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Background: In addition to high vaccination levels, COVID-19 control requires uptake and continued adherence to personal hygiene and social distancing behaviors. It is unclear whether residents of a city with successive experience in worldwide pandemics such as SARS, would quickly adopt and maintain preventive behaviors., Methods: A population-based, longitudinal telephone survey was conducted between in first local wave of the COVID-19 pandemic (April 2020) and third local wave (December 2020) (n = 403). The study examined factors associated with personal hygiene and social distancing behavior fatigue, as measured by reduced adherence., Results: Over 9 months, face mask use increased (96.5-100%, p < 0.001). Although habitual hand hygiene remained unchanged (92.0%), blue collar workers and non-working individuals showed higher risk of hand hygiene fatigue. There was a decline (p < 0.05) in avoidance of social gatherings (81.1 to 70.7%), avoidance of public places (52.9-27.5%) and avoidance of international travel (81.9-77.4%) even with rising caseloads. Lowered perception of COVID-19 disease severity was associated with decreased avoidance of social gatherings and public places while lower education was associated with decline in avoidance of social gatherings., Conclusion: Even in regions with past pandemic experience, maintaining social distancing behaviors during a protracted pandemic remains a major public health challenge., (© 2023. The Author(s).)

Objectives: To assess impacts of early detection and prompt antiretroviral therapy (ART) on the latest epidemiologic situation to inform intervention strategy., Methods: We analysed data from two clinical cohorts in Hong Kong where sexual transmission accounted for the majority of HIV infections. The two cohorts comprised patients newly diagnosed in 2007-2008 and 2016-2018 respectively. Secular trend and differences between men who have sex with men (MSM) and heterosexual patients were examined. Predictors of late presentation (defined as CD4 ≤350 or AIDS-defining illness within 3 months of diagnosis) and prolonged interval between diagnosis and ART initiation were assessed by multivariable regressions., Results: There were 1,136 newly diagnosed HIV patients with 644 in the first and 492 in the second cohort, a majority (91.7%) presented with sexually acquired infection. There were less MSM in the first than the second cohort (50.3%% vs 87.8%, χ2 = 117.05, p<0.001). The mean (SD) number of days between diagnosis and ART initiation decreased from 514.3 (516.1) to 61.8 (94.2) days across the two cohorts. Younger age, non-Chinese, outpatient-based service and lower CD4 count were predictors of faster ART initiation in the first but not in the second cohort. Interval between diagnosis and ART initiation became highly uniform among groups in the second cohort. Nearly 60% were classified as late presenters in both cohorts. Heterosexuals (aOR 1.58, 95% CI 1.13-2.19) had a higher risk of late presentation., Conclusions: There was remarkable improvement in acceleration of ART initiation. Clinical implementation of accelerated ART recommendations has been effective for both MSM and heterosexuals. Late presentation was more marked among heterosexuals and remained a problem. The continued phenomenon of late presentation could offset the epidemiologic gains from accelerated ART initiation., Competing Interests: The authors have declared that no competing interests exist.

Vaccination is an effective way in providing protection against COVID-19 infection and severe outcomes. However, vaccine resistance and hesitancy are a great concern among vulnerable populations including older adults who live alone or only with an older partner. This study examined their vaccination status and reasons and associated factors of vaccine resistance and hesitancy. A cross-sectional study was conducted among older adults living alone or only with an older partner in communities in Hong Kong. Participants were interviewed between October 2021 and February 2022. Logistic regression analyses were employed to examine factors associated with vaccine resistance and hesitancy. Of the 2109 included participants, the mean age was 79.3 years (SD 7.6), 1460 (69.2%) were female, 1334 (63.3%) lived alone, and 1621 (76.9%) were receiving social security support. The vaccine uptake, non-uptake (i.e., resistance), and hesitancy rates were 50.1%, 34.4%, and 15.5%, respectively. The top four reasons for vaccine resistance and hesitancy were "Not feeling in good health" (27%), "Worry about vaccine side effects" (18%), "Feeling no need" (10%), and "Lack of recommendation from doctors" (9%). Vaccine resistance and hesitancy was significantly associated with older age, living alone, more chronic conditions, fewer types of social media use, and lower self-rated health status. Similar associations can be observed in their separate analysis for vaccine resistance and vaccine hesitancy, and ever hospital admission over the past 6 months was additionally related to vaccine hesitancy. Older people who live alone or only with an older partner had a low vaccination rate. Poor health or worry about vaccine side effects were the most common reasons for their vaccine resistance and hesitancy. Actions are greatly needed to improve the uptake rate among this vulnerable population, especially those who were older, have poorer health, and use less social media.

Many recent studies show that the COVID-19 pandemic has been severely affecting the mental wellness of people with Parkinson's disease. In this study, we propose a machine learning-based approach to predict the level of anxiety and depression among participants with Parkinson's disease using surveys conducted before and during the pandemic in order to provide timely intervention. The proposed method successfully predicts one's depression level using automated machine learning with a root mean square error (RMSE) of 2.841. In addition, we performed model importance and feature importance analysis to reduce the number of features from 5,308 to 4 for maximizing the survey completion rate while minimizing the RMSE and computational complexity.

Competing Interests: I declare no competing interest.

Spectral imaging is a powerful tool for providing in situ material classification across a spatial scene. Typically, spectral imaging analyses are interested in classification, though often the classification is performed only after reconstruction of the spectral datacube. We present a computational spectral imaging system, the Adaptive Feature-Specific Spectral Imaging Classifier (AFSSI-C), which yields direct classification across the spatial scene without reconstruction of the source datacube. With a dual disperser architecture and a programmable spatial light modulator, the AFSSI-C measures specific projections of the spectral datacube which are generated by an adaptive Bayesian classification and feature design framework. We experimentally demonstrate multiple order-of-magnitude improvement of classification accuracy in low signal-to-noise (SNR) environments when compared to legacy spectral imaging systems.

The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of "shared care collaboration" between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.

Background: Patient Communication with healthcare professionals is an integral self-management skill. Yet the underlying mechanisms explaining how such communication might be enhanced across time have not been well studied., Objectives: Based on the transtheoretical model, the study aimed to develop an across-time Attitude-Social Influence-Efficacy model in order to explain changes in participants' patient-professional communication behaviors in the Chronic Disease Self-management Program (CDSMP). Readiness-to-change construct was hypothesized to be the overall predictors of psychological and behavioral parameters. It was hypothesized that social norm and attitude toward behaviors would be the indirect predictors of communication behavior., Methods: One hundred and thirty-six Chinese participants with chronic diseases underwent a 6-week CDSMP. Their attitude toward behavior, self-efficacy, social norm, readiness to change and communication behavior were obtained at 1st, 4th and 6th week of the structured program., Results: A modified latent growth change curve model yielded satisfactory model fit (χ(2)/df = 1.32; RMSEA = 0.063 (90% CI = 0.018-0.96)). The results showed that readiness to change had a positive influence on attitude and self-efficacy. Both attitude and social norm positively affected self-efficacy. Attitude and self-efficacy in turn positively influenced communication behavior at the beginning of the program. Across 6 weeks, self-efficacy imposed a negative influence on communication behavior while social norm exerted a positive influence on the behavior., Conclusion: This study revealed possible underlying mechanisms influencing CDSMP participants' communication with professionals. The results could shed light on further improvement of the structured program., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: The aim of this study is to test the psychometric properties and validity of the World Health Organization Assessment Schedule II Chinese Traditional Version (WHODAS II CT) in Traditional Chinese-speaking persons with disabilities and chronic illnesses., Method: The WHODAS II CT has been administrated to a sample of 1020 persons with disabilities and chronic illnesses. The construct validity, internal consistency, concurrent validity and convergent validity were evaluated., Results: WHODAS II CT showed a satisfactory model fit for the second-order confirmatory factor analysis model (χ(2)/df = 3.05, root means square error of approximation = 0.053, comparative fit index = 0.912, standardized root mean square residual = 0.076), high internal consistency (Cronbach's α = 0.98), high correlation with all domains of Dartmouth Primary Care Cooperative Research Network/World Organization of National Colleges, Academies, and Academic Associations of General Practices/Family Physicians (COOP/WONCA) charts (partial correlation coefficient ranged from 0.26 to 0.74) and significance between persons with and without co-morbidity (all regression coefficients >0)., Conclusions: WHODAS II CT is a reliable and valid instrument to measure the disability in persons with disabilities and chronic illnesses among Traditional Chinese-speaking population. A further study is required to validate the short version of WHODAS II in order to enhance its applicability in usual and clinical practices. Implications for Rehabilitation This is the first study to evaluate the reliability and validity of WHODAS II in persons with disability and chronic illnesses among Traditional Chinese-speaking population. The WHODAS II CT is a valid instrument in Chinese adults with disabilities and chronic illnesses. The WHODAS II CT is recommended to be used in population-based survey to investigate the health needs of persons with disabilities and chronic illnesses as well as in the rehabilitation programs as an outcome measure.

This paper presents the Static Computational Optical Undersampled Tracker (SCOUT), an architecture for compressive motion tracking systems. The architecture uses compressive sensing techniques to track moving targets at significantly higher resolution than the detector array, allowing for low cost, low weight design and a significant reduction in data storage and bandwidth requirements. Using two amplitude masks and a standard focal plane array, the system captures many projections simultaneously, avoiding the need for time-sequential measurements of a single scene. Scenes with few moving targets on static backgrounds have frame differences that can be reconstructed using sparse signal reconstruction techniques in order to track moving targets. Simulations demonstrate theoretical performance and help to inform the choice of design parameters. We use the coherence parameter of the system matrix as an efficient predictor of reconstruction error to avoid performing computationally intensive reconstructions over the entire design space. An experimental SCOUT system demonstrates excellent reconstruction performance with 16X compression tracking movers on scenes with zero and nonzero backgrounds.

Objective: This study evaluated the 6-week Chronic Disease Self-Management Program (CDSMP) in Hong Kong., Methods: A total of 148 subjects with chronic illness were recruited. Subjects were matched on duration of illness and gender, and then randomly allocated to experimental and comparison groups. The experimental group participated in the CDSMP, while the comparison group joined a Tai-Chi interest class in a mass-activity format. Subjects completed evaluation questionnaires before beginning their program and 1 week following the program., Results: Analysis of covariance showed that the CDSMP participants demonstrated significantly higher self-efficacy in managing their illness, used more cognitive methods to manage pain and symptoms, and felt more energetic than the subjects in the comparison group. The CDSMP participants also demonstrated changes in their profile of coping strategies, having a tendency to adopt the cognitive methods of diverting attention, reinterpreting pain, ignoring sensations, and making positive self-statements., Conclusion: The short-term evaluation results showed that the CDSMP primarily increased the self-efficacy, exercise behavior, and application of cognitive coping strategies of the participants., Practice Implication: The effect of the CDSMP in a Chinese population is similar to that found in studies in Western cultures, and the CDSMP could be applied effectively in a Chinese population.

This study reports the preliminary findings on the effects of the Chronic Disease Self-management Program on a group of Chinese participants who suffered from chronic diseases. A total of 23 participants were recruited in a multi-baseline study protocol. Their self-management behaviors, self-efficacy and health status were captured over three baseline assessments and one post-test assessment. The results indicated significant increases in the performance of stretching exercises, the management of cognitive symptoms and communication with physicians. Their self-efficacy in terms of these aspects was found to be significantly increased. However, changes in other aspects of self-management which required more special skills and coordination with outside agencies were not significant. The changes in the physical and mental statuses of the participants were also not significant. It was observed that the positive effects of the program could be attributed to traditional Chinese beliefs of 'self-discipline' and a welcoming response towards self-efficacy strategies. Further studies should adhere to standards of a randomized clinical trial and further examine the mechanisms underpinning the changes in self-management behaviors among Chinese people with chronic diseases.

Over an 18 month period, 34,495 livebirths were delivered in the Kuala Lumpur Maternity Hospital. 36 neonates (1.044 per 1000 livebirths) had Down's syndrome. The observed rates of Down's syndrome per 1000 livebirths by single year intervals of maternal age were calculated. By using the discontinuous slope model, our study showed that the incidence of Down's syndrome among the Malaysian liveborns increased markedly when the maternal age exceeded 35 years. This study also suggested that the Malay mothers had increased risk of producing babies with Down's syndrome at a later age than the Chinese and the Indians. However, a larger number of babies in each racial group needs to be studied to confirm this.