [PMID: 22109859 DOI: 10.4081/gh.2011.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Geographical variations in stroke incidence and case-fatality have been documented worldwide. This study examines whether there are spatio-temporal variations in stroke incidence and case-fatality in Hong Kong and attempts to determine to what extent socioeconomic status (SES) and healthcare provision account for these variations. Residence-based hospital discharge data from the Hospital Authority (HA) in Hong Kong were geo-referenced and used to examine incidence rates and case-fatality rates by stroke subtype among the population aged 35 years and above in 1999-2007. Multilevel models were used to examine the spatio-temporal variations. Ischemic stroke incidence was found to decrease among those aged above 55 years, while hemorrhagic stroke incidence increased. Ischemic stroke case-fatality was found to decrease but hemorrhagic stroke case-fatality remained stable. For both subtypes, there were significant variations in stroke incidence and case-fatality across the districts of residence, but insignificant variations across HA service clusters. Only variations in ischemic stroke incidence and hemorrhagic stroke case-fatality at the district level could be partly explained by district-level SES. Identification of districts with higher risk for stroke incidence and case-fatality would help to formulate enhanced preventive measures. Future studies are needed to identify factors that contribute to the geographical variations.
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Affiliation(s)
- Pui Hing Chau
- Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, People's Republic of China.
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48
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Chor JS, Pada SK, Stephenson I, Goggins WB, Tambyah PA, Clarke TW, Medina M, Lee N, Leung TF, Ngai KL, Law SK, Rainer TH, Griffiths S, Chan PK. Seasonal influenza vaccination predicts pandemic H1N1 vaccination uptake among healthcare workers in three countries. Vaccine 2011; 29:7364-9. [DOI: 10.1016/j.vaccine.2011.07.079] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 07/06/2011] [Accepted: 07/18/2011] [Indexed: 10/17/2022]
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49
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Chan FWK, Wong FYY, Yam CHK, Cheung WL, Wong ELY, Leung MCM, Goggins WB, Yeoh EK. Risk factors of hospitalization and readmission of patients with COPD in Hong Kong population: analysis of hospital admission records. BMC Health Serv Res 2011; 11:186. [PMID: 21831287 PMCID: PMC3162881 DOI: 10.1186/1472-6963-11-186] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [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: 11/12/2010] [Accepted: 08/10/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) accounts for around 4% of all public hospital annual admissions in Hong Kong. By year 2020, COPD will be ranked fifth among the conditions with the highest burden to the society. This study identifies admission and unplanned readmission of COPD patients, factors affecting unplanned readmission, and estimates its cost burden on the public healthcare system in Hong Kong. METHODS This is a retrospective study analyzing COPD admissions to all public hospitals in Hong Kong. All admission episodes to acute medical wards with the principal diagnosis of COPD (ICD-9:490-492, 494-496) from January 2006 to December 2007 were captured. Unplanned readmission was defined as an admission which followed a previous admission within 30 days. RESULTS In 2006 and 2007, 65497 (8.0%) of episodes from medical wards were identified as COPD admissions, and among these, 15882 (24.2%) were unplanned readmissions. The mean age of COPD patients was 76.81 ± 9.59 years and 77% were male. Unplanned readmission was significantly associated with male gender, receiving public assistance and living in nursing homes while no association was found with the Charlson comorbidity index. Patients who were readmitted unplanned had a significant longer acute length of stay (β = 0.3894, P < 0.001) after adjustment for other covariates. CONCLUSIONS Unplanned readmission of COPD patients has a huge impact on the public healthcare system. A systematic approach in programme provision and a good discharge planning process targeting on COPD patients who are at high risk of unplanned readmission are essential.
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Affiliation(s)
- Frank WK Chan
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - Fiona YY Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - Carrie HK Yam
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - Wai-ling Cheung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - Eliza LY Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - Michael CM Leung
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - William B Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
| | - Eng-kiong Yeoh
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong
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50
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Huang SP, Bao BY, Wu MT, Choueiri TK, Goggins WB, Huang CY, Pu YS, Yu CC, Huang CH. Impact of prostate-specific antigen (PSA) nadir and time to PSA nadir on disease progression in prostate cancer treated with androgen-deprivation therapy. Prostate 2011; 71:1189-97. [PMID: 21656829 DOI: 10.1002/pros.21334] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [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: 08/15/2010] [Accepted: 12/03/2010] [Indexed: 11/05/2022]
Abstract
BACKGROUND The influence of PSA kinetics on the outcome of metastatic prostate cancer after androgen deprivation therapy (ADT) is not well understood. We evaluated the prognostic significance of PSA nadir and time to PSA nadir as well as their potential interactive effect on the progression of disease after ADT. METHODS A total of 650 men with advanced or metastatic prostate cancer treated with ADT were studied. The prognostic significance of PSA nadir and time to PSA nadir on disease progression were analyzed using Kaplan-Meier analysis and the Cox regression model. RESULTS We found that both PSA nadir and time to PSA nadir were independent and significant predictors of disease progression. Patients with higher PSA nadir (≥0.2 ng/ml) and shorter time to PSA nadir (<10 months) had significant shorter time to disease progression after adjusting for other covariates. The combined analyses showed a potential synergistic effect of these two variables on disease progression. Patient with higher PSA nadir and shorter time to PSA nadir had significantly higher risk for disease progression compared to those with lower PSA nadir and longer time to PSA nadir (Hazard Ratios (HR) = 3.11, P < 0.001). CONCLUSIONS We concluded that both PSA nadir and time to PSA nadir are significant predictors of disease progression for prostate cancer patients receiving ADT.
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Affiliation(s)
- Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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