Psychosocial characteristics pattern correlated with suicidal ideation and non-suicidal self-injury among nurse staff: a latent profile analysis.

BACKGROUND: Nurses frequently endure elevated levels of psychosocial stress, which often correlates with an increased suicide risk. This study aimed to investigate the impact of latent psychosocial characteristic patterns on suicidal ideation and non-suicidal self-injury among nursing staff. METHOD: Participants were recruited from the Dehong districts of Yunnan province, China, between July 11th and July 26th, 2022. Subgroups were identified using variables linked to suicidal ideation and non-suicidal self-injury, including perceived cognitive deficits, anxiety symptoms, depressive symptoms, resilience, social support, childhood trauma, loneliness, and sleep quality. Measurement tools included the Perceived Deficit Questionnaire-5-item (PDQ-5), Generalized Anxiety Disorder-7 items (GAD-7), Patient Health Questionnaire (PHQ-9), Connor-Davidson Resilience Scale-10 items (CD-RISC10), Multidimensional Scale of Perceived Social Support (MSPSS), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Three-Item Loneliness Scale, and a single-item sleep quality scale. RESULTS: Latent profile analysis (LPA) revealed four distinct psychosocial characteristic patterns: "class 1," "class 2," "class 3," and "class 4." Compared to class 2, individuals in class 1 had a sixfold increased risk of suicidal ideation (OR = 6.59, 95%CI = 4.42-9.81) and a fivefold increased risk of non-suicidal self-injury (OR = 5.13, 95%CI = 3.38-7.78). Similarly, class 4 individuals had twice the risk of suicidal ideation (OR = 2.13, 95%CI = 1.25-3.62) and non-suicidal self-injury (OR = 2.13, 95%CI = 1.25-3.65) compared to class 2. Conversely, class 3 individuals had a lower risk of suicidal ideation (OR = 0.21, 95%CI = 0.11-0.42) and non-suicidal self-injury (OR = 0.15, 95%CI = 0.07-0.36) than class 2. Additionally, divorced/other marital status individuals had a higher risk of suicidal ideation (OR = 2.34, 95%CI = 1.02-5.35) and non-suicidal self-injury (OR = 2.58, 95%CI = 1.01-6.65) compared to married individuals, while unmarried individuals had a lower risk of suicidal ideation (OR = 0.58, 95%CI = 0.37-0.91). CONCLUSIONS: The study identified eight important psychosocial factors divided into four latent pattern classes. Individuals in "class 1" and "class 4" were more likely to have a higher risk of suicidal ideation and non-suicidal self-injury, while those in "class 3" were more likely to have a lower risk of both outcomes. It is suggested that further research should focus on "class 1" and "class 4" for targeted intervention.

Pathways linking workplace violence and suicidal ideation/non-suicidal self-injury among nurse staff: the mediating role of loneliness and depressive symptoms.

BACKGROUND: Nurses face disproportionately high rates of suicidal ideation and non-suicidal self-injury (NSSI). The role of workplace violence, loneliness, and depressive symptoms in exacerbating these issues is poorly understood. This study aims to explore these relationships to inform interventions for improving nurses' mental health. METHODS: A cross-sectional study involving 1,774 Chinese nurse staff selected through convenient sampling methods was conducted. Workplace violence, depressive symptoms, and loneliness were assessed using the Chinese versions of the Workplace Violence Scale (WVS), the 9-item Patient Health Questionnaire (PHQ-9), and a three-item loneliness scale, respectively. Participants completed self-report questionnaires anonymously to ensure adherence to ethical standards. Statistical analysis utilized structural equation modeling (SEM) to examine the intricate relationships among variables, thereby elucidating the impact of workplace violence, loneliness, and depressive symptoms on nurses' suicidal ideation/NSSI outcomes. RESULTS: Nurse staff 165 (7.8%) were reported different level of suicidal ideation and 139 (7.8%) participants were reported different level of NSSI. And the final model of workplace violence on suicidal ideation shown a good model fit index (CMIN/DF = 3.482 NFI = 0.969 CFI = 0.977 TLI = 0.955 RFI = 0.938, RMSEA = 0.037 SRMR = 0.035). The pathway of workplace violence to loneliness (ß = 0.163, P < 0.001), the indirect effect of workplace violence on suicidal ideation via loneliness and depressive symptoms were 0.100 (95%CI = 0.085, 0.121), the indirect effect of loneliness on suicidal ideation via depressive symptoms were 0.128 (95%CI = 0.100, 0.158). Similarly, the final model of workplace violence on NSSI shown a good model fit index (CMIN/DF = 3.482 NFI = 0.967 CFI = 0.976 TLI = 0.953 RFI = 0.935, RMSEA = 0.037 SRMR = 0.034), the pathways of workplace violence to NSSI (ß = 0.115, P < 0.001), the indirect effect of workplace violence on NSSI via loneliness and depressive symptoms were 0.075 (95%CI = 0.055, 0.096), the indirect effect of loneliness on NSSI via depressive symptoms were 0.102 (95%CI = 0.076, 0.130). CONCLUSION: Our study unveils the role of workplace violence in nurses' suicidal ideation and NSSI, mediated by loneliness and depressive symptoms. Interventions targeting workplace violence are crucial for nurses' well-being, potentially reducing loneliness and depressive symptoms and lowering the risk of suicidal ideation and NSSI. However, further research is needed to explore additional mediators and pathways, employing longitudinal designs to establish causality and develop tailored interventions for nurses affected by workplace violence.

The role of childhood left-behind experience on childhood trauma exposure and mental health outcomes: a propensity score matching (PSM) analysis.

BACKGROUND: China has a significant number of left-behind families. This study focuses on the long-term effects of childhood left-behind experience on different type of childhood trauma and mental health outcomes in later life development. METHODS: participants were 67 795 Chinese young adults. Psychosocial characteristics were screened by sleep quality, the nine-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, trauma screening questionnaire for post-traumatic stress, a short form of the Childhood Trauma Questionnaire for childhood trauma. Propensity score matching (PSM) and multivariate linear regression were applied to analyze the data. RESULTS: the results of the post-PSM analysis showed that the distributions of propensity scores for the two groups were approximately equal. And the total sample size in post-analysis dropped to 2358 (Nnuclear family = 1179, Nleft-behind family = 1179), with unmatched cases excluded. Post-matching results showed that the students from left-behind family were significantly associated with severer post-traumatic stress (b = 0.39, 95% CI = [0.15, 0.62]), loneliness (b = 0.29, 95% CI = [0.16, 0.42]), depressive symptoms (b = 0.44, 95% CI = [0.06, 0.82]) and CTQ-physical neglect (b = 0.34, 95% CI = [0.11, 0.58]). CONCLUSION: our study showed that childhood left-behind experiences are tightly related to childhood trauma experience and mental health issues (post-traumatic stress, loneliness and depression) in late adolescents.

Association between long-term exposure to ambient particulate matter and blood pressure, hypertension: an updated systematic review and meta-analysis.

Evidence of more recent studies should be updated to evaluate the effect of long-term exposure to particulate matter (PM) on blood pressure and hypertension.        Studies of long-term effects of PM1, PM2.5 and PM10 on blood pressure (SBP, DBP, MAP), hypertension were searched in Pubmed, Web of Science and Embase before May, 2021. Meta-analysis of 41 studies showed that exposure to PM1, PM2.5 was associated with SBP (1.76 mmHg (95%CI:0.71, 2.80) and 0.63 mmHg (95%CI:0.40, 0.85), per 10 µg/m3 increase in PM), all three air pollutants (PM1, PM2.5, PM10) was associated with DBP (1.16 mmHg (95%CI:0.34, 1.99), 0.31 mmHg (95%CI:0.16, 0.47), 1.17 mmHg (95%CI:0.24, 2.09), respectively. As for hypertension, PM1, PM2.5 and PM10 were all significantly associated with higher risk of hypertension (OR=1.27 (95%CI:1.06, 1.52), 1.15 (95%CI:1.10, 1.20) and 1.11 (95%CI:1.07, 1.16). In conclusion, our study indicated a positive association between long-term exposure to particulate matter and increased blood pressure, hypertension.

Impact of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region: propensity score matching analysis.

BACKGROUND: Owing to different social background factor in Yunnan-Myanmar Chinese border region, stressful working environment may lead to extra psychological burden among nurse staff in China. However, the prevalence of workplace violence and its effect on psychological characteristics among nurse staff are still unclear. This study aims to explore the effect of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region. METHODS: A cross-sectional survey was conducted among 18 local governmental hospitals in Dehong districts. Participants were 1,774 nurses. Psychosocial characteristics were screened by sleep quality, the 9-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, the Connor Davidson Resilience Scale - 10 item for resilience, the multidimensional scale of perceived social support for social support, the Chinese version of Work place Violence Scale for workplace violence. Propensity score matching and multivariate linear regression were applied to analyze the data. RESULTS: The nurse staff with workplace violence have a higher risk of bad sleep quality (b = -0.883, 95%CI = [-1.171, -0.595]), anxiety symptoms (b = 2.531, 95%CI = [2.031, 3.031]) and depressive symptoms (b = 3.227, 95%CI = [2.635, 3.819]), loneliness (b = 0.683, 95%CI = [0.503, 0.863]), perceived cognitive deficits (b = 1.629, 95%CI = [1.131, 2.127]), poor resilience (b = -2.012, 95%CI = [-2.963, -1.061]), and poor social support (b = -5.659, 95%CI = [-7.307, -4.011]). CONCLUSIONS: Preventing workplace violence can improve mental health outcomes significantly among nurse staff, including loneliness, perceived cognitive deficits, anxiety symptoms, depressive symptoms, sleep quality, resilience and social support.

Psychosocial characteristics pattern correlated with HIV-related risky sexual behavior among HIV-negative men who have sex with men: a latent profile analysis.

BACKGROUND: Men who have sex with men (MSM) have become a high risk population of HIV infection due to their risky sexual behaviors. The latent pattern of psychosocial characteristics plays an important effect in HIV-related risky behaviors among HIV-negative MSM. METHOD: Participants were recruited from Wuhan, Nanchang, and Changsha city from September 2017 to January 2018. Social support was assessed by the multidimensional scale of social support, Connor-Davidson Resilience scale-10 items for reliance, the assessment of Stigma towards Homosexuality for sexual minority stigma, the Likert subscale of nondisclosure for identity concealment, the ACE questionnaire-Kaiser-CDC for adverse childhood experience, the Centers for Epidemiological Studies Depression Scale for depression. Latent profile analysis (LPA) and multivariate regression were used to analyze the data. RESULTS: Three psychosocial characteristic patterns were revealed by the LPA. "Social support and resilience group" (SR group), "Identity concealment group" (IC group) and "Adverse childhood experience" (ACE group) were identified, respectively. In comparison with "SR group", "IC group" have a higher likelihood of one-night male partners (AOR = 2.74, 95%CI = [1.54, 4.90]), both fixed and one-night male partners (AOR = 2.01, 95%CI = [1.34, 3.01]) and HIV-unsure male partner (AOR = 2.12, 95%CI = [1.44, 3.13]). Similarly, "ACE group" were more likely having inconsistent condom use (AOR = 2.58, 95%CI = [1.41, 4.73]), and having sex with HIV-positive male partner (AOR = 4.90, 95%CI = [1.95, 12.30]) with comparison of "SR group". In addition, we further revealed that "ACE group" had a higher ratio (90.0%) of inconsistent condom use among MSM whose male partners were HIV-positive. CONCLUSIONS: Six important psychosocial factors were divided into three latent pattern classes. Compared with "SR group", "IC group" and "ACE group" were more likely to engage in HIV-related risky sexual behaviors. Further research may pay more attention to "IC group" and "ACE group" for targeted intervention.

Suicidal ideation and attempted suicide among cancer patients during the COVID-19 pandemic.

This study aimed to understand the suicidal ideation and suicidal attempts among cancer patients during the COVID-19 pandemic. The data were collected from patients diagnosed with cancer while attending the largest cancer center in the south of China. A structured questionnaire was used to investigate patients' demographic data, suicidal behavior, and factors related to COVID-19. Mental health conditions were measured by the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Brief Symptom Inventory. Comorbidities and medical conditions of cancer patients were extracted from the electronic healthcare records. Among the 5670 cancer patients, 755 (13.3%) reported suicidal ideation, and 266 (4.7%) reported suicidal attempts during the COVID-19 pandemic. The age group with the highest risk of suicidal ideation was 20-24 years (23.9%). Lifetime history of suffering from mental disorders, longer time since cancer diagnosis, regional and distant tumor stage, depression, anxiety, hostility, having a higher frequency of worrying about cancer management due to COVID-19, higher frequency feeling of overwhelming psychological pressure due to COVID-19, having a higher level of barriers to manage cancer due to COVID-19, and higher barriers to continue treatment of cancer due to inconveniences caused by COVID-19, were all significantly associated with increased risk of suicidal ideation. We also identified the risk factors of suicide attempts. This is the first study investigating the prevalence and risk factors associated with suicidal ideation and suicidal attempts in Chinese cancer patients during the COVID-19 pandemic. Our findings suggest that it is essential to monitor the mental health conditions of this vulnerable population, especially for cancer patients who have comorbidity with a history of mental disorders. Also, government policymakers should take action to protect cancer patients to avoid any interruption of their continued treatment. Further efforts are urgently required to develop specific psychological interventions to reduce the risk factors among cancer patients during the COVID-19 pandemic.

Latent profile analysis to identify subgroups of Chinese sexual minority adolescents at risk of suicidality.

BACKGROUND: This study aimed to identify latent class profiles of sexual minority adolescents (Men Sexually attracted to Men, Women Sexually attracted to Women, and Bisexual) with elevated suicidal ideation. METHODS: Data were collected from 18 secondary schools in China. Sub-group classifications were identified using variables associated with suicidal ideation in sexual minority adolescents, including parental relationship quality, electronic equipment time, school bullying, and sleep quality using the Chinese version of the Pittsburgh Sleep Quality Index to measure sleep. Anxiety was measured using the Generalized Anxiety Disorder 7 (GAD-7), depression was measured using the Patient Health Questionnaire 9 (PHQ-9), hypomania using the Hypomanic Checklist-32 (HCL-32), positive coping style was identified using the Trait Coping Style Questionnaire, and self-efficacy was measured by the General Self-Efficacy Scale. RESULTS: Four distinctive profiles were derived from the data. Compared to "low-risk" group (Class 3), the "adolescent with mood problems" group (Class 2) had a 9.81 times higher risk of suicidal ideation; the those who classified as "severe bullied adolescent" (Class 4) had a 9.26 times higher risk of suicidal ideation. and the "adolescents with low self-efficacy" group (Class 1) had a 4.48 times higher risk of suicidal ideation. CONCLUSIONS: Sexual minority adolescents with mood problems have the highest risk of suicidal ideation, followed by adolescents frequently being bullied at school. Interventions aimed at reducing suicide risk among sexual minority adolescents may benefit from attending to such profile factors identified in this study to develop targeted clinical care.

Systemic inflammation accelerates the adverse effects of air pollution on metabolic syndrome: Findings from the China health and Retirement Longitudinal Study (CHARLS).

Long-term exposure to air pollution and systemic inflammation are associated with increased prevalence of metabolic syndrome (MetS); however, their joint effects in Chinese middle-aged and older adults is unknown. In this cross-sectional study, 11,838 residents aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) Wave 3 in 2015 were included. MetS was diagnosed using the Joint Interim Societies' definition. C-Reactive Protein (CRP) was assessed to reflect systemic inflammation. Individual exposure to air pollutants (particulate matter with a diameter ≤2.5 µm (PM2.5) or ≤ 10 µm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and carbon monoxide (CO)) was evaluated using satellite-based spatiotemporal models according to participant residence at county-level. Generalized linear models (GLMs) were applied to examine the association between air pollution and MetS, and the modification effects of CRP between air pollution and MetS were estimated using interaction terms of CRP and air pollutants in the GLM models. The prevalence of MetS was 32.37%. The adjusted odd ratio (OR) of MetS was 1.192 (95% confidence interval (CI): 1.116, 1.272), 1.177 (95% CI: 1.103, 1.255), 1.158 (95% CI: 1.072, 1.252), 1.303 (95% CI: 1.211,1.403), 1.107 (95% CI: 1.046, 1.171) and 1.156 (95% CI:1.083, 1.234), per inter-quartile range increase in PM2.5 (24.04 µg/m3), PM10 (39.00 µg/m3), SO2 (19.05 µg/m3), NO2 (11.28 µg/m3), O3 (9.51 µg/m3) and CO (0.46 mg/m3), respectively. CRP was also associated with increased prevalence of MetS (OR = 1.049, 95% CI: 1.035, 1.064; per 1.90 mg/L increase in CRP). Interaction analysis suggested that high CRP levels enhanced the association between air pollution exposure and MetS. Long-term exposure to air pollution is associated with increased prevalence of MetS, which might be enhanced by systemic inflammation. Given the rapidly aging society and heavy burden of MetS, measures should be taken to improve air quality and reduce systemic inflammation.

Association between air quality satisfaction, family relationships, and depression symptoms among middle-aged and elderly chinese people: the mediation role of perceived health status.

BACKGROUND: Population aging has led to depression becoming a serious public health problem both in China and worldwide. Marital relationships, relationships with their children, and air pollution might play an important role in the process of depressive disorders. In this study, we aimed to reveal the mechanism of the effects of these factors on depression. METHODS: Participants were recruited from The China Health and Retirement Longitudinal Study (CHARLS) (wave 4) from July 2018 to March 2019. Depression symptoms were evaluated using the 10-item Center for Epidemiologic Studies depression scale (CESD-10). Marital relationships, relationships with their children, air quality satisfaction, and perceived health status were analyzed using Likert 5-point evaluation methods. Structural equation modeling-path (SEM) models were used to explore these variables' mediation effects on depression symptoms. RESULTS: Marital relationships, relationships with their children, air quality satisfaction, perceived health status, and depression symptoms were significantly associated with each other (P < 0.001). Mediation analysis showed that family relationships (standardized beta = -0.28 [-0.31, -0.26]) and quality satisfaction (standardized beta = -0.03 [-0.05, -0.01]) had negative effects on depression symptoms. The total indirect effects of family relationships and air quality satisfaction on depression symptoms were -0.06 (95% confidence interval (CI) = [-0.07, -0.05]) and -0.016 (95% CI = [-0.02, -0.01]), respectively. CONCLUSION: Family relationships, air quality satisfaction, and perceived health status influenced depression symptoms. The effects of family relationships and air quality satisfaction on depression symptoms were significantly mediated by perceived health status. Therefore, perceived health status aspects should be considered when conducting targeted intervention toward depression symptoms among middle-aged and elderly adults.

Associations of long-term exposure to ambient ozone with hypertension, blood pressure, and the mediation effects of body mass index: A national cross-sectional study of middle-aged and older adults in China.

BACKGROUND: The associations between long-term exposure to ozone (O3) and respiratory diseases are well established. However, its association with cardiovascular disease (CVD) remains controversial. In this study, we examined the associations between O3 and the prevalence of hypertension and blood pressure, and the mediation effects of body mass index (BMI) in Chinese middle-aged and older adults. METHODS: In this national cross-sectional study, we estimated the O3 exposure of 12,028 middle-aged and older adults from 126 county-level cities in China, using satellite-based spatiotemporal models. Generalized linear mixed models were used to evaluate the associations of long-term exposure to O3 with hypertension and blood pressure, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP). Mediation effect models were applied to examine the mediation effects of BMI among O3-induced hypertension and elevated blood pressure. RESULTS: Each 10 µg/m3 increase in O3 concentration was significantly associated with an increase of 13.7% (95% confidence interval (CI): 4.8%, 23.3%) in the prevalence of hypertension, an increase of 1.128 mmHg (95% CI: 0.248, 2.005), 0.679 mmHg (95% CI: 0.059, 1.298), 0.820 mmHg (95%CI: 0.245, 1.358) in SBP, DBP, and MAP, respectively. Mediation effect models showed that BMI played 40.08%, 37.25%, 39.95%, and 33.51% mediation roles in the effects of long-term exposure to O3 on hypertension, SBP, DBP, and MAP, respectively. CONCLUSIONS: Long-term exposure to O3 can increase the prevalence of hypertension and blood pressure levels of middle-aged and older adults, and an increase of BMI would be an important modification effect for O3-induced hypertension and blood pressure increase.

Exposure to ambient air pollution during trimesters of pregnancy and childhood allergic diseases in Wuhan, China.

The study explored the associations between maternal exposure to air pollution during different trimesters and allergic diseases including asthma, allergic rhinitis, allergic conjunctivitis or/and eczema. Individual exposure to air pollutants was assessed by an inverse distance weighted (IDW) method using daily concentrations of SO2, NO2, PM10, and PM2.5 from air quality monitoring stations. Multiple logistic regression model was performed to estimate the associations between air pollution during each trimester of pregnancy and childhood allergic diseases. A total of 332 children (51.3%) were reported by their parents having been diagnosed with allergic diseases. After adjusting for covariates, allergic diseases were significantly associated with per interquartile range (IQR) increase in NO2, PM10, PM2.5 during the second trimester with odds ratios (ORs) and 95% confidence intervals (95%CIs) being 1.292 (1.005,1.662), 1.210 (1.042,1,405) and 1.270 (1.004,1.606), respectively. These findings suggest that maternal exposure to certain air pollutants during pregnancy, especially in the second trimester, is associated with childhood allergic diseases.

A comparison of Knowledge, attitude and practice (KAP) of nurses on nursing Post-stroke dysphagia patients between iii-A and ii-A hospitals in China: a propensity score-matched analysis.

BACKGROUND: Whether knowledge, attitude and practice of nurses on nursing post-stroke dysphagia patients varies between different ranking hospitals is still unknown. This study aimed to compare the knowledge, attitude and practice level of nurses on nursing post-stroke dysphagia patients between iii-A and ii-A hospitals in China. DESIGN: A cross-sectional study design was used. METHODS: Data were collected from eighteen hospitals in Wuhan, Hubei in May-July 2020, and a total of 824 nurses were recruited by convenient sampling. After propensity score matching, 205 participants in iii-A hospitals were matched with 205 participants in ii-A hospitals. RESULTS: There were no statistically differences in the socio-demographic characteristics between two groups after propensity score matching. Before matching, the regression coefficients between hospital ranking and knowledge, attitude, practice were -0.415, -0.718 and -1.855, respectively. After matching, the coefficients changed to -0.394, -0.824 and -1.278. Nurses from iii-A hospitals had higher knowledge and attitude scores than nurses from ii-A hospitals, but no significant practice scores difference was observed between various rankings of hospitals. CONCLUSIONS: The KAP of nurses on nursing post-stroke dysphagia patients were different in iii-A and ii-A hospitals. Administrators should strengthen management, provide more learning resources and trainings to meet nurses' needs about methods to deal with and recognize dysphagia, so as to further improve the quality of post-stroke dysphagia management.

Acute Stress Disorder Among Frontline Health Professionals During the COVID-19 Outbreak: A Structural Equation Modeling Investigation.

OBJECTIVE: The outbreak of COVID-19 that commenced in December 2019 in Wuhan, China, has caused extensive public health concerns and posed substantial challenges to health professionals, especially for those in the center of the epidemic. The current study aimed to assess the prevalence, related factors, and mechanism of acute stress disorder (ASD) among health professionals in Wuhan during this critical period. METHODS: The study used a cross-sectional design. Self-administered questionnaires were distributed to the frontline health professionals in Wuhan hospitals from January 28 to February 1, 2020. Mental health-related measurements included ASD, depression, anxiety, conflict experiences, hostility, and psychosomatic symptoms. Structural equation modeling was used to analyze the factors associated with ASD among health professionals. RESULTS: A total of 332 frontline health professionals were included in the analysis (mean [standard deviation] age = 32.21 [8.77] years; 78.0% women). ASD was a prominent mental health problem in the health professionals surveyed, with a prevalence of 38.3%. Anxiety (24.7%) and depression (20.2%) were also common. Structural equation modeling analyses revealed that emotional distress (i.e., anxiety and depressive symptoms) fully mediated the association between conflicts with ASD (the standardized indirect coefficient ß = 0.47, p = .016). The most common reported symptom was chest pain (51.2%). ASD was significantly associated with psychosomatic symptoms. The majority (67.8%) reported being easily annoyed or irritated, and ASD was associated with hostility. CONCLUSIONS: During the COVID-19 outbreak, a substantial number of health professionals in Wuhan suffered from ASD. Furthermore, ASD was found to be associated with psychosomatic symptoms as well as the hostility. The poor mental health of health professionals has detrimental impacts both on the well-being of staff in health care systems and may adversely affect the quality of patient care. We call for interventions that aim to relieve the psychological and occupational stress. Considering that most of our participants were young, female frontline health professionals, the results may not be generalized to more heterogenous samples.

Relationship between sexual sensation seeking and condom use among young men who have sex with men in China: testing a moderated mediation model.

The present study incorporated a moderated mediation model to explore the role of attitude towards condom use in mediating the link between sexual sensation seeking (SSS) and condom use and whether this indirect link was modified by HIV-related knowledge among Chinese YMSM. Survey data were collected from a cross-sectional study conducted in Wuhan, China and 373 YMSM were recruited. The mediation and moderated mediation modelling analyses were performed with the software SPSS PROCESS macro. Mediation analysis indicated that attitude towards condom use partly mediated the link between SSS and condom use (indict effect = -0.158, P < 0.001). Moderation analysis found HIV-related knowledge acted as a moderator in the relationship between SSS and attitude towards condom use (interact effect = 0.089, P = 0.001). Final moderated mediation analysis demonstrated that the indirect effect from SSS to condom use through attitude towards condom use was moderated by HIV-related knowledge, that is the interaction between HIV-related knowledge and SSS was positively associated with attitude towards condom use (ß = 0.101, P < 0.001). Therefore, increased YMSM-specific HIV-related knowledge education programs need to be conducted. Further longitudinal research is required to verify the findings of this study.

Psychosocial characteristics and HIV-related sexual behaviors among cisgender, transgender, and gender non-conforming MSM in China.

BACKGROUND: While a growing number of studies focus on men who have sex with men (MSM), they typically ignore the heterogeneity of gender minorities within the MSM population. The recognition of new sub-groups among gender minorities (i.e., transgender and gender non-conforming), who also identify as MSM, play a considerable role in new HIV infections in China. Information on the psychosocial factors and HIV-related sexual behaviors require further consideration to understand the prevalence of HIV infection among MSM within these gender minority sub-groups. METHODS: From September 2017 to January 2018, MSM without HIV were recruited in Wuhan, Nanchang, and Changsha cities in China. Participants were asked to fill out a structured self-administered questionnaire to assess depression, perceived social support, resilience, identity concealment, and HIV-related risky sexual behaviors. RESULTS: A total of 715 MSM completed the structured questionnaire, the number of MSM identifying as gender minorities were 63 and accounted for 8.8% of the population. Compared to the cisgender MSM population, transgender MSM were more likely to have a one-night stand/occasional partner (AOR = 3.49, 95% CI =1.02-11.98), to have sex after drug use in the past 6 months (AOR = 2.57, 95%CI =1.05-6.29), and to have reported a significantly lower likelihood of identity concealment (mean difference = - 3.30, 95%CI = -5.86, - 0.74, P = 0.01). CONCLUSIONS: The findings highlight the significance of providing targeted interventions for different gender minorities within the MSM population. Research is required to further understand the relationship between gender identity, mental health, and HIV-related sexual behaviors.

Postpartum depression in mothers and fathers: a structural equation model.

BACKGROUND: Post-partum depression (PPD) is a growing mental health concern worldwide. There is little evidence in the Chinese context of the relationship between paternal PPD and maternal PPD. Given the growing global concerns this relationship requires further exploration. METHODS: A survey was conducted with 950 total couples from March 2017 to December 2018. The study was conducted using a standardized questionnaire that included basic demographic information, information on the relationship between the mother-in-law and daughter-in-law, marital satisfaction (both maternal and paternal), and PPD symptoms. Structural Equation Modelling (SEM) analysis was used to explore the underlying mechanism for PPD symptoms in mothers and fathers. RESULTS: In 4.4% of the couples both the wife and the husband showed depressive symptoms. Maternal marital satisfaction showed a significant mediating effect on paternal PPD (B = -0.114, p < 0.01), and there was a direct effect of maternal PPD on paternal PPD (B = 0.31, p < 0.001). CONCLUSIONS: This is the first study to investigate the possible correlation between maternal PPD, mother-in-law and daughter-in-law relationship satisfaction, maternal marital satisfaction, paternal marital satisfaction, and paternal PPD. It is important for future PPD interventions to target both maternal and paternal mental health, as well as the mechanisms identified that can lead to PPD.

Mapping out a spectrum of the Chinese public's discrimination toward the LGBT community: results from a national survey.

BACKGROUND: China has the world's largest lesbian, gay, bisexual, and transgender (LGBT) population. This study assessed the discrimination experienced by LGBT individuals in China in a comprehensive way, covering discrimination perpetrated by family, media, medical services, religious communities, schools, social services, and in the workplace. METHODS: The current study involved a national survey of 31 provinces and autonomous regions. Discrimination was measured both in terms of heterosexual participants' attitudes towards LGBT individuals, and LGBT participants' self-perceived discrimination. Pearson correlation analysis was performed to examine the difference between heterosexual participants' attitudes towards LGBT individuals and LGBT participants' self-perceived discrimination. Linear regression was used to investigate the association between gross domestic product per capita and discrimination. RESULTS: Among 29,125 participants, 2066 (7.1%) identified as lesbian, 9491 (32.6%) as gay, 3441 (11.8%) as bisexual, 3195 (11.0%) as transgender, and 10,932 (37.5%) as heterosexual. Heterosexual people were generally friendly towards the LGBT community with a mean score of 21.9 (SD = 2.7, total scale score = 100) and the grand averaged score of self-perceived discrimination by LGBT participants was 49.9 (SD = 2.5). Self-perceived discrimination from family and social services is particularly severe. We created a series of provincial level choropleth maps showing heterosexual participants' acceptance towards the LGBT community, and self-perceived discrimination reported by members of the LGBT community. We found that a higher level of economic development in provinces was associated with a decrease in discrimination, and we identified that every 100 thousand RMB increase in per capita GDP lead to a 6.4% decrease in discriminatory events perpetrated by heterosexuals. CONCLUSIONS: Chinese LGBT groups consistently experience discrimination in various aspects of their daily lives. The prevalence of this discrimination is associated with the economic development of the province in which it occurs. In order to reduce discrimination, it is important for future studies to discover the underlying reasons for discrimination against LGBT individuals in China.

Mediating role of loneliness and emotional disturbance in the association between childhood trauma and occupational burnout among nurses: a cross-sectional study.

Background: The occupational burnout status of nurses in China warrants attention. Childhood trauma, loneliness, and emotional disturbance are significant predictors of this burnout, yet few studies have delved into the underlying mechanisms. This study seeks to explore the mediating pathway from childhood trauma to loneliness, emotional disturbance, and ultimately occupational burnout among nurses through a cross-sectional analysis. Method: Data for the study were collected from Yunnan province, China, from 11 July to 26 July 2022. Key variables were measured using standardized scales: the Childhood Trauma Questionnaire Short Form for childhood trauma, the three-item loneliness scale for loneliness, the Patient Health Questionnaire and the Generalized Anxiety Disorder questionnaire for emotional disturbance, and the Maslach Burnout Inventory-Human Service Survey for occupational burnout. Mediation modeling analysis was employed for data analysis to test the effect of loneliness and emotional disturbance on the association between childhood trauma and occupational burnout. Data analysis was conducted using AMOS and SPSS software. Results: Loneliness and emotional disturbance fully mediated the association between childhood trauma and emotional exhaustion [indirect effect (95% CI) = 0.228 (0.196, 0.270)]. Loneliness and emotional disturbance partially mediated the association between childhood trauma [indirect effect (95% CI) = -0.020 (-0.039, 0.002)] and personal accomplishment or depersonalization [indirect effect (95% CI) = 0.221 (0.186, 0.255)]. Conclusion: Childhood trauma could affect occupational burnout through loneliness and emotional disturbance among nurses. Preventive strategies could include protective interventions like treatment of loneliness and emotional disturbance, especially in nurses who experienced childhood trauma.

Long-term exposure to PM1 is associated with increased prevalence of metabolic diseases: evidence from a nationwide study in 123 Chinese cities.

Exposure to particulate matter (PM) has been linked to metabolic diseases. However, the effects of PM with an aerodynamic diameter ≤ 1.0 µm (PM1) on metabolic diseases remain unclear. This study is aimed at assessing the associations of PM1 with metabolic disease risk and quantifying the concentration-response (C-R) relationship of PM1 with metabolic disease risk. A national cross-sectional study was conducted, including 12,495 middle-aged and older adults in 123 Chinese cities. The two-year average concentration of PM1 was evaluated using satellite-based spatiotemporal models. Metabolic diseases, including abdominal obesity, diabetes, hypertension, dyslipidemia, and metabolic syndrome, were identified based on physical examination, blood standard biochemistry examination, and self-reported disease histories. Generalized linear models and C-R curves were used to evaluate the associations of PM1 with metabolic diseases. A total of 12,495 participants were included in this study, with a prevalence of 45.73% for abdominal obesity, 20.22% for diabetes, 42.46% for hypertension, 41.01% for dyslipidemia, and 33.78% for metabolic syndrome. The mean ± standard deviation age of participants was 58.79 ± 13.14 years. In addition to dyslipidemia, exposure to PM1 was associated with increased risks of abdominal obesity, diabetes, hypertension, and metabolic syndrome. Each 10 µg/m3 increase in PM1 concentrations was associated with 39% (odds ratio (OR) = 1.39, 95% confidence interval (CI) 1.33, 1.46) increase in abdominal obesity, 18% (OR = 1.18, 95%CI 1.12, 1.25) increase in diabetes, 11% (OR = 1.11, 95%CI 1.06, 1.16) increase in hypertension, and 25% (OR = 1.25, 95%CI 1.19, 1.31) in metabolic syndrome, respectively. C-R curves showed that the OR values of abdominal obesity, diabetes, hypertension, and metabolic syndrome were increased gradually with the increase of PM1 concentrations. Subgroup analysis indicated that exposure to PM1 was associated with increased metabolic disease risks among participants with different lifestyles and found that solid fuel users were more susceptible to PM1 than clean fuel users. This national cross-sectional study indicated that exposure to higher PM1 might increase abdominal obesity, diabetes, hypertension, and metabolic syndrome risk, and solid fuel use might accelerate the adverse effects of PM1 on metabolic syndrome risk. Further longitudinal cohort studies are warranted to establish a causal inference between PM1 exposure and metabolic disease risk.