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Objective: This paper aimed to examine the longitudinal validity of self-rated health (SRH) and whether it would be affected by possible changes in evaluation standards (i.e., response shift) over time. Design: Data are from a longitudinal survey of a nationally representative sample in China. Analytical sample was restricted to respondents aged 45 and above (n = 15,893). Individual fixed effects models were used to analyze changes in ratings on health anchoring vignettes and self-rated health over time. Main outcome measures: SRH at two time points with a -two-year span. Results: Both SRH and anchoring vignettes ratings displayed changes over a two-year span for all the studied age groups. Compared with the self-assessed change in health ("How would you rate your health as compared to that of last year?"), changes in SRH reported over time displayed a more stable and optimistic pattern. SRH responded to doctor diagnosed chronic disease and changes in functional limitation, before and after adjusting for evaluation standards. Conclusion: SRH is responsive to the newly diagnosed chronic disease and functional limitation, regardless of whether we consider response shift within the same respondents over time. [ABSTRACT FROM AUTHOR]

The formation of information security behavioural intention (ISBI) can be complex and dynamic in different contexts. This paper aims to examine and compare different users' ISBI formalisation mechanisms when dealing with their personal affairs (non-work users) and organisational affairs (work users). Drawing on two principles of Conservation of Resources (COR) theory (i.e. resource loss principle, and resource gain principle), we developed two models to examine how situational support affects ISBI formation. The results of a study of 432 non-worker users and 261 work users indicate a curvilinear relationship between situational support and ISBI through subjective norms and risk perception for non-worker users, whilst a linear relationship via subjective norms is found for worker users. This is the first time that COR has been applied to explain the formation of ISBI. The findings broaden the research scope of individuals' ISBI by revealing how situational support affects the formalisation mechanism for different users in cross-contexts. The theoretical and practical implications of the findings and the future study are discussed. [ABSTRACT FROM AUTHOR]

To identify the prognostic value of the pretreatment geriatric nutritional risk index (GNRI) in colorectal cancer. Several electronic databases were searched up to March 15, 2022, for relevant studies. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined. Bess's funnel plot and Egger's test were conducted to detect publication bias, and the trim-and-fill method was performed to identify potentially unpublished papers and their impacts on the overall results. Nine studies from Japan and China involving 3440 participants were enrolled in the current meta-analysis. The pooled results indicated that a low pretreatment GNRI was significantly associated with poorer OS (HR = 2.28, 95% CI: 1.69–3.07, P < 0.001; I2=63.5%, Pheterogeneity=0.005) and DFS (HR = 1.62, 95% CI: 1.35–1.96, P < 0.001; I2=46.4%, Pheterogeneity=0.114). Subgroup analysis stratified by country and treatment showed similar results. Significant publication bias was manifested by the asymmetric Begg's funnel plot and P = 0.012 of Egger's test, but three potentially unpublished studies did not have a significant impact on the overall results. A lower pretreatment GNRI was a novel prognostic risk factor for Japanese and Chinese colorectal cancer patients. [ABSTRACT FROM AUTHOR]

Hedonia and eudaimonia have been proposed as pathways to well-being. However, the direction of the causal relationship between them remains unclear. This study examined if happiness motivations may be resources leading to a happy life, or vice versa. Cross-lagged associations between happiness motivations (i.e. hedonic motivation and eudaimonic motivation) and subjective well-being (i.e. positive affect, negative affect, and life satisfaction) were tested. Four hundred and ninety-four Chinese adolescents (233 males; mean age 13.26 ± 0.70 years) participated in a two-wave paper and pencil study. The cross-lagged analysis showed that eudaimonic motivation was a significant predictor of positive affect and life satisfaction over time. No cross-lagged effects between eudaimonic motivation and negative affect, or between hedonic motivation and subjective well-being components were established. The results highlight the predictive power of eudaimonic motivation on adolescents' subjective well-being later on. [ABSTRACT FROM AUTHOR]

We discovered that vitiligo was associated with sexual dysfunction in clinical diagnosis and treatment; however, no further analysis had been performed due to a lack of data. This study aimed to clarify the relationship between vitiligo and sexual dysfunction. We searched six databases (PubMed, Embase, Cochrane, China National Knowledge Infrastructure, China Science and Technology Journal, and Wanfang Data Knowledge Service Platform) for nearly 40 years. According to the search strategy, 91 relevant studies were retrieved, of which 4 were included in the analysis. The Arizona Sexual Experience Scale (ASEX) score (mean difference [MD] 4.96, 95% confidence interval [CI] 2.78–7.13, p < 0.00001) was higher in the vitiligo group than in the control group. The Arabic version of the Female Sexual Function Index (AVFSFI) score (mean difference [MD] − 3.40, 95% confidence interval [CI] − 5.49 to −1.31, p = 0.001) was lower in the vitiligo group than in the control group. Patients with vitiligo were found to be at greater risk of sexual dysfunction. Moreover, the association between vitiligo and sexual dysfunction was stronger in women than in men. Patients with vitiligo were found to be at greater risk of sexual dysfunction. The association between vitiligo and sexual dysfunction was stronger in women than in men. [ABSTRACT FROM AUTHOR]

This study integrates the theory of planned behavior with a structural approach to examining social capital to investigate how bonding social capital affected Chinese women's tampon use intentions. Bonding social capital was operationalized as network closure, which included two main dimensions: density and hierarchy. Results from an online survey (N = 766) showed that network density was positively associated with attitudes toward, social norms about, and perceived behavior control around tampon usage, while network hierarchy negatively predicted attitudes only. Moreover, the indirect effects of network density on tampon use intentions were mediated by descriptive norms and perceived behavior control. Examining women's intentions to adopt a rarely used product in China, this study extended the theory of planned behavior into the realm of social capital in an understudied context. The findings provide practical implications for health communication practitioners in public education concerning feminine hygiene products and gynecological health. [ABSTRACT FROM AUTHOR]

Background:The third nationwide hepatitis B virus (HBV) sero-epidemiological survey conducted in China in 2006 showed a hepatitis B surface antigen (HBsAg)-positive rate of 7.18% and the number of carriers to be 93 million. To compensate for the lack of data on the national prevalence of hepatitis B from 2006 onwards, we performed a meta-analysis to investigate HBsAg-positive rates among the general Chinese population aged 1–59 years.Methods:We systemically reviewed published studies (January 2007 to September 2013) from full-text databases such as VIP, Chinese National Knowledge Infrastructure, and PubMed and assessed HBsAg-positive rates using a random effects regression model with comprehensive meta-analysis software.Results:After evaluation of the quality of the papers, 36 were finally included, with a total sample size of 314 103 individuals. The meta-analysis showed that the combined HBsAg-positive rate was 6.1% (95% confidence interval (CI), 5.4–6.8%) among general Chinese populations aged 1–59, with a higher HBsAg-positive rate in males (6.6%; 95% CI, 5.7–7.7%) than in females (5.1%; 95% CI, 4.4–5.9%). Our data also showed a higher HBsAg-positive rate of 6.9% in mid-western China (95% CI, 5.2–9.1%) against 5.6% in eastern China (95% CI, 4.9–6.4%).Conclusion:This meta-analysis suggested that the positive rates of HBsAg in China are reducing compared with previous 2006 sero-survey results, and China has changed from a high endemic area for HBV to an intermediate endemic area. However, owing to the large population, there remain an estimated 80 million HBsAg carriers in China. Thus, the prevention and control of hepatitis B represent a serious challenge, particularly in mid-western China. [ABSTRACT FROM AUTHOR]

Previous studies have shown that parental attachment is associated with higher levels of posttraumatic growth (PTG) and resilience in individuals who have experienced traumatic events. The present study investigated perceived social support as one pathway in which parental attachment is related to PTG and resilience among Chinese adolescents who have experienced trauma by considering the role of perceived social support. Participants were 443 Chinese adolescents who had experienced a severe tornado a year prior to this study. The results showed that our model fitted the data well [χ2/df = 2.847, comparative fit index (CFI) = 0.970, TLI = 0.963, root mean square error of approximation (RMSEA) (90% CI) = 0.065 (0.056-0.073)] and revealed that perceived social support partially mediated the relationship between parental attachment, and PTG and resilience. The clinical implications and limitations of our research, and recommendations for future research are discussed in this paper. [ABSTRACT FROM AUTHOR]

Limited research has been conducted on dispositional mindfulness, posttraumatic stress disorder (PTSD) symptoms and academic burnout in Chinese adolescents following a tornado. The present study investigated the ways in which dispositional mindfulness is related to PTSD symptoms and academic burnout in Chinese adolescents following a tornado by considering the role of regulatory emotional self-efficacy. A total of 431 Chinese adolescents (mean age: 14.75 years) who had experienced a severe tornado 9 months prior to this study were recruited for this study. The results indicated that our model fit the data well [χ2/df = 2.774, CFI = 0.952, TLI = 0.934, RMSEA (90% CI) = 0.064 (0.051-0.077)], and revealed that regulatory emotional self-efficacy partially mediates the relationships between dispositional mindfulness and PTSD symptoms and academic burnout, respectively. The clinical implications and limitations of our research, and recommendations for future research, are discussed in this paper. [ABSTRACT FROM AUTHOR]

Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18–52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32–4.93;p< 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84–7.38;p< 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21–0.80;p< 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20–0.79;p< 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05–0.91;p< 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers. [ABSTRACT FROM AUTHOR]

Using panel data from mainland China, this study incorporates uncertainty, information seeking, and social support into the goal disruption theoretical model to examine the indirect influence of goal disruption on psychological disequilibrium through uncertainty and the moderating roles of information seeking and social support in this relationship. The results demonstrate that goal disruption causes uncertainty and then leads to psychological disequilibrium. Information seeking can reduce uncertainty and social support can attenuate psychological disequilibrium as well. Limitations and further directions are discussed. [ABSTRACT FROM AUTHOR]

Air pollution is a major public health concern in China. Notwithstanding this, there is limited evidence regarding the impact of short-term exposure to ambient ozone on cardiovascular mortality in the Chinese population. Therefore, we conducted this meta-analysis to address this important question. The random-effects model was applied to pool the results from individual studies. Finally, 32 effect estimates extracted from 19 studies were pooled in this meta-analysis. The pooled relative risk for cardiovascular mortality for each 10 µg/m3 increment in ozone concentration was 1.0068 (95% CI: 1.0049, 1.0086). Ths significant positive association between ozone exposure and cardiovascular mortality was also observed in different two-pollutant models. This meta-analysis revealed that exposure to ozone was associated with an increased risk of cardiovascular mortality in China, and more efforts on controlling the population from ozone are needed to improve cardiovascular health of Chinese population. [ABSTRACT FROM AUTHOR]

This study empirically tested the relationship between sub-dimensions of employees' lean construction (LC) competence and construction safety performance (SP), while incorporating organizational LC competence as a mediator. Data were collected from 710 employees on 300 construction projects. The hypothesis model was validated using multiple regression analysis. The results show that employees' cognitive competence can positively influence construction SP both directly and indirectly via organizational LC competence. However, employees' social competence had a direct negative effect on construction SP, but it can have an indirect positive effect on construction SP via organizational LC competence. Coincidentally, employees' continuous improvement competence had no direct effect on construction SP, but it can have an indirect positive impact via organizational LC competence. This article clarifies the definition of LC competence and empirically validates its influence on construction SP, enriching LC management theory and guiding managers on how to improve construction SP in LC practice. [ABSTRACT FROM AUTHOR]

Despite the substantial attention paid to the effects of game violence and game addiction, insufficient research has been conducted on other moral risks of gaming behaviour. Drawing upon the General Learning Model and the Differential Susceptibility to Media Effects Model, the current study utilised a survey approach to investigate the effect of online gameplay on emerging adults' real-life unethical decision-making. The mediation analyses showed no direct effect of gaming intensity on unethical decision-making, but revealed two significant indirect effects: the specific indirect effect through game cheating and the serial indirect effect through game cheating and moral disengagement. Both the indirect effects were contingent upon the moderator of peer cheating. Specifically, the relationship between gaming intensity and unethical decision-making was positively significant at low levels of peer cheating and negatively significant at high levels. In addition to contributing to a broader view of the effects of online gameplay, this study also contributes to the literature on divergent gaming behaviours and online ethics. [ABSTRACT FROM AUTHOR]

Little concern has been paid to the relationship between temperature and varicella among adults. Daily meteorological data and varicella cases in Qingdao among adults from 1 January 2008 to 31 December 2019 were collected. A combination of quasi-Poisson generalized additive model (GAM) and distributed lag non-linear model (DLNM) was conducted to assess the temperature-lag-varicella relationship. We also estimated the lag-response curves for different temperatures and the exposure-response relationships for different lag days. The number of varicella cases was 10,296. Compared with the minimum-varicella temperature (25°C), we found the largest effect of temperature on varicella within 21 lag days was at 1°C (RR, 6.72; 95% CI, 2.90–15.57), and then the effect declined as the temperature increased. A similar trend of rising first and then falling was found in temperature-response curves for different lag days. A reverse U-shape lag pattern was found for different levels of temperatures. Temperature may affect varicella. [ABSTRACT FROM AUTHOR]

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Background: Overuse of antibiotics contributes to the development of antimicrobial resistance. Objective:This study aims to assess the condition of antibiotic use at health facilities at county, township and village levels in rural Guangxi, China. Methods:We conducted a cross-sectional study of outpatient antibiotic prescriptions in 2014 for children aged 2–14 years with upper respiratory infections (URI). Twenty health facilities were randomly selected, including four county hospitals, eight township hospitals and eight village clinics. Prescriptions were extracted from the electronic records in the county hospitals and paper copies in the township hospitals and village clinics. Results:The antibiotic prescription rate was higher in township hospitals (593/877, 68%) compared to county hospitals (2736/8166, 34%) and village clinics (96/297, 32%) (p < 0.001). Among prescriptions containing antibiotics, county hospitals were found to have the highest use rate of broad-spectrum antibiotics (82 vs 57% [township], vs 54% [village],p < 0.001), injectable antibiotics (65 vs 43% [township], vs 33% [village],p < 0.001) and multiple antibiotics (47 vs 15% [township], vs 0% [village],p < 0.001). Logistic regression showed that the likelihood of prescribing an antibiotic was significantly associated with patients being 6–14 years old compared with being 2–5 years old (adjusted odds ratio [aOR] = 1.3, 95% CI 1.2–1.5), and receiving care at township hospitals compared with county hospitals (aOR = 5.0, 95% CI 4.1–6.0). Prescriptions with insurance copayment appeared to lower the risk of prescribing antibiotics compared with those without (aOR = 0.8, 95% CI 0.7–0.9). Conclusions:Inappropriate use of antibiotics was high for outpatient childhood URI in the four counties of Guangxi, China, with the highest rate found in township hospitals. A significant high proportion of prescriptions containing antibiotics were broad-spectrum, by intravenous infusion or with multiple antibiotics, especially at county hospitals. Urgent attention is needed to address this challenge. [ABSTRACT FROM PUBLISHER]

This study aimed to explore the association between family function and sleep disturbances in preschool children in rural areas of China. Caregivers of preschool children completed sociodemographic questionnaires, the Children's Sleep Habits Questionnaire (CSHQ), the Self-rating Anxiety Scale (SAS) and the Family APGAR scale. Using sleep disturbances in children as the dependent variable, family function and other related factors as independent variables, binary logistic regression analyses were performed to examine associations between family function and sleep disturbances in children. A total of 3,636 caregivers of preschool children were enrolled in our study, and the prevalence of sleep disturbances among their preschool children was 89.4%. In our study, lower family function was associated with higher risk of sleep disturbances among preschool children. After adjusting for age (years), education level of mother, discipline attitudes of father and mother, only child status and caregivers' anxiety, the associations were statistically significant both in families of which caregivers of children are their parents or other relatives. (AOR for parents = 1.487, 95% CI:1.152–1.919, P = 0.002; AOR for other relatives = 1.963, 95% CI:1.302–2.958, P = 0.001). Our study results indicated that family function was associated with sleep disturbances in preschool children, and future high-quality cohort studies are needed to explore this topic in more detail. [ABSTRACT FROM AUTHOR]

To date, the relationship between conjunctivitis and air pollutants has been widely concerned, but the conclusions are not very unified. This study aims to explore the short-term effects of ambient ozone (O3) on the conjunctivitis outpatient visits in Pudong New Area, Shanghai. A quasi-Poisson model combined with the distributed lag nonlinear model (DLNM) was performed to study the short-term effects of O3 on the risk of outpatient visits for conjunctivitis, after controlling the effects of temperature, relative humidity and wind speed. Taking the median concentration of O3 as a reference, the moderate high O3 (75th percentile) showed the largest effect estimates for single and cumulative lag effects at lag 4 (RR 1.013, 95% confidence interval [CI] 1.006–1.019) and lag 0–10 (RR 1.075, 95%CI 1.025–1.128), respectively. Our study suggested that the moderate high O3 increased the chances of conjunctivitis outpatient visits and had an evident lag effect. [ABSTRACT FROM AUTHOR]

Objective: This study focused on casual sex motivation to explore why some users tend to have more sexual partners and are more likely to take risks in sexual practices, thereby raising their chances of contracting sexually transmitted infections (STIs). Methods: We recruited Chinese heterosexual dating app users (N = 582) online to investigate the serial mediation model. Results: Casual sex motivation for dating app use was not directly related to the diagnoses of STIs. Number of sexual partners and frequency of risky sexual behavior serially mediated the relationship between casual sex motivation and STI diagnoses. Conclusions: Using dating apps for casual sex motivation is not necessarily associated with higher incidences of STIs, provided that users do not engage in risky sexual practices. [ABSTRACT FROM AUTHOR]

Evidence of more recent studies should be updated to evaluate the effect of long-term exposure to particulate matter (PM) on blood pressure and hypertension. Studies of long-term effects of PM1, PM2.5 and PM10 on blood pressure (SBP, DBP, MAP), hypertension were searched in Pubmed, Web of Science and Embase before May, 2021. Meta-analysis of 41 studies showed that exposure to PM1, PM2.5 was associated with SBP (1.76 mmHg (95%CI:0.71, 2.80) and 0.63 mmHg (95%CI:0.40, 0.85), per 10 μg/m3 increase in PM), all three air pollutants (PM1, PM2.5, PM10) was associated with DBP (1.16 mmHg (95%CI:0.34, 1.99), 0.31 mmHg (95%CI:0.16, 0.47), 1.17 mmHg (95%CI:0.24, 2.09), respectively. As for hypertension, PM1, PM2.5 and PM10 were all significantly associated with higher risk of hypertension (OR=1.27 (95%CI:1.06, 1.52), 1.15 (95%CI:1.10, 1.20) and 1.11 (95%CI:1.07, 1.16). In conclusion, our study indicated a positive association between long-term exposure to particulate matter and increased blood pressure, hypertension. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak and related confinement have highly impacted psychological health among children and adolescents. This study aimed to explore the potential risk factors for depression among primary and middle school students and provide advices for psychological interventions during the outbreaks. An online cross-sectional survey was conducted among 18 primary and middle school students via quota sampling in Beijing during March 2020. The Center for Epidemiological Studies Depression Scale (CES-D) was used to assess depression. Differences between characteristics and depression were examined by chi-square tests. Multivariate logistic regression was used to reveal the potential risk factors for depression. A total of 7377 participants were included. The proportion of depression was 29.7%. Students in rural areas, with higher school categories, in graduating grades, with poor or excessive sleep duration, and without daily exercise were associated with a higher proportion of depression. Furthermore, students with a higher knowledge performance of COVID-19 showed a lower proportion of depression (odds ratio [OR] = 0.900, 95% confidence intervals [95% CI]: 0.888–0.913). Students who worried about academic performance (OR = 1.919, 95% CI: 1.718–2.144) or COVID-19 infection (OR = 1.450, 95% CI: 1.268–1.658) exhibited a high proportion of depression. The proportion of depression among primary and middle school students was negatively associated with the knowledge score and positively associated with their worry. Our findings suggest that psychological intervention might be more necessary for students with specific characteristics. [ABSTRACT FROM AUTHOR]

Pervasive social networking sites (SNSs) access has forced people to pay continuous attention to the overwhelming volume of information which ultimately increases their usage. The extensive use of SNSs has contributed to the overuse of technology and that can lead to overload which may produce negative behavioural consequences. This study used cognitive load theory as foundation of the model to examine the effect of overloads and discontinuous intentions incorporating SNS addiction, social media self-efficacy and SNS fatigue. To test the proposed model and hypothesis, a total of 371 Chinese university students participated in the study. Findings reveal that information and communication overload exert a direct impact on SNS addiction, and the relationship between SNS addiction and discontinuous intentions amongst users is negatively significant. The moderated mediation analysis result indicates that social media self-efficacy moderates the mediating effect of SNS addiction between overloads (information and communication) and discontinuous intentions. Moreover, the relationship between SNS addiction and discontinuous intentions is partially mediated by SNS fatigue. Implications emphasise that SNS providers should effectively prevent the negative behavioural response of SNS users by providing training on the effective use of SNSs. [ABSTRACT FROM AUTHOR]

To investigate the potential associations between household renovation and allergic diseases among preschool children in Wuhan, we conducted a large cross-sectional questionnaire survey among 9455 preschool children aged 3–6 years in Wuhan during November to December 2019. Data on demographics, health status, and home decoration conditions were analysed based on a questionnaire. Compared with tiles/stone/cement floor covering, the use of composite floor significantly increased the risk of diagnosed rhinitis and eczema among children (rhinitis: AOR, 95% CI: 1.36, 1.06–1.73; eczema: AOR, 95% CI: 1.47, 1.17–1.85). Household renovation had significant associations with diagnosed eczema (within 1 year before pregnancy: AOR, 95% CI: 1.34, 1.20–1.50; during pregnancy: AOR, 95% CI: 1.25, 1.08–1.44). This study suggests that use of artificial synthetic materials in home renovation during early childhood and pregnancy may be potential risk factors for childhood asthma, allergic rhinitis, and eczema. [ABSTRACT FROM AUTHOR]

The study explored the associations between maternal exposure to air pollution during different trimesters and allergic diseases including asthma, allergic rhinitis, allergic conjunctivitis or/and eczema. Individual exposure to air pollutants was assessed by an inverse distance weighted (IDW) method using daily concentrations of SO2, NO2, PM10, and PM2.5 from air quality monitoring stations. Multiple logistic regression model was performed to estimate the associations between air pollution during each trimester of pregnancy and childhood allergic diseases. A total of 332 children (51.3%) were reported by their parents having been diagnosed with allergic diseases. After adjusting for covariates, allergic diseases were significantly associated with per interquartile range (IQR) increase in NO2, PM10, PM2.5 during the second trimester with odds ratios (ORs) and 95% confidence intervals (95%CIs) being 1.292 (1.005,1.662), 1.210 (1.042,1,405) and 1.270 (1.004,1.606), respectively. These findings suggest that maternal exposure to certain air pollutants during pregnancy, especially in the second trimester, is associated with childhood allergic diseases. [ABSTRACT FROM AUTHOR]

Social media has been widely used as an important source of health information, particularly during public health crises. However, findings regarding social media's impact on young adults' mental health are mixed. There is a need to identify social mechanisms underlying the effect of social media on mental health outcomes. Our study breaks new ground by proposing and testing a moderated mediation pathway from social media use to stress in young adults during the COVID-19 pandemic. We conducted a two-wave online panel survey in the context of China. With a general basis of the Street's three-stage model, our results indicated that social media failed to directly affect young adults' stress. Instead, fatalism completely mediated this relationship. Also, one's perceived social media exhaustion negatively moderated this mediation pathway. The findings have significant theoretical and practical implications for the use of social media to promote health, well-being, and quality of life among young people during public health crises. [ABSTRACT FROM AUTHOR]

Purpose: To assess the correlation between meteorological factors and spinal disease admissions. Methods: Data was obtained from the electronic medical records of a tertiary general hospital. Meteorological data was collected from China Meteorological Science Data Sharing Service. Distributed lag nonlinear models were used to evaluate the impact of meteorological variables on weekly spinal disease admissions. Results: A total of 2739 spinal cases were documented. Compared with estimates at the 50th, the cumulative relative risk (RR) for extremely high temperatures at the 97.5th over lag week 18 to lag week 20 increased by 75.7%. When the weekly maximum temperature reached 38°C during lag week 20, the maximum RR was 1.96 (95% CI:1.095–3.506). Moreover, the effects of extremely high temperatures on spinal disease admissions were more obvious in females and the age group ≥65 years old compared with males and the age group<65 years old. Conclusions: Extremely high temperatures were significantly associated with higher risks of spinal disease admissions. [ABSTRACT FROM AUTHOR]

To identify nursing students' intention and the predictors of intention to work as a community health nurse in China. A cross-sectional investigation was conducted. A questionnaire based on the Theory of Planned Behavior was delivered by Wechat to a convenience sample of 810 students. In the study, 345 students (42.6%) expressed the intention to be a community health nurse, and the program type, students' attitude, subjective norm and perceived behavioral control were significant predictors of this intention. The results highlight the necessity of community health nursing education reform in curriculum, teaching methods and nursing educators training, so as to improve students' ability and acceptance of community health nursing. Working as community health nurse is not favored by students, and the current situation of community health nursing and nursing education system in China has not helped students recognize the attractive complexity in community care. [ABSTRACT FROM AUTHOR]

This study bridges understandings of character strengths, based on McGrath and Walker's four-factor analysis of VIA-Youth, and a key text in current Chinese moral education: The Code for Primary and Secondary Schools. We utilise two research methods, textual analysis and survey questionnaires, to garner data theoretically and empirically. Our research has three aims. First, through analysing 'the Code' from a VIA-Youth perspective, we identify 30 implicit character strengths, of which 11 are nominally in common with VIA-Youth. Second, we fit all the 30 strengths into the four-factor model through textual analysis. Third, we test the model by factor-analysing student self-report surveys based on the Code. Our analysis reveals that one of the six extracted factors matches the adaptation of the four-factor model while the remaining five present a mix of virtue categories. Moreover, the nine clusters that constitute the Code present a high resemblance with the structuration of the components' matrix. [ABSTRACT FROM AUTHOR]

Objective: Our study explored whether and how media usage can mediate the path from anxiety and fear to physician-patient trust. Design: Study 1 was a population-based, longitudinal study using nationally representative data from 29 provinces in mainland China. The baseline sample (N = 3233) was obtained from February 1 to 9, 2020. Follow-up (N = 1380) took place during March 17 to 24, 2020. Study 2 was a machine learning-based sentiment analysis in which data were captured from Sina Weibo, a Chinese microblogging website, among the most popular official, unofficial, and health-related media accounts. The screened blogs from November to December 2019 and February to March 2020 were scored by Google APIs for positivity and magnitude. Main Outcome Measures: Physician-patient trust. Results: Study 1 showed fear and anxiety affected changes in physician-patient trust through media usage, the indirect effect of which was 0.14 (0.03) and the 95% CI was [0.08, 0.19]. Study 2 indicated a more positive image of physicians after the outbreak compared to before [F (2, 3537) = 3.646, p = 0.026, partial 2=0.002]. Conclusion: The negative impact of anxiety and fear on physician-patient trust was mediated by media use, which can be explained by the more positive media image during the pandemic. [ABSTRACT FROM AUTHOR]

Objectives: Accumulating evidence suggests that there may be differences in sexual behaviors, condom use, and HIV prevention service utilization (e.g., HIV testing, PrEP use) between gay and bisexual men, but this remains under-explored, especially among gay and bisexual men in China. Methods: We surveyed 4,142 gay and bisexual men on a geosocial networking app in China. Results: In adjusted model, bisexual men were less likely to have received HIV testing in their lifetime (AOR =.62, 95% CI [.53,.72]) or to have received a recent HIV test (AOR =.78, 95% CI [.68,.90]). Conversely, among those who reported having had anal sex in the past six months, bisexual men were more likely to report consistent condom use than gay men (OR = 1.38, 95% CI [1.17, 1.62]). Compared with gay men, bisexual men were significantly less likely to be aware of PrEP (AOR =.62, 95% CI [.52,.74]) and significantly less willing to use PrEP (AOR =.58, 95% CI [.46,.73]). Conclusions: Tailored HIV prevention interventions are needed to address bisexual men's needs in the context of the unique sociocultural influences on sexual behavior in China. [ABSTRACT FROM AUTHOR]

This study aimed to assess the relationship between nitrogen dioxide (NO2) exposure and the risk of eye and adnexa diseases (EADs) among children in Shenzhen, China. Information about the daily number of outpatients with EADs and the concentration of air pollutants and meteorological data were collected. A generalized additive model was used to assess the effect of NO2 exposure on the risk of EADs during outpatient visits. An increase in NO2 level by 10 μg/m3 was related to an increase in the daily number of outpatients by 5.43% (95% confidence interval [CI]: 2.25%, 8.70%) at lag0, by 4.35% (95% CI: 1.15%, 7.66%) at lag1, and by 3.21% (95% CI: 0.05%, 6.47%) at lag3. In addition, the relationship between NO2 exposure and the risk of dacryoadenitis was the strongest, with an estimated value of 15.0% (95% CI: 7.99%, 22.5%) at lag0. Moreover, the association between NO2 exposure and the risk of EADs among children in Shenzhen was confirmed in this study. Therefore, the government should introduce stringent environmental policies to control air pollution and protect human health, particularly that of the vulnerable population. [ABSTRACT FROM AUTHOR]

Healthcare workers (HCWs) exposed to Coronavirus disease 2019 (COVID-19) are not immune to stressors. This study aimed to explore the prevalence of posttraumatic stress symptoms (PTSS) among HCWs during the COVID-19 epidemic and investigate the associations among negative coping, fatigue and PTSS. A total of 507 HCWs from Anhui province enrolled in the study and completed the cross-sectional survey including demographic data, Simplified Coping Style Questionnaire (SCSQ), 14-item Fatigue Scale (FS-14), and PTSD Checklist-civilian Version (PCL-C). Univariate linear regression, Pearson correlation and Mackinnon's four-step procedure were performed in the statistical analysis. Results indicated that the prevalence of PTSS among HCWs during the pandemic was 24%. Univariate linear regression showed HCWs aged 31–40 years exhibited significantly higher scores of PTSS than those aged 51–60 (β = 0.20, 95% CI: 0.59 to 9.41). Having at least one child was associated with a higher risk of developing PTSS (β = 0.01, 95% CI: 0.36 to 5.45). Negative coping and fatigue were positively correlated with all three PTSS (all P < 0.001), including re-experiencing, avoidance and hyper-arousal. Fatigue has mediated the association between negative coping and PTSS among HCWs during the pandemic (ab = 0.09, SE = 0.03, bootstrap 95% CI: 0.04 to 0.14). A considerable proportion of HCWs was traumatized during the COVID-19 outbreak. Hence, the institutions should screen out and pay close attention to HCWs who tend to use negative coping (e.g., withdrawal thinking, distraction and blaming others) and arrange work scientifically to avoid overfatigue and PTSS amid the public health crisis. [ABSTRACT FROM AUTHOR]

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The association between lung cancer and trace element levels, such as serum copper (Cu) and zinc (Zn) levels and the Cu:Zn ratio, vary among different demographic groups; however, it is unknown whether variations in serum Cu and Zn levels and Cu:Zn ratios are related to the prediction and prognosis of lung cancer. We aimed to clarify this relationship in the Han Chinese population of Northeast China. We recruited 146 patients with lung cancer and 146 age- and resident area-matched cancer-free controls. Increased serum Cu and Zn levels and the Cu:Zn ratio were positively associated with lung cancer (OR: 72.243, 95% CI 24.159–216.030; OR: 3.513, 95% CI, 1.476–8.358, and; OR: 58.582, 95% CI, 20.023–171.395, respectively). The critical serum Cu level for the prediction of lung cancer was 1.37 mg/L (sensitivity, 77.4%; specificity, 84.9%), while the critical Cu:Zn ratio was 1.45 (sensitivity, 69.9; specificity, 88.4%). Patients with stage IV non-small-cell lung cancer (NSCLC) had higher serum Cu levels and a higher Cu:Zn ratio than patients with stage I, II, or III NSCLC. The serum Cu level and the Cu:Zn ratio are effective predictive indicators of lung cancer and may help evaluate the prognosis of patients with NSCLC. [ABSTRACT FROM AUTHOR]

Soybean is one of the most important crops in the world. There were dramatic changes in soybean plantation in China in recent decades. Heilongjiang Province has the greatest acreage of soybean plantation in China. Therefore, it is taken as a representative soybean region in this study for monitoring purposes. A 30-m dataset that mapped the areas of soybean planting in Heilongjiang Province was produced, for the period of 1984 ~ 2020, based on Landsat-5/7/8 images and the Google Earth Engine (GEE) platform. Maps were made with a random forest classifier and had overall accuracies better than 84%. The areas planted with soybean were calculated at both the provincial and city level and these were compared with the areas obtained from official statistics. At the provincial level, for more than 85% of the time periods, the areas given in the official statistics fell within the confidence intervals of the estimates. At the city level, soybean areas were also in good agreement with the statistical data in most years giving average R2 values as 0.75. These results demonstrate the effectiveness of using phenological features extracted by a double-logistic model and a linear harmonic model with the RF classifier to obtain a long time-series of soybean maps without using samples obtained by field measurements every year. [ABSTRACT FROM AUTHOR]

To determine the association between self-reported hearing status and risk of hospitalisation among Chinese middle-aged and older adults. Prospective cohort study. Discrete-time hazards models and negative binomial models were fitted to examine the relationship. About 11,902 participants aged 45 years or older with no hospitalisation at baseline. 49.28–62.70% of the participants reported their hearing as fair or poor. For older adults aged 60 and above, compared to people with excellent and very good hearing, those with good, fair or poor hearing reported shorter time to first hospitalisation [hazard ratio (HR) = 1.38, 1.38, 1.63, respectively]. They also manifested greater number of hospitalisations [incident rate ratio (IRR) = 1.21, 1.25, 1.54, respectively], and longer duration of hospitalisation (IRR = 1.36, 1.26, 1.53, respectively). However, there was no significant association between hearing status and hospitalisation for middle-aged adults for none of the hearing categories. Although no significant relationship between hearing and hospitalisation was found for middle-aged adults, older adults with poorer hearing experienced greater risk of hospitalisation. Given that hearing impairment is highly prevalent among older adults, future analyses are needed to investigate whether hearing rehabilitative therapies could help mitigate hospitalisations in hearing-impaired older adults. [ABSTRACT FROM AUTHOR]

In this report, we provided an overview of the prevalence, control, and prevention of water-borne arsenicosis in China during 2001–2016. Random sampling was continuously performed during 2001–2010 to find villages having high levels of arsenic (>50 µg/L) in drinking water. The high-arsenic-exposure villages with more geographically dispersed water supplies were subsequently analyzed for characteristics of arsenic distribution, and villages with relatively large populations were investigated for arsenicosis. The results showed that among 32,673,677 inhabitants in 36,820 villages, 1,894,587 inhabitants in 2,476 villages were at risk of high arsenic exposure. Among the 33,318 drinking water sources surveyed in 625 high-arsenic-exposure villages, 9,807 drinking water sources that contained high levels of arsenic (>50 µg/L) were identified. The overall prevalence rate of arsenicosis was 1.93%. Further, some representative villages were chosen to monitor arsenicosis annually, showing that the prevalence rate of arsenicosis was lower in villages with arsenic-safe water supplies than in villages without arsenic-safe water supplies. To the best of our knowledge, this report provides the most comprehensive assessment of the distribution of high arsenic exposure and arsenicosis in China until now. [ABSTRACT FROM AUTHOR]

The current study examined the attachment development of 92 internationally adopted Chinese girls, focusing on the influence of type of pre-adoption care (institutional versus foster care) and sensitive adoptive parenting. Although the children were more often insecurely attached than non-adopted children 2 and 6 months after adoption (Times 1 and 2, N = 92), they had similar levels of secure base script knowledge (SBS knowledge) as a non-adopted comparison group at age 10 (Time 3, N = 87). Furthermore, concurrently observed sensitive parenting was positively associated with SBS knowledge. Finally, a significant interaction between type of pre-adoption care and early-childhood sensitive parenting indicated that the post-institutionalized children showed a stronger increase in security than the post-foster children when parents were more sensitive. [ABSTRACT FROM AUTHOR]

Earthquake survivors whose physical injuries result in disability may be at increased risk for prolonged and severe post-traumatic stress disorder. We estimated the prevalence of post-traumatic stress disorder, functional limitations, and environmental barriers in 289 survivors with disabilities induced by the 2008 Wenchuan earthquake eight years after the disaster. We also investigated the relationship of post-traumatic stress disorder symptom severity with function, considering a mediating role of environmental barriers. Post-traumatic stress disorder was measured with post-traumatic stress disorder checklist-civilian version. Physical and mental functioning was assessed with Medical Outcomes Short Form-36 and perceived environmental barriers were evaluated with Nottwil Environmental Factors Inventory-Short Form. Path analysis was employed to examine the relationship of exposures, post-traumatic stress disorder symptom severity, environmental barriers, and physical and mental function. Prevalence of probable post-traumatic stress disorder was 18.68% (95% CI: 14.19–23.18%). Earthquake survivors with lower physical and mental functioning perceived more environmental barriers, and those who perceived more barriers demonstrated more severe post-traumatic stress disorder symptoms, confirming a mediating role of environmental barriers. Long-term community-based health services for earthquake survivors with disabilities should combine both mental and physical rehabilitation and focus on creating disability-inclusive environments. Earthquake survivors whose physical injuries result in permanent disability may experience two different types of psychological trauma. The first originates from the initial psychological impact of the disaster and their injuries and the second arises from the added difficulty of coping with environmental barriers given the limitations imposed by their impairments. Even years after the disaster, prevalence of post-traumatic stress disorder is likely high in earthquake survivors with acquired musculoskeletal or neurological impairments and needs to be considered in the rehabilitation process. Physical and mental functioning, as well as environmental barriers, are important intervention targets to reduce post-traumatic stress disorder symptoms. Long-term community-based health services for earthquake survivors with disabilities are needed that combine both mental health and physical rehabilitation components with advocating for disability-inclusive environments. [ABSTRACT FROM AUTHOR]

Based on the cognitive model of suicide and broaden-and-build theory of gratitude, this study constructed a moderated mediation model to examine whether hopelessness mediated the relationship between brooding and Chinese college students' suicidal ideation and whether this mediating process was moderated by gratitude, from the positive psychology perspective. A total of 1191 college students were investigated using four scales. The results were as follows: (1) Brooding significantly contributed to suicidal ideation; (2) Hopelessness played a mediating role in the relationship between brooding and suicidal ideation; and (3) Gratitude moderated the mediated path through hopelessness, such that this mediating effect was only significant in individuals with low gratitude. This study may shed light on how brooding influences Chinese college students' suicidal ideation theoretically and on their prevention practically. [ABSTRACT FROM AUTHOR]

Widowhood is a significant predictor of loneliness in older adults and research on the underlying mechanisms of this link using longitudinal data is limited. This study examined whether education would moderate the effect of widowhood on loneliness, and whether such a relationship would differ by gender among Chinese older adults. A total of 2,704 older adults from the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey were included. They were aged 65 years and above, were not lonely, and were married. Logistic regression models were applied to examine the interaction between widowhood, education, and gender on loneliness in the 2011 wave. Widowhood was a significant predictor of loneliness and could increase the odds of becoming lonely by 193%. The interaction between widowhood and education was significant only in older women, not in older men. Literate older women reported lower loneliness than did their illiterate counterparts when they remained married during the follow-up. However, when their spouse passed away, literate women did not differ from their illiterate counterparts in loneliness. This study revealed a gendered pattern in the interaction between widowhood and education on loneliness and demonstrated the complexity of the mechanisms. Furthermore, it highlighted the importance of considering the role of education and gender simultaneously in a Chinese context. [ABSTRACT FROM AUTHOR]

Little is known about pre-exposure prophylaxis (PrEP) awareness and willingness among male rural-to-urban migrant workers, a high-risk population of HIV infection and transmission in China. The aim of this study was to assess the awareness of and willingness to use PrEP among this vulnerable population in two cities in Guangxi Zhuang autonomous region, a province in southwestern China. A cross-sectional survey was conducted among male rural-to-urban migrant workers in Guangxi province, during June to August, 2015. Multivariable logistic regression analysis was used to examine the factors related to PrEP acceptance. Among 669 male rural-to-urban migrant workers surveyed, the HIV prevalence was 1.79%. Among the 657 HIV-negative participants, 23.0% had heard of PrEP, 1.2% had used PrEP, and 64.7% were willing to use PrEP. Being afraid of HIV/AIDS (OR = 2.08, 95%CI: 1.04–4.19) and willing to have an HIV test (OR = 3.74, 95%CI: 1.64–8.52) were associated with willingness to use PrEP. The findings suggest that among male migrant workers in Southwestern China, the awareness of and willingness to use PrEP were relatively low. Given the fact that the HIV prevalence was high among this population, more educational campaigns about PrEP and targeted interventions are necessary for this high-risk population in Guangxi. [ABSTRACT FROM AUTHOR]

We carried out the investigation to evaluate hepatitis B virus (HBV) infection status and the influence of HBV infection in pregnant women in Tianjin of China. We founded that the prevalence of HBsAg was 3.77% (69/1829). 88.57% (1620/1829) pregnant women conducted HBsAg screening in last pregnancy. Spontaneous abortion and premature delivery did not show significant differences between HBV infected and uninfected pregnant women. But ALT and AST levels were significantly higher in infected women. And 56.65% of participants (997/1760) were anti-HBs positive. In conclusion, HBsAg prevalence was moderate in pregnant women in this region, which was consistent with the total population in western Pacific regions. And HBV infection did not influence spontaneous abortion and premature delivery. But the HBsAg screening was conducted mostly in the last pregnancy. Early screening and intervention were suggested in pregnant women within countries of moderately endemic regions. [ABSTRACT FROM AUTHOR]

We conducted an epidemiological study to identify the demographics and pre-operative characteristics of patients undergoing primary anterior cruciate ligament (ACL) reconstruction in a multi-ethnic Asian population. A retrospective study was performed on 696 patients who registered in our ACL reconstruction registry from January 2013 to August 2016. Important inter-ethnic differences were found. Indian patients were significantly older compared to Malay and Chinese patients. Malay and Indian patients were more likely to be male, overweight, and obese compared to Chinese patients. Soccer was the predominant sport involved, although ethnic predominance in specific sports exists. Novel findings from this study include increased prevalence of concomitant chondral injuries in the Chinese population compared to Malays and Indians, and significantly higher rates of concomitant intra-articular injuries in soccer and basketball compared to netball. Identification of these high-risk subgroups would serve useful in guiding the formulation of prevention strategies within our multi-ethnic community. [ABSTRACT FROM AUTHOR]

Chronic disease multimorbidity has become a major challenge for health systems. While a lot of research has evaluated the direct economic burden of multimorbidity on health care utilization and cost, little attention has been given to the impacts on work productivity and functional limitations, as indirect indicators of disease burden. This study aims to examine the prevalence of multimorbidity among Chinese adults and its impact on functional disability and work productivity. It also investigates urban-rural differences in these relationships. This study utilized the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, including 11,176 participants aged 45 years and older. Multivariable logistic regression models were used to estimate the effect of multimorbidity on functional disability (i.e. ADL: activities of daily life; IADL: instrumental activities of daily life), and work productivity loss due to health problems. Negative binomial regression models were used to assess the association of multimorbidity with sickness absences from agricultural work and employed non-agricultural work. 68.8% of total participants in CHARLS had multimorbidity in China in 2015. Rural residents with multimorbidity reported higher proportions of physical functions and days of sick leave than urban residents. Multimorbidity was positively associated with ADL limitation (odds ratio 1.924, 95% CI 1.656–2.236), IADL limitation (1.522, 1.326–1.748), limited work due to health problems (1.868, 1.601–2.178) and days of sick leave (for agricultural work, incidence rate ratio 1.676, 95% CI 1.390–2.020; for employed non-agricultural work, 2.418, 1.245–4.696). For the rural group, the impact of multimorbidity on functional limitations and work productivity loss (except for early retirement), was less than the urban group. Multimorbidity poses significant challenges for functional health and work productivity These have significant negative economic consequences for individuals, the Chinese health system and the society. [ABSTRACT FROM AUTHOR]

Many people die from cardiovascular diseases each year, and extreme temperatures are regarded as a risk factor for cardiovascular deaths. However, the relationship between temperature and cardiovascular deaths varies in different regions because of population density, demographic inequality, and economic situation, and the evidence in Ganzhou, China is limited and inconclusive. This study aimed to assess extreme temperature-related cardiovascular mortality and identify the potential vulnerable people. After controlling other meteorological measures, air pollution, seasonality, relative humidity, day of the week, and public holidays, we examined temperature-related cardiovascular mortality along 21 lag days by Poisson in Ganzhou, China. A J-shaped relationship was observed between mean temperature and cardiovascular mortality. Extremely low temperatures substantially increased the relative risks (RR) of cardiovascular mortality. The effect of cold temperature was delayed by 2–6 days and persisted for 4–10 days. However, the risk of cardiovascular mortality related to extremely high temperatures was not significant (p > 0.05). Subgroup analysis indicated that extremely low temperatures had a stronger association with cardiovascular mortality in people with cerebrovascular diseases (RR: 1.282, 95% confidence interval [CI]: 1.020–1.611), males (RR: 1.492, 95% CI: 1.175–1.896), married people (RR: 1.590, 95% CI: 1.224–2.064), and people above the age of 65 years (RR: 1.641, 95% CI: 1.106–2.434) than in people with ischemic heart disease, females, unmarried people, and the elderly (≥65 years old), respectively. The type of cardiovascular disease, sex, age, and marital status modified the effects of extremely low temperatures on the risk of cardiovascular mortality. These findings may help local governments to establish warning systems and precautionary measures to reduce temperature-related cardiovascular mortality. [ABSTRACT FROM AUTHOR]

The conventional survival analysis model on HIV/AIDS prognosis is the Cox proportional hazard model, which deals with only one event type, death, regardless of the cause. Few studies have used a competing risk model to evaluate the predictors of AIDS-related mortality. To estimate the influence of antiretroviral therapy (ART) initiation time and baseline CD4+ cell counts on acquired immunodeficiency syndrome (AIDS)-related death among former plasma donors. A retrospective cohort study was conducted involving 11,905 human immunodeficiency virus (HIV) or AIDS patients in a high-risk area of Henan province in China between 1995 and 2016. Demographic and clinical data were collected. Sub-distribution hazard ratios (sHRs) for AIDS-related mortality with baseline CD4+ cell counts and ART initiation time were determined using a competing risk model. Patients who initiated ART within 90 days of HIV/AIDS diagnosis (sHR: 0.24, 95% CI: 0.22–0.27) or had baseline CD4+ counts of >500 cells/μL (sHR: 0.23, 95% CI: 0.19–0.28) were associated with lower AIDS-related mortality risk. Patients with ART initiation time >1 year but CD4+ counts >350 cells/μL (sHR: 4.42, 95% CI: 3.30–5.91) had a higher AIDS-related mortality risk than those with ART initiation time >90 days but CD4+ counts ≤350 cells/μL (sHR: 4.33, 95% CI: 3.58–5.23). Our results demonstrate that patients with high CD4+ cell counts and late ART had a 9% higher risk of AIDS-related death than those with low CD4+ cell counts and early ART. This study confirms the great significance of immediate ART initiation among former plasma donor HIV patients in China. [ABSTRACT FROM AUTHOR]

Hyperuricemia (HUA) is becoming a global public health problem and associated with multiple diseases. We conducted a systematic review to synthesize the pooled prevalence of HUA in mainland China and delineate its demographic, regional, and temporal trends over the past two decades. Systematic literature searches of PubMed, SCOPUS, Web of Science, the China National Knowledge Infrastructure (CNKI), and the Wanfang digital database were conducted to screen studies published from 1 January 2000 to 31 August 2019, reporting the prevalence of HUA in mainland China. The search strings were ('hyperuricemia' OR 'hyperuricaemia' OR 'uric acid') AND ('prevalence' OR 'epidemiology') AND 'China'. Article quality was appraised quantitatively from 11 items. Before formal meta-analysis, age-standardized prevalence was transformed. The random-effects model was applied to synthesize the pooled prevalence due to its high heterogeneity. Then we stratified the prevalence estimates by age, gender, area, nationality, and publication year for subgroup analysis. Totally 177 eligible studies with a whole population of 2,277,712 were included in the present meta-analysis. The pooled prevalence in mainland China was estimated at 16.4% (95% CI: 15.3%~17.6%). In studies with the onset age at 20 ~ 29 years old, males had a twice times higher HUA prevalence than females (21.5% vs. 8.9%). The prevalence of HUA was 13.7% (11.8%~15.7%) in people aged 15~ years old, 16.5% in 30~ (14.8%~18.4%), 17.9% in 40~ (16.4%~19.5%), 19.4% in 50~ (17.8%~21.0%), 20.5% in 60~ (18.8%~22.3%), and 24.9% in over 70 (22.9%~27.1%). Stratified by regions, southern (25.5%) and southwestern (21.2%) China shared the highest prevalence, and the lowest prevalence was observed in the northwest (12.6%). From 2001 to 2017, the prevalence estimates of HUA steadily climbed from 8.5% to 18.4% with minor fluctuations. Multiple regression revealed that HUA prevalence was positively correlated to the larger sample size, area, advanced onset age, and published year. The last two decades witnessed the rapid growth prevalence of HUA in China. Early screening and personalized health education for HUA need to be given enough attention. [ABSTRACT FROM AUTHOR]

Background: Problematic smartphone usage has become a worldwide problem due to its high prevalence, rapid growth, and serious adverse consequences. Objective: The purpose of this study was to explore the mediating role of depressive symptoms in the relationship between stressful life events and problematic smartphone usage and the protective role of peer support between stressful life events and depressive symptoms in boarding-school adolescents. Method: 124 rural boarding-school adolescents (61 boys, 49%) completed questionnaires about stressful life events (wave 1), peer support (wave 1), depressive symptoms (wave 2), and problematic smartphone usage (wave 3) between 2016 and 2018. Results: A structural equation modeling and multi-group analysis showed that (1) depressive symptoms mediated the effect of stressful life events on later problematic smartphone usage; (2) peer support had a negative effect on depressive symptoms, but it did not moderate the relationship between stressful life events and depressive symptoms; and (3) no gender difference were found on these associations. Conclusions: Depressive symptoms fully mediated the association between stressful life events and problematic smartphone usage among boarding-school adolescents. Peer support can alleviate depressive symptoms, thereby reducing the risk of problematic smartphone usage. [ABSTRACT FROM AUTHOR]