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BACKGROUND: High-quality mental health services can improve outcomes for people with mental health problems and abate the burden of mental disorders. We sought to identify the challenges the country's mental health system currently faces and the human resource situation related to psychological services and to provide recommendations on how the mental health workforce situation could be addressed in China. METHODS: This study used a cross-sectional survey design. A web-based questionnaire approach and a convenience sampling method were adopted. It was carried out from September 2020 to January 2021 in China, and we finally included 3824 participants in the analysis. Descriptive statistical analysis of the characteristics of the study sample was performed. The risk factors for competence in psychological counseling/psychotherapy were assessed using multiple linear regression analysis. RESULTS: Workforce related to psychotherapy is scarce in China, especially in Western China and community mental health sectors. Psychiatrists (39.1%) and nurses (38.9%) were the main service providers of psychotherapy in psychiatric hospitals, and clinical psychologists (6.9%) and counsellors (5.0%) were seriously scarce in mental health care sectors. A total of 74.2% of respondents had no systematic psychological training, and 68.4 and 69.2% of them had no self-experience and professional supervision, respectively. Compared with clinical psychologists and counselors, psychiatrists and nurses had less training. Systematic psychological training (ß = - 0.88), self-experience (ß = - 0.59) and professional supervision (ß = - 1.26) significantly influenced psychotherapy capacity (P<0.001). CONCLUSIONS: Sustained effort will be required to provide a high-quality, equitably distributed psychotherapy workforce in China, despite challenges for community mental health sectors and western China being likely to continue for some time. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits.
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Serviços de Saúde Mental , China , Estudos Transversais , Atenção à Saúde , Humanos , Recursos HumanosRESUMO
Today, autogenous bone graft (ABG) is still considered as the gold standard for joint fusion. Recombinant human platelet-derived growth factor-BB (rhPDGF-BB) which is of chemotactic and mitogenic to mesenchymal stem cells and possesses outstanding osteogenetic potentials has been used for ankle and foot fusion in recent years. The goal of this article is to evaluate the safety and efficacy of rhPDGF-BB versus ABG in foot and ankle fusion. The PubMed MEDLINE, EMBASE, Web of Science, and Cochrane Library were systematic searched. Finally, three randomized controlled trials (RCTs) with 634 patients were enrolled in this study. Results of radiologic effectiveness which included CT and radiographic union rates revealed that there was no significant difference between rhPDGF-BB approach and ABG approach. Analysis of clinical results held the same outcomes expect that ABG group was superior in long-term Short Form-12 physical component scores. The pooled results also demonstrated that rhPDGF-BB was as safe as ABG in foot and ankle surgery. However, autograft harvesting procedure has some drawbacks such as donor-site pain and morbidity, additional operation time, blood loss, and scarring, which can be overcome by rhPDGF-BB. Thus, rhPDGF-BB is a viable alternative to autograft in foot and ankle fusion surgery. Yet, more high-quality RCTs with long-term follow-up are still required to make the final conclusion.
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Indutores da Angiogênese/uso terapêutico , Articulação do Tornozelo , Artrodese , Transplante Ósseo , Artropatias/cirurgia , Proteínas Proto-Oncogênicas c-sis/uso terapêutico , Becaplermina , Humanos , Artropatias/diagnóstico , Artropatias/etiologia , Transplante AutólogoRESUMO
Atmospheric water harvesting has emerged as an efficient strategy for addressing the global challenge of freshwater scarcity. However, the in being energy-consuming water-collecting process has obstructed its practicality. In this work, a soft drain bed, which was composed of hydrophilic cloth and hygroscopic gel, has been demonstrated to capture atmospheric water effectively, followed by converting it into liquid water spontaneously and sustainably, under all-weather humidity conditions. Under the optimal working condition of 30°C with a relative humidity level of 75%, the bed can provide a spontaneous water oozing ability of 1.25 g (liquid water)/hour within the 8 h of working time. More importantly, after 5 working cycles, 80% of the oozing ability can be reserved, suggesting the high potential for practical freshwater supply application. The proposed design strategy is expected to provide new hints for the development of future energy-saving decentralized freshwater supply systems.
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With the normalization of deep mining, the risk of residual coal spontaneous combustion (CSC) in deeply mined areas has gradually increased. To investigate the thermal characteristics and microgroup transformation mechanisms during the secondary oxidation of deep-well oxidized coal, a deep-well oxidation process was simulated in a synchronous thermal analyzer, and the thermal parameters of the oxidized coal were tested. The correlated transformation pathways of microscopic active groups was studied by electron paramagnetic resonance (EPR) and in situ diffuse reflectance (in situ FTIR) experiments during the reoxidation of oxidized coal. The results showed that with increasing deep-well ambient temperature and oxidation temperature, the characteristic temperature of coal gradually decreased, exothermic heat release gradually increased, and active aliphatic structures and -OH, -CHO and other active functional groups gradually accumulated and became distributed more uniformly. When the thermal conditions and oxidation temperature were very high (> 160 °C), the active free radicals in the oxidized coal were rapidly consumed, resulting in a gradual decrease in the characteristic temperature and heat release during the secondary oxidation process, while the contents of peroxy and carboxyl groups continued to increase. In the slow oxidation stage of oxidized coal, methyl groups were mainly transformed with hydroxyl and peroxide groups (r > 0.96), and the associated oxidative consumption of -CHO and -COOH mainly occurred in the rapid oxidation stage (r > 0.99). Geminal diols and peroxy groups are important intermediates in the coal-oxygen composite reaction process. With an increase in the deep-well temperature and initial oxidation temperature, the reoxidation tendency and heat release capacity of residual coal in the goaf gradually increased, and the risk of CSC intensified. The research results provide a theoretical reference for the prevention and control of coal fires in deep mines and play an important role in guiding environmental management and gas emissions reduction measures in mining areas.
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Carvão Mineral , Incêndios , Combustão Espontânea , Temperatura , Temperatura AltaRESUMO
In recent decades, respiratory infections, including SARS, HINI and the currently spreading COVID-19, caused by various viruses such as influenza and coronavirus have seriously threatened human health. It has generated inconsistent recommendations on the mandatory use of facemasks across countries on a population level due to insufficient evidence on the efficacy of facemask use among the general population. This meta-analysis aimed to explore (1) the efficacy of facemask use on preventing respiratory infections, and (2) the perceptions, intentions, and practice about facemask use among the general population worldwide. We searched PubMed, MEDLINE, Web of Science, Cochrane, bioRxiv, and medRxiv databases since inception to August 17, 2020. From 21,341 records identified, eight RCTs on facemask in preventing infections and 78 studies on perception, intention, and practice of facemask use among the general population were included in the analysis. The meta-analysis of RCTs found a significant protective effect of facemask intervention (OR = 0.84; 95% CI = 0.71-0.99; I2 = 0%). This protective effect was even more pronounced when the intervention duration was more than two weeks (OR = 0.76; 95% CI = 0.66-0.88; I2 = 0%). The meta-analysis of observational studies on perception, intention, and practice on facemask use showed that 71% of respondents perceived facemasks to be effective for infection prevention, 68% of respondents would wear facemasks, and 54% of respondents wore facemasks for preventing respiratory infections. Differences in perception, intention, and practice behavior of facemask use in different regions may be related to the impact of respiratory infections, regional culture, and policies. The governments and relevant organizations should make effort to reduce the barriers in the use of facemasks.
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COVID-19 , Infecções Respiratórias , Humanos , Máscaras , Infecções Respiratórias/prevenção & controle , SARS-CoV-2RESUMO
BACKGROUND: Vaccination is an important preventive measure against the coronavirus disease 19 (COVID-19) pandemic. We aimed to examine the willingness to vaccination and influencing factors among college students in China. METHODS: From March 18 to April 26, 2021, we conducted a cross-sectional online survey among college students from 30 universities in Wuhan, Hubei Province, China. The survey was composed of the sociodemographic information, psychological status, experience during pandemic, the willingness of vaccination and related information. Students' attitudes towards vaccination were classified as 'vaccine acceptance', 'vaccine hesitancy', and 'vaccine resistance'. Multinomial logistic regression analyses were performed to identify the influencing factors associated with vaccine hesitancy and resistance. RESULTS: Among 23,143 students who completed the survey, a total of 22,660 participants were included in the final analysis with an effective rate of 97.9% after excluding invalid questionnaires. A total of 60.6% of participants would be willing to receive COVID-19 vaccine, 33.4% were hesitant to vaccination, and 6.0% were resistant to vaccination. Social media platforms and government agencies were the main sources of information vaccination. Worry about the efficacy and adverse effects of vaccine were the top two common reason of vaccine hesitancy and resistance. Multiple multinomial logistic regression analysis identified that participants who worried about the adverse effects of vaccination were more likely to be vaccine hesitancy (aOR = 2.44, 95% CI = 2.30, 2.58) and resistance (aOR = 2.71, 95% CI = 2.40, 3.05). CONCLUSION: More than half of college students are willing to receive the COVID-19 vaccine, whereas nearly one-third college students are still hesitant or resistant. It is crucial to provide sufficient and scientific information on the efficacy and safety of vaccine through social media and government agencies platforms to promote vaccine progress against COVID-19 and control the pandemic in China.
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COVID-19 , Vacinas , COVID-19/prevenção & controle , Vacinas contra COVID-19 , China , Estudos Transversais , Humanos , SARS-CoV-2 , Estudantes , VacinaçãoRESUMO
BACKGROUND: Trauma experience increases the risk of suicidal ideation, but little is known about potentially psychological mechanisms underlying this relationship. This study aims to examine the relationship between coronavirus disease 2019 (COVID-19)-related traumatic event (CTE) exposure and suicidal ideation among hospital workers, and identify mediating roles of sleep disturbances in this relationship. METHODS: Workers in seven designated hospitals in Wuhan, China, were invited to participate in an online survey from May 27, 2020, to July 31, 2020. Participants completed a self-report questionnaire to evaluate demographic characteristics, level of CTE exposures, nightmare frequency, insomnia severity, symptoms of depression and anxiety, and suicidal ideation. A series of correlation analyses were performed, and a mediation model was generated to examine correlations between CTE exposure, sleep disturbances, and suicidal ideation. RESULTS: A total of 16,220 hospital workers were included in the final analysis, 13.3% of them reported suicidal ideation in the past month. CTE exposure was significantly associated with insomnia severity, nightmare frequency, and suicidal ideation. After controlling potential confounders, nightmares but not insomnia, depression, or anxiety were shown to be independent risk factors for suicidal ideation. Pathway analyses showed that the relationship between CTE exposure and suicidal ideation was fully mediated by nightmares (proportion mediated 66.4%) after adjusting for demographic characteristics and psychological confounders. LIMITATIONS: Cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS: CTE exposure increases risk of hospital workers' suicidal ideation that is mediated by nightmares, suggesting nightmares intervention might be considered as a component when developing suicide prevention strategies.
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COVID-19 , Distúrbios do Início e da Manutenção do Sono , Estudos Transversais , Sonhos/psicologia , Humanos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Ideação SuicidaRESUMO
COVID-19 might have long-term mental health impacts. We aim to investigate the longitudinal changes in mental problems from initial COVID-19 peak to its aftermath among general public in China. Depression, anxiety and insomnia were assessed among a large-sample nationwide cohort of 10,492 adults during the initial COVID-19 peak (28 February 2020 to 11 March 2020) and its aftermath (8 July 2020 to 8 August 2020) using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Insomnia Severity Index. We used generalized estimating equations and linear mixed models to explore factors associated with long-term mental health symptoms during COVID-19. During the five months, mental health symptoms remained consistently elevated (baseline 46.4%; follow-up 45.1%). Long-term depression, anxiety and insomnia were associated with several personal and work-related factors including quarantine (adjusted OR for any mental health symptoms 1.31, 95%CI 1.22-1.41, p < 0.001), increases in work burden after resuming work (1.77, 1.65-1.90, p < 0.001), occupational exposure risk to COVID-19 (1.26, 1.14-1.40, p < 0.001) and living in places severely affected by initial COVID-19 peak (1.21, 1.04-1.41, p = 0.01) or by a COVID-19 resurgence (1.38, 1.26-1.50, p < 0.001). Compliance with self-protection measures, such as wearing face masks (0.74, 0.61-0.90, p = 0.003), was associated with lower long-term risk of mental problems. The findings reveal a pronounced and prolonged mental health burden from the initial COVID-19 peak through to its aftermath in China. We should regularly monitor the mental health status of vulnerable populations throughout COVID-19.
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COVID-19 , Saúde Mental , Adulto , Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Humanos , Estudos Longitudinais , SARS-CoV-2RESUMO
BACKGROUND: Kyphoplasty has been proven to be an efficient method to relieve patient suffering from osteoporotic vertebral compression fractures (OVCFs). Because of its technological superiority, unilateral kyphoplasty consumes less operative time and bone cement than traditional bilateral kyphoplasty. However, there is controversy about which method is most efficient in the treatment of OVCFs. Thus, an overall analysis should be performed to shed light on the facts corroborating both procedures. OBJECTIVE: To evaluate the safety and efficacy of unipedicular kyphoplasty versus bipedicular kyphoplasty in treating OVCFs. STUDY DESIGN: Inclusion criteria were randomized controlled trials focusing on comparing unilateral versus bilateral balloon kyphoplasty in treatment of OVCFs. The exclusion criteria contained infection, neoplastic etiology, traumatic fracture, neural compression, neurological deficit, spinal stenosis, previous surgery at the involved vertebral body, long-term use of steroids, and kyphoplasty with other invasive or semi-invasive intervention treatment. Retrospective studies, reviews, technology introductions, and biochemical trials were also excluded. SETTINGS: The PubMed MEDLINE, Cochrane Library, Web of Science, and EMBASE were systematic searched. Only randomized controlled trials published up to June 2015 comparing unilateral kyphoplasty with bilateral kyphoplasty in treatment of OVCFs were identified. METHODS: Two researchers independently screeded the works for inclusion and data extraction. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the methodological quality and evidence synthesis. RESULTS: Six articles with 563 patients were enrolled in this study. Results showed that the unilateral approach required less surgical time (MD, -23.19; 95% CI, [-27.08, -19.31]; P < 0.00001) and cement consumption (MD, -2.07; 95% CI, [-2.23, -1.91]; P < 0.00001), as well as a reduced cement leakage ratio (RR, 0.59; 95% CI, [0.35, 0.99]; P < 0.05) and improved short-term general health (MD, 1.48; 95% CI, [0.02, 2.93], P < 0.05). No significant difference was found in the visual analog scale score (short-term and long-term), Oswestry Disability Index score (mid-term and long-term) kyphotic angle reduction, restoration rate of anterior vertebral height, vertebral height loss rate, postoperative adjacent-level fractures, or in other assessments of 36-Item Short Form Health Survey parameters (short-term and long-term). LIMITATIONS: Only 6 studies were included, so that the sample size was still relatively small and publication bias could not be revealed in this study. Observation time of some data was inconsistent. All of these problems could influence the reliability of the results. CONCLUSION: Both unilateral kyphoplasty and bilateral kyphoplasty are safe and effective treatments for OVCFs. However, when operative time, cement volume, cement leakage, short-term general health, radiation dose, and hospitalization costs are taken into consideration, unilateral kyphoplasty may be the better choice. Yet, more high-quality RCTs with long-term follow-up are still required to make the final conclusion.Key words: Kyphoplasty, unilateral approach, bilateral approach, osteoporotic vertebral compression fractures, meta-analysis.