Globally, the coronavirus disease 2019 (COVID-19) pandemic has caused severe and multi-dimensional resource losses among individuals. The Conservation of Resource (COR) theory postulates that ...resource loss generates related stress responses. It can suitably be applied to understand the pandemic’s encompassing adverse consequences. Yet, no assessment tool exists. This study hence developed and validated the COR Scale for COVID-19 (CORS-COVID-19) to facilitate relevant research. The five hypothesized domains included losses in financial resource, family resource, future control, fun, and social resource. A population-based random telephone survey interviewed 300 Chinese adults in the general population in Hong Kong, China during April 3–10, 2020. The levels of different types of resource losses were high (especially for loss in fun). The 5-factor structure identified by factor analysis matches with the five hypothesized dimensions. Its psychometric properties are acceptable, including good internal consistency, content validity (the correlations between the items and their respective subscales were stronger than that between the items and the other four subscales), concurrent validity (significant correlations between the scale/subscale scores and both emotional distress due to COVID-19 and satisfaction with living in Hong Kong), and convergent validity (significant correlations between specific subscales and corresponding external variables). Relatively high floor effects were detected in some subscales. The scale, which is the first of the types to assess resource losses during a pandemic, can provide theory-based understandings/assessment about the negative impacts of COVID-19. It also facilitates warranted comparisons across countries and time periods in future studies.
Healthcare workers (HCWs) are at an increased risk of coronavirus disease 2019 (COVID-19) and warrant COVID-19 vaccination to reduce nosocomial infections. This study investigated: (1) the prevalence ...of behavioral intention of COVID-19 vaccination (BICV) under eight scenarios combining vaccines' effectiveness/safety/cost, plus two general scenarios of free/self-paid vaccination given governmental/hospital recommendations, (2) perceptions involving preferred timing of COVID-19 vaccination and impacts of various attributes on BICV, and (3) factors of BICV based on the Health Belief Model. An anonymous online cross-sectional survey was conducted among 2,254 full-time doctors/nurses in three Chinese provinces during 10/2020-11/2020. The prevalence of BICV was 75.1%/68.0% among nurses/doctors under the most optimum scenario of this study (free/80% effectiveness/rare mild side effects); it dropped to 64.6%/56.5% if it costed 600 Yuan (USD90). Similar prevalence was obtained (72.7%/71.2%) if the vaccination was recommended by the government/hospitals but dropped to <50% if effectiveness was 50% or mild side effects were common; 13.0% preferred to take up COVID-19 vaccination at the soonest (81.8% would wait and see). Scientific proof (completion of phase III clinical trials and approval from health authorities) was rated the highest in its impacts on vaccination decision, followed by vaccines' performance, and then logistics. Multivariable logistic regression analyses showed that perceived severity, perceived barriers, cues to action, and self-efficacy (but neither perceived susceptibility nor perceived barriers) were significantly associated with the two BICV outcomes. The coverage of COVID-19 vaccination would be high only if the vaccines perform well. Health promotion may take the findings into account.
Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, ...palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018. Recommendations on other topics covered in the 2016 Metastatic Pancreatic Cancer Guideline were endorsed by the Expert Panel. Results Two new studies were found that met the inclusion criteria. Recommendations For second-line therapy, gemcitabine plus nanoparticle albumin-bound paclitaxel should be offered to patients with first-line treatment with FOLFIRINOX (leucovorin, fluorouracil, irinotecan, and oxaliplatin), an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 1, and a favorable comorbidity profile; fluorouracil plus nanoliposomal irinotecan can be offered to patients with first-line treatment with gemcitabine plus NAB-paclitaxel, an ECOG PS of 0 to 1, and a favorable comorbidity profile; fluorouracil plus irinotecan or fluorouracil plus oxaliplatin may be offered when there is a lack of availability of fluorouracil plus nanoliposomal irinotecan; gemcitabine or fluorouracil should be offered to patients with either an ECOG PS of 2 or a comorbidity profile that precludes other regimens. Testing select patients for mismatch repair deficiency or microsatellite instability is recommended, and pembrolizumab is recommended for patients with mismatch repair deficiency or high microsatellite instability tumors. Endorsed recommendations from the 2016 version of this guideline for computed tomography, baseline performance status and comorbidity profile, defining goals of care, first-line therapy, and palliative care are also contained within the full guideline text. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .
The prevalence of coronavirus disease 2019 (COVID-19) vaccination is very critical in controlling COVID-19. This study mainly aimed to (1) investigate behavioral intentions of COVID-19 vaccination ...under various specific scenarios, and (2) associated factors of the afore-mentioned vaccination intentions.
A random anonymous telephone survey interviewed 450 Chinese adults from September 16-30, 2020 in Hong Kong, China. Nine scenarios of behavioral intentions of COVID-19 vaccinations were measured combining effectiveness (80% versus 50%), safety (rare versus common mild side effect), and cost (free versus HK$ 500).
The prevalence of behavioral intentions of COVID-19 vaccination under the 9 specific scenarios was very low and varied greatly (4.2% to 38.0%). The prospective countries of manufacture also influenced vaccination intention (eg, Japan: 55.8% vs China: 31.1%). Only 13.1% intended to take up COVID-19 vaccination at the soonest upon its availability. The attributes of effectiveness and side effect influenced vaccination intention most. Positively associated factors of behavioral intentions of COVID-19 vaccination included trust/satisfaction toward the government, exposure to positive social media information about COVID-19 vaccines, descriptive norms, perceived impact on the pandemic, perceived duration of protectiveness, and life satisfaction.
Intention of COVID-19 vaccination was low in the Hong Kong general population, especially among younger people, females, and single people. Health promotion is warranted to enhance the intention. The significant factors identified in this study may be considered when designing such health promotion. Future research is required to confirm the findings in other countries. Such studies should pay attention to the specific context of cost, safety, and effectiveness, which would lead to different responses in the level of behavioral intention of COVID-19 vaccination (BICV).
Women engaging in compensated dating is one of the at risk group of HIV infection due to multiple sexual partnerships and risky sexual practices. The present study examined the prevalence of HIV ...testing behavior and intention, and identified factors associated with HIV testing intention among women engaging in compensated dating in Hong Kong. Factors from the Theory of Planned Behaviors and the role of various types of barriers to HIV testing were also explored.
An anonymous, cross-sectional survey was conducted online. Target participants were women who have engaged in compensated dating and provided sex services to clients. Participants were recruited via three sources, including i) online outreaching, ii) referral made by NGOs, and iii) referral made by participants. A total of 183 participants completed the study.
Respectively 29.7% and 18.6% have taken up HIV testing and showed intention to take up HIV testing in the future year. Results from the multiple hierarchical regression model showed that having ever received HIV testing (β = 0.44, p < .001), attitudes towards HIV testing (β = 0.22, p < .01), subjective norm (β = 0.18, p < .05), perceived behavioral control (β = 0.18, p < .01) and perceived discrimination from health care workers (β = -0.24, p < .05) significantly predicted intention to take up HIV testing.
The present study demonstrates the applicability of extended TPB in HIV testing intention among women engaging in compensated dating. Interventions to promote HIV testing among this group are greatly warranted.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The highly infectious human papillomavirus (HPV) causes both genital warts and cervical cancer in women. In 2009, the prevalence of genital warts in Hong Kong was 203.7 per 100,000 person-years. ...Cervical cancer, more seriously, was the eight most common cancer among women and girls in Hong Kong, accounting for 2.3% of all new cancer cases in females in 2014. Cervical cancer is a significant global public health problem and HPV is a major risk factor leading to the development of cervical cancer. HPV is also the most common sexually transmitted disease among university students. This is the first study to examine the acceptability of HPV vaccines and associations with perceptions related to HPV and HPV vaccines among the male baccalaureate student population locally.
A self-administrative cross-sectional survey was used to assess whether male baccalaureate students from eight local Hong Kong universities intended to be immunized for HPV. The study also asked questions concerning how its subjects perceived HPV and HPV vaccines using the Health Belief Model. Data collection spanned from June to September 2015. A multiple stepwise regression model was used to examine associations between cognitive factors and subjects' intention to take up the HPV vaccine.
A total of 1,004 (83.7%) students aged 18 and 26 participated in this study. 23.3% found vaccinating for HPV acceptable, a level correlating with a number of indicators. Subjects were more likely to find vaccinating acceptable if 1) they knew something about HPV vaccines; 2) they understood that men were susceptible to infection by HPV; 3) they realised they could benefit by HPV vaccination, and 4) they were aware of the arguments for and against HPV vaccination, as disseminated by either the media or peers.
HPV remains a significant public health concern in Hong Kong and China more broadly. This study's findings show a disconnect between the perceived and actual risk of being infected with the HPV vaccine among male baccalaureate students. This disconnect may be bridged by informing young men of the benefits of their being vaccinated against HPV, by removing the psychological and financial barriers that prevent them from taking up the vaccine and by improving how primary healthcare providers motivate them to get immunized.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary Background Characterisation of the severity profile of human infections with influenza viruses of animal origin is a part of pandemic risk assessment, and an important part of the assessment ...of disease epidemiology. Our objective was to assess the clinical severity of human infections with avian influenza A H7N9 virus, which emerged in China in early 2013. Methods We obtained information about laboratory-confirmed cases of avian influenza A H7N9 virus infection reported as of May 28, 2013, from an integrated database built by the Chinese Center for Disease Control and Prevention. We estimated the risk of fatality, mechanical ventilation, and admission to the intensive care unit for patients who required hospital admission for medical reasons. We also used information about laboratory-confirmed cases detected through sentinel influenza-like illness surveillance to estimate the symptomatic case fatality risk. Findings Of 123 patients with laboratory-confirmed avian influenza A H7N9 virus infection who were admitted to hospital, 37 (30%) had died and 69 (56%) had recovered by May 28, 2013. After we accounted for incomplete data for 17 patients who were still in hospital, we estimated the fatality risk for all ages to be 36% (95% CI 26–45) on admission to hospital. Risks of mechanical ventilation or fatality (69%, 95% CI 60–77) and of admission to an intensive care unit, mechanical ventilation, or fatality (83%, 76–90) were high. With assumptions about coverage of the sentinel surveillance network and health-care-seeking behaviour for patients with influenza-like illness associated with influenza A H7N9 virus infection, and pro-rata extrapolation, we estimated that the symptomatic case fatality risk could be between 160 (63–460) and 2800 (1000–9400) per 100 000 symptomatic cases. Interpretation Human infections with avian influenza A H7N9 virus seem to be less serious than has been previously reported. Many mild cases might already have occurred. Continued vigilance and sustained intensive control efforts are needed to minimise the risk of human infection. Funding Chinese Ministry of Science and Technology; Research Fund for the Control of Infectious Disease; Hong Kong University Grants Committee; China–US Collaborative Program on Emerging and Re-emerging Infectious Diseases; Harvard Center for Communicable Disease Dynamics; US National Institute of Allergy and Infectious Disease; and the US National Institutes of Health.
This study investigated parental acceptability of COVID-19 vaccination for children under the age of 18 years among Chinese parents who are healthcare workers. A closed online survey among full-time ...doctors or nurses employed by the five collaborative hospitals who had access to smartphones was conducted. Facilitated by the hospital administrators, prospective participants received an invitation sent by the research team via the existing WeChat/QQ groups to complete an online questionnaire. A total of 2,281 participants completed the survey. This study was a sub-analysis of 1332 participants who had at least one child under the age of 18 years. Among the participants, 44.5% reported that they would likely or very likely to have their children under the age of 18 years take up COVID-19 vaccination in the next six months. After adjusting for significant background characteristics, perceived higher vaccine efficacy, longer protection duration, perceived high/very high chance for China to prevent another wave of COVID-19 outbreak with vaccines in place and willingness to receive a COVID-19 vaccination for themselves were associated with higher parental acceptability of COVID-19 vaccination. At interpersonal level, higher frequency of information exposure through social media and direct interpersonal communication were associated with higher parental acceptability of COVID-19 vaccination, while knowing some people who experienced serious side effects following COVID-19 vaccination were associated with lower parental acceptability of COVID-19 vaccination. Despite their important roles in vaccination promotion, Chinese doctors and nurses showed low parental acceptability of COVID-19 vaccination. Effective health promotion is needed when COVID-19 vaccination become available.
Abstract Objectives Resilience refers to psychological characteristics that promote effective coping and positive adaptation in adversity. This study investigated the factor structure and ...psychometric properties of the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) among adolescents. Methods A total of 2914 Chinese adolescents living in Chengdu, Sichuan, completed the CD-RISC 1 month after the 2008 Sichuan earthquake. They also self-administered the Multidimensional Scale of Perceived Social Support, the Children's Depression Inventory, and the Screen for Child Anxiety Related Emotional Disorders. With confirmatory factor analysis, various factor structures of the CD-RISC reported in previous studies (eg, the 5- and 3-factor models) were examined at the first-order level; and a single factor of resilience was investigated at the second-order level in this sample. The internal consistency and concurrent validity were investigated. Sex and age differences were also examined. Results Confirmatory factor analysis results showed that the 5-factor model originally derived among US community adults was replicated in our sample, and these 5 factors also loaded on a higher-order “resilience” factor. The Cronbach α coefficient was 0.89. The resilience scores demonstrated expected positive correlation with social support ( r = 0.44) and negative correlations with depression ( r = −0.38) and anxiety ( r = −0.25) ( P s < .001). Male participants reported higher resilience scores than female participants, and younger participants also reported higher resilience scores than older participants. Conclusions The Chinese version of the CD-RISC was demonstrated to be a reliable and valid measurement in assessing resilience among Chinese adolescents.
BackgroundRestriction of gathering size in all public areas is a newly and commonly exercised governmental social distancing policy during the COVID-19 pandemic. Its effectiveness depends on the ...general public's compliance. This study applied the Protection Motivation Theory (PMT) to investigate determinants (i.e., perceived severity, perceived susceptibility, perceived response efficacy, and perceived self-efficacy) of compliance with the social distancing policy of banning gathering of >4 people in all public areas (BG4PA) in the Hong Kong general adult population.Methods300 participants were interviewed through a population-based telephone survey during April 21-28, 2020.ResultsThe compliance rate of BG4PA was high (78%). Adjusted for the background factors, multiple linear regression analysis found that perceived response efficacy and perceived self-efficacy were significantly and positively associated with compliance with BG4PA (p<0.05), while the associations between perceived severity/perceived susceptibility and compliance were of marginal significance (0.05<p<0.10). A stepwise linear regression model considered four PMT constructs as candidates; its final model only selected self-efficacy but not the other three PMT constructs.ConclusionsPMT can be applied to understand compliance with BG4PA. Perceived response efficacy and perceived self-efficacy were more influential than perceived severity and perceived susceptibility. Health promotion may focus on improving coping appraisal.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK