Changes of PM2.5 and O3 and their impact on human health in the Guangdong-Hong Kong-Macao Greater Bay Area.

In recent years, the combined pollution of PM2.5 and O3 in China, particularly in economically developed regions such as the Guangdong-Hong Kong-Macao Greater Bay Area (GBA), has garnered significant attention due to its potential implications. This study systematically investigated the changes of PM2.5 and O3 and their associated human health effects in the GBA, utilizing observational data spanning from 2015 to 2019. The findings revealed a spatial trend indicating a gradual decrease in PM2.5 levels from the northwest to the southeast, while the spatial distribution of MDA8 O3 demonstrated an opposing pattern to that of PM2.5. The monthly fluctuations of PM2.5 and MDA8 O3 exhibited V-shaped and M-shaped patterns, respectively. Higher MDA8 O3 concentrations were observed in autumn, followed by summer and spring. Over the five-year period, PM2.5 concentrations exhibited a general decline, with an annual reduction rate of 1.7 µg m-3/year, while MDA8 O3 concentrations displayed an annual increase of 3.2 µg m-3. Among the GBA regions, Macao, Foshan, Guangzhou, and Jiangmen demonstrated notable decreases in PM2.5, whereas Jiangmen, Zhongshan, and Guangzhou experienced substantial increases in MDA8 O3 levels. Long-term exposure to PM2.5 in 2019 was associated with 21,113 (95% CI 4968-31,048) all-cause deaths (AD), 1333 (95% CI 762-1714) cardiovascular deaths (CD), and 1424 (95% CI 0-2848) respiratory deaths (RD), respectively, reflecting declines of 27.6%, 28.0%, and 28.4%, respectively, compared to 2015. Conversely, in 2019, estimated AD, CD, and RD attributable to O3 were 16,286 (95% CI 8143-32,572), 7321 (95% CI 2440-14,155), and 6314 (95% CI 0-13,576), respectively, representing increases of 45.9%, 46.2%, and 44.2% over 2015, respectively. Taken together, these findings underscored a shifting focus in air pollution control in the GBA, emphasizing the imperative for coordinated control strategies targeting both PM2.5 and O3.

The association between posttraumatic disorder symptoms and addictive behaviours in Macao within a sample of female Filipino migrant workers: a network analysis.

Background: Filipino migrant workers in Macao are vulnerable to posttraumatic stress disorder (PTSD) symptoms and addictive behaviours due to trauma histories, postmigration stressors, and access to alcohol and gambling venues. While PTSD addiction comorbidity is well-established in the existing literature, such research among migrant workers is lacking.Objective: The current study investigated differential relations between PTSD symptoms and addictive behaviours in a polytrauma exposed sample of Filipino domestic workers in Macao (SAR), China.Methods: Data were collected from 1375 Filipino migrant workers; data from a subsample of 1200 participants who reported an index traumatic event and PTSD symptoms were used in the analyses. Participants responded to the PTSD Checklist for DSM-5, gambling disorder symptoms checklist from DSM-5, and The Alcohol Use Disorders Identification Test. We estimated a regularized partial correlation network structure of PTSD symptoms and addictive behaviours employing graphical LASSO and extended Bayesian information criterion.Results: PTSD symptoms of arousal and negative emotions had bridge connections with gambling disorder symptoms; while PTSD symptoms of arousal, restricted affect, negative emotions, and emotional reactivity had bridge connections with alcohol misuse.Conclusions: PTSD's arousal and negative emotion symptoms were common in the networks of PTSD and addictive behaviours, while PTSD's restricted affect and emotional reactivity symptoms were unique to the network of PTSD and alcohol misuse. Treatment of the comorbidity of PTSD and addictive behaviours may yield optimal effects when tailored to these symptoms.

A network analytic study was conducted to explore patterns of comorbidity among international migrants.Post-traumatic stress disorder symptoms are associated with addiction symptoms among female Filipino migrant workers in Macau.Negative emotions symptoms of post-traumatic stress disorder are associated with both gambling disorder and alcohol misuse.Restricted affect and emotional reactivity are associated with alcohol misuse only.

Smoking Bans and Circulatory System Disease Mortality Reduction in Macao (China): Using GRA Models.

This study evaluates the association between smoking rates and mortality from circulatory system diseases (CSD) after implementing a series of smoking bans in Macao (China). (1) Background: Macao phased in strict total smoking bans since 2012. During the past decade, smoking rates among Macao women have dropped by half. CSD mortalities in Macao also show a declining trend. (2) Method: Grey relational analysis (GRA) models were adopted to rank the importance of some key factors, such as income per capita, physician density, and smoking rates. Additionally, regressions were performed with the bootstrapping method. (3) Results: Overall, smoking rate was ranked as the most important factor affecting CSD mortality among the Macao population. It consistently remains the primary factor among Macao's female population. Each year, on average 5 CSD-caused deaths were avoided among every 100,000 women, equivalent to about 11.45% of the mean annual CSD mortality. (4) Conclusions: After the implementation of smoking bans in Macao, the decrease in smoking rate among women plays a primary role in the reduction in CSD mortality. To avoid excess CSD mortality due to smoking, Macao needs to continue to promote smoking cessation among the male population.

Profiling of Gamblers and Problem Gamblers Among Casino Patrons in Macao SAR.

The study is one of the first prevalence studies of gambling and problem gambling among casino patrons in Macao. It aims to identify the demographic profile of gamblers and evaluate the extent of problem gambling among casino patrons. Using a convenience sampling approach, over 6,000 people were intercepted in the proximity of casinos and were invited to answer a structured questionnaire anonymously and voluntarily. Among these people 1,352 respondents indicated that they gambled in casinos at least once in the past 12 months. Over 90% (1,228) of the respondents reported that they gambled in Macao's casinos and slot lounges. The three most popular forms of casino gambling were baccarat, Sic Bo, and slot machines. The monthly median expenditure on gambling was HKD 1,845 with a range from HKD 2 to HKD 375,175. The prevalence rates for problem gambling and pathological gambling were 15.1% and 7.1%, respectively. Implications of the study's findings are given.

The backbone symptoms of depression: a network analysis after the initial wave of the COVID-19 pandemic in Macao.

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted the working lives of Macau residents, possibly leading to mental health issues such as depression. The pandemic served as the context for this investigation of the network structure of depressive symptoms in a community sample. This study aimed to identify the backbone symptoms of depression and to propose an intervention target. Methods: This study recruited a convenience sample of 975 Macao residents between 20th August and 9th November 2020. In an electronic survey, depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9). Symptom relationships and centrality indices were identified using directed and undirected network estimation methods. The undirected network was constructed using the extended Bayesian information criterion (EBIC) model, and the directed network was constructed using the Triangulated Maximally Filtered Graph (TMFG) method. The stability of the centrality indices was evaluated by a case-dropping bootstrap procedure. Wilcoxon signed rank tests of the centrality indices were used to assess whether the network structure was invariant between age and gender groups. Results: Loss of energy, psychomotor problems, and guilt feelings were the symptoms with the highest centrality indices, indicating that these three symptoms were backbone symptoms of depression. The directed graph showed that loss of energy had the highest number of outward projections to other symptoms. The network structure remained stable after randomly dropping 50% of the study sample, and the network structure was invariant by age and gender groups. Conclusion: Loss of energy, psychomotor problems and guilt feelings constituted the three backbone symptoms during the pandemic. Based on centrality and relative influence, loss of energy could be targeted by increasing opportunities for physical activity.

COVID-19 prevention and control strategies: learning from the Macau model.

Background: Macau is a densely populated international tourist city. Compared to most tensely populated countries/territories, the prevalence and mortality of COVID-19 in Macau are lower. The experiences in Macau could be helpful for other areas to combat the COVID-19 pandemic. This article introduced the endeavours and achievements of Macau in combatting the COVID-19 pandemic. Method: Both qualitative and quantitative analysis methods were used to explore the work, measures, and achievements of Macau in dealing with the COVID-19 pandemic. Results: The results revealed that Macau has provided undifferentiated mask purchase reservation services, COVID-19 vaccination services to all residents and non-residents in Macau along with delivering multilingual services, in Chinese, English and Portuguese, to different groups of the population. To facilitate the travels of people, business and trades between Macau and mainland China, the Macau government launched the Macau Health Code System, which uses the health status declaration, residence history declaration, contact history declaration of the declarant to match various relevant backend databases within the health authority and provide a risk-related colour code operations. The Macau Health Code System connects to the Chinese mainland's own propriety health code system seamlessly, whilst effectively protecting the privacy of the residents. Macau has also developed the COVID-19 Vaccination Appointment system, the Nucleic Acid Test Appointment system, the Port and Entry/Exit Quarantine system, the medical and other supporting systems. Conclusion: The efforts in Macau have achieved remarkable results in COVID-19 prevention and control, effectively safeguarding the lives and health of the people and manifesting the core principle of "serving the public". The measures used are sustainable and can serve as an important reference for other countries/regions.

Social Media Engagement in Two Governmental Schemes during the COVID-19 Pandemic in Macao.

Social media engagement is a vehicle for effective communication and engagement between governments and individuals, especially in crises such as the COVID-19 pandemic. Additionally, it can be used to communicate resilience measures and receive feedback. This research aims to investigate public social media engagement with resilience measures related to COVID-19 in Macao. We examined 1107 posts and 791 comments about the government's face mask supply and consumption voucher schemes on Facebook. Using the Crisis Lifecycle model, we partitioned the data and analyzed the content and engagement of related posts, as well as the word semantics in user comments. Our findings show that social media engagement in these resilience measures is high and positive in the early stages of the pandemic, suggesting social media's potential in mobilizing society, preserving social resilience, and serving as a two-way communication tool in public health emergencies.

The Changing Patterns and Correlates of Adolescent Substance Use in China's Special Administrative Region of Macau.

Most of the research on adolescent substance use is from either the U.S, Europe, or other non-Eastern countries, but very little attention is paid to that in the Greater China Region. As a special administrative region of China, Macau is known for its gambling industry, its proximity to the Golden Triangle, and its lenient drug laws, all of which can be conducive to high-level drug use in the population, including its adolescents. Yet, the extent and patterns of adolescent substance use in Macau are not well understood. Using the data collected from two large representative samples of secondary school students in 2014 and 2018, this study provided population-based estimates of the prevalence rates of lifetime and past 30-day substance use among Macau adolescents in the two separate survey years. By comparing the two sets of estimates, it established the patterns of changes in cigarette smoking, alcohol use, and illicit drug use among adolescents in Macau during the period. Additionally, through the analysis of the data in the latest year, it identified risk factors for adolescent substance use in the special administrative region. Among the key results, the rates of cigarette smoking and illicit drug use were low to moderate while the rates of alcohol use were relatively high; cigarette smoking decreased during the period, but alcohol use and illicit drug use remained stable; Macau adolescents shared similar risk factors for substance use with adolescents elsewhere, but unique circumstances might exist to influence their alcohol consumption.

Pooled incidence and case-fatality of acute stroke in Mainland China, Hong Kong, and Macao: A systematic review and meta-analysis.

BACKGROUND: Stroke incidence and case-fatality in Mainland China, Hong Kong, and Macao vary by geographic region and rates often differ across and within regions. This systematic review and meta-analysis (SR) estimated the pooled incidence and short-term case-fatality of acute first ever stroke in mainland China, Hong Kong, and Macao. METHODS: Longitudinal studies published in English or Chinese after 1990 were searched in PubMed/Medline, EMBASE, CINAHL, Web of Science, SinoMed and CQVIP. The incidence was expressed as Poisson means estimated as the number of events divided by time at risk. Random effect models calculated the pooled incidence and pooled case-fatality. Chi-squared trend tests evaluated change in the estimates over time. When possible, age standardised rates were calculated. Percent of variation across studies that was due to heterogeneity rather than chance was tested using the I2 statistic.The effect of covariates on heterogeneity was investigated using meta-regressions. Publication bias was tested using funnel plots and Egger's tests. RESULTS: Overall, 72 studies were included. The pooled incidences of total stroke (TS), ischaemic stroke (IS) and haemorrhagic stroke (HS) were 468.9 (95% confidence interval (CI): 163.33-1346.11), 366.79 (95% CI: 129.66-1037.64) and 106.67 (95% CI: 55.96-203.33) per 100,000 person-years, respectively, varied according to the four economic regions (East Coast, Central China, Northeast and Western China) with the lowest rates detected in the East Coast. Increased trends over time in the incidence of TS and IS were observed (p<0.001 in both). One-month and three-to-twelve-month case-fatalities were 0.11 (95% CI: 0.04-0.18) and 0.15 (95% CI: 0.12-0.17), respectively for IS; and 0.36 (95% CI: 0.26-0.45) and 0.25 (95% CI: 0.18-0.32), respectively for HS. One-month case-fatality of IS and HS decreased over time for both (p<0.001). Three-to-twelve-month fatalities following IS increased over time (p<0.001). Publication bias was not found. CONCLUSIONS: Regional differences in stroke incidence were observed with the highest rates detected in less developed regions. Although 1-month fatality following IS is decreasing, the increased trends in 3-12-month fatality may suggest an inappropriate long-term management following index hospital discharge. REGISTRATION: Registration-URL: https://www.crd.york.ac.uk/prospero/; Reference code: CRD42020170724.

Omicron subvariant BA.5 is highly contagious but containable: Successful experience from Macau.

Introduction: Due to its high transmissibility and immune escape, Omicron subvariant BA.5 has become the dominant strain of the SARS-CoV-2 virus and led to escalating COVID-19 cases, how to cope with it becomes an urgent issue. A BA.5 infection surge burst out on 18 June 2022 and brought an unprecedented challenge to Macau, the most densely populated region worldwide. This study aimed to analyze the characteristics of this outbreak and summarize the useful anti-epidemic measures and experiences during this outbreak. Methods: All data were obtained from the Government Portal of Macao SAR (https://www.gov.mo), and the Special Webpage Against Epidemics, the Macao Health Bureau (www.ssm.gov.mo). An epidemiologic study was performed to analyze epidemic outcomes, including the infection rate, the proportion of symptomatic cases, the case fatality ratio (CFR), etc. Data were analyzed using SPSS Version 20. A p-value <0.05 was considered statistically significant. The anti-epidemic measures and experience were reviewed and summarized. Results: The BA.5 outbreak resulted in 1,821 new cases, which was significantly more than the cumulative cases of the previous variants of COVID-19 in Macau. The symptomatic cases accounted for 38.71% of the total cases, which was higher than that of the previous variants. After 6-week concerted efforts, Macau effectively controlled the outbreak, with an infection rate of 0.27%, which was much lower than many BA.5-attacked regions. The CFR was approximately 0.86%, which was not statistically different from that of previous variants. Six victims were chronically ill senior elders and their vaccination rate was much lower than the average level. Macau took a comprehensive anti-epidemic strategy to win a quick victory against BA.5, especially the "relatively static" strategy that was first formulated and applied by Macau for the management of the COVID-19 pandemic. Successful experience showed that although BA.5 was highly contagious, it could be contained by comprehensive anti-epidemic measures, including adequate anti-epidemic preparation, herd immunity through vaccination, repeated mass nucleic acid tests and rapid antigen tests, KN-95 mask mandate, the "relatively static" strategy, precise prevention and control, epidemiological investigation and tracing, and traditional Chinese medicine treatment, etc. Discussion: In Macau, compared with the previous subvariants, BA.5 is associated with increased transmissibility and a higher proportion of symptomatic cases, however, the risk of death remains similar, and the infection rate is much lower than that in many other BA.5-attacked regions. BA.5 is highly contagious but still containable, Macau's experience may offer hints for the regions experiencing the BA.5 waves to choose or adjust a more rational anti-epidemic strategy.

Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017.

BACKGROUND: Acute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao. METHODS: A retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality. RESULTS: Of the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup. CONCLUSIONS: This is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.

Can population BRCA screening be applied in non-Ashkenazi Jewish populations? Experience in Macau population.

BACKGROUND: Pathogenic mutation in BRCA genes causes high cancer risk. Identifying the mutation carriers plays key roles in preventing BRCA mutation-related cancer. Population screening has demonstrated its power for comprehensive identification of the mutation carriers. However, it is only recommended for the Ashkenazi Jewish population with high prevalence of three founder mutations, but not for non-Ashkenazi Jewish populations as the cost-effectiveness could be too low due to their lower mutation prevalence and lack of founder mutation. Population screening would not benefit the majority of the human population for BRCA mutation-related cancer prevention. METHODS: We used population BRCA screening in 6000 residents, 1% of the Macau population, an ethnic Chinese population with unique genetic, linguistic and cultural features, and its BRCA mutation has not been analysed before. RESULTS: We called BRCA variants, identified 18 carriers with 14 pathogenic mutations and determined the prevalence of 0.29% in the population (95% CI 0.15% to 0.42%). We compared the testing cost between the Ashkenazi Jewish population, the Sephardi Jewish population and the Macau population, and observed only a few fold differences. CONCLUSION: Our study shows that testing cost is not the most important factor in considering population BRCA screening, at least for the populations in the developed countries/regions, regardless of the status of mutation prevalence and founder mutation.

Structural validation of The Patient Health Questionnaire-9 (PHQ-9) among Filipina and Indonesian female migrant domestic workers in Macao: STRUCTURAL VALIDATION OF PHQ-9.

Within diverse global populations, validated tools are needed to assess common mental disorders. The Patient Health Questionnaire-9 (PHQ-9) is one of the most commonly used depression screeners. However, the PHQ-9 has not been structurally validated among female migrant domestic workers (MDWs). Female MDWs constitute a population numbering 11.5 million, and commonly report depression. This study aimed to structurally validate the PHQ-9 among Filipina and Indonesian female MDWs in Macao Special Administrative Region of China. Participants were recruited using respondent driven sampling. Participants were adult female MDWs from The Philippines (N=1375) or Indonesia (N=367) and legally working in Macao. We used confirmatory factor analysis (CFA) to test five structural models of depression using all PHQ-9 items with the Filipina and Indonesian samples. We applied multi-group CFA to test measurement invariance across samples. A two-factor (cognitive/affective, somatic) model yielded the best fit within both samples, and the multi-group CFA demonstrated invariance across samples. The two-factor model best represents the factor structure of the PHQ-9 among Filipina and Indonesian female MDWs.

Spatiotemporal spread pattern of the COVID-19 cases in China.

The COVID-19 pandemic is currently spreading widely around the world, causing huge threats to public safety and global society. This study analyzes the spatiotemporal pattern of the COVID-19 pandemic in China, reveals China's epicenters of the pandemic through spatial clustering, and delineates the substantial effect of distance to Wuhan on the pandemic spread. The results show that the daily new COVID-19 cases mostly occurred in and around Wuhan before March 6, and then moved to the Grand Bay Area (Shenzhen, Hong Kong and Macau). The total COVID-19 cases in China were mainly distributed in the east of the Huhuanyong Line, where the epicenters accounted for more than 60% of the country's total in/on 24 January and 7 February, half in/on 31 January, and more than 70% from 14 February. The total cases finally stabilized at approximately 84,000, and the inflection point for Wuhan was on 14 February, one week later than those of Hubei (outside Wuhan) and China (outside Hubei). The generalized additive model-based analysis shows that population density and distance to provincial cities were significantly associated with the total number of the cases, while distances to prefecture cities and intercity traffic stations, and population inflow from Wuhan after 24 January, had no strong relationships with the total number of cases. The results and findings should provide valuable insights for understanding the changes in the COVID-19 transmission as well as implications for controlling the global COVID-19 pandemic spread.

Internet addiction among adolescents in Macau and mainland China: prevalence, demographics and quality of life.

Internet addiction (IA) is common among adolescents and significantly determined by sociocultural and economic factors. The aim of this study was to compare the prevalence of IA among adolescents between Macau and mainland China and also examine its association with quality of life. A total of 2892 secondary school students were included. Standardized instruments were used to measure IA, depressive symptoms and quality of life. The overall prevalence of IA was 23.7%, with 32.5% in Macau and 19.8% in mainland China. Students in Macau were more likely to suffer from IA than those in mainland China (OR = 2.15, p < 0.001). Correlates of IA included being in higher school grades, poor academic performance, and more severe depressive symptoms. Students with IA reported lower quality of life in physical, psychological, social, and environmental domains. IA is common among Chinese adolescents, particularly in Macau. Considering the negative impact of IA on health and quality of life, regular screening and effective interventions should be undertaken for young Internet users.

Factors Impacting Risk Perception under Typhoon Disaster in Macao SAR, China.

Studying typhoon risk perception and its influencing factors help reveal potential risk factors from the perspective of the public and provide a basis for decision-making for reducing the risk of typhoon disasters. The purpose of this study is to assess the risk perception and related factors of Macao residents in China. Information was collected from 983 participants using a structured questionnaire with an effective utilization rate of 94.2%. Descriptive statistics, univariate analysis and correlation analysis were used to analyze the data. The results show that, on the one hand, there are significant differences in risk perception on the factors included: (1) age, education and other demographic characteristics; (2) health status, occupation, length of stay, residence area, residence floor, family organization structure and individuals monthly income and other personal or family conditions; (3) channels and quantity of typhoon information acquisition; (4) degree of mastery of relevant risk aversion knowledge. On the other hand, some factors still have a moderate or high level of correlation with risk perception: (1) The older the respondent, the lower the education level, the lower the income, the lower the risk perception of property damage, health impact and life threat. (2) The more children or elderly people in the family, the higher the risk perception of respondents. (3) The more risk knowledge, the lower the risk perception. (4) The more channels for obtaining information, the lower the fear level and the overall impact of risk perception. (5) The stronger the risk perception, the more positive disaster response behaviors would be taken by the public. In addition, the more information acquisition channels and the less risk knowledge respondents have, the greater the risk perception of the overall impact and the fear of the typhoon; the fewer information access channels and less risk knowledge respondents have, the greater the risk perceptions of property damage, health effects and life threats.

Prevalence of depression and its relationship with quality of life among university students in Macau, Hong Kong and mainland China.

There is compelling evidence that depressive symptoms (depression hereafter) are common in university students and are considerably influenced by the given socioeconomic context. Being former European colonies, Macau and Hong Kong are China's special administrative regions, with different sociocultural and economic background compared to mainland China. This study compared the prevalence of depression in university students between Macau, Hong Kong and mainland China and examined the association between depression and quality of life (QOL). The Beck Depression Inventory-II and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) were used to measure depression and QOL, respectively. Altogether, 2,312 university students participated in this study. The overall prevalence of depression was 28.9%; 35.2% in Macau, 41.0% in Hong Kong, and 16.8% in mainland China. Compared to the "No depression" group, students with depression had significantly lower QOL scores in the physical, psychological, social and environmental domains. Factors associated with depression were different between the three study sites. Sleep disturbances and high academic pressure were positively associated with depression in all the three samples. In mainland China, male students (OR = 1.68; 95% CI: 1.10-2.56) were more likely to have depression while those who were interested in their major (OR = 0.45; 95% CI: 0.29-0.69) were less likely to have depression. In Macau, students in Grade 3 (OR = 0.56; 95% CI: 0.36-0.89) and those who were interested in their major (OR = 0.58; 95% CI: 0.42-0.81) or had optimistic perspective about their future (OR = 0.51; 95% CI: 0.36-0.73) were less likely to have depression. Nursing students (OR = 1.86; 95% CI: 1.21-2.87) and students with the average score on major subject less than 65 (OR = 3.13; 95% CI: 1.70-5.78) were more likely to have depression. In Hong Kong, students with optimistic perspective about their future (OR = 0.44; 95% CI: 0.22-0.91) were less prone to have depression. Depression is common among Chinese university students, particularly in Macau and Hong Kong. Considering the negative impact of depression on QOL, regular screening and effective treatments should be offered to this population.

Community pharmacist in public health emergencies: Quick to action against the coronavirus 2019-nCoV outbreak.

The 2019-nCoV infection that is caused by a novel strain of coronavirus was first detected in China in the end of December 2019 and declared a public health emergency of international concern by the World Health Organization on January 30, 2020. Community pharmacists in one of the first areas that had confirmed cases of the viral infection, Macau, joined the collaborative force in supporting the local health emergency preparedness and response arrangements. This paper aimed to improve the understanding of community pharmacists' role in case of 2019-CoV outbreak based on the practical experiences in consultation with the recommendations made by the International Pharmaceutical Federation on the Coronavirus 2019-nCoV outbreak.

Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China.

To help health workers and the public recognize and deal with the 2019 novel coronavirus (2019-nCoV) quickly, effectively, and calmly with an updated understanding. A comprehensive search from Chinese and worldwide official websites and announcements was performed between 1 December 2019 and 9:30 am 26 January 2020 (Beijing time). A latest summary of 2019-nCoV and the current outbreak was drawn. Up to 24 pm, 25 January 2020, a total of 1975 cases of 2019-nCoV infection were confirmed in mainland China with a total of 56 deaths having occurred. The latest mortality was approximately 2.84% with a total of 2684 cases still suspected. The China National Health Commission reported the details of the first 17 deaths up to 24 pm, 22 January 2020. The deaths included 13 males and 4 females. The median age of the people who died was 75 (range 48-89) years. Fever (64.7%) and cough (52.9%) were the most common first symptoms among those who died. The median number of days from the occurence of the first symptom to death was 14.0 (range 6-41) days, and it tended to be shorter among people aged 70 years or more (11.5 [range 6-19] days) than those aged less than 70 years (20 [range 10-41] days; P = .033). The 2019-nCoV infection is spreading and its incidence is increasing nationwide. The first deaths occurred mostly in elderly people, among whom the disease might progress faster. The public should still be cautious in dealing with the virus and pay more attention to protecting the elderly people from the virus.