Adolescence exposure to China's great famine period and the association of metabolic syndrome in adulthood: a retrospective study.

BACKGROUND: Exposure to famine during early life is related to several adverse health outcomes in adulthood, but the effect of famine exposure during adolescence is unclear. This study aims to examine whether exposure to famine in adolescence is associated with metabolic syndrome (MetS) in adulthood. METHODS: This study included 4130 Chinese adults (2059 males and 2071 females) aged 59-71 from the 2011 China Health and Retirement Longitudinal Study (CHARLS). All the selected participants were exposed to the three-year time period (1959-1961) of China's Great Famine. Participants were categorized into an adolescent-exposed group (born 01/01/1944-12/31/1948) and a non-adolescent-exposed group (born 01/01/1940-12/31/1941 and 01/01/1951-12/31/1952). Sex-stratified multiple logistic regression models were used to estimate the association between exposure to famine in adolescence and MetS. RESULTS: Participants exposed to famine during adolescence were more likely to report MetS (aOR = 1.35; 95%CI 1.01-1.78) compared to the non-adolescent-exposed group. Further, males were 45% less likely to report MetS than females (aOR = 0.55; 95%CI 0.36-0.83). After stratification by sex, the effects of famine exposure during adolescence on MetS were detected among males only (aOR = 1.97; 95%CI 1.20-3.24). Additionally, males with a history of drinking were more likely to report MetS compared to those with no history of drinking (aOR = 2.63; 95%CI 1.41-4.90). CONCLUSIONS: Our findings reveal that exposure to famine during adolescence is associated with higher odds of MetS in adulthood overall, and this association is only pronounced among males. This study emphasizes that undernutrition in early life, including adolescence, may have a long-term effect and be associated with adverse health events in middle-to-late life. Targeting those elderly people who suffered famine during adolescence may help prevent the development of MetS in later life.

Is there an association among sleep duration, nap, and stroke? Findings from the China Health and Retirement Longitudinal Study.

PURPOSE: The objective of this study was to assess the association among nighttime sleep, daytime napping, total sleep duration (nighttime sleep plus daytime napping), and stroke in an elderly Chinese population. METHODS: Data were derived from the 2011 China Health and Retirement Longitudinal Study (CHARLS) with 4785 Chinese respondents over 65 years old. Four binary logistic regression models were used to estimate odds ratios and 95% confidence intervals of the association among total sleep duration, nighttime sleep, daytime napping, and stroke, adjusting for confounders. RESULTS: After controlling for sociodemographic characteristics, lifestyle, health status, and comorbidity, there was no association between abnormal nighttime sleep and stroke (P values > 0.05). Compared to individuals with normal total sleep duration (7-8 h per day), short sleep duration (< 7 h per day) was approximately two times more likely to increase the risk of stroke (AOR = 1.81, 95%CI 1.10-2.97). Individuals who reported vision impairment, disability, hypertension, dyslipidemia, and mental health issues were at higher risk of stroke. In addition, physical activities with different levels were associated with a lower risk of stroke. Taking naps was not associated with stroke incidence (AOR = 1.12, 95%CI 0.77-1.64). CONCLUSION: In this elderly Chinese population, short total sleep duration per 24 h, not merely daytime napping or nighttime sleep, was significantly associated with an increased risk of stroke. Preventive measures for stroke may require a focus on elderly, sedentary individuals who report other health problems.

The Association Between Pain and Fall Among Middle-Aged and Older Chinese.

BACKGROUND: Falls and fall-induced injuries in elderly people are common worldwide. However, few reports have examined the association between body pain and fall in middle-aged and older Chinese adults. The objective of this study is to access the association between pain and fall among middle-aged and older Chinese. METHODS: Data were drawn from the 2011 China Health and Retirement Longitudinal Study (CHARLS) from respondents who were middle-aged and older (over 45 years old). A logistic regression model was used to estimate the odds ratios (AOR) and 95% confidence interval (95% CI) of the association between body pain and fall, after controlling for confounders. RESULTS: After adjusting for demographic characteristics, socioeconomic status, lifestyle, health status and comorbidity, those participants who had pain were 73% more likely to report falls than those who did not have pain (AOR = 1.73, 95% CI 1.56-1.92). Elder age was associated with a higher risk of fall (AOR = 1.77, 95% CI 1.47-2.13). Comparing to female, male was associated with a lower risk of fall (AOR = 0.64, 95% CI 0.56-0.74). Lifestyle such as drinking status, self-reported health status, chronic diseases, vision impairment and disability were significantly associated with fall. CONCLUSION: Body pain is significantly associated with fall among middle-aged and older Chinese adults. Appropriate pain management programs and policies are needed in fall prevention.

Do post-COVID-19 symptoms exist? A longitudinal study of COVID-19 sequelae in Wenzhou, China.

OBJECTIVE: We conducted a cohort of tracing discharge patients of COVID-19. MATERIALS AND METHODS: We used the Mann-Whitney U test, χ2 test, or Fisher's exact test to compare differences between age groups and gender groups where appropriate. RESULTS: Our study provides insights into the nature and severity of medical conditions specific to survivors of COVID-19. CONCLUSIONS: It also highlights the potential mental health issues resulting from infectious disease outbreaks within communities.

OBJECTIFS: Nous avons suivi une cohorte de patients à la sortie du COVID-19. MATÉRIAUX ET MÉTHODES: Nous avons utilisé les test de Mann­Whitney U, de Fisher ou du Chi2 pour comparer les différences entre les groupes d'âge et de genre, le cas échéant. RÉSULTATS: Notre étude fournit un aperçu de la nature et de la gravité des troubles médicaux propres aux survivants du COVID-19. CONCLUSIONS: Elle met également en lumière les problèmes de santé mentale potentiels découlant des éclosions de maladies infectieuses dans les collectivités.

Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020.

To determine possible modes of virus transmission, we investigated a cluster of coronavirus disease cases associated with a shopping mall in Wenzhou, China. Data indicated that indirect transmission of the causative virus occurred, perhaps resulting from virus contamination of common objects, virus aerosolization in a confined space, or spread from asymptomatic infected persons.

Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002-2006.

INTRODUCTION: In the United States, type 2 diabetes has reached epidemic proportions among indigenous people. Community-based participatory research offers American Indian communities and university partners an opportunity to integrate skills in community action and systematic inquiry to develop locally acceptable primary prevention interventions to combat diabetes risk factors. The Hualapai Tribe and the University of Arizona designed, implemented, and assessed a school-based physical activity intervention to reduce diabetes risk factors among youth. METHODS: During a 2-year period, trained community members led in-school physical activity classes 2 times per week among students in grades 3 through 8. Body mass index (BMI), fitness measures, and fasting blood glucose level were measured on 6 occasions. Descriptive statistics and t tests were used to assess change in outcome measures. RESULTS: Of the more than 100 youth who took part in the physical activity classes for 2 years, 71 youth (38 male, 33 female) participated in 3 or more data collection sessions. Over time, the percentage of youth with a high fasting blood glucose level of more than 125 mg/dL decreased concurrently with significant improvements in fitness measures. However, BMI increased in both male and female participants. The high number of youth who missed more than 3 data collection sessions was attributed to poor school attendance and tardiness. CONCLUSION: Classes led by lay physical activity leaders can affect diabetes risk factors in youth. Incongruous health and fitness outcomes suggest that one indicator does not adequately define the risk profile; BMI alone may not be sufficient as a measure of diabetes risk in youth.

The impact of COVID-19 on health professions student's perceptions, future education and career aspirations and confidence in public health responses.

Objective: To understand student perceptions, interest and intentions of pursuing public health as a result of COVID-19 during educational experiences. Participants: Two hundred seventy-seven students completed the survey representing 38 states and two countries. Methods: An online survey was administered to current undergraduate and graduate students at two institutions. Results: The difference between the ease of attaining a public health job for nonpublic health and public health students was significant prior to (p = .002) and during the pandemic (p = .015). There was an increase of 5.8% in student interest in continuing education in public health. 13% of respondents agreed the pandemic had been handled appropriately at the national level and 33% at the state level, and 57% expressed distrust of future responses. Conclusions: This study demonstrates a positive influence of COVID-19 on the desire to seek further education and careers in public health, highlights a lack of confidence in effective future pandemic responses.

Corrigendum to: Do Stay at Home Orders and Cloth Face Coverings Control COVID-19 in New York City? Results From a SIER Model Based on Real-world Data.

[This corrects the article DOI: 10.1093/ofid/ofaa442.].

Do Stay at Home Orders and Cloth Face Coverings Control COVID-19 in New York City? Results From a SIER Model Based on Real-world Data.

BACKGROUND: Public health interventions have been implemented to contain the outbreak of coronavirus disease 2019 (COVID-19) in New York City. However, the assessment of those interventions-for example, social distancing and cloth face coverings-based on real-world data from published studies is lacking. METHODS: The Susceptible-Exposed-Infectious-Removed (SEIR) compartmental model was used to evaluate the effect of social distancing and cloth face coverings on the daily culminative laboratory confirmed cases in New York City (NYC) and COVID-19 transmissibility. The latter was measured by Rt reproduction numbers in 3 phases that were based on 2 interventions implemented during this timeline. RESULTS: Transmissibility decreased from phase 1 to phase 3. The initial R0 was 4.60 in phase 1 without any intervention. After social distancing, the Rt value was reduced by 68%, while after the mask recommendation, it was further reduced by ~60%. CONCLUSIONS: Interventions resulted in significant reduction of confirmed case numbers relative to predicted values based on the SEIR model without intervention. Our findings highlight the effectiveness of social distancing and cloth face coverings in slowing down the spread of severe acute respiratory syndrome coronavirus 2 in NYC.

Clinical features and viral RNA shedding of imported and local cases with COVID-19 in Wenzhou, China.

ABSTRACT: Wenzhou had the highest number of confirmed novel coronavirus 2019 (COVID-19) cases outside the Hubei province. The aim of this study was to identify the difference in clinical features and viral RNA shedding between the imported and local COVID-19 cases in Wenzhou.All patients with confirmed COVID-19 admitted to Wenzhou Sixth People's Hospital, Wenzhou Central Hospital Medical Group, from January 17 to February 11, 2020, were enrolled in this study. Data was analyzed and compared for the imported and local cases with regard to epidemiological, demographic, clinical, radiological features, and laboratory findings. Outcomes for the enrolled participants were followed up until May 7, 2020.Of the 136 cases, 50 were imported from Wuhan. The median age was 45 years and 73 (53.7%) were men. The most common symptoms at onset were fever (104 [76.5%]) and cough (85[62.5%]). Pleural effusion was more common among imported cases compared to local cases. The white blood cell count, neutrophil count, lymphocyte count and platelet count of the imported cases were significantly lower than those of the local cases, while the prothrombin time was significantly longer than that of the local cases. Severe and critically ill patients accounted for 15.4% and 2.9%, respectively. The median duration of SARS-CoV-2 RNA shedding from symptom onset was 26 days (IQR 17-32.3 days) and there were no significant differences in duration of viral RNA shedding between the two groups.The study findings suggest that imported cases from Wuhan were more likely to be severe compared to the local cases in Wenzhou. However, there was no difference between imported and local cases on the viral shedding among the COVID patients.

Does Exposure to Primary Care Early in the Didactic Phase of the Physician Assistant (PA) Curriculum Influence Field Choice Post-Graduation?

BACKGROUND: Over the past 10 years, the nation has witnessed a significant increase in the number of physician assistant (PA) education programs. Primary care shortages throughout the United States have reached a staggering deficiency. The purpose of this project was to expand the primary care workforce in the Commonwealth of Virginia by increasing exposure to primary care setting early in the academic didactic year of physician assistant schooling. METHODS: This innovative research project originated in 2017 and was inclusive of PA students ranging from 20 to 44 years of age, across multiple demographics, conducted during the first year of didactic studies. This cross-sections study examined a total size of 115 students over from three different cohort years that participated in the free medical clinic completed a pre/post exposure survey. RESULTS: This study highlighted that an increased exposure to primary care in the early didactic phase of physician assistant graduate studies yielded a moderate increase in the interest to pursue a career in primary care upon graduation. Throughout the 2016 to 2017, 2017 to 2018, and 2018 to 2019 academic cohorts, 19% more from baseline indicated at the end of their primary care experience that they were more likely to practice in the field of primary care following the free medical clinic experience. CONCLUSIONS: This study demonstrates a positive influence of early exposure to primary care for Physician Assistant students with the increased affinity to practice in the field upon graduation and has set a foundation for continuation of data collection in future PA cohorts.

Does Wuhan Need to be in Lockdown during the Chinese Lunar New Year?

On 23 January 2020, the government of China announced a lockdown of all public transportationdeparting from Wuhan, including airports, trains, and buses [...].

The association between the socioeconomic status and body pain: A nationwide survey.

Pain is a significant burden among different communities, but little is known regarding the epidemiology of pain, particularly with respect to socioeconomic status (SES).The aim of the study was to estimate the prevalence of body pain and to identify risk factors of pain in middle-aged and older Chinese.The data were extracted from the 2008 Chinese Suboptimal Health Study that consisted of 18,316 Chinese subjects aged 18 to 65 years. Information on SES including occupation and education levels and body pain were collected. A Likert scale was used to evaluate reported body pain. We used the multiple logistic regression model to examine the association between SES and body pain.Overall, 65.34% reported body pain (male: 60.93%; female: 69.73%). After adjustments based on sex, age, education, area of residence, marital status, smoking, drinking and health status, the results showed that students (odds ratio [OR] = 1.51; 95% confidence interval [CI]: 1.32-1.74) and professionals (OR = 1.22; 95% CI: 1.08-1.37) had significant high risk for body pain, compared with civil servants and farmers (OR = 0.64; 95% CI: 0.55-0.75) who significantly lower risk of body pain. The study demonstrates there is a significant negative association between education and reported body pain.The results indicated an association between SES and body pain within the Chinese community. Body pain varied among different Chinese occupation-related population and people with higher education level are less like to have body pain.

Systematic review of physical activity interventions implemented with American Indian and Alaska Native populations in the United States and Canada.

OBJECTIVE: To describe physical activity (PA) interventions implemented in American Indian/Alaska Native (AI/AN) populations in the United States and Canada. DATA SOURCES: MEDLINE, PubMed, ERIC, and Sociological Abstracts were used to identify peer-reviewed journal articles. Dissertation abstracts, Web sites, and conference proceedings were searched to identify descriptions within the gray literature from 1986 to 2006. STUDY INCLUSION AND EXCLUSION CRITERIA: The target population had to be described as AI/ AN, aboriginal, native Hawaiian, and/or native U.S. Samoan. PA interventions among indigenous populations of Latin America were not included. DATA EXTRACTION: Descriptions of 64 different AI/AN PA interventions (28 peer-reviewed journal articles and 36 in the gray literature) were identified. DATA SYNTHESIS: Data were synthesized by geographic region, intervention strategy, target audience, activities, and sustainability. RESULTS: Most interventions were conducted in the southwest United States (35.4%), in reservation communities (72%), and among participants 18 years and younger (57.8%). Forty-one percent of the 27 interventions with evaluation components reported significant changes in health, behavior, or knowledge. CONCLUSIONS: Effective AI/AN PA interventions demonstrated impact on individual health and community resources. Program sustainability was linked to locally trained personnel, local leadership, and stable funding. Culturally acceptable and scientifically sound evaluation methods that can be implemented by local personnel are needed to assess the health and social impact of many long-running AI/AN PA interventions.

Socioeconomic status and self-rated health in China: Findings from a cross-sectional study.

To investigate whether socioeconomic status is associated with the self-rated health (SRH) status among Chinese.A cross sectional study including a national sample was conducted among Chinese adults in 2008. In total, 3225 participants were selected by a multistage cluster sampling method. Both general self-rated health and time-comparative self-rated health were measured by a standardized questionnaire. Logistic regression models were used to estimate the odds ratios (ORs) (95% confidence intervals, CIs) of occupation with SRH by occupation, and adjusted for age, sex, education, area, marriage, smoking, drinking, and health status.Overall, 34.4% of study participants reported "good" on the general SRH (male: 35.8%; female: 32.9%) and 26.2% reported "good" on the time-comparative SRH (male: 27.2%; female: 25.3%). The prevalence of "good" general SRH varied from 28.8% to 52.8% and the prevalence of time-comparative SHR varied from 21.7% to 33.9% in different occupations. The adjusted OR (Odd Ratio) for "good" on the general SRH was 1.35 (95% CI: 1.20-1.52) for the occupation of civil servants, 2.23 (95% CI: 1.96-2.54) for farmers, and 1.15 (95%CI: 1.01-1.31) for businessmen. The full adjusted OR of "good" on the time-comparative SRH was 1.36 (95% CI: 1.17-1.58) for students and was 1.25 (95% CI: 1.10-1.42) for civil servants.In presented study, 34.4% of the participants reported "good" on the general SRH, and 26.2% participants reported "good" on the time-comparative SRH. The prevalence of "good" general SRH and "good" time-comparative SRH varied among occupations.