Socioeconomic inequalities in psychosocial well-being among adolescents under the COVID-19 pandemic: a cross-regional comparative analysis in Hong Kong, mainland China, and the Netherlands.

BACKGROUND: Despite evidence on socioeconomic inequalities in psychosocial well-being of adolescents under the COVID-19 pandemic, the explanatory factors and their potential variations across contexts remained understudied. Hence, this cross-regional study compared the extent of inequalities and the mediating pathways across Hong Kong, Mainland China, and the Netherlands. METHODS: Between July 2021 and January 2022, 25 secondary schools from diverse socioeconomic background were purposively sampled from Hong Kong, Zhejiang (Mainland China), and Limburg (the Netherlands). 3595 junior students completed an online survey during class about their socioeconomic position, psychosocial factors, and well-being. Socioeconomic inequalities were assessed by multiple linear regressions using the Slope Index of Inequality (SII), whereas the mediating pathways through learning difficulty, overall worry about COVID-19, impact on family' financial status, resilience, trust in government regarding pandemic management, and adaptation to social distancing were examined by mediation analyses moderated by regions. RESULTS: The adverse psychosocial impact of COVID-19 was stronger in the Netherlands and Hong Kong compared with Mainland China. The greatest extent of socioeconomic inequalities in the change in psychosocial well-being was observed among students in the Netherlands (SII = 0.59 [95% CI = 0.38-0.80]), followed by Hong Kong (SII = 0.37 [0.21-0.52]) and Mainland China (SII = 0.12 [0.00-0.23]). Learning difficulty and resilience were the major mediators in Mainland China and Hong Kong, but to a lesser extent in the Netherlands. CONCLUSION: Socioeconomic inequalities in psychosocial well-being were evident among adolescents under the pandemic, with learning difficulty and resilience of students as the key mediators. Differences in the social contexts should be considered to better understand the variations in inequalities and mediating pathways across regions.

Experience of South and Southeast Asian minority women in Hong Kong during COVID-19 pandemic: a qualitative study.

BACKGROUND: Hong Kong has a relatively low incidence rate of COVID-19 across the globe. Nevertheless, ethnic minorities in Hong Kong, especially South Asians (SAs) and Southeast Asians (SEAs), face numerous physical, mental, social, economic, cultural and religious challenges during the pandemic. This study explores the experiences of SA and SEA women in a predominantly Chinese metropolitan city. METHODS: Ten SA and SEA women were recruited and face-to-face interviews were conducted. Questions about participants' daily life experience, physical and mental health conditions, economic situation and social interaction amid COVID-19 pandemic were asked to assess the impact of COVID-19. RESULTS: SAs and SEAs have a distinctive family culture, and women experienced significant physical and mental impact of COVID-19 due to their unique gender role in the family. In addition to taking care of their family in Hong Kong, SA and SEA women also had to mentally and financially support family members residing in their home countries. Access to COVID-related information was restricted due to language barrier. Public health measures including social distancing imposed extra burden on ethnic minorities with limited social and religious support. CONCLUSIONS: Even when COVID-19 incidence rate is relatively low in Hong Kong, the pandemic made life even more challenging for SAs and SEAs, which is a community already struggling with language barriers, financial woes, and discrimination. This in turn could have led to greater health inequalities. Government and civil organizations should take the social determinants of health inequalities into account when implementing COVID-19-related public health policies and strategies.

The mediating role of individual-level social capital among worries, mental health and subjective well-being among adults in Hong Kong during the COVID-19 pandemic.

The COVID-19 pandemic has substantially induced worries and affected individual mental health and subjective well-being. Nonetheless, a high level of social capital could potentially protect individuals who suffer from mental health problems and thus promote their subjective well-being, especially under the social distancing policies during the pandemic. To this end, based on a random sample of 1053 Hong Kong adults, structural equation modeling was applied to study the path relationships between the worries of COVID-19, social capital, mental health problems, and subjective well-being. The study found that worries during the pandemic were associated with mental health and subjective well-being, through social capital as a mediator. Moreover, social capital exhibited a stronger influence on mental health and subjective well-being in the economically inactive group than in the economically active group. This study highlights the important role of social capital during the COVID-19 pandemic. While Hong Kong's COVID-19 response has primarily focused on disease prevention, it must be noted that social services and mutual-help activities are also crucial for people to withstand the crisis.

Prognostic significance of abdominal obesity and its post-diagnosis change in a Chinese breast cancer cohort.

PURPOSE: It is well-known that obesity has an adverse impact on breast cancer prognosis; nonetheless, the prognostic role of abdominal obesity, especially its post-diagnosis change, has been understudied. This study aims to examine the prospective associations of general and abdominal obesity and their post-diagnosis changes with all-cause mortality, breast cancer-specific mortality, and breast cancer recurrence in Chinese breast cancer patients. METHODS: From 2011 to 2014, 1460 Chinese breast cancer patients were recruited and followed up at 18, 36, and 60 months after diagnosis. Body mass index (BMI), waist-to-hip ratio (WHR), and their changes between baseline and 18-month follow-up were derived. Clinical records on diagnosis, treatment, and death were also obtained. In total, 1309 women who completed the 18-month follow-up were included for Cox regression analyses, stratified by follow-up periods. RESULTS: Within 18-48 months post-diagnosis, substantial WHR loss (5% or above) had reduced risk of all-cause (HR = 0.21 [95% CI 0.06-0.75]) and breast cancer-specific mortality (0.21 [0.06-0.77]) relative to stable WHR; whereas after 48 months post-diagnosis, substantial WHR gain showed elevated risks of all-cause mortality (2.67 [1.22-5.85])). Higher baseline WHR was also associated with both mortality outcomes. Nonetheless, no such associations were observed for BMI measures. Also, the effects of obesity measures on breast recurrence were less apparent. CONCLUSION: Abdominal obesity, rather than general obesity, was linked to worse survival in Chinese breast cancer patients. Prevention on abdominal obesity and waist gain following breast cancer diagnosis may have a beneficial effect on longer-term survival over and above conventional weight management. Waist assessment and abdominal obesity control should therefore be incorporated as a vital component of the evaluation and interventions of breast cancer prognosis.

Sociodemographic moderation of the association between depression and stroke incidence in a retrospective cohort of 0.4 million primary care recipients with hypertension.

BACKGROUND: Previous research has suggested an association between depression and subsequent acute stroke incidence, but few studies have examined any effect modification by sociodemographic factors. In addition, no studies have investigated this association among primary care recipients with hypertension. METHODS: We examined the anonymized records of all public general outpatient visits by patients aged 45+ during January 2007-December 2010 in Hong Kong to extract primary care patients with hypertension for analysis. We took the last consultation date as the baseline and followed them up for 4 years (until 2011-2014) to observe any subsequent acute hospitalization due to stroke. Mixed-effects Cox models (random intercept across 74 included clinics) were implemented to examine the association between depression (ICPC diagnosis or anti-depressant prescription) at baseline and the hazard of acute stroke (ICD-9: 430-437.9). Effect modification by age, sex, and recipient status of social security assistance was examined in extended models with respective interaction terms specified. RESULTS: In total, 396 858 eligible patients were included, with 9099 (2.3%) having depression, and 10 851 (2.7%) eventually hospitalized for stroke. From the adjusted analysis, baseline depression was associated with a 17% increased hazard of acute stroke hospitalization [95% confidence interval (CI) 1.03-1.32]. This association was suggested to be even stronger among men than among women (hazard ratio = 1.29, 95% CI 1.00-1.67). CONCLUSION: Depression is more strongly associated with acute stroke incidence among male than female primary care patients with hypertension. More integrated services are warranted to address their needs.

Resilience and coping strategies of older adults in Hong Kong during COVID-19 pandemic: a mixed methods study.

BACKGROUND: Despite the adverse physical health impact of COVID-19 on older adults, whether they are psychosocially vulnerable under the pandemic remains debatable. In this mixed methods study, we examined the psychosocial vulnerability of older adults relative to their younger counterparts and explored how they coped with the pandemic. METHODS: From September to October 2020, 1067 adults in Hong Kong were randomly sampled and completed a telephone survey, whereas 10 older adults were recruited for individual interviews between September 2020 and April 2021. Quantitative measurements included subjective well-being, worries about COVID-19, and changes in social capital and social interaction since the pandemic. The transcribed qualitative data were closely read and summarized using thematic analyses. RESULTS: Compared with younger adults, older adults tended to be less worried about COVID-19 infection and economic activity/livelihood, despite being slightly more worried about supplies of personal protective equipment. They also had better subjective well-being in terms of happiness and life satisfaction, with their social capital and social interaction less affected. In addition, five themes emerged from the qualitative interviews: (1) life philosophy; (2) economic security; (3) telecommunication; (4) role of community organizations and social workers; and (5) positive coping strategies. CONCLUSIONS: Older adults in this study showed better psychosocial well-being than their younger counterparts under the COVID-19 pandemic, which challenged the deeply rooted societal stereotype about the vulnerability of older adults. The stronger resilience for positive coping, technological assistance, and targeted government and community support may have protected older adults from distress during the pandemic.

Socioeconomic Patterns of COVID-19 Clusters in Low-Incidence City, Hong Kong.

Although coronavirus disease (COVID-19) outbreaks have been relatively well controlled in Hong Kong, containment remains challenging among socioeconomically disadvantaged persons. They are at higher risk for widespread COVID-19 transmission through sizable clustering, probably because of exposure to social settings in which existing mitigation policies had differential socioeconomic effects.

Gender-specific trends of educational inequality in diagnosed diabetes from 1999 to 2014 in Hong Kong: a serial cross-sectional study of 97,481 community-dwelling Chinese adults.

BACKGROUND: Gender differences in the trend of educational inequality in diabetes have been widely observed in the Western populations, indicating the increasing importance of educational attainment as a social determinant of diabetes among women. Nonetheless, relevant evidence is scarce in developed Asian settings for comparisons. This study examined the gender-specific trends of educational inequality in diagnosed diabetes in Hong Kong between 1999 and 2014. METHODS: A series of eight territory-wide population-representative samples of 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were surveyed between 1999 and 2014. Regression-based Relative Index of Inequality (RII) and age-standardized Slope Index of Inequality (SII) were adopted to examine the extent and trend of gender-specific educational inequality in self-reported physician-diagnosed diabetes. RESULTS: Age-standardized prevalence of diabetes increased in both genders over time, with a steeper surge among men. In addition, educational inequalities in diabetes, in both relative and absolute terms, significantly widened among women over the study period (annual RII change = 1.04; 95% CI = 1.02-1.07, annual SII change = 0.36%; 95% CI = 0.16-0.56%), with the peak in 2011 (RII = 2.44; 95% CI = 1.83-3.24, SII = 9.21%; 95% CI = 6.47-11.96%). However, no significant widening inequality was found among men. Further adjustment for household income level did not attenuate the observed educational inequality. CONCLUSIONS: Despite a greater increase in diabetes prevalence among men, disparity in diabetes substantially widened across education levels among women in the past decade in Hong Kong. The gender perspective should be taken into considerations for policy making to alleviate the prevalence surge and rising educational inequality in diabetes.

Differential educational patterning of cardiometabolic risks between women and men among community-dwelling Chinese adults in Hong Kong: the mediating role of obesity.

OBJECTIVES: Educational inequalities in cardiometabolic diseases (CMD) are globally recognised; nonetheless, the evidence on potential explanatory mechanisms and effective strategies for CMD prevention and inequality reduction is relatively scarce in Asia. Therefore, the current study examined the extent and potential mediators of the association of education level with CMD conditions (i.e., hypertension and diabetes) in an advanced economy in Asia. DESIGN: A cross-sectional study. SETTING: This territory-wide cross-sectional Population Health Survey in 2014-2015 was performed in Hong Kong. Demographic, socio-economic and lifestyle factors were collected via questionnaire, while clinical data on blood pressure and glucose levels, lipid profiles and anthropometric measures were obtained during health examination. Hypertension and diabetes statuses were objectively defined by both clinical data and the use of relevant medications. PARTICIPANTS: 2297 community-dwelling adults aged between 15-84 years recruited via systematic replicated sampling of living quarters. RESULTS: Multivariable binary logistic regression analysis showed that lower education level was significantly associated with hypertension among women but not men, whereas similar pattern was also observed for diabetes and other related clinical risk factors. Also, general and abdominal obesity were independently associated with hypertension and diabetes among both women and men, and substantially mediated the observed inequalities across education levels among women. Specifically, abdominal obesity was a particularly strong risk factor and mediator for diabetes. CONCLUSION: Educational patterning of CMD was more apparent among women in Hong Kong. Obesity control appears to be important for both overall CMD prevention and reduction of educational inequalities in CMD among women.

A heat-sensitive Osh protein controls PI4P polarity.

BACKGROUND: Phosphoinositide lipids provide spatial landmarks during polarized cell growth and migration. Yet how phosphoinositide gradients are oriented in response to extracellular cues and environmental conditions is not well understood. Here, we elucidate an unexpected mode of phosphatidylinositol 4-phosphate (PI4P) regulation in the control of polarized secretion. RESULTS: We show that PI4P is highly enriched at the plasma membrane of growing daughter cells in budding yeast where polarized secretion occurs. However, upon heat stress conditions that redirect secretory traffic, PI4P rapidly increases at the plasma membrane in mother cells resulting in a more uniform PI4P distribution. Precise control of PI4P distribution is mediated through the Osh (oxysterol-binding protein homology) proteins that bind and present PI4P to a phosphoinositide phosphatase. Interestingly, Osh3 undergoes a phase transition upon heat stress conditions, resulting in intracellular aggregates and reduced cortical localization. Both the Osh3 GOLD and ORD domains are sufficient to form heat stress-induced aggregates, indicating that Osh3 is highly tuned to heat stress conditions. Upon loss of Osh3 function, the polarized distribution of both PI4P and the exocyst component Exo70 are impaired. Thus, an intrinsically heat stress-sensitive PI4P regulatory protein controls the spatial distribution of phosphoinositide lipid metabolism to direct secretory trafficking as needed. CONCLUSIONS: Our results suggest that control of PI4P metabolism by Osh proteins is a key determinant in the control of polarized growth and secretion.

Long Working Hours, Precarious Employment and Anxiety Symptoms Among Working Chinese Population in Hong Kong.

This study aimed to examine the association between working hours and anxiety of a working population in Hong Kong. We used a cross sectional data from a population-based household survey of Hong Kong Chinese adults. Key measures included employment status, skill level, working hours, length of stay at current job and anxiety level. Symptoms of anxiety were assessed using the Depression Anxiety Stress Scale (DASS-21). The data were analysed using logistic regression. Chinese adults who had long working hours (≥ 72 h per week) had higher odds of developing symptoms of anxiety than those who worked for ≤ 36 h per week (odds ratio [OR] 5.94, 95% confidence interval [CI]: 1.82‒19.41). Compared with short period (< 1 year), long period of stay at current job (≥ 5 years) was found as a protective factor from anxiety (OR 0.38, 95% CI: 0.20‒0.73). We found that a working period of 72 h per week was a significant threshold to cause anxiety to workers. Stable job arrangement was a protective factor to workers from anxiety. Implementation of labour market regulations, such as standard working hour policy and stable job arrangement, was also significant to mitigate risk of anxiety for working people in Hong Kong.

Association between antipsychotic use and acute ischemic heart disease in women but not in men: a retrospective cohort study of over one million primary care patients.

BACKGROUND: Research comparing sex differences in the effects of antipsychotic medications on acute ischemic heart disease (IHD) is limited and the findings ambiguous. This study aimed to investigate these associations within a primary care setting. METHODS: Hong Kong public general outpatient electronic records of patients aged 45+ during 2007-2010 were extracted, with the last consultation date as the baseline for a 4-year follow-up period to observe acute IHD hospitalizations (2011-2014). Antipsychotic use was defined as any prescription over the previous 12 months from a list of 16 antipsychotics, while acute IHD was defined by ICD-9: 410.00-411.89. Both sex-specific and sex-combined (both sexes) mixed-effects Cox models (random intercept across 74 clinics) were implemented to examine the association and test the interaction between antipsychotics and sex. RESULTS: Among 1,043,236 included patients, 17,780 (1.7%) were prescribed antipsychotics, and 8342 (0.8%) developed IHD. In sex-specific analyses, antipsychotic prescription was associated with a 32% increased hazard rate of acute IHD among women (95% CI 1.05-1.67) but not among men. A likelihood ratio test comparing sex-combined models with and without the interaction between antipsychotic use and sex suggested significant interaction (χ2 = 4.72, P = 0.030). The association between antipsychotic use and IHD among women attenuated and became non-significant when haloperidol was omitted from the operationalization of antipsychotic use (HR = 1.23, 95% CI 0.95-1.60). CONCLUSION: Our results suggest that antipsychotic prescription is moderately associated with an increased risk of acute IHD among women in primary care and this relationship may be explained by specific antipsychotics. Further research should observe and capture the potential intermediary mechanisms and the dose-response relationship of this association to provide more rigorous evidence to establish causality and inform clinical practices.

Perceived poverty and health, and their roles in the poverty-health vicious cycle: a qualitative study of major stakeholders in the healthcare setting in Hong Kong.

BACKGROUND: Poverty and ill-health are closely inter-related. Existing studies on the poverty-health vicious cycle focus mainly on less developed countries, where the identified mechanisms linking between poverty and ill-health may not fit the situations in developed Asian regions. This study aims to qualitatively explore the perceived mechanisms and drivers of the poverty-health vicious cycle among major stakeholders in the healthcare setting in Hong Kong. METHODS: Data were collected via focus group interviews with social workers (n = 8), chronically ill patients (n = 8), older adults (n = 6), primary care doctors (n = 7) and informal caregivers (n = 10). The transcribed data were then closely read to capture key themes using thematic analyses informed by social constructivism. RESULTS: In this highly developed Asian setting with income inequality among the greatest in the world, the poverty-health vicious cycle operates. Material and social constraints, as a result of unequal power and opportunities, appear to play a pivotal role in creating uneven distribution of social determinants of health. The subsequent healthcare access also varies across the social ladder under the dual-track healthcare system in Hong Kong. As health deteriorates, financial hardship is often resulted in the absence of sufficient and coordinated healthcare, welfare and labour policy interventions. In addition to the mechanisms, policy drivers of the cycle were also discussed based on the respondents' perceived understanding of the nature of poverty and its operationalization in public policies, as well as of the digressive conceptions of disease among different stakeholders. CONCLUSIONS: The poverty-health vicious cycle has remained a great challenge in Hong Kong despite its economic prosperity. To break the cycle, potential policy directions include the adoption of proportionate universalism, social integration and the strengthening of medical-social collaboration.

Medical device active surveillance of spontaneous reports: A literature review of signal detection methods.

PURPOSE: The collection and analysis of real-world data for the active monitoring of medical device performance and safety has become increasingly important. Spontaneous reports, such as those in the Food & Drug Administration's (FDA's) Manufacturer and User Facility Device Experience (MAUDE), provide early warning of potential issues with marketed devices. This review synthesizes the current literature on medical device surveillance signal detection and provides a framework for application of methods to active surveillance of spontaneous reports. METHODS: Ovid MEDLINE, Ovid Embase, Scopus, and PubMed databases were systematically searched up to January 2019. Additionally, five methods articles from pharmacovigilance were added that had potential applications to medical devices. RESULTS: Among 105 articles included, the most common source of data (84%) was registries; median time between data collection and publication was 8 years. Surgical procedure outcome signal detection articles comprised 83% while 14% were on device outcome signal detection. The most common family of methods cited (70%) was Sequential Probability Ratio. CONCLUSION: Application of any signal detection algorithm requires careful consideration of influential factors, data limitations, and algorithmic assumptions. We recommend approaches using disproportionality, statistical process control, and sequential probability tests and provide R packages to further development efforts. The small number of published examples suggest that further development of statistical methods and technological solutions to analyze large amounts of data for device safety and performance is needed. Fundamental differences in products, data infrastructure, and the regulatory landscape suggest that medical device vigilance requires its own body of research distinct from pharmacovigilance.

Socioeconomic disadvantages over the life-course and their influence on obesity among older Hong Kong Chinese adults.

BACKGROUND: The life-course perspective on socioeconomic inequality in health is a burgeoning field of research. Nonetheless, the three classic life-course models (i.e. sensitive period, cumulative risk and social mobility models) have rarely been simultaneously applied to studies on obesity. Therefore, this study examined the associations of socioeconomic positions (SEPs) across life stages and their associated life-course models with both general and abdominal obesity. METHODS: Face-to-face interviews were conducted among 1077 community-dwelling adults aged 50 or above during 2014-15 in Hong Kong. Experiences of poverty, educational attainment and deprivation of necessities represented respondents' SEP in childhood, early adulthood and late adulthood, respectively. General and abdominal obesity were defined as body mass index ≥25 kg m-2 and waist-to-height ratio >0.5. Multivariable modified Poisson regression with a robust error variance was performed. RESULTS: Respondents with low childhood SEP tended to have reduced risk of general obesity [relative risk (RR) = 0.85; 95% confidence interval (CI) = 0.72-1.00], whereas those with low childhood SEP and low late-adulthood SEP tended to have increased risk of abdominal obesity (RR = 1.10; 95% CI = 1.00-1.21 and RR = 1.14; 95% CI = 1.03-1.26, respectively). Cumulative socioeconomic disadvantages showed a dose-response relationship with abdominal obesity. Also, those with upward socioeconomic mobility had lower risk of abdominal obesity, whereas those with downward socioeconomic mobility had greater risk. CONCLUSIONS: Low SEP, especially in childhood, exerted contrasting effects on general and abdominal obesity among older Hong Kong Chinese adults. The three life-course models operated simultaneously in determining the risk of abdominal obesity, while support for cumulative risk and social mobility models was weak in general obesity.

The independent role of deprivation in abdominal obesity beyond income poverty. A population-based household survey in Chinese adults.

BACKGROUND: Individual-level deprivation takes into account the non-monetary aspects of poverty that neither income poverty nor socio-economic factors could fully capture; however, it has rarely been considered in existing studies on social inequality in obesity. Therefore, we examined the associations of deprivation, beyond income poverty, with both general and abdominal obesity. METHODS: A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed via face-to-face household interviews between 2014 and 2015. Deprivation was assessed by a Deprivation Index specific to the Hong Kong population. General obesity was defined as body mass index (BMI) ≥ 25 kg/m2, while abdominal obesity was defined as waist circumference (WC) ≥ 90 cm/80 cm for male/female. Multivariable binary logistic regressions were performed. RESULTS: Deprivation was independently associated with abdominal obesity (odds ratios (OR) = 1.68; 95% confidence intervals (CI): 1.27-2.22); however, no significant association was found with general obesity (OR=1.03; CI: 0.77-1.38). After additional adjustment for BMI, deprivation remained strongly associated with abdominal obesity (OR=2.00; CI: 1.41-2.83); and after further adjustment for WC, deprivation had a marginal inverse association with general obesity (OR=0.72; CI: 0.51-1.01). CONCLUSIONS: Deprivation is an important risk factor of abdominal obesity and plays a critical role in capturing the preferential abdominal fat deposition beyond income poverty.

Acute depletion of diacylglycerol from the cis-Golgi affects localized nuclear envelope morphology during mitosis.

Dysregulation of nuclear envelope (NE) assembly results in various cancers; for example, renal and some lung carcinomas ensue due to NE malformation. The NE is a dynamic membrane compartment and its completion during mitosis is a highly regulated process, but the detailed mechanism still remains incompletely understood. Previous studies have found that isolated diacylglycerol (DAG)-containing vesicles are essential for completing the fusion of the NE in nonsomatic cells. We investigated the impact of DAG depletion from the cis-Golgi in mammalian cells on NE reassembly. Using advanced electron microscopy, we observed an enriched DAG population of vesicles at the vicinity of the NE gaps of telophase mammalian cells. We applied a mini singlet oxygen generator-C1-domain tag that localized DAG-enriched vesicles at the perinuclear region, which suggested the existence of NE fusogenic vesicles. We quantified the impact of Golgi-DAG depletion by measuring the in situ NE rim curvature of the reforming NE. The rim curvature in these cells was significantly reduced compared with controls, which indicated a localized defect in NE morphology. Our novel results demonstrate the significance of the role of DAG from the cis-Golgi for the regulation of NE assembly.

Deprivation is associated with worse physical and mental health beyond income poverty: a population-based household survey among Chinese adults.

PURPOSE: In studying health inequality, poverty as measured by income is frequently used; however, this omits the aspects of non-monetary resources and social barriers to achieving improved living standard. Therefore, our study aimed to examine the associations of individual-level deprivation of material and social necessities with general physical and mental health beyond that of income poverty. METHODS: A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed between 2014 and 2015. Income poverty and a Deprivation Index were used as the main independent variables. General health was assessed using the validated 12-item Short-Form Health Survey version 2, from which physical component summary and mental component summary were derived. RESULTS: Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income poverty, socio-demographic and lifestyle factors, being deprived was significantly associated with worse physical (OR 1.66; CI 1.25-2.20) and mental health (OR 1.83; CI 1.43-2.35). Being income poor was also significantly associated with worse mental health (OR 1.63; CI 1.28-2.09) but only marginally with physical health (OR 1.34; CI 1.00-1.80) after adjustments. CONCLUSIONS: Income does not capture all aspects of poverty that are associated with adverse health outcomes. Deprivation of non-monetary resources has an independent effect on general health above and beyond the effect of income poverty. Policies should move beyond endowment and take into account the multidimensionality of poverty, in order to address the problem of health inequality.

Endomembrane PtdIns(3,4,5)P3 activates the PI3K-Akt pathway.

PKB/Akt activation is a common step in tumour growth, proliferation and survival. Akt activation is understood to occur at the plasma membrane of cells in response to growth factor stimulation and local production of the phosphoinositide lipid phosphatidylinositol (3,4,5)-trisphosphate [PtdIns(3,4,5)P3] following phosphoinositide 3-kinase (PI3K) activation. The metabolism and turnover of phosphoinositides is complex--they act as signalling molecules as well as structural components of biological membranes. The localisation and significance of internal pools of PtdIns(3,4,5)P3 has long been speculated upon. By using transfected and recombinant protein probes for PtdIns(3,4,5)P3, we show that PtdIns(3,4,5)P3 is enriched in the nuclear envelope and early endosomes. By exploiting an inducible dimerisation device to recruit Akt to these compartments, we demonstrate that Akt can be locally activated in a PtdIns(3,4,5)P3-dependent manner and has the potential to phosphorylate compartmentally localised downstream substrates. This could be an important mechanism to regulate Akt isoform substrate specificity or influence the timing and duration of PI3K pathway signalling. Defects in phosphoinositide metabolism and localisation are known to contribute to cancer, suggesting that interactions at subcellular compartments might be worthwhile targets for therapeutic intervention.

Principle of duality in phospholipids: regulators of membrane morphology and dynamics.

To suggest and develop intelligent strategies to comprehend the regulation of organelle formation, a deeper mechanistic interpretation requires more than just the involvement of proteins. Our approaches link the formation of endomembranes with both signalling and membrane physical properties. Hitherto, membrane morphology, local physical structure and signalling have not been well integrated. Our studies derive from a cross-disciplinary approach undertaken to determine the molecular mechanisms of nuclear envelope assembly in echinoderm and mammalian cells. Our findings have led to the demonstration of a direct role for phosphoinositides and their derivatives in nuclear membrane formation. We have shown that phosphoinositides and their derivatives, as well as acting as second messengers, are modulators of membrane morphology, and their modifying enzymes regulate nuclear envelope formation. In addition, we have shown that echinoderm eggs can be exploited as a milieu to directly study the roles of phospholipids in maintaining organelle shape. The use of the echinoderm egg is a significant step forward in obtaining direct information about membrane physical properties in situ rather than using simpler models which do not provide a complete mechanistic insight into the role of phospholipids in membrane dynamics.