The associations of social isolation with depression and anxiety among adults aged 65 years and older in Ningbo, China.

Social isolation was associated with emotional problems (depression and anxiety) among older adults, however, little is known in China. Thus, we conducted a cross-sectional study including 6,664 ≥ 65 years older adults in Ningbo, China. We collected data on social isolation, depression, and anxiety by specific scales. The relationship between social isolation and emotional problems was estimated by multivariate-adjusted logistic regression models. The population-attributable risk percentage (PAR%) was used to explore the contribution of social isolation to emotional problems. Overall, the percentage of participants who had experienced social isolation, depression, and anxiety was 12.67%, 4.83%, and 2.63%. Compared with the elderly without social isolation, the adjusted odds ratios (95% confidence interval) of depression and anxiety with social isolation were 1.77 (1.25-2.51) and 1.66 (1.05-2.63), respectively. The PAR analysis showed that 10.66% of depression and 9.03% of anxiety could be attributable to social isolation. In the gender subgroup, ORs and PAR% were only significantly observed in female participants. In Chinese older adults, social isolation has been linked to depression and anxiety, suggesting the importance of taking effective and feasible interventions to reduce social isolation and emotional problems, especially among females.

Effect of COVID-19 pandemic on serious mental illness-related outpatient department utilization in Ningbo, China: an interrupted time series analysis.

Background: Globally, the coronavirus disease 2019 (COVID-19) pandemic has negatively affected mental health services, but there is no clear evidence of this in China. Therefore, we examined the effect of the COVID-19 pandemic on the use of serious mental illness (SMI)-related outpatient services in Ningbo, China. Methods: We analyzed the trends in monthly SMI-related outpatient department utilization from January 2018 to June 2022 using interrupted time series (ITS) regression analysis, and we defined the onset of the COVID-19 pandemic as January 2020. We also performed ITS regression analyses for sex and age subgroups. Results: A significant difference in the monthly number of outpatient visit slopes before and after the onset of the pandemic was shown in the SMI analysis [-175.6, 95% confidence interval (CI) (-338.3 to -12.9), p < 0.05]. All sex and age categories, except the 20-30 years age category, showed statistically significant changes in their slopes after the onset of the pandemic. Significant differences in the number of outpatient visit slopes before and after the onset of the pandemic were seen for schizophrenia and bipolar disorders [-153.3, 95% CI (-294.1 to -12.5) and -16.8 (-31.0 to -2.6), respectively]. Moreover, a negative relationship was observed between the monthly number of outpatient visits and the number of incidents and accidents due to SMI (r = -0.38, p < 0.05). Conclusion: The COVID-19 pandemic has had a negative effect on SMI-related outpatient visits in Ningbo, especially by patients with schizophrenia. A strategy should be developed and implemented to maintain access to SMI services during the COVID-19 pandemic.

Association between secondhand smoke exposure and negative emotions among 12-15-year-old non-smoking adolescents from 63 low- and middle-income countries.

BACKGROUND: Secondhand smoke (SHS) exposure is associated with negative emotions in adolescents, but the association between SHS exposure and negative emotions has been understudied, especially in low- and middle-income countries. Hence, we studied the association between SHS exposure and negative emotions among 12-15-year-old non-smoking adolescents from 63 low- and middle-income countries (LMICs). METHODS: We calculated the pooled prevalence of SHS exposure, loneliness, and anxiety in 12-15-year-old non-smoking adolescents. Multivariable logistic regression was used to evaluate country-specific associations between SHS exposure and negative emotions, after adjusting for important confounders. Meta-analyses were performed to evaluate the overall, regional, and country-income level pooled associations. RESULTS: Of the adolescents included in the analysis, 34.88 % had less than daily SHS exposure and 13.41 % were exposed to SHS daily. The overall prevalence of loneliness and anxiety in the adolescents was 10.51 % and 8.95 %, respectively. Exposure to SHS in the past 7 days was associated with loneliness and anxiety, with odds ratios (95 % confidence intervals) of 1.15 (1.09-1.21) and 1.24 (1.17-1.31), respectively. These positive associations were observed in girls, but not in boys. In addition, there was a positive dose-response relationship between the day of exposure to SHS and loneliness and anxiety. LIMITATIONS: The GSHS data were obtained from a self-report questionnaire and the participants were only adolescents in school. CONCLUSIONS: Our study revealed a positive association between SHS exposure and negative emotions among non-smoking adolescents from LMICs.

The effectiveness and associated factors of online psychotherapy on COVID-19 related distress: A systematic review and meta-analysis.

Objective: A quantitative synthesis of online psychotherapies' effectiveness in managing COVID-19 related distress is lacking. This study aimed to estimate online psychological interventions' effectiveness and associated factors on COVID-19 related psychological distress. Methods: Multi-databases including PubMed, EBSCO, ProQuest, and Cochrane were searched repeatedly till the end of June 2022. Hand-picking was also utilized for relevant papers. Depression, anxiety, stress, and quality of sleep were evaluated as outcomes. The risk of bias was evaluated using the Cochrane tool. Data analyses were conducted through Review Manager (version 5.4.1). Results: A total of 13 studies involving 1,897 participants were included for meta-analysis. Results showed that online psychotherapy significantly reduced the levels of depression [standard mean difference, SMD = -0.45, 95% CI (-0.69, -0.20)], anxiety [SMD = -0.67, 95% CI (-0.99, -0.36)], and stress [SMD = -0.73, 95% CI (-1.11, -0.34)], but not quality of sleep [SMD = -0.53, 95% CI (-1.23, 0.17)]. In addition, guided therapies were more effective than self-help ones on reducing levels of anxiety (χ2 = 5.58, p = 0.02, and I 2 = 82.1%), and ≤ 2 weeks' daily interventions were more effective on treating depression than 2-month weekly interventions (χ2 = 7.97, p = 0.005, I 2 = 87.5%). Conclusion: Online psychological interventions effectively reduced COVID-19 related depression, anxiety, and stress levels, and the effectiveness was influenced by settings like guidance and duration and frequency. Systematic review registration: https://inplasy.com/inplasy-2022-7-0081/, identifier: INPLASY202270081.

Prevalences of Parental and Peer Support and Their Independent Associations With Mental Distress and Unhealthy Behaviours in 53 Countries.

Objective: Parental and peer support are both associated with mental distress and unhealthy behaviour indices in adolescents. Methods: We used the Global School-Based Student Health Survey data (n = 192,633) from 53 countries and calculated the weighted prevalence of individual and combined parental and peer support. Multiple logistic regression analysis was used to estimate the adjusted associations between combined parental and peer support with mental distress and unhealthy behaviours. Results: The prevalence figures for having all four categories of parental support and two peer-support were 9.7% and 38.4%, respectively. Compared with no parental support, adolescents with all four parental support negatively associated with all five mental distress and eight unhealthy behaviours factors, and the ORs ranged from 0.19 to 0.75. Additionally, adolescents with two peer support were negative association with all mental distress and four health risk behaviours, and positively associated with a sedentary lifestyle. Conclusion: Parental and peer support were lacking in some countries, while greater parental and peer support were negative associated with mental distress and most unhealthy behaviours in adolescents, and the relationships were independent.

Temporal trends in suicide attempts among adolescents aged 12-15 years from 12 low- and middle-income countries.

PURPOSE: Suicide is a major public health problem, especially in low- and middle-income countries (LMICs). However, current data on temporal trends in suicide attempts are limited. Therefore, we explored the temporal trends in suicide attempts among adolescents aged 12-15 years from 12 LMICs. METHODS: The data for this study were obtained from the Global School-based Student Health Survey (GSHS) 2009-2017, wherein the interval between two surveys in most of the participating countries was approximately 6 years. The prevalences of suicide attempts were reported as weighted prevalences and 95% confidence intervals (CIs). Pooled overall estimates were calculated using meta-analysis with a random-effects model. Linear regression was used to assess the associations of a country's GNI/capita with the prevalence and temporal variations of suicide attempts. RESULTS: The pooled prevalence of suicide attempts in the LMICs decreased significantly from 17.56% in the first survey to 13.77% in the second survey (difference = 3.65%, 95% CI = 0.35-6.95%, P = 0.03). However, significant decreasing trends were only observed in two countries (Benin and Samoa), the prevalence in the remaining countries remained relatively stable. The pooled prevalence of suicide attempts decreased significantly in boys and in the 12- to 13 year age group (difference = 3.77% and 4.44%, Both P < 0.05). In addition, the correlations of gross national income per capita with the prevalences of suicide attempts was negative but not significant (P > 0.05). CONCLUSIONS: Our findings reveal a decreasing trend in the prevalence of suicide attempts among 12-15 year-old adolescents in 12 LMICs. However, the trend varied in each country. This suggests the need for tailored suicide prevention strategies in each country to reduce suicide attempts.

Metacognitive training: a useful complement to community-based rehabilitation for schizophrenia patients in China.

BACKGROUND: The traditional general practitioner-based model (community-based rehabilitation [CBR]) for Chinese schizophrenia patients lacks sufficient content, usefulness, and theoretical basis for rehabilitation. Based on previous research, we postulate that Metacognitive Training (MCT) is effective in the community for schizophrenic patients. METHOD: A randomized controlled, assessor-blinded trial was conducted. A total of 124 schizophrenia patients were recruited from Ningbo China and were randomly assigned to an intervention or a control group. A general practitioner (GP) training plan was carried out before intervention. Intervention and control groups received two CBR follow-ups once a month, while the intervention group, received an additional eight once-a-in-week session of MCT. The Positive and Negative Syndrome Scale (PANSS), and the Psychotic Symptom Rating Scales (PSYRATS) were the primary outcome instruments, while the Quality of Life Scale (SQLS) was the secondary outcome instrument. RESULTS: In the post-treatment between-groups assessment, the patients in the intervention group showed significantly more reductions on PSYRATS delusions, PSYRATS total, PANSS P6, PANSS core delusions, PANSS positive, PANSS negative, PANSS general and PANSS total, and a significant improvement in SQLS psychosocial aspect. CONCLUSIONS: The study provides preliminary evidence for the usefulness of MCT as a complementary measure for community-based rehabilitation of schizophrenia patients. TRIAL REGISTRATION: ISRCTN, ISRCTN17333276 . Registered 09 August 2020 - Retrospectively registered.

Exposure-lag-response association between sunlight and schizophrenia in Ningbo, China.

Previous studies found that mental disorders such as bipolar disorder, seasonal affective disorder and schizophrenia, often show seasonal variability, which usually be attributed to the variations in the number of natural sunlight. However, few studies have been conducted on the acute effects of exposure to sunlight on the onset of these disease. The aim of this study was to evaluate the exposure-response relationship between sunshine duration and the hospital admissions for schizophrenia. We obtained data on hospital admissions for schizophrenia from the largest psychiatric hospital in Ningbo, China, during 2012-2016. A Distributed lag non-linear model was used to estimate the exposure-lag-response relationship between sunlight and schizophrenia. We calculated the effects of short and long sunshine duration, defined using the cutoffs at the 1st and 99th sunshine duration percentiles. We detected significant and non-linear associations between sunlight and schizophrenia, and the overall estimated relative risk (RR) for a lag of 0-21 days was 1.45 (95% CI: 1.07, 1.97) and 1.41(95% CI: 0.72, 2.75) for short and long sunshine duration, respectively. The burden of schizophrenia was greater during periods with short sunshine duration than during periods with long sunshine duration, with the AFs of 19.94% (95% CI: 8.65%, 28.24%) and 2.12% (95% CI: -2.70%, 5.57%), respectively. The female and people more than 45 years old were most susceptible to these effects. We repeated our analysis by using global solar radiation as a continuous exposure variable of sunlight intensity in the model, and the result shows that the female and middle-aged and eldly patients were also susceptible to the effects of low levels of global solar radiation. Our findings suggest that there may be a relationship between lack of exposure to sunlight and increased risk of hospital admissions for schizophrenia. Policymakers and doctors should promote further understanding of the health benefits of sunlight and take effective measures to prevent schizophrenia.

Impact of PM10 and meteorological factors on the incidence of hand, foot, and mouth disease in female children in Ningbo, China: a spatiotemporal and time-series study.

Hand, foot, and mouth disease (HFMD) is a viral illness that is considered a critical public health challenge worldwide. Previous studies have demonstrated that meteorological parameters are significantly related to the incidence of HFMD in children; however, few studies have focused only on female children. This study quantified the associations of HFMD incidence with meteorological parameters and PM10 (particulate matter with an aerodynamic diameter of 10 µm) among female children. Data were collected on daily HFMD cases, meteorological variables, and PM10 levels in Ningbo, China, from January 2012 to December 2016. Data were assessed using a distributed lag nonlinear model (DLNM) with Poisson distribution. A total of 59,809 female children aged 0-15 years with HFMD were enrolled. The results showed that highest relative risk (RR) of HFMD for temperature was 3 °C and the lag effect was 3 days. The highest RR for PM10 was 80 mg/m3 and the lag effect was 5 days. Spatial analysis showed that female HFMD incidence was mainly concentrated in the suburban of Ningbo city indicating that female children in this area should be more paid attention on avoiding this disease outbreak. Our findings suggest that HFMD prevention strategies should focus more attention on local meteorological parameters.

Effects of Meteorological Parameters and PM10 on the Incidence of Hand, Foot, and Mouth Disease in Children in China.

Hand, foot, and mouth disease (HFMD) is a globally-prevalent infectious disease. However, few data are available on prevention measures for HFMD. The purpose of this investigation was to evaluate the impacts of temperature, humidity, and air pollution, particularly levels of particulate matter with an aerodynamic diameter 10 micrometers (PM10), on the incidence of HFMD in a city in Eastern China. Daily morbidity, meteorological, and air pollution data for Ningbo City were collected for the period from January 2012 to December 2014. A total of 86,695 HFMD cases were enrolled in this study. We used a distributed lag nonlinear model (DLNM) with Poisson distribution to analyze the nonlinear lag effects of daily mean temperature, daily humidity, and found significant relationships with the incidence of HFMD; in contrast, PM10 level showed no relationship to the incidence of HFMD. Our findings will facilitate the development of effective preventive measures and early forecasting of HFMD outbreaks.

Apodemus agrarius is a potential natural host of severe fever with thrombocytopenia syndrome (SFTS)-causing novel bunyavirus.

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne, novel bunyavirus-caused emerging infectious disease. It becomes a threat to public health due to its high fatality rate. OBJECTIVE: To clarify the epidemiological characteristics of SFTS and natural host(s) of SFTS-causing virus (SFTSV) in East China. STUDY DESIGN: Serum antibody against SFTSV in 496 healthy villagers was examined by ELISA. SFTSV in acute sera of SFTS cases and lung tissues of house and field mouse/rats were identified using quantitative RT-PCR, cell culture, and sequencing. RESULTS: A total of 22 laboratory-confirmed SFTS cases were diagnosed between 2012 and 2014, of which 5 (22.7%) reported a history of tick-bites. The seroprevalance of SFTSV antibody was 10.5% in healthy villagers. SFTSV genomic RNAs were identified in 2 of 8 Apodemus agrarius but not in Rattus norvegicus (n=40) and Rattus losea (n=4). The 3 segments of SFTSV from 11 SFTS cases and 2 A. agrarius were successfully sequenced. Phylogenetic analyses indicated that at least 3 different SFTSV strains (inland-type, Ningbo-native-type, and their reassortant-type) were present in Ningbo. The 3 segments of the 2 SFTSV isolates from A. agrarius shared great sequence homologies to those isolated from the patients living in nearby villages. CONCLUSION: The present study indicated that A. agrarius might be a natural host of SFTSV in East China.

Long-term clinical observation of the immunogenicity of inactivated hepatitis A vaccine in children.

110 children who were given the complete course of the inactivated hepatitis A vaccine (Havrix) were followed up 10 years later. Age-matched healthy children who were not inoculated served as controls. One month after two primary injections, all children were positive for serum antibody. After 10 years, 99.09% of inoculated children remained positive for serum anti-HAV antibody, with a geometric mean concentration (GMC) of 61.59mIU/mL. GMC values following a secondary immunization in children with antibody levels <20mIU/mL were significantly elevated (567.9mIU/mL), compared with the primary injection alone. Havrix appears to induce persistent immunity and potent immune memory.

[Levels of transition on maternal transferred measles antibody in infants in 3 cities in China].

OBJECTIVE: To understand the epidemiological characteristics of age distribution of measles and related policies on measles vaccines (live; MV) in infants through analyzing the antibody levels of comparison in maternal-infant pairs. Transition of immunity in infants was also studied to provide theoretic basis for measles immunization strategy and to reduce the incidence of month-old infants. METHODS: In cities of Ningbo, Harbin, and Jinan from Zhejiang, Heilongjiang and Shandong provinces, data was collected from 2004 to 2007 and analyzed regarding the epidemic situation of measles. Studies on maternal-transferred measles antibody were carried our sero-epidemiologically. RESULTS: Most of the measles cases were found among babies younger than 12 months, and the incidence of < 1 year olds had been increasing. The distribution was dominated by 5 - 8 month olds in infant measles cases. The positive rate and GRMT of measles antibody in newborns were 89.3 percent and 738.93. The positive rate of the measles antibody and GMRT of the 6-month infant were 6.9% and 6.89, while 6.7% and 3.69 in 8-month infant. There was a declining trend of the positive rate of the measles antibody during the newborns to 8-month infant. The positive rate and GRMT of measles antibody in mothers were 84.3 percent and 516.94. Mother's measles antibodies mainly to be at low and moderate level, which accounted for 50.4 percent and 30.3 percent respectively, the correlation coefficient between mother and infant was 0.840. CONCLUSION: Maternal-transferred measles antibody decreased as the growth of infants. The positive rates of measles antibody were quite low in 6-month and 8-month olds which were the age range that needs most attention.