Prevalence of psychological symptoms and associated risk factors among nurses in 30 provinces during the COVID-19 pandemic in China

Background With the outbreak of the coronavirus disease 2019 (COVID-19), nurses have won well-deserved recog-nition for their indispensable roles in providing humane and professional healthcare for patients. However, by the nature of their role working at the forefront of patient care, nurses are prone to experiencing mental health conse-quences. Therefore, we pay attention to measuring the magnitude of psychological symptoms and identifying associ-ated factors among nurses in China.Methods We launched a nationwide, cross-sectional survey of nurses who worked in secondary or tertiary hospitals and public or private hospitals from 30 provinces in China. The prevalence and severity of symptoms of burnout, depression, and anxiety were investigated, respectively. Multivariable logistic regression analyses were performed to identify factors associated with each psychological symptom.Findings A total of 138 279 respondents who worked in 243 hospitals completed this survey. A substantial propor-tion of nurses reported symptoms of burnout (34%), depression (55.5%), and anxiety (41.8%). In line with the dispro-portionality of economic development, we noted that the middle or western region was an independent risk factor for depression and anxiety. Compared with those working in the secondary hospital, nurses who worked in tertiary hospitals were associated with a higher likelihood of burnout and depression.Interpretation Nurses are experiencing emotional, physical, and mental exhaustion during the COVID-19 epidemic. Governments and health policymakers need to draw attention to reinforcing prevention and ameliorating counter-measures to safeguard nurses' health.Funding The strategic consulting project of the Chinese Academy of Engineering [2021-32-5]. Advanced Institute of Infomation Technology, Peking University, Zhejiang Province [2020-Z-17]Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Interpersonal-function topoi in Chinese central government's work report (2020) as epidemic (counter-)crisis discourse

Using Systemic Functional Grammar and conceptual framework in the argumentation-oriented approach to discourse, this study analyzes Chinese central government's " Report on the Work of the Government" in 2020 (henceforth the Report) to explore the "interpersonal-function topoi" in the political discourse. The Report was delivered and issued against the backdrop of the surging covid-19 epidemic. This study first calculated the frequency of mood, modality and persons in the Report. The statistics were qualitatively analyzed in relation to various topoi-imagery of the crisis vis-a-vis representing the agency-reflected in the interpersonal metafunction of the language in the Report. These topoi play a vital role in winning popular support for the Chinese central government's anti-epidemic measures and mobilizing the widest public into actions against the covid-19 pandemic. The analysis demonstrates how the analysis of interpersonal metafunction from an argumentation-oriented perspective can shed light on dealing with crisis discourse, especially in the pandemic settings.

A Multi-Service Composition Model for Tasks in Cloud Manufacturing Based on VS-ABC Algorithm

This study analyzes the impact of Industry 4.0 and SARS-CoV-2 on the manufacturing industry, in which manufacturing entities are faced with insufficient resources and uncertain services;however, the current study does not fit this situation well. A multi-service composition for complex manufacturing tasks in a cloud manufacturing environment is proposed to improve the utilization of manufacturing service resources. Combining execution time, cost, energy consumption, service reliability and availability, a quality of service (QoS) model is constructed as the evaluation standard. A hybrid search algorithm (VS-ABC algorithm) based on the vortex search algorithm (VS) and the artificial bee colony algorithm (ABC) is introduced and combines the advantages of the two algorithms in search range and calculation speed. We take the customization production of automobiles as an example, and the case study shows that the VS-ABC algorithm has better applicability compared with traditional vortex search and artificial bee colony algorithms.

Assessing the asymptomatic proportion of SARS-CoV-2 infection with age in China before mass vaccination

Some asymptomatic individuals carrying SARS-CoV-2 can transmit the virus and contribute to outbreaks of COVID-19. Here, we use detailed surveillance data gathered during COVID-19 resurgences in six cities of China at the beginning of 2021 to investigate the relationship between asymptomatic proportion and age. Epidemiological data obtained before mass vaccination provide valuable insights into the nature of pathogenicity of SARS-CoV-2. The data were collected by multiple rounds of city-wide PCR testing with contact tracing, where each patient was monitored for symptoms through the whole course of infection. The clinical endpoint (asymptomatic or symptomatic) for each patient was recorded (the pre-symptomatic patients were classified as symptomatic). We find that the proportion of infections that are asymptomatic declines with age (coefficient = -0.006, 95% CI: -0.008 to -0.003, p < 0.01), falling from 42% (95% CI: 6-78%) in age group 0-9 years to 11% (95% CI: 0-25%) in age group greater than 60 years. Using an age-stratified compartment model, we show that this age-dependent asymptomatic pattern, together with the distribution of cases by age, can explain most of the reported variation in asymptomatic proportions among cities. Our analysis suggests that SARS-CoV-2 surveillance strategies should take account of the variation in asymptomatic proportion with age.

Experience with Travel Mobile Apps and Travel Intentions-The Case of University Students in China

The popularization of smart phones has fostered the use of e-hailing apps, which can effectively reduce information asymmetry and provide ease and convenience during travel. Meanwhile, problems such as product homogeneity, slow operation speed, and interface confusion in travel apps also exist, leading to negative user experience. Building on the theory of planned behavior and technology acceptance model, this study examines multiple features of travel apps and their influence on university students' experience and travel intentions. Findings of the study suggest that, compared to the contents of travel apps, the ease of use seems to have a stronger influence on students' attitude, perceived behavioral control, and travel intention. The study contributes to the integration of the technology acceptance model and the theory of planned behavior in travel contexts. The findings also offer meaningful practical implications and recommendations on product and service design to relevant stakeholders willing to offer a better travel app user experience.

Chinese travellers' mobility decision-making processes during public health crisis situations: a Bayesian network model

Travellers' mobility decisions are fraught with uncertainty and instability during public health crises. However, existing studies have not revealed the internal mechanism of travellers' mobility changes in a public health crisis. This paper established and trained a Bayesian network model from multiple data to analyse Chinese travellers' mobility decision-making processes under COVID-19 and simulated the changes in mobility decisions in different scenarios. The results show that travellers reformulate mobility decisions in response to various information and negotiate between social customs and personal needs. Mobility can be modified through risk communication and habits adaptation. Bayesian network models provide a methodological contribution to causal exploration and scenario prediction.

Providing social support for adults with cystic fibrosis during the COVID-19 pandemic: Pilot study of a web-based support group

Introduction: Heightened anxiety and social isolation were experienced among our Northwell Health adult cystic fibrosis (CF) population during the first wave of the COVID-19 pandemic in New York. To mitigate this, clinical staff implemented a web-based support group. Herein, we compare pre/post psychosocial factors and knowledge among participants. Methods: Adults from Northwell Health's CF Clinic participated in a 10-session, CF social worker-moderated, live, web-based support group study comprised of 6 open and 4 topic-based sessions covering: pre-lung transplant preparation, anxiety/mental health, nutrition, and a presentation by a lung transplant team. Participants completed baseline surveys: demographics and needs assessment, baseline/final session: GAD-7(anxiety), PHQ-9(depression), UCLALS(UCLA Loneliness Scale), and COVID-19 Impact Scale, pre/post topic session knowledge tests, and a 1-time final assessment. Sessions were audio recorded and transcribed for content analysis. Results: Between May 14-September 24, 2020, 9 CF adults (6 female/3 male) participated. Average pre-support group needs assessment scores showed most participants believed there was greater need for support, education and social interaction for CF adults (12.77/total score 15). Baseline/final scores showed average improvement for anxiety, depression and COVID-19 impact - decreased scores: GAD-7 (7.33/7.11), PHQ-9 (8/6.11) and COVID-19 impact (16.44/15.55), but increased loneliness: UCLALS (20.22/23.33), perhaps due to the toll of long-term quarantine. Pre/post knowledge scores from topic sessions showed slightly increased average scores for pre-lung transplant preparation (3.25/3.75/total score 4), nutrition guidelines (3.66/4/total score 4), and lung transplant team presentation (3.00/3.34/total score 4), but no change in CF anxiety/mental health knowledge (3.25/3.25/total score 4). Post-support group evaluations showed participants found the support group beneficial (68.11 out of total score of 80). Content analysis revealed participants' anxiety from family/friends not taking seriously COVID-19 risks to people with CF, and isolation from feeling “left behind” as the wider society reopened during summer months. Participants shared different COVID- 19 coping strategies (e.g., viewing opera online, meditation apps, outdoor exercise). Participants were concerned about the pandemic's toll on the well-being of their non-CF family members who were practicing strict social distancing to protect the CF person. While some participants had prior social interactions with other CF individuals, other participants stated they rarely/never interacted with other CF people and, therefore, expressed positive sentiments about their support group experiences. Conclusions: Our CF adult support group provided opportunities for social interaction and CF-specific education during the first wave of the COVD-19 pandemic, resulting in decreased anxiety and depression, and increased knowledge about CF treatment and long-term health. .

Traditional Chinese Medicine guidelines for coronavirus disease 2019

OBJECTIVE: To summarize the evidence from Traditional Chinese Medicine (TCM) practice in the treatment of coronavirus disease 2019 (COVID-19) and provide timely clinical practice guidance. METHODS: The guidelines were developed in accordance with the World Health Organization rapid guideline process. The evidence on TCM for COVID-19 from published guidelines, direct and indirect published clinical evidence, first hand clinical data, and expert experience and consensus were collected. The grading of recommendations assessment, development and evaluation (GRADE) method was used to grade the evidence and make the recommendations. RESULTS: Based on the available evidence, the guidelines recommended 17 Chinese medicines for COVID-19: 2 Chinese herbal granules, 7 Chinese patent medicines, and 8 Chinese herbal injections. CONCLUSION: As the literature search was conducted on March, any subsequent versions of these guidelines require an up-to-date literature review. We hope that the evidence summary in these guidelines will be helpful in global efforts to address COVID-19. (C) 2020 JTCM. All rights reserved.

[Analysis of the first cluster of cases in a family of COVID-19 in Gansu Province].

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.

[Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China].

Objective: To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus (2019-nCoV) infection in children from six provinces (autonomous region) in northern China. Methods: A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces (autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong. Results: The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months-17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted >3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 10%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate (19%, 4/21), procalcitonin (4%,1/28), liver enzyme (22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred. Conclusions: In this case series, 2019-nCoV infection in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis of 2019-nCoV infection. After general treatment, the short-term prognosis is good.

[Analysis of the first cluster of cases in a family of novel coronavirus pneumonia in Gansu Province].

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.