Project description:Background: The COVID-19 pandemic has led to an increasing mental health burden. We examined the factors associated with mental health symptoms in Chinese general adults in Hong Kong. Methods: We conducted a dual-frame (landline and mobile) survey on Chinese adults aged 18 years or older in April 2020. Shortage of preventive materials, perceptions of the outbreak (each item range 1-5), and reduction in income were assessed. Mental health symptoms measured included stress (Perceived Stress Scale-4, range 0-16), anxiety (General Anxiety Disorders-2, range 0-6, cutoff >2), and depressive symptoms (Patient Health Questionnaire-2, range 0-6, cutoff >2). Results were weighted by the general population distribution. Associations were analyzed by multivariable linear (for stress) and logistic (for anxiety and depressive symptoms) regression adjusting for sociodemographic and health-related covariates, including confirmed or in close contacts of confirmed cases, chronic disease, self-rated health, and smoking and alcohol drinking behavior. Results: Of the 1,501 participants (52.5% female, 55.0 aged 30-59 years), the average stress score was 7.20 (SD 2.12). 218 (15.8%) and 206 (14.8%) participants had anxiety and depressive symptoms, respectively. Shortage in facemasks (20.8%), alcohol-based hand sanitizers (13.9%), and cleaning products (7.3%) was reported. Participants generally disagree with the perception of at risk of getting infected in the coming 6 months (mean 2.2, SD 1.1), but tended to agree with the perception of worry that the people around pose a threat to them (mean 3.6, SD 0.9) and the outbreak has greatly affected their daily life (mean 3.7, SD 0.9). 59.3% employed participants had income reduction and 6.2% had become unemployed since the outbreak. Stress, anxiety, and depressive symptoms were more prevalent in those with shortages of preventive materials and negative perceptions of the outbreak (all P < 0.05). Reduction in income and unemployment were associated with more mental health symptoms (all P < 0.05). Conclusions: Shortage of preventive materials, negative perceptions, financial loss, and unemployment were prevalent during the outbreak and found in association with higher stress and more anxiety and depressive symptoms. Further research and urgent actions are warranted to relieve stress and promote mental health, targeting the many risk factors identified by our study.
Project description:The rapid trend towards globalization has led to the expansion of English as Medium of Instruction (EMI) in tertiary education. The academic challenges faced by non-native speakers have been broadly discussed in Anglophone countries, whilst those learning through EMI in the Chinese context are still underexplored. To examine Chinese EMI university students' perceived language challenges in learning, as well as their language-related learning strategies, this study investigated 73 students studying at EMI universities in Hong Kong, taking account of their gender, EMI experience in higher education, and English exposure prior to tertiary education. Participants completed a survey to provide self-evaluations of their academic situation and their perceptions of their disciplinary learning. The study found that students perceived a relatively low level of language and learning challenges, and they showed a preference for using their second language (L2)-related learning strategies over strategies related to their first language. Specifically, male students tended to be more actively engaged in communication with their peers than females, and were more likely to search for additional learning support in English. In addition, first-year undergraduates perceived a greater degree of challenges in knowledge application and relied more on L2-related learning strategies than their senior counterparts. Although the importance of English exposure prior to higher education has been highlighted in many existing studies, this study found that prior exposure to English was neither connected with students' perceived challenges nor their learning strategies.
Project description:This study examined the prevalence and correlates of mental illness in homeless people in Hong Kong and explored the barriers preventing their access to health care. Ninety-seven Cantonese-speaking Chinese who were homeless during the study period were selected at random from the records of the three organisations serving the homeless population. The response rate was 69%. Seventeen subjects could not give valid consent due to their poor mental state, so their responses were excluded from the data analysis. A psychiatrist administered the Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I) and the Mini -Mental State Examination. Consensus diagnoses for subjects who could not complete the SCID-I were established by three independent psychiatrists.The point prevalence of mental illness was 56%. Seventy-one percent of the subjects had a lifetime history of mental illness, 30% had a mood disorder, 25% had an alcohol use disorder, 25% had a substance use disorder, 10% had a psychotic disorder, 10% had an anxiety disorder and 6% had dementia. Forty-one percent of the subjects with mental illness had undergone a previous psychiatric assessment. Only 13% of the subjects with mental illness were receiving psychiatric care at the time of interview. The prevalence of psychotic disorders, dementia and the rate of under treatment are hugely underestimated, as a significant proportion (18%) of the subjects initially selected were too ill to give consent to join the study.The low treatment rate and the presence of this severely ill and unreached group of homeless people reflect the fact that the current mode of service delivery is failing to support the most severely ill homeless individuals.
Project description:ImportanceMental health issues among young people are increasingly concerning. Conventional psychological interventions face challenges, including limited staffing, time commitment, and low completion rates.ObjectiveTo evaluate the effect of a low-intensity online intervention on young people in Hong Kong experiencing moderate or greater mental distress.Design, setting, and participantsThis randomized clinical trial was conducted from May 12, 2022, to September 22, 2023, in Hong Kong. Participants (aged 12-30 years) were recruited from a community project, self-reported moderate to severe distress (Kessler Psychological Distress Scale score ≥5), and were randomized 1:1 to receive the low-intensity online intervention or self-help tips (waitlist group).InterventionThe low-intensity online intervention group received 4 weekly 1-on-1 online sessions on stress management, sleep, or problem-solving delivered by trained psychological well-being practitioners. The waitlist group received weekly mental health tips via text messaging.Main outcomes and measuresPrimary outcomes were changes in Kessler Psychological Distress Scale scores and depression and anxiety subscale scores of the Depression, Anxiety, and Stress Scale. Secondary outcomes included general stress, overall negative emotions, quality of life, sleep quality, resilience, and self-efficacy. The primary outcome analysis was based on intention to treat with the last observation carried forward approach. Sensitivity analyses were conducted using per-protocol and multiple imputation methods.ResultsOf 332 screened participants, 120 (mean [SD] age, 22.4 [3.4] years; 87 [72.5%] female) were randomized. From baseline to 4 weeks, the low-intensity online intervention group and the control group both saw reductions in scores for depression (mean [SD] difference, 6.0 [7.7] and 4.8 [7.9]; P = .17; ηp2 = 0.02), anxiety (mean [SD] difference, 6.0 [7.7] and 3.5 [7.7]; P = .07; ηp2 = 0.03), and psychological distress (mean [SD] difference, 3.8 [3.8] and 2.9 [3.8]; P = .24; ηp2 = 0.01), but none of these differences were statistically significant. However, the intervention group showed greater reductions in general stress (mean [SD] difference, 7.5 [7.2] vs 4.4 [7.2]; P = .02; ηp2 = 0.05), negative emotion (mean [SD] difference, 20.3 [19.2] vs 12.7 [19.2]; P = .03; ηp2 = 0.04), and increased resilience (mean [SD] difference, 0.5 [0.6] vs 0.2 [0.6]; P = .01; ηp2 = 0.05) compared with the waitlist group. Younger participants and those with lower initial distress experienced greater improvements. The findings were supported by the per-protocol analysis but not by multiple imputation analysis.Conclusions and relevanceA low-intensity online intervention did not significantly improve distress, depressive, or anxiety symptoms but showed some potential in reducing general stress and negative emotions and improving resilience. These findings are encouraging but not definitive, and caution is needed due to missing data. These data suggest that a low-intensity online intervention may offer a scalable option for youth mental health.Trial registrationClinicalTrials.gov Identifier: NCT05510453.
Project description:Hong Kong has implemented stringent public health and social measures (PHSMs) to curb each of the four COVID-19 epidemic waves since January 2020. The third wave between July and September 2020 was brought under control within 2 m, while the fourth wave starting from the end of October 2020 has taken longer to bring under control and lasted at least 5 mo. Here, we report the pandemic fatigue as one of the potential reasons for the reduced impact of PHSMs on transmission in the fourth wave. We contacted either 500 or 1,000 local residents through weekly random-digit dialing of landlines and mobile telephones from May 2020 to February 2021. We analyze the epidemiological impact of pandemic fatigue by using the large and detailed cross-sectional telephone surveys to quantify risk perception and self-reported protective behaviors and mathematical models to incorporate population protective behaviors. Our retrospective prediction suggests that an increase of 100 daily new reported cases would lead to 6.60% (95% CI: 4.03, 9.17) more people worrying about being infected, increase 3.77% (95% CI: 2.46, 5.09) more people to avoid social gatherings, and reduce the weekly mean reproduction number by 0.32 (95% CI: 0.20, 0.44). Accordingly, the fourth wave would have been 14% (95% CI%: -53%, 81%) smaller if not for pandemic fatigue. This indicates the important role of mitigating pandemic fatigue in maintaining population protective behaviors for controlling COVID-19.
Project description:In Hong Kong, kindergartens and primary schools were closed when local transmission of pandemic (H1N1) 2009 was identified. Secondary schools closed for summer vacation shortly afterwards. By fitting a model of reporting and transmission to case data, we estimated that transmission was reduced approximately 25% when secondary schools closed.
Project description:Our study was conducted to assess the sepsis-associated hospitalisations and antimicrobials prescribed for sepsis inpatients in Hong Kong. Demographic, diagnostic and antimicrobial prescription data were analysed for patients admitted to public hospitals with a diagnosis of septicaemia from 2000 to 2015. A total of 223 250 sepsis hospitalisations were recorded in Hong Kong from 2000 to 2015 during which the hospitalisation rate increased by 85.6%. The majority of the sepsis hospitalisations occurred in adults ≥65 years and children aged 0–4 years. Adults with a secondary diagnosis of sepsis were often admitted with a primary diagnosis of urological conditions or pneumonia; whereas diabetes mellitus was the most common secondary diagnosis among those with primary sepsis. Paediatric sepsis patients aged 0–4 years were often diagnosed with disorders relating to short gestation and low birthweight. Antimicrobial prescriptions increased by 51.1% and 34.4% for primary and secondary sepsis patients, respectively. β-Lactam and β-lactamase inhibitor combinations were the most used antibiotics whereas the usage of carbapenems increased more than 10 times over the study period. A substantial burden of hospitalisations was attributable to sepsis in Hong Kong, particularly in the extremes of age. Broad-spectrum and last-resort antibiotics had been increasingly dispensed for sepsis inpatients.
Project description:This study aimed to reflect on mental health professionals' experiences with online counseling during the COVID-19 pandemic, as well as their perceptions and recommendations for the future. The method of qualitative research with semi-structured interviews was used. The sample consisted of 17 mental health professionals working in the public or private sectors. A framework analysis revealed four main themes, namely (a) the evaluation of online counseling; (b) comparing in-person and online counseling; (c) factors influencing the effectiveness of online counseling; and (d) suggestions for the future use of online counseling. Most therapists reported that their overall experience with online counseling was positive. The main advantages cited were the accessibility for everyone and the reductions in time, money, and distance. Its primary drawbacks included less nonverbal communication, the inability to employ certain therapeutic tools, problems with confidentiality, lack of experience, and technical difficulties during online sessions. Its effectiveness depends on contextual factors and factors related to the therapeutic process itself. Organizational planning, training, and a solid implementation strategy may help ensure that this communication medium is used to its fullest potential. In addition, the possible utilization of remote counseling combined with in-person psychotherapeutic intervention methods will provide solutions for the future, especially in crisis situations.
Project description:Resistance to oseltamivir was observed in influenza A pandemic (H1N1) 2009 virus isolated from an untreated person in Hong Kong, China. Investigations showed a resistant virus with the neuraminidase (NA) 274Y genotype in quasi-species from a nasopharyngeal aspirate. Monitoring for the naturally occurring NA 274Y mutation in this virus is necessary.
Project description:COVID-19 has significant impacts on young smokers in their smoking behaviors. This qualitative study summarises the lived experience of young smokers during COVID-19. Moreover, through their lived experience, we aim to understand how the COVID-19 pandemic influence tobacco use behaviours in this population. A purposive sampling of 48 smokers aged between 17-25 years old is individually interviewed for 30 to 45 min. All interviews are transcribed in verbatim and analysed by two researchers separately using Colaizzi's method of descriptive phenomenology. The results reveal the following six important themes, which could explain the mixed pattern of smoking behaviour changes in young smokers: (1) perceptions of COVID-19 and its association with smoking, (2) more time at home, (3) taking masks off to smoke, (4) the effects of COVID-19 on smokers' financial status and academic performance, (5) reduced social gatherings, and (6) restricted access to tobacco products. To conclude, this pandemic and the anti-pandemic measures, i.e., mask mandates, stay-at-home and work-from-home orders, and class suspension, result in both new obstacles and new advantages for smoking cessation among young people. More studies should be performed to monitor any transition of tobacco products and the trajectory of use in this population during this pandemic, thus informing public health policy making.