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As the ageing population in China continues to grow, more people will be living with long-term health conditions and require support from family care-givers. This scoping review therefore aims to explore sources of stress and coping mechanisms adopted by care-givers of older relatives living with long-term conditions in mainland China. Literature searches were conducted in English (CINAHL, EMBASE, MEDLINE, PsycINFO and SCOPUS) and Chinese (CNKI, WANFANG DATA, CQVIP and CBM) databases between October and November 2019. The searches focused on the stressors and coping mechanisms utilised by family care-givers residing in the community. Narrative synthesis was used to identify themes within the data. Forty-six papers were included: 20 papers from English and 26 from Chinese databases. Six themes captured stressors: care-giving time (N = 22), financial resources (N = 17), role and personal strains (N = 42), preparedness (N = 4), social roles (N = 10) and lack of adequate formal support (N = 22); and one theme captured coping (N = 14). Unmet needs of care-givers of older relatives in mainland China were found to be extensive. Only a few studies had attempted to explore the causal link between stressors, coping and the influence of culture. Findings underscore the significance of adequately capturing intricacies around care-givers' unmet needs, rather than generalising on the basis of culture. Qualitative studies are critical to providing a better understanding of the relationship between stressors, coping and resources afforded to care-givers by their cultural environment. Having such understanding is crucial to inform the development of competent care, which promotes self-efficacy and self-actualisation in care-givers in mainland China. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Introduction: Cancer patients and caregivers have myriad unmet needs which can have detrimental consequences on their psychosocial wellbeing. This systematic review aims to identify the unmet supportive care needs of immigrant and native Chinese cancer patients and caregivers. Methods: We systematically searched various electronic databases (e.g. Scopus, CINAHL, PsycInfo, etc.) from the earliest date available until January 2018. Additional studies were identified through reference lists and citation tracking. Eligibility criteria included: (a) qualitative, quantitative and/or mixed methods studies published in English; (b) immigrant and native Chinese cancer patients and/or caregivers (age ≥18 years); (c) unmet needs and/or their correlates. Studies were assessed for their risk of bias, and a narrative synthesis of findings was performed. Results: Forty‐seven papers from 45 studies met eligibility criteria. The most prevalent area of unmet needs was health system and information. Patients most commonly desired one member of the hospital to talk to about all aspects of their care. Caregivers preferred information about the patient's prognosis and likely outcome. Anxiety was most commonly associated with higher levels of health system and information needs. Conclusion: Chinese patients and caregivers experience a range of unmet health system and information needs, which differ depending on their stage along the cancer trajectory. [ABSTRACT FROM AUTHOR]

Aims and objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Results: Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Relevance to clinical practice: Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed. [ABSTRACT FROM AUTHOR]

The ageing population has been rapidly growing over recent years. Theoretically, religion seemingly plays an important role in improving older people's health. This study examines whether believing in religion is related to better health conditions among Chinese older adults through a meta-analysis. Two researchers independently extracted the studies from a comprehensive database and grey literature search and evaluated their scientific quality. From the 3,777 potentially eligible papers, just 76 were selected. The pooled effect size detected no significant difference between Chinese religious and non-religious older adults' overall health and wellbeing. Dividing the outcomes into different categories, religious older adults reported both a higher level of anxiety (Hedge's g = −0.392, 95% confidence interval (CI) = −0.494, −0.290; p = 0.004) and yet a higher level of happiness (Hedge's g = 0.342, 95% CI = 0.074, 0.610; p = 0.018). Having a higher proportion of females in the sample is related to a smaller effect size in overall health outcomes (β = −2.205, 95% CI = −3.800, −0.613; p = 0.007) and social support specifically (β = −4.660, 95% CI = −6.261, −3.058; p < 0.0001). This study is among the first to synthesise the quantitative evidence regarding health differences between older religion believers and non-believers in China. It calls for future studies investigating the pathways underlying the religion–health relationship. [ABSTRACT FROM AUTHOR]

Background Chronic fatigue syndrome (CFS) is a global public health concern. We performed this systematic review of randomised controlled trials (RCTs) to evaluate the effects and safety of traditional Chinese mind-body exercises (TCME) for patients with CFS. Methods We comprehensively searched MEDLINE, Embase, Web of Science, PsycINFO, Cochrane Library, CNKI, VIP databases, and Wanfang Data from inception to October 2022 for eligible RCTs of TCME for CFS management. We used Cochran's Q statistic and I2 to assess heterogeneity and conducted subgroup analyses based on different types of TCME, background therapy, and types of fatigue. We also assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Results We included 13 studies (n=1187) with a maximal follow-up of 12 weeks. TCME included Qigong and Tai Chi. At the end of the treatment, compared with passive control, TCME probably reduces the severity of fatigue (standardised mean differences (SMD)=0.85; 95% confidence interval (CI)=0.64, 1.07, moderate certainty), depression (SMD=0.53; 95% CI=0.34, 0.72, moderate certainty), anxiety (SMD=0.29; 95% CI=0.11, 0.48, moderate certainty), sleep quality (SMD=0.34; 95% CI=0.10, 0.57, low certainty) and mental functioning (SMD=0.90; 95% CI=0.50, 1.29, low certainty). Compared with other active control therapies, TCME results in little to no difference in the severity of fatigue (SMD= 0.08; 95% CI = -0.18, 0.34, low certainty). For long-term outcomes, TCME may improve anxiety (SMD= 1.74; 95% CI = 0.44, 3.03, low certainty) compared to passive control. We did not identify TCME-related serious adverse events. Conclusions In patients with CFS, TCME probably reduces post-intervention fatigue, depression, and anxiety and may improve sleep quality and mental function compared with passive control, but has limited long-term effects. These findings will help health professionals and patients with better clinical decision-making. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To assess the effectiveness of different nonpharmacological treatments for severe radiation‐induced oral mucositis in patients with head and neck cancer. Background: Radiation‐induced oral mucositis is highly prevalent in patients with head and neck cancer. Current medications for radiation‐induced oral mucositis are limited in effectiveness and susceptible to side effects, and while there is an increasing adoption of nonpharmacological interventions, the optimal one remains unclear. Design: Systematic review and network meta‐analysis based on the PRISMA‐NMA guidelines. Methods: Six databases were searched. Two authors independently performed the literature screening, data extraction and methodological quality assessment of the included studies. Traditional pairwise meta‐analysis was performed by R Studio. A network meta‐analysis was then conducted to assess the effects of nonpharmacological interventions for severe radiation‐induced oral mucositis in patients with head and neck cancer. Results: Fifty‐two studies involving seven types of nonpharmacological interventions were enrolled. The network meta‐analysis indicated that natural plant‐based therapies might be the most effective, health education interventions might be the second most effective, and honey might be the third most effective interventions for reducing the incidence of severe radiation‐induced oral mucositis. For reducing the incidence of severe oral mucositis‐related pain, the pairwise meta‐analysis showed that only natural plant‐based therapies and health education interventions were effective. Conclusions: Nonpharmacological interventions are effective in the management of severe radiation‐induced oral mucositis among patients with head and neck cancer. Relevance to clinical practice: Nonpharmacological interventions are a category of safe and effective adjunctive therapies that should be encouraged in clinical practice. Trial registration details: CRD42023400745. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends that women exclusively breastfeed until their babies are 6 months old and continue to breastfeed while introducing complementary foods. A meta‐aggregation methodology was used to systematically review and synthesise the qualitative studies on factors influencing breastfeeding practices of healthy Chinese women in Greater China. English and Chinese databases were searched to identify peer‐reviewed qualitative studies (published 2008–2019). Relevant data were extracted, and key themes related to factors influencing breastfeeding practices were identified. Of 7587 articles identified, 22 qualitative studies met inclusion criteria for the review, 10 of which were published in Chinese. A total of 87 themes were extracted from all included studies and classified into 9 subcategories: government enactment of policies, implementation of policies in workplaces, social expectations, social support, medical and health services, services with Chinese characteristics, breastfeeding and pumping facilities, maternal perceptions of breastfeeding and self‐efficacy to breastfeed. The nine subcategories were then grouped into four categories. Potential effect associations among these influence factors of breastfeeding practices emerged from categories and subcategories. Family members' influence on breastfeeding motivation and self‐efficacy suggest a potential benefit of breastfeeding promotion interventions targeting the whole family. The role of primary care should be fully exploited in breastfeeding promotion, including both prenatal education and post‐partum visits. Standardising the training and qualifications of maternity matrons (yuesao) and folk breastfeeding specialists (cuirushi) can promote evidence‐based approaches to facilitating breastfeeding during the confinement period. Increased availability of breastfeeding and pumping facilities in the workplace would facilitate continuing breastfeeding after returning to work. [ABSTRACT FROM AUTHOR]

Aim: To critically assess the effects of white noise on the pain level, weight gain and vital signs (heart rate, respiratory rate and oxygen saturation) of preterm infants in neonatal intensive care units (NICUs). Design: A systematic review and meta‐analysis of randomised controlled trials (RCTs). Methods: Ten databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP and Wanfang Data) were systematically reviewed from inception to July 2022. Two reviewers evaluated the risk of bias separately using the Cochrane Collaboration criteria and extracted data using a predesigned information form. Results: The meta‐analysis included eight eligible RCTs. According to statistical analysis, white noise significantly affected the pain level, weight gain, heart rate, respiratory rate and oxygen saturation in preterm infants. Regardless of the outcome measurement timing, gestational age and birth weight of preterm infants, subgroup analysis demonstrated that white noise reduced the pain level, heart rate and respiratory rate and promoted weight gain in preterm infants in NICUs. Conclusion: White noise is a practical and potentially useful therapy for premature neonates in NICUs. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Infection prevention competencies are critical for successful job performance, career progression and robust performance of infection prevention and control programs. Aim/objective: Identify competency assessment tools available to infection preventionists and describe their characteristics, validation processes and reliability. Methods: A scoping review was conducted on five databases and grey literature from 1999 to 2022. A descriptive synthesis approach was undertaken to analyse the data. Finding/results: Seven tools that meet the inclusion criteria were identified. Of those, one tool was reviewed twice. All tools were developed in the United Kingdom, Canada, China and the United States, and were published between 2009 and 2022. All tools use a rating scale; and the most used method to assess competencies was self-assessment. Levels of competency were cited by five tools. Two tools provided information on validation methods and reliability tests for internal consistency. Discussion: Few competency assessment tools are available in the literature, and there is a lack of information on their development process. A global effort to develop an assessment tool that allows comparison across countries and cultures can be a step forward to propel infection preventionists' careers and enhance the efficacy of Infection Prevention and Control Programs. [ABSTRACT FROM AUTHOR]

We aim to provide an overview of clinical and demographical features and neuropathological research on frontotemporal dementia (FTD) from China over the past decade. We reviewed the demographic features, clinical presentations, and neuropathology of the FTD-spectrum disorders from the 49 cases in China published since 1998. On the basis of these findings, we retrospect the history and speculate on future progress in terms of FTD in China. We found that most published papers comprise case reports with a few retrospective studies with small sample sizes. Behavior variant FTD (bvFTD) was the most common diagnostic subtype, of which 35% were associated with amyotrophic lateral sclerosis or Parkinsonian syndrome. More than 47% patients with FTD had age onset before 65. There were no differences in age of onset and sex distribution between diagnostic subtypes. The spectrum of neuropathological diagnosis of bvFTD was frontotemporal lobe degeneration (FTLD) with tau protein or ubiquitin-immunopositive inclusions, and FTLD without intracellular inclusions. Median survival in bvFTD was 14 years. This paper provides an overview of the current status and pointers for future research directions of FTD in China. [ABSTRACT FROM AUTHOR]

Physical distancing and contact restrictions have been implemented in most countries and territories due to the rapid spread of SARS‐CoV‐2. This has caused physical, emotional, and psychological distress for adults living in the community. Diversified telehealth interventions have been widely applied in health care and have proven to be cost‐effective and well accepted by patients and health professionals. Currently, the effectiveness of telehealth interventions on psychological outcomes and quality of life among community adults during the COVID‐19 pandemic remains unclear. A literature search was conducted using PubMed, PsycINFO, CINAHL, EMBASE, MEDLINE, and the Cochrane Library from 2019 to October 2022. Twenty‐five randomized controlled trials with 3228 subjects were finally included in this review. Two independent reviewers performed the screening, extraction of key data points, and appraisal of the methodological quality. There were positive effects of telehealth interventions on anxiety, stress, loneliness, and well‐being among community adults. Participants who were women or older adults were more likely to recover from negative emotions, increase well‐being, and improve quality of life. The real‐time and interactive interventions and remote cognitive‐behavioural therapy (CBT) may be better choices during the COVID‐19 pandemic. Based on the findings of this review, health professionals have more options and alternatives for delivering telehealth interventions in the future. Rigorously designed randomized controlled trials (RCTs) with higher statistical power and long‐term follow‐up should be conducted in the future to strengthen the currently weak evidence. [ABSTRACT FROM AUTHOR]

Objectives: More people with dementia live in low‐ and middle‐income countries (LMICs) than in high‐income countries, but best‐practice care recommendations are often based on studies from high‐income countries. We aimed to map the available evidence on dementia interventions in LMICs. Methods: We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias. Results: We included 340 RCTs with 29,882 (median, 68) participants, published 2008–2018. Over two‐thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%). Conclusions: Evidence‐generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence‐generation for LMICs. Key points: While the majority of people with dementia reside in low‐ and middle‐income countries (LMICs), it is not known what types of interventions have been studied in these settings and how effective they are.We conducted the first comprehensive mapping study of interventions for people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs.This high‐level overview of dementia intervention research in LMICs identified the following gaps: dementia intervention research is highly concentrated in just a few LMICs, and skewed towards Traditional Chinese Medicine, Western pharmaceuticals, and supplements, with comparatively little evidence generated on interventions for carers.Lack of robust and locally relevant evidence on effective interventions presents a substantial challenge to designing evidence‐based treatment and care systems that help people with dementia or MCI and their carers to live better lives. [ABSTRACT FROM AUTHOR]

Aims: A meta‐analysis was carried out to review and identify correlates of stigma in poststroke patients. Background: Patients suffer from impaired physical functions and sequelae of stroke. Stroke‐related stigma hinders the recovery process and produces poorer clinical outcomes of stroke, leading to compromised quality of life. Design: A systematic review and meta‐analysis was reported by following PRISMA 2020 guidelines. Review Methods: Nine databases were searched from their inception to May 2021 to identify studies focused on the relationships among demographics, disease‐related factors, psychosocial factors and poststroke stigma. Included studies were assessed by using the Agency for Healthcare Research and Quality (AHRQ) scale. The statistical software R studios were used to perform statistical analysis. Results: Nineteen studies were included in the meta‐analysis. Four demographic factors (age, caregiver, residence, monthly income), seven stroke‐related characteristics (type of stroke, mRS, ADLs, stroke duration, recurrence, sequelae, chronic disease comorbidity) and three psychosocial factors (depression, social support, quality of life) showed significant associations with stroke‐related stigma. Conclusions: The results of our study can serve as a foundation for designing interventions to reduce stigma and improve the overall quality of life of poststroke patients and may produce positive clinical outcomes. Healthcare professionals should be aware of stroke patients who are characterised by correlates of stigma. Relevance to clinical practice Poststroke patients showed a moderate‐to‐high level of stigma, and this issue warrants more attention. This review provides a preliminary foundation for healthcare professionals to develop interventions to address stroke‐related stigma by focusing on demographic, disease‐related and psychosocial factors. Additionally, stigma identification should be a part of clinical nursing evaluation. The involvement of clinical and community nursing is very important to screen stroke‐related stigma and pay attention to this population. [ABSTRACT FROM AUTHOR]

This systematic review aims to identify potential moderators of academic stress and internalizing problems among high-school students in mainland China and to facilitate future research and interventions. The initial search identified 3875 publications, including 34 that met the inclusion criteria. We identified 19 potential moderators in total. According to the ranking system based on the frequency and weight of each moderator, personal relationships, gender, grades, family relationships, school climate, and resilience are identified as the most important moderators of academic stress and internalizing problems among Chinese high schoolers. The biopsychosocial model was used to explain the top moderators. Future interventions include increasing physical activities and sleep time, providing monthly unexcused absence for girls, hiring more school-based psychotherapist, providing more psychology classes, generalizing mandated report system in China, and providing financial supports for students from low-income families. [ABSTRACT FROM AUTHOR]

Effects of religion, spirituality and supernatural beliefs (RSS) upon health in mainland China remain poorly understood, despite strong RSS beliefs influencing Chinese society. We conducted a Chinese–English bilingual systematic review to summarize the state of RSS-health research in mainland China. Study quality was assessed using the Critical Appraisal Skills Program tool. We screened 1858 studies, 162 of which were included in the review. From 2000–2004 to 2015–2019, the number of RSS-health studies in China increased from five to 73. However, only 7% of studies were rated as higher quality. Cross-sectional and case–control studies represented the vast majority of study designs (94%) and religious affiliation was the only RSS measure for 58% of studies. Higher, moderate, and lower quality studies indicated that RSS has both beneficial and adverse health implications. RSS-health research in China has accelerated rapidly in the last 20 years, but fundamental gaps in knowledge remain. Longitudinal study designs and nuanced RSS measures are needed to advance understanding of RSS health effects in China. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the neglect of left-behind children (LBC) in China. Method: Participants: Children separated from one or both parents for at least 6 months. Intervention: Trauma of separation. Comparison: Non-left-behind children (NLBC). Outcomes: Neglect rates and severity. Only case–control studies were included. Results: Thirteen studies were included; there were 18,688 LBC in a large sample (N = 42,003) of children aged 0–18 years in China. The overall neglect rate was significantly higher in LBC compared to NLBC (odds ratio [ OR ] = 1.58, 95% confidence interval [CI] = [1.50, 1.67], p <.01) based on the Chinese Rural Child Neglected Evaluation Model (CRCNEM) and the Parents–Child Conflict Tactics Scales (OR = 1.44, 95% CI [1.35, 1.54], p <.01). The overall neglect severity in LBC was also significantly higher than NLBC (SMD = 0.31, 95% CI [0.28, 0.33], p <.01). The same trends were observed in sex subgroups. With regard to subtypes, LBC were significantly more likely to have emotional neglect (OR = 2.29, 95% CI [1.88, 2.78], p <.01), medical neglect (OR = 1.79, 95% CI [1.62, 1.98], p <.01), physical neglect (OR = 1.75, 95% CI [1.60, 1.91], p <.01), security neglect (OR = 1.52, 95% CI [1.32, 1.75], p <.01), educational neglect (OR = 1.50, 95% CI [1.31, 1.72], p <.01), and social neglect (OR = 1.33, 95% CI [1.18, 1.51], p <.01). Furthermore, LBC had significantly higher severity in medical neglect (SMD = 0.31, 95% CI [0.27, 0.35], p <.01), emotional neglect (SMD = 0.28, 95% CI [0.24, 0.32], p <.01), physical neglect (SMD = 0.24, 95% CI [0.18, 0.29], p <.01), security neglect (SMD = 0.26, 95% CI [0.23, 0.29], p <.01), educational neglect (SMD = 0.25, 95% CI [0.20, 0.31], p <.01), and social neglect (SMD = 0.25, 95% CI [0.10, 0.40], p <.01). Conclusion: The neglect rates and severity in LBC in China were both significantly higher than those in NLBC. There was a strong association between neglect and LBC. Public policy changes are urgently needed to improve the dire situation and the well-being of the LBC. [ABSTRACT FROM AUTHOR]

Mental health problems are highly prevalent in China; however, China's mental health services lack resources to deliver high-quality care to people in need. Digital mental health is a promising solution to this short-fall in view of the population's digital literacy. In this review, we aim to: (i) investigate the effectiveness, acceptability, usability, and safety of digital health technologies (DHTs) for people with mental health problems in China; (ii) critically appraise the literature; and (iii) make recommendations for future research directions. The databases MEDLINE, PsycINFO, EMBASE, Web of Science, CNKI, WANFANG, and VIP were systemically searched for English and Chinese language articles evaluating DHTs for people with mental health problems in mainland China. Eligible studies were systematically reviewed. The heterogeneity of studies included precluded a meta-analysis. In total, 39 articles were retrieved, reporting on 32 DHTs for various mental health problems. Compared with the digital mental health field in the West, the Chinese studies targeted schizophrenia and substance use disorder more often and investigated social anxiety mediated by shame and culturally specific variants, DHTs were rarely developed in a co-production approach, and methodology quality was less rigorous. To our knowledge, this is the first systematic review focused on digital mental health in the Chinese context including studies published in both English and the Chinese language. DHTs were acceptable and usable among Chinese people with mental health problems in general, similar to findings from the West. Due to heterogeneity across studies and a paucity of robust control trial research, conclusions about the efficacy of DHTs are lacking. [ABSTRACT FROM AUTHOR]

Background: In China, workplace violence (WPV) toward health-care professionals has been a major concern, but no meta-analysis on this topic has been published. This study is a meta-analysis of the pooled prevalence of WPV against health-care professionals in China and its associated risk factors. Method: English- (PubMed, PsycINFO, and Embase) and Chinese-language (Chinese National Knowledge Infrastructure, WanFang, and SinoMed) databases were systematically searched. Data on the prevalence of WPV and the subtypes of violence experienced by health-care professionals in China were extracted and pooled using random-effects models. Findings: A total of 47 studies covering 81,771 health-care professionals were included in the analyses. The overall prevalence of WPV from 44 studies with available data was 62.4% (95% confidence interval [CI] = [59.4%, 65.5%]). The estimated prevalence of physical violence, psychological violence, verbal abuse, threats, and sexual harassment were 13.7% (95% CI [12.2%, 15.1%]), 50.8% (95% CI [46.2%, 55.5%]), 61.2% (95% CI [55.1%, 67.4%]), 39.4% (95% CI [33.4%, 45.4%]), and 6.3% (95% CI [5.3%, 7.4%]), respectively. Males were more likely to experience WPV than females. Interpretation: WPV against health-care professionals appears to be a significant issue in China. Relevant policies and procedures related to WPV should be developed. Staff should be provided with adequate training, education, and support to implement violence management policies to ensure safety at the workplace. [ABSTRACT FROM AUTHOR]

With the widespread implementation of antiretroviral therapy in many countries, the HIV/AIDS epidemic has declined. However, little is known about the prevalence of adherence rate to Highly Active Antiretroviral Therapy (HAART) in patients with HIV infection in China. This is the first meta-analysis of cross-sectional studies of treatment adherence (≥ 95%) to HAART in Chinese patients. Both English (PubMed, PsycINFO, EMBASE, and Web of Science) and Chinese (WanFang, CNKI, and SinoMed) databases were systematically and independently searched by three investigators. Studies with adherence rate estimates of HAART were included. Adherence rate estimates of each eligible study were extracted and pooled using the random-effects model. A total of 40 studies conducted in China were eligible and analyzed. The mean rate of ≥ 95% adherence to HAART was 81.1% (95%CI: 75.1%–88.0%, I2 = 97.3%) at one week, 80.9% (95%CI: 74.7%–85.9%, I2 = 96.6%) at one month, and 68.3% (95%CI: 46.1%–84.4%, I2 = 97.1%) at 3 months or longer. Subgroup analyses revealed that samples with no gender predominance, low education level, middle economic region, rural area, older age (42.3 years), and recent publication (2013 or later) were correlated to higher HAART adherence. The average rate of HAART adherence was relatively high in China, which indicates effective HIV/AIDS policy, prevention and control measures. However, the HAART adherence rate decreased over the study time period. [ABSTRACT FROM AUTHOR]

Aim: Ethnic Chinese women are one of the populations at high risk of gestational diabetes mellitus (GDM) internationally. This systematic review aimed to determine which dietary intervention strategies were found to be effective in improving glycaemic control and pregnancy outcomes among ethnic Chinese women with GDM. Methods: The review protocol was registered with PROSPERO (CRD42016043585). Eight English and four Chinese language databases were searched for randomised controlled trials and cohort studies of dietary intervention among ethnic Chinese women with GDM. Review Manager 5.3 and GRADE criteria were used in meta‐analysis and assessment of quality of evidence. Results: Included studies comprised 3944 women in 29 eligible studies. Compared to standard treatment, low glycaemic index (GI) diets, low glycaemic load (GL) diets and fibre‐enriched diets were associated with a reduction in fasting plasma glucose, 2‐hour plasma glucose and HbA1c, and improved neonatal outcomes. Low GL diets were associated with reduced caesarean section risk. Conclusions: In ethnic Chinese women with GDM, low GI diets, low GL diets and fibre‐enriched diets were associated with improved glycaemic control and pregnancy outcomes. Given the lack of direct comparison of these three diets, future direct comparison trials are necessary to determine optimal dietary intervention strategies. [ABSTRACT FROM AUTHOR]

Objective: Childhood physical abuse (CPA) can lead to adverse mental health outcomes in adulthood, but its potential impact on Chinese populations is still unclear. This meta-analysis is the first to examine the association between CPA and mental health outcomes in Chinese populations. Study Design: Studies published before December 31, 2014 were identified from Embase, CINAHL, Scopus, PsycINFO, PubMed, and Chinese National Knowledge Infrastructure databases. Studies with data on the association between CPA and mental health outcomes from Chinese subjects were included. Twenty-four studies were initially identified but two were excluded because of poor quality. Two reviewers independently extracted data to generate summary effect sizes using a random-effects meta-analytic model. A priori subgroup and sensitivity analyses were performed to evaluate heterogeneity and bias in these studies. Results: Our meta-analysis of 22 studies found a significant positive association between CPA and overall mental health outcomes among all Chinese subjects (pooled effect size: odds ratio [OR] = 2.16, 95% confidence interval [CI] = [1.87, 2.49]) and among community samples (pooled effect size: OR = 2.06, 95% CI [1.71, 2.48]). Based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, diagnostic criteria, CPA was more strongly associated with Axis II (OR = 2.62, 95% CI [2.13, 3.22]) than Axis I disorders (OR = 1.85, 95% CI [1.58, 2.17]). Conclusions: The detrimental effects of CPA on mental health outcomes in Chinese populations were comparable to, if not more than, the West. Contrary to the Chinese belief that physical punishment is a safe way to discipline children, our findings highlight the potential harm to mental health and the need to change this parenting practice. [ABSTRACT FROM AUTHOR]

Background Health-care professionals worldwide have started to appreciate patients' perspectives on the use of complementary and alternative medicine ( CAM) particularly given its popularity. However, cultural perspectives may vary and it may not be possible to apply research findings on the use of CAM from the west to the east. Objective This systematic review aims to synthesize usage patterns of traditional Chinese medicine ( TCM) amongst Chinese populations in different parts of the world and explore potential geographical variations. Search strategy Six international and four Chinese databases were searched, and manual searches of relevant monographs and government publications were carried out. Inclusion criteria Quantitative, qualitative or mixed-method research that aimed to investigate Chinese patients' perception of, and perspectives on, TCM was included. Data extraction and synthesis For each study included, texts under the headings of 'results' or 'findings' were extracted and subjected to analysis. A thematic synthesis approach was adopted for synthesizing qualitative and quantitative studies. Main results Amongst the 28 studies included, twenty were quantitative surveys, six were qualitative studies and two were mixed-method studies. The overall methodological quality was mediocre. Data synthesis suggested that patients from all regions share a common cultural affinity to TCM and consider it to be an effective complement to western medicine (WM) for treating chronic or serious diseases. However, heterogeneous views on (i) disclosing TCM use to WM doctors and (ii) the potential harm of herbs emerged across different study locations. Discussion and conclusions Future research should explore how variation in health systems may influence patients' perception of CAM in different countries. [ABSTRACT FROM AUTHOR]

Background: China has an unusual pattern of suicides, with overall suicide rates in rural areas higher than urban areas. While suicide rates have decreased dramatically, older people increasingly contribute to the overall burden of suicide. However, it is unclear if elderly people within rural areas experience greater suicide risk than those in urban areas. We aimed to systematically review the incidence of suicide in rural and urban China among the elderly (aged over 60 years), with a view to describing the difference in rates between rural and urban areas and trends over time. Methods: Chinese and English language articles were searched for using four databases: EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (EBSCOhost) and CNKI (in Chinese). Articles describing completed suicide among elderly people in both rural and urban areas in mainland China were included. The adapted Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. One reviewer (ML) assessed eligibility, performed data extraction and assessed risk of bias, with areas of uncertainty discussed with the second reviewer (SVK). Random effects meta-analysis was conducted. Suicide methods in different areas were narratively summarised. Results: Out of a total 3065 hits, 24 articles were included and seven contributed data to meta-analysis. The sample size of included studies ranged from 895 to 323.8 million. The suicide rate in the general population of China has decreased in recent decades over previous urban and rural areas. Suicide rates amongst the elderly in rural areas are higher than those in urban areas (OR = 3.35; 95% CI of 2.48 to 4.51; I2 = 99.6%), but the latter have increased in recent years. Insecticide poisoning and hanging are the most common suicide methods in rural and urban areas respectively. Suicide rates for these two methods increase with age, being especially high in elderly people. Conclusions: The pattern of suicide in China has changed in recent years following urbanisation and aging. Differences in suicide rates amongst the elderly exist between rural and urban areas. Addressing the high suicide rate amongst the elderly in rural China requires a policy response, such as considering measures to restrict access to poisons. [ABSTRACT FROM AUTHOR]