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1.
Artigo em Inglês | MEDLINE | ID: mdl-36673741

RESUMO

(1) Background: Hypertension (HT) is the most common chronic condition, affecting approximately 1.13 billion people worldwide. Despite freely available blood pressure (BP) devices in primary care (PC) clinics, many patients do not regularly screen for HT and are untreated. (2) Methods: This study investigated the proportion of PC patients who did not screen for HT and the underlying reasons in Hong Kong. An explanatory mixed-method cross-sectional study was conducted in 2020, which included a questionnaire survey, office BP measurements, and subsequent semi-structured interviews. Adult patients who had no diagnosis of HT were recruited in a large PC clinic by convenience sampling. The relationships between not having HT screening and sociodemographic data were investigated by logistic regression. Twenty-four patients were purposefully sampled (based on demographics) and were interviewed until data saturation. (3) Results: Among 428 participants, 190 (44.4%) had not had HT screening in the last two years, but 197 (46.0%) had HT. No HT screening in the last two years or ever was associated with being male, being single, being of younger age, having no family history of HT, having no clinic visits in the last two years, employment status, and self-perceived HT condition. Most participants (77.8%) misinterpreted their BP readings. Individual, social, and healthcare service barriers were identified in patients' interviews. Many PC patients had no regular HT screening but around half had elevated BP. (4) Conclusion: The study results indicate that the barriers to HT screening were multifactorial. HT screening in PC is urgently needed.


Assuntos
Hipertensão , Adulto , Humanos , Masculino , Pré-Escolar , Feminino , Hong Kong/epidemiologia , Estudos Transversais , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Programas de Rastreamento , Atenção Primária à Saúde/métodos
2.
JAMA Netw Open ; 6(1): e2251177, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36648944

RESUMO

Importance: Patients with diabetes are at higher risk for obstructive airway disease (OAD). In recent meta-analyses of post hoc analyses of cardiorenal trials, sodium-glucose cotransporter 2 inhibitors (SGLT2Is) were suggested to reduce the risk of OAD adverse events. However, a clinical investigation of this association is warranted. Objective: This study aimed to investigate the association of SGLT2I use vs dipeptidyl peptidase-4 inhibitor (DPP4I) use with OAD incidence and exacerbation events in patients with type 2 diabetes. Design, Setting, and Participants: This retrospective population-based cohort study used electronic health data from a territory-wide electronic medical database in Hong Kong. Data were collected for patients with type 2 diabetes who were prescribed SGLT2Is or DPP4Is between January 1, 2015, and December 31, 2018. Patients were followed for a median of 2.2 years between January 1, 2015, and December 31, 2020. A prevalent new-user design was adopted to match patients based on previous exposure to the study drugs. Propensity score matching was used to balance baseline characteristics. Exposures: Patients with type 2 diabetes using SGLT2Is (exposure of interest) or DPP4Is (active comparator). Main Outcomes and Measures: The main outcomes were the first incidence of OAD and the count of OAD exacerbations. The risk of incident OAD was estimated using a Cox proportional hazards regression model. The rate of exacerbations was estimated using zero-inflated Poisson regression. Statistical analysis was performed on November 13, 2022. Results: This study included 30 385 patients. The propensity score-matched non-OAD cohort (incidence analysis) consisted of 5696 SGLT2I users and 22 784 DPP4I users, while the matched OAD cohort (exacerbations analysis) comprised 381 SGLT2I users and 1524 DPP4I users. At baseline, 56% of patients in the non-OAD cohort were men and the mean (SD) age was 61.2 (9.9) years; 51% of patients in the OAD cohort were men and the mean age was 62.2 (10.8) years. Compared with DPP4I use, SGLT2I use was associated with a lower risk of incident OAD (hazard ratio, 0.65 [95% CI, 0.54-0.79]; P < .001) and a lower rate of exacerbations (rate ratio, 0.54 [95% CI, 0.36-0.83]; P = .01). The associations were consistent in sex subgroup analysis. Conclusions and Relevance: The findings of this retrospective cohort study of patients with type 2 diabetes in Hong Kong suggest that SGLT2I use was associated with a reduced risk of incident OAD and a lower rate of exacerbations in a clinical setting compared with DPP4I use. These findings further suggest that SGLT2Is may provide additional protective effects against OAD for patients with type 2 diabetes and that further investigation is warranted.


Assuntos
Diabetes Mellitus Tipo 2 , Inibidores da Dipeptidil Peptidase IV , Doença Pulmonar Obstrutiva Crônica , Inibidores do Transportador 2 de Sódio-Glicose , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/induzido quimicamente , Inibidores da Dipeptidil Peptidase IV/efeitos adversos , Estudos Retrospectivos , Estudos de Coortes , Hong Kong/epidemiologia , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Hipoglicemiantes/efeitos adversos , Doença Pulmonar Obstrutiva Crônica/complicações , Dipeptidil Peptidases e Tripeptidil Peptidases , Glucose , Sódio
3.
Viruses ; 15(1)2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36680190

RESUMO

Domestic cat hepadnavirus (DCH) is an emerging virus related to the hepatitis B virus (HBV). The pathogenic potential of DCH in cats remains to be established. The molecular prevalence of DCH varies widely in the regions investigated so far. The aim of this study was to determine the prevalence, load, and risk factors for DCH detection among cats in Hong Kong, and to generate molecular and epidemiological data on the DCH strains circulating in cats in Hong Kong. DCH DNA was detected using DCH-specific qPCR in 57/513 (11.1%) residual diagnostic blood samples from owned cats. The median viral load was 8.85 × 103 copies/mL of whole blood (range for the 5th to the 95th percentile, 3.33 × 103 to 2.2 × 105 copies per mL). Two outliers had higher viral loads of 1.88 × 107 copies/mL and 4.90 × 109 copies/mL. DCH was detected in cats from 3 months to 19 years of age. Sex, age, neuter status, breed, or elevated serum alanine aminotransferase were not statistically associated with DCH DNA detection. On phylogenetic analysis based on 12 complete genome sequences, the Hong Kong DCH viruses clustered in Genotype A with viruses from Australia and Asia (clade A1), distinct from viruses from Europe (clade A2). Sequence analysis found that DCH has similar epsilon and direct repeat regions to human HBV, suggesting a conserved method of replication. Based on our findings, the DCH strains circulating in Hong Kong are a continuum of the Asiatic strains.


Assuntos
Hepadnaviridae , Gatos , Animais , Humanos , Hong Kong/epidemiologia , Filogenia , Hepadnaviridae/genética , Epidemiologia Molecular , Fatores de Risco
4.
Soc Sci Med ; 318: 115648, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36608364

RESUMO

RATIONALE: Help-seeking can convert an individual's bonding social capital into social support, which has been shown to buffer the impact of psychological distress. The younger generation (individuals aged 15-35 years) have been the least likely to actively seek help despite facing a rising burden of mental health problems. COVID-19 pandemic restrictions may have altered their help-seeking behaviors, but the extent of such shift remains little understood, particularly in Asian contexts. OBJECTIVE: To understand how the younger generation's patterns of help-seeking (activation of different combinations of support sources) have shifted in pandemic times, who have experienced the shift, and what explanatory factors are involved. METHODS: Data were obtained from two waves (2019, 2020) of online survey responses by 438 community-dwelling younger generation people in Hong Kong, recruited through the authors' affiliated institutions and territory-wide community outreach organizations. Latent class analysis was conducted on participants' self-reported help-seeking behaviors in each survey wave. Constituents' characteristics in each latent class were examined, and between-wave changes in individuals' class membership were identified. Logistic regressions identified explanatory factors that significantly explained the changes. RESULTS: Three consistent patterns of help-seeking were identified in both survey waves. A major shift was observed for individuals with poorer mental health histories who faced moderate distress. They relied on their family, friends, and partner pre-pandemic, but no longer activated these supports during the pandemic. Posting status updates on social media, along with various communication habits and sociodemographic factors that differed by age group, were associated with this shift. CONCLUSIONS: Shifts in the younger generation's patterns of help-seeking may be an early warning signal to invest additional resources in facilitating help-seeking among the younger generation. Findings also serve as a reminder that public health restrictions may have inadvertent mental health implications that should be considered in future scenarios.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pandemias , Hong Kong/epidemiologia , Saúde Mental
5.
Invest Ophthalmol Vis Sci ; 64(1): 2, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36595274

RESUMO

Purpose: The purpose of this study was to investigate optical coherence tomography (OCT)-measured retinal thickness (RT) and best-corrected distance visual acuity (BCDVA) in eyes with different types of astigmatism. Methods: This is a case-control study of 101 participants stratified into With-The-Rule (WTR; n = 41), Against-The-Rule (ATR; n = 25), and control (n = 35) groups by noncycloplegic subjective refraction. Inclusion criteria were ages between 18 and 45 years, spherical-equivalent (SE) refraction ≥-10.00 diopters (D), negative cylindrical power (CYL) ≤-0.75 D with axes of 0 to 30 degrees/150 to 180 degrees for WTR and 60 to 120 degrees for ATR, or CYL ≥-0.25 D for controls. Participants suffering from ocular diseases related to retinal defects, having a history of ocular surgery, with BCDVA >0.10 LogMAR, or poor OCT imaging quality were excluded. Fovea-centered scans were performed using spectral-domain OCT (SD-OCT), and RT automatically measured by the inbuilt software. Only right eyes were analyzed. Groups were matched for age, gender, SE, axial length, and corneal curvature. Results: One-way ANOVA showed a significant difference in both BCDVA (P = 0.039) and macular RT (P = 0.028) among the three groups. Bonferroni's post hoc test revealed statistically significant between-group differences in BCDVA (WTR vs. controls, P = 0.041), as well as in RT at inner-nasal (WTR vs. ATR, P = 0.034) and outer-temporal subfields (WTR vs. controls, P = 0.042). BCDVA was positively associated with macular RT (r = 0.206, P = 0.041) after adjusting for age, gender, and axial length. Conclusions: Greater RT and poorer BCDVA were found in eyes with WTR astigmatism. Our findings suggest that the effect of astigmatism on retinal thickness and BCDVA may vary depending on not only magnitude, but also axis of astigmatism.


Assuntos
Astigmatismo , Humanos , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Estudos de Casos e Controles , Hong Kong/epidemiologia , Acuidade Visual , Refração Ocular
6.
PLoS One ; 18(1): e0280925, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36701401

RESUMO

BACKGROUND: A progressive approach to quitting smoking has been a popular strategy for motivating smokers who are reluctant to quit. However, whether this strategy can effectively achieve complete cessation or is as successful as quitting immediately remains unresolved. This study aimed to determine whether quitting immediately or progressively was more effective in achieving complete cessation among smokers in Hong Kong who presented at emergency departments. METHODS AND FINDINGS: A posteriori analysis of a single-blinded, multicenter, randomized controlled trial was performed. The original trials was conducted at emergency departments of four major acute hospitals in different districts of Hong Kong. In total, 1571 smokers 18 years or older who presented at 4 major emergency departments between July 4, 2015 and March 17, 2017 were randomized into an intervention group (n = 787) and a control group (n = 784). The intervention group received brief advice (about 1 minute) and could choose their own quit schedules (immediate or progressive, labeled QI and QP, respectively). The control group received a smoking cessation leaflet. Follow-ups were conducted at 1, 3, 6 and 12 months. The primary outcomes, by intention-to-treat, were biochemically validated abstinence between the QI subgroup and control group; between the QP subgroup and control group, and between the QI subgroup and QP subgroup at 6 months. After the propensity sore matching, the biochemically validated abstinence was statistically significantly higher in the QI subgroup than the control group at 6 months (12.1% vs 3.4%, P = 0.003; adjusted odds ratio [aOR] 4.34, 95% CI 1.63-11.52) and higher in the QP subgroup than the control group at 6 months (9.8% vs 3.4%, P = 0.02; aORs 2.95, 95% CI: 1.04-8.39). No statistically significant differences of biochemically validated abstinence at both 6 month (12.1% vs 9.8%, P = 0.49; aORs 1.50, 95% CI: 0.71-3.19) were found in the comparison between QI and QP subgroups. CONCLUSIONS: This study demonstrates that the strategy of quitting progressively is effective, especially for smokers who lack motivation or find it difficult to quit. If adopted routinely, such an approach can help achieve a greater level of smoking abstinence in the community. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02660957.


Assuntos
Abandono do Hábito de Fumar , Humanos , Abandono do Hábito de Fumar/métodos , Fumantes , Hong Kong/epidemiologia , Fumar , Serviço Hospitalar de Emergência
7.
Sci Rep ; 13(1): 1650, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36717700

RESUMO

Weakened circadian activity rhythms (CARs) were associated with mild cognitive impairment (MCI) in the general population. However, it remains unclear among pneumoconiosis patients. We aimed to address this knowledge gap. This cross-sectional study comprised 186 male pneumoconiosis patients (71.3 ± 7.8 years) and 208 healthy community men. Actigraphy was used to determine CARs parameters (percent rhythm, amplitude, MESOR, and acrophase). Values below the corresponding medians of the CARs parameters represented weakened CARs. The Cantonese version of Mini-Mental State Examination (CMMSE) was used to assess cognitive function, MCI, and the composite outcome of MCI plus cognitive impairment. Compared with the community referents, pneumoconiosis patients had worse cognition and dampened CARs. Compared with the community referents or pneumoconiosis patients with robust circadian rhythm, pneumoconiosis patients with weakened circadian rhythm were consistently associated with increased risk of MCI and the composite outcome. However, significant association was only observed between MESOR and the composite outcome (adjusted OR = 1.99, 95%: 1.04-3.81). A delayed phase of CARs was insignificantly associated with MCI and the composite outcome. Our findings showed that weakened CARs were associated with worse cognitive function among male pneumoconiosis workers. Intervention in improving CARs may mitigate cognitive deterioration in male pneumoconiosis workers.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Humanos , Masculino , Estudos Transversais , Hong Kong/epidemiologia , Ritmo Circadiano
8.
Artigo em Inglês | MEDLINE | ID: mdl-36634978

RESUMO

INTRODUCTION: Type 2 diabetes mellitus (T2DM) has traditionally been considered a coronary heart disease 'risk equivalent' for future mortality, but significant heterogeneity exists across people with T2DM. This study aims to determine the risk of all-cause mortality of patients with cardiovascular disease (CVD) and T2DM in UK and Hong Kong, with stratifications for hemoglobin A1 (HbA1c) concentrations, compared with those without CVD and diabetes mellitus. RESEARCH DESIGN AND METHODS: This is a retrospective cohort study of 3 839 391 adults from Hong Kong and a prospective cohort study of 497 779 adults from the UK Biobank. Individuals were divided into seven disease groups: (1) no T2DM and CVD, (2) T2DM only with HbA1c <7%, (3) T2DM only with HbA1c 7%-7.9%, (4) T2DM only with HbA1c 8%-8.9%, (5) T2DM only with HbA1c ≥9%, (6) CVD only, and (7) T2DM and CVD. Differences in all-cause mortality between groups were examined using Cox regression. RESULTS: After around 10 years of median follow-up, 423 818 and 19 844 deaths were identified in the Hong Kong cohort and UK Biobank, respectively. Compared with individuals without T2DM and CVD, the adjusted HR for all-cause mortality in the other six disease groups for the Hong Kong cohort was 1.25 (95% CI 1.23 to 1.27) for T2DM only with HbA1c <7%, 1.21 (95% CI 1.19 to 1.23) for T2DM only with HbA1c 7%-7.9%, 1.36 (95% CI 1.33 to 1.39) for T2DM only with HbA1c 8%-8.9%, 1.82 (95% CI 1.78 to 1.85) for T2DM only with HbA1c ≥9%, 1.37 (95% CI 1.36 to 1.38) for CVD only, and 1.83 (95% CI 1.81 to 1.85) for T2DM and CVD, and for the UK Biobank the HR was 1.45 (95% CI 1.33 to 1.58), 1.50 (95% CI 1.32 to 1.70), 1.72 (95% CI 1.43 to 2.08), 2.51 (95% CI 2.05 to 3.08), 1.67 (95% CI 1.59 to 1.75) and 2.62 (95% CI 2.42 to 2.83), respectively. This indicates that patients with T2DM had an increased risk of mortality compared with those without T2DM and CVD, and in those with HbA1c ≥9% an even higher risk than people with CVD. CONCLUSIONS: Patients with T2DM with poor HbA1c control (8%-8.9% and ≥9%) were associated with similar and higher risk of mortality compared with patients with CVD, respectively. Optimal HbA1c, controlled for risk reduction and prevention of mortality and complications in diabetes management, remains important.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Adulto , Humanos , Diabetes Mellitus Tipo 2/complicações , Hong Kong/epidemiologia , Estudos de Coortes , Doenças Cardiovasculares/etiologia , Estudos Retrospectivos , Estudos Prospectivos , Bancos de Espécimes Biológicos , Reino Unido/epidemiologia
10.
Ann Med ; 55(1): 146-154, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36519234

RESUMO

OBJECTIVE: To assess the trends in non-melanoma skin cancer (NMSC) incidence in Hong Kong from 1990 to 2019 and the associations of age, calendar period, and birth cohort, to make projections to 2030, and to examine the drivers of NMSC incidence. METHODS: We assessed the age, calendar period, and birth cohort effects of NMSC incidence in Hong Kong between 1990 and 2019 using an age-period-cohort model. Using Bayesian age-period-cohort analysis with integrated nested Laplace approximations, we projected the incidence of NMSC in Hong Kong to 2030. RESULTS: From 1990 to 2019, the age-standardized incidence rate of NMSC increased from 6.7 per 100,000 population to 8.6 per 100,000 population in men and from 5.4 per 100,000 to 5.9 per 100,000 population in women, among the 19,568 patients in the study (9812 male patients [50.14%]). The annual net drift was 2.00% (95% confidence interval [CI]: 1.50-2.50%) for men and 1.53% (95% CI: 0.95-2.11%) for women. Local drifts increased for both sexes above the 35-39-year age group. The period and cohort risk of developing NMSC tended to rise but slowed gradually in the most recent period and post-1975 birth cohort. From 2019 to 2030, it is projected that the number of newly diagnosed NMSC cases in Hong Kong will increase from 564 to 829 in men and from 517 to 863 in women. Population aging, population growth, and epidemiologic changes contributed to the increase in incident NMSCs, with population aging being the most significant contributor. CONCLUSION: The slowing of the period and cohort effects suggests that the rising incidence of NMSC is partly attributable to increased awareness and diagnosis. The increasing prevalence of NMSC among the elderly and an aging population will significantly impact the clinical workload associated with NMSC for the foreseeable future.


Assuntos
Neoplasias Cutâneas , Humanos , Masculino , Feminino , Idoso , Incidência , Hong Kong/epidemiologia , Teorema de Bayes , Neoplasias Cutâneas/epidemiologia
11.
Arch Osteoporos ; 18(1): 1, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36462068

RESUMO

We explored how the severity of radiological osteoporotic vertebral fracture (OVF) can be converted to the equivalent T-score values. INTRODUCTION: To perform a study to define what portion of older community women with what severity of radiographic OVF correspond to what low T-score status. METHODS: There were age-matched 301 Italian community women and 301 Chinese community women (sub-group A, age, 73.6 ± 6.1 years). In addition, Chinese sub-groups B and C included 110 community women (age, 68.9 ± 5.5 years) and 101 community women (age: 82.2 ± 4.3 years), respectively. For each vertebra in women, a score of 0, - 0.5, - 1, - 1.5, - 2, - 2.5, and - 3 was assigned for no OVF or OVF of < 20%, ≥ 20 ~ 25%, ≥ 25% ~ 1/3, ≥ 1/3 ~ 40%, ≥ 40%-2/3, and ≥ 2/3 vertebral height loss, respectively, OVFss was defined as the summed score of vertebrae T4 to L5. OVFss and T-scores were ranked from the smallest to the largest values. RESULTS: For the Chinese total group (sub-groups A, B, and C together), OVFss = - 1 corresponded to lowest T-score (lowest T-score of lumbar spine, femoral neck, and total hip) of - 3.4 ~ - 3.2. OVFss ≤ - 1.5 corresponded to femoral neck T-score ≤ - 2.5. OVFss = -1.5 corresponded to a mean femoral neck T-score of - 3.0, - 2.6, and - 2.4, among Chinese sub-groups B, A, and C subjects, respectively. For Italians, all cases with OVFss ≤ - 1 had lowest T-score ≤ - 2.5. For cases with femoral neck T-score = - 2.5, 41.7% had OVFss = - 1.5, and 58.3% had OVFss = - 1. CONCLUSION: For older women, statistically OVFss ≤ - 1 suggests this subject is osteoporotic according to lowest T-score. If using femoral neck T-score, OVFss ≤ - 1.5 qualifies osteoporosis diagnosis.


Assuntos
Osteoporose , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Hong Kong/epidemiologia , Cidade de Roma , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/epidemiologia , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Vértebras Lombares
12.
Front Public Health ; 10: 1012146, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36466453

RESUMO

Background: We have reported both perceived benefits and harms of the COVID-19 outbreak and their socioeconomic disparities amid the pandemic in Hong Kong. We further investigated whether such perceptions and disparities had changed after 10 months. Methods: Under the Hong Kong Jockey Club SMART Family-Link Project, we conducted two cross-sectional surveys online on perceived personal and family benefits and harms of the COVID-19 outbreak in Hong Kong adults in May 2020 (after Wave 2 was under control; N = 4,891) and in February and March 2021 (after Wave 4 was under control; N = 6,013). We collected sociodemographic information, including sex, age, education, household income, and housing. Using multivariate models of analysis of covariance (MANCOVA), we compared perceived benefits and harms and socioeconomic disparities between the two surveys. Results: Adjusting for sex and age, the prevalence of 17 out of 18 perceived personal and family benefits of COVID-19 outbreak increased (Ps < 0.001). Six of 11 perceived personal and family harms decreased (Ps < 0.001) and 4 increased (Ps < 0.001). The total number of perceived personal and family benefits increased substantially (Ps < 0.001), whereas that of perceived personal harms decreased (P = 0.01) and family harms remained stable (P > 0.05). Socioeconomic disparities, however, persisted-more perceived benefits in those with higher socioeconomic status (Ps < 0.001) and more perceived harms in those with lower (Ps ≤ 0.005). Conclusion: We have first reported that perceived personal and family benefits of the COVID-19 outbreak increased substantially over 10 months amid the pandemic, while perceived personal and family harms were lower and stable, respectively. Socioeconomic disparities of the perceived benefits and harms persisted, which need to be monitored and addressed urgently.


Assuntos
COVID-19 , Adulto , Humanos , COVID-19/epidemiologia , Estudos Transversais , Hong Kong/epidemiologia , Surtos de Doenças , Escolaridade
13.
Geospat Health ; 17(2)2022 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-36468591

RESUMO

After the fifth wave of the COVID-19 outbreak in May 2022, the Hong Kong government decided to ease the restrictions policy step by step. The main change was to re-open some venues that people like to visit and extend the hours of operation. With the implementation of the relaxed policy, however, the number of confirmed cases rose again. As a result, further relaxation was delayed. As an evaluation of the effectiveness of the restrictions policy could be a reference for future policies balancing viral spread and functionality of society, this paper aimed to respond to this question from the spatial point distribution view. The time, from late March 2020 to February 2021, during which the related policies took place was divided into six periods based on the policy trend (tightening or relaxing). The two-variable Ripley's Kfunction was applied for each period to explore the spatial dependence between confirmed cases and venues as changes in the spatial pattern can reveal the effect of the policy. The results show that, as time passed, the clustering degree decreased and reached its lowest level from August to mid-November 2020, then significantly increased, with the extent of clustering becoming more remarkable and the significant cluster size widening. Our results indicate that the policy had a positive effect on suppressing the spread of the virus in mid-July 2020. Then, with the virus infiltrating the community, the policy had little impact on containing the virus but likely contributed to avoid further infection.


Assuntos
COVID-19 , Humanos , Hong Kong/epidemiologia , COVID-19/epidemiologia , Políticas , Análise por Conglomerados , Surtos de Doenças
14.
BMJ Open ; 12(12): e062609, 2022 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-36521899

RESUMO

OBJECTIVES: To examine the physical, psychological and pandemic fatigue during the COVID-19 pandemic, and to explore the correlates of fatigue using a representative, population-based, community sample of Chinese adults in Hong Kong. DESIGN: Cross-sectional study. SETTING: Telephone surveys in Hong Kong from December 2020 to January 2021 (during the fourth wave of COVID-19 outbreak). PARTICIPANTS: 1255 adults living in Hong Kong aged 18 years or older sampled using a multistage approach (53% women). MAIN OUTCOME MEASURES: Physical and psychological fatigue: The Fatigue Assessment Scale (with a cut-off score of 22). Pandemic fatigue: Adherence to six disease prevention measures (DPM) recommended by the government. RESULTS: About 25.7% of the participants were feeling fatigued physically and psychologically. Physical and psychological fatigue was not directly associated with pandemic fatigue, and their association was fully mediated by self-perceived disruptions of COVID-19-related restrictions in daily life. Results from the hierarchical regression analysis showed that higher levels of fatigue were associated with economically inactive status (B=0.18, SE=0.04, p<0.001), having family or friend infected with COVID-19 before or during the study (B=0.17, SE=0.01, p<0.001), lower acceptability of DPM (B=-0.16, SE=0.03, p<0.001), greater disruptions in daily life (B=0.22, SE=0.02, p<0.001), and greater trust in authorities in ending the pandemic (B=0.11, SE=0.02, p<0.001). CONCLUSIONS: Fatigue affected many individuals during the pandemic. Disruptions of DPM in daily life may serve as a mediator in the association between pandemic fatigue and physical and psychological fatigue, reflecting the need of effective interventions to reduce self-perceived disruptions of COVID-19-related restrictions in the general population. Resources should be allocated to provide sufficient services to individuals vulnerable to fatigue during the prolonged pandemic.


Assuntos
COVID-19 , Pandemias , Adulto , Humanos , Feminino , Masculino , COVID-19/epidemiologia , Estudos Transversais , Hong Kong/epidemiologia , Surtos de Doenças
15.
BMJ ; 379: o2903, 2022 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-36523188
17.
Artigo em Inglês | MEDLINE | ID: mdl-36498252

RESUMO

Communal space is regarded as essential for human well-being in high-rise developments in Asia and increasing attention has been given to the underlying mechanism of its effects in light of the ongoing COVID-19 pandemic. From the perspective of person-place processes, this paper explores 'sense of place' and its possible mediating effects on the relationship between communal space and the mental health of residents in high-rise public housing. An analysis of data from a questionnaire survey conducted in Hong Kong and Guangzhou revealed differentiated mechanisms according to local context and age group. Sense of place and its subcomponents mediated the connection between communal space and mental health in Hong Kong but not in Guangzhou. More specifically, place identity, place attachment and place dependence had stronger effects among older residents in HK than younger ones. The findings from this study can inform evidence-based planning and decision-making for public housing policy for health-oriented environments in high-density cities.


Assuntos
COVID-19 , Habitação Popular , Humanos , Saúde Mental , Pandemias , COVID-19/epidemiologia , Hong Kong/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-36498275

RESUMO

The violation of children's right to a safe home environment is a major public health problem in need of serious attention. Evidence has been limited about the family characteristics that go with the co-occurrence of harsh parenting and family conflict. By using a representative community sample of Hong Kong families, this study aims to examine the prevalence and risk factors of harsh parenting and family conflict. This study was conducted using a secondary analysis obtained from the 2017 Hong Kong Family Survey with a sample size of 1926 respondents who have children. Results showed that participants' ages are negatively related to the occurrence and co-occurrence of harsh parenting and/or family conflict. Married mothers reported less family conflict. Fathers with lower education levels reported more experiences of family violence. Mothers reporting a higher level of family satisfaction were less associated with harsh parenting. This study provides insights into the unique and shared familial elements that prevent harsh parenting and family conflict and help facilitate the development of effective intervention strategies for family violence co-occurrence. Family-based prevention for family violence may screen for the presence of harsh parenting and family conflict and take into consideration these signals to better support families in need.


Assuntos
Violência Doméstica , Conflito Familiar , Criança , Feminino , Humanos , Poder Familiar , Mães , Hong Kong/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-36497852

RESUMO

The health and well-being of school leaders during the COVID-19 pandemic have been largely neglected compared to the health and well-being of students and teachers. This study assessed the magnitude of perceived stress and well-being and the associated factors, including number of working hours, work-related sense of coherence (work-SoC), perceived stress, self-endangering work behaviour, secondary burnout symptoms, and satisfaction with work, among school leaders in Hong Kong, China during the COVID-19 pandemic. This cross-sectional, survey-based study collected demographic data and mental health measurements from 259 eligible school leaders in Hong Kong from April 2021 to February 2022. Pearson's correlation analyses, multilinear regression models, and independent-samples Student's t-tests were performed. The findings revealed that school leaders' perceived stress was negatively correlated with their well-being (r = -0.544, p < 0.01) and work-related SoC (r = -0.327, p < 0.01) but positively correlated with their extensification of work (r = 0.473, p < 0.01), exhaustion related to work situations (r = 0.559, p < 0.01), and psychosomatic complaints (r = 0.439, p < 0.01). In a model that adjusted for gender and age, student leaders with higher subjective well-being scores had a lower level of perceived stress (B = -0.031; 95% confidence interval [CI], -0.59, -0.02; p = 0.034), whereas leaders in schools with a larger student population had a higher level of perceived stress (B = 0.002; 95% CI, 0.000, 0.003; p = 0.030). School leaders with a higher likelihood of performing the self-endangering work behaviour of 'intensification of work' had higher perceived stress levels (B = 1.497; 95% CI, 0.717, 2.278; p < 0.001). School leaders with a higher work-related SoC (B = 4.20; 95% CI, 1.290, 7.106; p = 0.005) had a higher level of well-being. School leaders with higher levels of perceived stress (B = -0.734; 95% CI, -1.423, -0.044; p = 0.037), a higher likelihood of performing the self-endangering work behaviour of 'extensification of work' (B = -4.846; 95% CI, -8.543, -1.149; p = 0.010), and a higher score for exhaustion related to work (B = -10.449; 95% CI, -13.864, -7.033; p = 0.000) showed lower levels of well-being. The finding of a high incidence of stress among school leadership justifies the need for more societal attention to the well-being of school leaders in Hong Kong. It is important that policies and initiatives are designed to enhance the well-being of school leaders and that they are supported in leading the management of schools and coping with stress in school settings.


Assuntos
Esgotamento Profissional , COVID-19 , Humanos , COVID-19/epidemiologia , Estudos Transversais , Pandemias , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Instituições Acadêmicas , Hong Kong/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-36554390

RESUMO

BACKGROUND: The prevalence of allergic diseases has been increasing in developing areas but has reached a plateau in many developed areas. Regular surveys are imperative to assess the disease burden for the prioritization of resource allocation. OBJECTIVES: We examined the change in the prevalence of wheezing, allergic rhinitis (AR), and eczema in school-aged children with possible associative factors and possible health effects of school air quality. METHODS: This was the third repeated cross-sectional study conducted in 2015-2016 using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. Our first and second surveys were conducted in 1994-1995 and 2000-2001, respectively. Regarding the third survey, we recruited 3698 children aged 6-7 from 33 local schools in 18 districts. Air quality, temperature, and humidity were also measured. The changes in prevalence, multiple regression, and GLIMMIX procedure were analyzed. RESULTS: From our first survey to our third survey, the increased prevalences for lifetime wheeze, current wheeze, lifetime rhinitis, current rhinitis, current rhinoconjunctivitis, lifetime chronic rash, and current chronic rash were 4.2%, 2.1%, 12.5%, 12.6%, 14.2%, 3.9%, and 4.1%, respectively. Increased prevalence of parental atopy had the strongest association with an increased prevalence of each of these seven health outcomes. There was no significant association between school air pollutant levels and the prevalence of health outcomes. CONCLUSIONS: There was an increase in the prevalence of wheezing, allergic rhinitis, and eczema across the surveys. The most important associated risk factor identified was the increased prevalence of a parental history of atopy.


Assuntos
Eczema , Exantema , Hipersensibilidade Imediata , Rinite Alérgica , Rinite , Criança , Humanos , Rinite/epidemiologia , Hong Kong/epidemiologia , Sons Respiratórios , Estudos Transversais , Eczema/epidemiologia , Rinite Alérgica/epidemiologia , Inquéritos e Questionários , Prevalência
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