Development and validation of the COVID-19 vaccine beliefs scale for the Chinese population.

BACKGROUND: At present, there is no culturally appropriate scale designed to measure Chinese people's attitudes and beliefs about COVID-19 vaccines. Understanding people's attitudes and beliefs about vaccines can help policy makers and health care professionals better evaluate local beliefs to increase vaccine coverage and minimize COVID-19 vaccine hesitancy. METHODS: We developed a COVID-19 vaccine attitudes and beliefs scale comprising items based on qualitative research data. We then conducted an explorative and confirmatory factor analysis using data from two online sources. RESULTS: The 26-item vaccine belief scale includes a five-factor model: vaccine benefit (VB), vaccine concern (VC), observing others' reactions to vaccination (VR), the influence of authority and others toward vaccination (VI), and common sense about vaccination (VS). The multivariate analysis results showed that VB (OR = 1.065, 95% CI 1.035-1.097), VR (OR = 0.878, 95% CI 0.832-0.927), and VS (OR = 1.076, 95% CI 1.032-1.122) were associated with the intention to receive the vaccine. These results implied that VC (OR = 0.957, 95% CI 0.928-0.987) could predict the choice not to be vaccinated. A correlation between beliefs about vaccines and conspiracy theories and fear of COVID-19 was also found and discussed. CONCLUSIONS: These findings suggest that the locally designed and culturally sensitive scale has good reliability and validity. The questionnaire provides researchers with a standardized assessment tool to measure Chinese people's beliefs about the COVID-19 vaccine.

Factors associated with diagnostic delay in recurrent TB.

BACKGROUND: Recurrent tuberculosis (TB) contributes to the burden of TB. The study was designed to explore the time of diagnostic delay and risk of delay in patients with recurrent TB in China. METHODS: A total of 13,334 patients with new and recurrent TB registered in Yulin a city in China were included. The Kaplan-Meier survival curve was employed to estimate the median delay time. The mixed-effects survival model was used to identify the correlates associated with diagnostic delay. The outcome of interest in the model was"being diagnosed". RESULTS: We found that 6.5% of cases with TB were attributed to recurrence. The median delay time of recurrent TB cases (73 days) was more than twice as long as that of new TB (35 days). Individuals with recurrent TB had a higher risk of diagnostic delay than new TB (HR, 0.5, 95%CI, 0.5-0.6). Factors associated with diagnostic delay differed between new TB and recurrent TB cases. Immigrants (HR, 0.5, 95%CI, 0.3-0.9), cases notified by way of recommendation (HR, 0.6, 95%CI, 0.4-0.9) and diagnosed at TB dispensary (HR, 0.4, 95%CI, 0.3-0.6) were associated with a higher risk of a longer delay for recurrent TB cases. CONCLUSIONS: The proportion of TB cases attributed to recurrence was high. Patients with recurrent TB had a longer delay time and a higher risk of diagnostic delay. Further interventions to improve diagnostic delay should focus on screening for TB in immigrants, improving public health services at the lowest healthcare level and update of TB diagnosis and management model.

Religious Perfectionism Scale Among Believers of Multiple Faiths in China: Development and Psychometric Analysis.

In China, many people are converting to various world religions. Nonetheless, religious adherence for them, as with many people, can still function as a double-edged sword with regards to mental health. In particular, religious perfection can become either a healthy commitment or a rigid outlook that leads to distress. Thus, we developed the Religious Perfectionism Scale (RPS) from Chinese religious believers. In the first phase (N = 171), we collected qualitative data through an open-question survey from different religious groups (i.e., Buddhism, Protestantism, and Islam). Then, we developed an item pool based on themes that emerged from these qualitative data. In the second phase, participants (N = 1055) were randomly split into two subsamples. Exploratory factor analyses were performed on the first subsample (N = 519) to select the scale items. The nine-item RPS subsequently includes two dimensions-Zealous Religious Dedication and Religious Self-Criticism. Confirmatory factor analyses (CFA) were performed on the second subsample (N = 536) to cross-validate the factor structure. Results indicate that the internal consistency reliability for the RPS subscale scores was all adequate. Furthermore, the construct validity of the RPS was supported through its correlations with measures of perfectionism perceived to have come from God (or a higher power), psychological indicators, and a personality variable (i.e., discipline) in expected directions. Results of the psychometric evaluations of this newly developed scale suggest that the RPS is a promising measure in that it can facilitate future research that leads to a more comprehensive understanding of the impact of religious perfectionism on psychological well-being.

A novel enzyme-linked ligand-sorbent assay (ELLSA) to screening pulmonary tuberculosis: a retrospective cross-sectional study.

BACKGROUND: Little knowledge of antigen existence in the pulmonary tuberculosis (PTB) patient serum impeded its development in antigen detection technology, despite its considerable potential. METHODS: Human ligand proteins and their adsorbent Mycobacterium tuberculosis (M.tb) proteins in the serum of PTB patients were identified using human protein chip (HuProt™) and LC-MS/MS, successively. The monoclonal antibody of ligand proteins, C5orf24, and polyclonal antibody of 9 M.tb proteins were prepared on mice and rabbits which were used to develop a novel enzyme-linked ligand-sorbent assay (ELLSA). The 412 volunteers were divided into the PTB group (n = 250) and the healthy control (n = 162). The PTB group was further divided into ATB (n = 131), LTBI (n = 18), Clinical diagnosis (n = 18), and Suspected (n = 73). All samples were tested by ELLSA to evaluate the diagnostic performance of ELLSA in PTB patients. RESULTS: Nine ligand proteins specific to PTB patients were identified on chips, with Chromosome 5 Open Reading Frame 24 (C5orf24) and kinocilin (KNCN) showing significantly higher signals. Proteomic analysis of the C5orf24-and KNCN-adsorbent protein complexes revealed 10 and 10 of the M.tb proteins, respectively. According to the composition reference of standard, the ELLSA based on C5orf24 ligand demonstrated a higher sensitivity of 69.6% and specificity of 90.18% in ATB patients and had a sensitivity of 64.22% in bacterial negative pulmonary tuberculosis, whereas the sensitivity of MGIT 960 and Xpert M.tb/RIF were 0%, respectively. CONCLUSIONS: M.tb proteins in serum can be enriched by ligand proteins and detected by ELLSA which proved to have excellent diagnostic performance for PTB.

Call for Faith: Religiousness, Religious Coping and Psychological Disturbance of Chinese Christians During COVID-19.

OBJECTIVES: This study is aimed at investigating the relationships between religious practice, religious coping strategies, and mental health among Chinese Christians in the context of the COVID-19 outbreak. METHODS: A total of 915 participants from several cities in China completed online questionnaires, including sociodemographic data, mental disorder history, and years as a Christian, as well as frequency of weekly religious practice, Religious Coping Scale, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder scale (GAD-7). RESULTS: The result of multivariate analysis indicated that during the COVID-19 pandemic, among Chinese Christians without a history of mental disorder, negative religious coping were associated with depression, and anxiety symptoms. Among Chinese Christians with a history of mental disorders, comorbidity with 1 mental disorder, comorbidity with 2 or more mental disorders, negative religious coping, and positive religious coping were associated with depression symptoms. Comorbidity with 2 or more mental disorders, negative religious coping, and positive religious coping were associated with anxiety symptoms. CONCLUSION: Christians with a previous history of mental illness are more likely to experience anxiety during the epidemic. In the future, mental health services during disasters may put more attention on certain religious groups and provide more spiritual care to maintain their well-being accordingly.

The Journey of Individuation: Experiences of Chinese Patients Treated by Western Psychoanalysts in Online Psychodynamic Psychotherapy.

This qualitative study focuses on the process of treatment over the internet from a psychodynamic perspective based on the experiences of seventeen patients in China who underwent online treatment by psychoanalysts based in the United States or other Western nations. The data were collected and analyzed using psychodynamic themes. Seventeen participants involved in online cross-national and cross-cultural psychodynamic treatment were recruited in China. Various themes in regard to the process of online treatment in a cross-national and cross-cultural context emerged. Findings indicate the following: (1) in contrast to traditional relational patterns, psychodynamic treatment provides a new relationship model; (2) psychodynamic treatment creates a space of self-reflection for Chinese patients in terms of their relationships; (3) the therapeutic setting emphasizes clear boundaries, free space, equal relationships, and emotional expression for patients. The results provide new insights into self-examination, which frees patients from the inflexible aspects of traditional relationships, family hierarchies, and rigid cultural values. In addition, psychodynamic treatment in a cross-national and cross-cultural setting not only enables patients to work through their trauma but also empowers them to explore their unique journey of individuation.

Predictors of Anxiety and Depression in Medical Professionals During the Time of COVID-19 Outbreak.

OBJECTIVES: The aim of this study was to investigate the influences of sociodemographic data, mental disorder history, confusion and somatic discomfort triggered by social media on anxiety and depression symptoms among medical professionals during the coronavirus disease 2019 (COVID-19) outbreak. METHODS: A total of 460 participants completed online questionnaires that included sociodemographic data, mental health disorder history, an assessment of confusion and somatic discomfort triggered by social media, and psychological disturbance. Hierarchical linear regression model was adopted to analysis the data. RESULTS: The hierarchical linear regression model was able to explain 41.7% of variance in depression symptoms, including comorbidity with 1 mental disorder (B = 0.296; P < 0.001), confusion (B = 0.174; P < 0.001), and somatic discomfort (B = 0.358; P < 0.001) triggered by social media. The hierarchical linear regression model was able to explain 41.7% of variance in anxiety symptoms, including sex (B = -0.08; P < 0.005), comorbidity with 1 mental health disorder (B = 0.242; P < 0.001), confusion (B = 0.228; P < 0.001), and somatic discomfort (B = 0.436; P < 0.001) triggered by social media. CONCLUSIONS: These results suggest that it is important to provide adequate psychological assistance for medical professionals with mental health problems in COVID-19 to buffer the negative impact of social media.

Nosocomial tuberculosis transmission from 2006 to 2018 in Beijing Chest Hospital, China.

INTRODUCTION: Strong evidence is lacking to support effectiveness of currently implemented tuberculosis infection prevention control (TB-IPC) measures for preventing nosocomial tuberculosis (TB) transmission. This 13-year analysis is the longest follow-up investigation to date to identify risk factors underlying nosocomial TB transmission. METHODS: We monitored all staff of Beijing Chest Hospital each year from 2006 to 2018. Age, gender, duration, department, education, income, respirator, ultraviolet, and ventilation were chosen as variables. Univariate cox regression, correlation analysis, and multivariate cox regression were analyzed sequentially. RESULTS: Using multivariable cox regression analysis, variables of income, ultraviolet germicidal irradiation (UVGI), natural ventilation and mechanical ventilation conferred significant protective effects, with odds ratios of 0.499, 0.058, 0.003, and 0.015, respectively (P < 0.05). Medical N95 respirator conferred an excellent protective effect, with an associated TB infection rate of 0%. Notably, inadequately maintained mechanical ventilation systems were less protective than natural ventilation systems. CONCLUSION: UVGI, adequate ventilation, and use of medical N95 respirator may be risk factors of nosocomial TB transmission.