Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey.

(1) Background: The COVID-19 pandemic has not only changed people's health behavior, but also induced a psychological reaction among the public. Research data is needed to develop scientific evidence-driven strategies to reduce adverse mental health effects. The aims of this study are to evaluate the anxiety reaction of Chinese people and the related determinants during the earliest phase of the COVID-19 outbreak in China. Evidence from this survey will contribute to a targeted reference on how to deliver psychological counseling service in the face of outbreaks. (2) Methods: A cross-sectional, population-based online survey was conducted from 28 January to 5 February 2020 using an open online questionnaire for people aged 18 years or above, residing in China and abroad. The socio-demographic information of the respondents was collected, and anxiety scores were calculated. A direct standardization method was used to standardize anxiety scores and a general linear model was used to identify associations between some factors (e.g., sex, age, education, etc.) and anxiety scores. (3) Results: A total of 10,946 eligible participants were recruited in this study, with a completion rate of 98.16% (10,946/11,151). The average anxiety score was 6.46 ± 4.12 (total score = 15); women (6.86 ± 4.11) scored higher than men (5.67 ± 4.04). The age variable was inversely and significantly associated with the anxiety score (ß = -2.12, 95% CI: -2.47--1.78). People possessing higher education (ß = 1.15, 95% CI: 0.88-1.41) or a higher awareness of cognitive risk (ß = 4.89, 95% CI: 4.33-5.46) reported higher levels of anxiety. There was a close association between poor subjective health and anxiety status (ß = 2.83, 95% CI: 2.58-3.09). With the increase of confidence, the anxiety of the population exhibited a gradual decline (ß = -2.45, 95% CI: -2.77--2.13). (4) Conclusion: Most people were vulnerable to anxiety during the earliest phase of the COVID-19 outbreak in China. Younger women, individuals with high education, people with high cognitive risk and subjective poor health were vulnerable to anxiety during the epidemic. In addition, increasing confidence in resisting this pandemic is a protective determinant for individuals to develop anxiety. The findings suggest that policymakers adopt psychosocial interventions to reduce anxiety during the pandemic.

The Change of Public Individual Prevention Practice and Psychological Effect From the Early Outbreak Stage to the Controlled Stage of COVID-19 in China in 2020: Two Cross-Sectional Studies.

BACKGROUND: COVID-19 broke out in China and spread rapidly in January and February 2020. Following the prevention and control measures of the Chinese government, the outbreak was gradually brought under control after March. The changes in people's attention to the epidemic, individual prevention practice and psychological effect from the early outbreak stage to the under controlled stage need to be evaluated. METHODS: Two cross-sectional, population-based online surveys were conducted from January 28 to February 1, 2020 and from February1 to March 18, 2020. Socio-demographic information and individual protective practice were collected and the State-Trait Anxiety Inventory (STAI) was used for measuring anxiety. The range of STAI score was 5-25, and the higher the score, the more anxious it was. The respondents of the two surveys were matched on a one-to-one basis according to their province, gender, age, education, and marriage. Wilcoxon signed ranks test and Mann-Whitney U test were used to compare STAI score changes in two stages and in different demographic characteristics. RESULTS: We included 9,764 individuals in the first survey and 1,669 in the second survey, covering 30 provincial administrative regions in Mainland China. COVID-19 has affected almost every aspect of people's normal life, especially lifestyle. The proportion of people who paid attention to it every day had dropped from 97.6 to 88.9%. We identified that vast majority people wore masks when they went out. The proportion has declined from 96.5 to 92.4% for hand hygiene and from 98.4 to 95.3% for not attending parties. People's anxiety (STAI score) across the country has decreased from a median of 19 in the early outbreak stage to a median of 12, including people with all demographic characteristics, but some have increased in 16 provinces. CONCLUSION: People's attention to information about the epidemic has declined slightly, but a high proportion of people maintained good practices such as wearing masks, hand hygiene, and not attending parties. People's anxiety had generally declined from the early outbreak stage to the under controlled stage, but it was still at a high level.

Dietary purslane (Portulaca oleracea L.) promotes the growth performance of broilers by modulation of gut microbiota.

Purslane is a widespread wild vegetable with both medicinal and edible properties. It is highly appreciated for its high nutritional value and is also considered as a high-quality feed resource for livestock and poultry. In this study, Sanhuang broilers were used to investigate the effect of feeding purslane diets on the growth performance in broilers and their gut microbiota. A total of 48 birds with good growth and uniform weight were selected and randomly allocated to four treatment groups A (control), B, C and D. Dietary treatments were fed with basal diet without purslane and diets containing 1%, 2% and 3% purslane. The 16S rDNA was amplified by PCR and sequenced using the Illumina HiSeq platform to analyze the composition and diversity of gut microbiota in the four sets of samples. The results showed that dietary inclusion of 2% and 3% purslane could significantly improve the growth performance and reduce the feed conversion ratio. Microbial diversity analysis indicated that the composition of gut microbiota of Sanhuang broilers mainly included Gallibacterium, Bacteroides and Escherichia-Shigella, etc. As the content of purslane was increased, the abundance of Lactobacillus increased significantly, and Escherichia-Shigella decreased. LEfSe analysis revealed that Bacteroides_caecigallinarum, Lachnospiraceae, Lactobacillales and Firmicutes had significant differences compared with the control group. PICRUSt analysis revealed bacteria mainly enriched in carbohydrate metabolism pathway due to the additon of purslane in the diet. These results suggest that the addition of purslane to feed could increase the abundance of Lactobacillus in intestine, modulate the environment of gut microbiota and promote the metabolism of carbohydrates to improve its growth performance. This study indicates that the effect of purslane on the growth-promoting performance of broilers might depend on its modulation on gut microbiota, so as to provide a certain scientific basis for the application of purslane in the feed industry.

Public Awareness, Individual Prevention Practice, and Psychological Effect at the Beginning of the COVID-19 Outbreak in China.

BACKGROUND: The COVID-19 has spread to more than 200 countries and territories. But less is known about the knowledge, protection behavior and anxiety regarding the outbreak among the general population. METHODS: A cross-sectional, population-based online survey was conducted in China and abroad from January 28 to February 1, 2020. Socio-demographic information was collected and knowledge scores, practice scores, anxiety scores and perceived risk were calculated. General linear model and binary logistic regression were used to identify possible associations. RESULTS: We included 9,764 individuals in this study, and 156 (1.6%) were from Hubei Province. The average knowledge score was 4.7 (standard deviation, 1.0) (scored on a 6-point scale); 96.1% maintained hand hygiene, and 90.3% of participants had varying levels of anxiety. People in Hubei Province were the most anxious, followed by those in Beijing and Shanghai. People who had experienced risk behaviors did not pay more attention to wearing masks and hand hygiene. CONCLUSIONS: The public had high awareness on knowledge of COVID-19 outbreak, and a high proportion of people practiced good hand hygiene behavior. Many people claimed anxiety, especially in heavily affected areas during pandemic, suggesting the importance of closing the gap between risk awareness and good practice and conduct psychological counseling to public and patients.

Do Male University Students Know Enough About Human Papillomavirus (HPV) to Make Informed Decisions About Vaccination?

BACKGROUND The aim of this study was to evaluate the awareness of human papillomavirus (HPV), knowledge of HPV-associated diseases, as well as willingness to undergo HPV vaccination among male university students in China, especially factors influencing vaccination willingness. MATERIAL AND METHODS We conducted a cross-sectional study among university students in Beijing, Tianjin, and Hebei, China by using a convenience sampling method. We assessed a) the awareness of HPV, b) knowledge of HPV-associated diseases, c) willingness to undergo HPV vaccination, and d) sexual behaviors among male university students. RESULTS A total of 1274 male university students aged 16 to 26 years old were recruited to complete a self-administered questionnaire. In total, 39.6% of students had awareness of HPV. Among students who were aware of HPV, the percentage of participating students who knew that HPV causes cervical cancer, genital warts, penile cancer, anal cancer, and oropharyngeal cancer were 94.0%, 66.1%, 32.7%, 20.4%, and 18.7%, respectively. In total, 79.0% knew that men can acquire HPV; 38.7% were willing to receive HPV vaccination. Age, region, and major were related to the awareness of HPV. In addition, students who had previous sexual experiences had more knowledge about HPV and were more likely to express willingness to vaccinate. CONCLUSIONS Male university students do not know enough about HPV infection, and males' attitudes regarding vaccination are not sufficient. Education should be provided to promote awareness of HPV-associated diseases and vaccination.

Has the public lost confidence in vaccines because of a vaccine scandal in China.

BACKGROUND: A vaccine manufacturer in China and regulatory authorities have been the focus of widespread outrage due to a vaccine scandal. We conducted a rapid survey during a time of intense mainstream and social media attention to determine whether the public's confidence in vaccines was affected. METHODS: We selected 7 cities that were not involved in the scandal as the setting for the survey, which was conducted in August 2018. We used a convenience sampling strategy to select subjects in urban streets and rural villages for a face-to-face questionnaire-based survey. Subjects were asked to describe their levels of confidence on a scale from 0 to 9, in which 0 means no confidence, and 9 means very confident. Respondents were asked to assess confidence for two points in time - recollection of their level of confidence before hearing about the scandal and their level of confidence at the time of the survey. RESULTS: In total, 683 individuals were invited to participate and 591 questionnaires were completed, for a response rate of 86.5%. Among respondents, 86.80% had heard of the vaccine scandal. The most common channel for hearing about the scandal was social media (e.g., WeChat), 40.6% of respondents. Regardless of gender, age, education level, province, town or country, or having children under 15 years old, respondents reported a significant decrease in confidence in domestically-produced vaccines. The mean pre-scandal confidence level recalled by respondents was 6.7, and the mean confidence level at the time of the survey was 3.2. Confidence in vaccine manufacturers, institutes for drug control, and drug supervision authorities decreased from 5.6 to 6.0 before the vaccine scandal to 2.0-3.2 at the time of the survey. Confidence in vaccine manufacturers decreased the most, from 5.6 before the scandal to 2.0; confidence in institutes for drug control decreased from 5.8 before the scandal to 2.6 at the time of the survey. CONCLUSION: This study demonstrated that public confidence was significantly affected by the vaccine scandal, particularly for vaccine producers and drug regulators. The decline in confidence is a reminder to governments that in order to build public confidence for vaccination, regulators have to reform regulatory practices and manufacturers have to ensure vaccine quality.