The Association of Suicidal Ideation With Family Characteristics and Social Support of the First Batch of Students Returning to a College During the COVID-19 Epidemic Period: A Cross Sectional Study in China.

Objective: To investigate the prevalence of suicidal ideation among the first batch of students returning to a college during the COVID-19 epidemic, and to explore the correlation of suicidal ideation with family characteristics and social support. Methods: A cluster sampling survey with a self-designed questionnaire was conducted among the first batch of students returning to a college in Wuhu, China. The Positive and Negative Suicidal ideation (PANSI) and Social Support Scale (SSRS) were used to define students' suicidal ideation and social support, respectively. The influence of family characteristics and social support on the students' suicidal ideation was investigated using multivariate unconditional logistic regression analysis. Results: Two thousand seven hundred valid questionnaires were collected, including 673 males (24.9%) and 2,027 females (75.1%), in this study. A total of 146 students (5.4%) showed suicidal ideation. Male respondents reported higher rates (7.9%) than females (4.6%). Multivariate logistic regression analysis showed that a higher risk level of residence before returning to school and lower objective support were the risk factors for suicidal ideation in males. In contrast, a higher level of maternal education, a poorer relationship with the mother, and lower scores for subjective support and support availability had significant effects on females' suicidal ideation. Limitations: This is a cross-sectional study, and lacks comparison to the time point unaffected by COVID-19. Moreover, it was limited by COVID-19 epidemic prevention and control restrictions, and the differences in returning to school in different regions. Only one college was investigated in this study, and all of the respondents were sophomores, so there may be some limitations in the representativeness of the sample and extrapolation of the results. Conclusion: Family characteristics and social support have had an important influence on suicidal ideation among students returning to school during the COVID-19 epidemic. Some gender differences were identified. Targeted interventions are needed for early prevention and control.

Utilization willingness of institutional care between disabled and non-disabled seniors: evidence from Jiangsu, China.

BACKGROUND: Due to rapidly growing number of old adults and diminishing supportive functions of family in China, the issue of willingness to use institutional care is of high priority, especially for disabled seniors. The objective of this study is to compare the willingness of institutional care and its determinants between disabled and non-disabled seniors in China. METHODS: 2493 seniors (60+) were randomly selected from a cross-sectional study conducted in three urban districts and three rural counties in Jiangsu Province. Binary logistic regression model was employed to examine differences towards the preference for institutional care between two subgroups, and to identify factors associated with willingness of institutional care between disabled and non-disabled seniors. RESULTS: Of 2493 respondents, 402 (16.1%) were disabled seniors. Overall, 14.2% of the participants had willingness for institutional care in Jiangsu, China. The willingness for institutional care among non-disabled seniors (OR = 0.513; 95%CI 0.387-9.680) was significantly lower than that among disabled ones. The preference for institutional care of both disabled and non-disabled seniors was associated with household income. The willingness of institutional care was also related to age, education and living arrangement among disabled seniors. Meanwhile, non-disabled seniors who had non-communicable diseases were found to be more likely to choose elder care in institution. CONCLUSIONS: Our findings indicated that the willingness for institutional care among disabled seniors was significantly higher than that among non-disabled ones. Household income was determinant of utilization willingness for institutionalization both in disabled and non-disable seniors. Different policies should be made or modified for disabled and non-disabled seniors separately.

[Causes of moderate to severe visual impairment and blindness in population aged 50 years or more in rural Shandong province].

OBJECTIVE: To investigate the etiological spectrum of moderate to severe visual impairment and blindness in population aged 50 years or more in rural Shandong province, China. METHODS: A population based, random cluster sampling was used to screening the adults aged 50 years or more living in rural Shandong Province from April to July 2008. Three counties and one suburb representing the different levels of socioeconomic development within Shandong area were selected as the investigated areas. Geographically defined cluster sampling was used in randomly selecting a cross-section of residents aged ≥ 50 years from each county. Best corrected visual acuity and intra-ocular pressure were evaluated in those with presenting visual acuity ≤ 0.5 and suspected glaucoma respectively. The major causes of visual impairment and blindness were diagnosed in those with presenting visual acuity ≤ 0.3. According to the results of presenting visual acuity and best corrected visual acuity, the etiology constituent ratios of the moderate to severe visual impairment and blindness were analyzed respectively. RESULTS: According to the number of people, the first three principal causes for blindness based on the presenting visual acuity were cataract (59.8%, 168/281), fundus disease (12.1%, 34/281) and corneal opacity (4.3%, 12/281) or ametropia (4.3%, 12/281). The first three principal causes for moderate to severe visual impairment and blindness were cataract (55.2%, 844/1530), uncorrected refractive error (18.2%, 278/1530) and fundus disease (11.9%, 182/1530). Based on the best corrected visual acuity, the first three principal causes for blindness were cataract (64.6%, 153/237), fundus disease (10.5%, 25/237) and corneal opacity (4.7%, 11/237), respectively. The first three principal causes for moderate to severe visual impairment and blindness were cataract (66.4%, 590/889), fundus disease (16.0%, 142/889) and optic nerve atrophy (3.0%, 27/889). According to number of the eyes, proportion of cataract in cases with moderate to severe visual impairment and blindness had positive relation with age, the proportion of ametropia and fundus disease had negative relation with age. The etiology constituent ratio had no difference between male and female. The proportion of cataract in cases with moderate to severe visual impairment and blindness in Huaiyin District of Jinan was slightly lower than those in other areas, however, the proportion ratio of ametropia and fundus disease was slightly higher than those in other areas. CONCLUSION: Cataract, uncorrected refractive error, and fundus diseases are ranked in the top three causes of moderate to severe visual impairment and blindness in adults aged 50 years or more in rural Shandong Province.

[Prevalence of visual impairment and blindness in older adults in rural Shandong Province].

OBJECTIVE: To describe the prevalence of visual impairment/blindness among older adults aged > or = 50 years in rural populations in Shandong Province, China. METHODS: Population-based, cross-sectional study was designed in this survey. Three counties and one suburbs representative of the different levels of socioeconomic development were selected as the study areas within the province from April to July 2008. Geographically defined cluster sampling was used in randomly selecting a cross-section of residents aged > or = 50 years from each county. Eligible persons were invited to local examination sites for visual acuity (VA) testing and eye examination. Those presenting with VA < or = 0.5 in either eye were refracted to achieve best-corrected VA. Chi2-test was used to compare the prevalence of blindness and visual impairment in the different groups. Multiple logistic regressions were used to investigate the association of age, gender, education, and county with presenting and best-corrected visual impairment and blindness. Adjusted odds ratio was used to compare the prevalence of blindness and visual impairment in the different counties. RESULTS: Of 19 583 enumerated eligible persons, 17 816 (90.98%) were examined and tested for VA. The prevalence of presenting visual impairment (0.05- < 0.3) in the better-seeing eye was 7.01% (the age-standardized rate was 6.56%) and presenting blindness (< 0.05) was 1.58% (the age-standardized rate was 1.48%). Across the 4 counties, presenting visual impairment ranged from 4.51% to 8.65%, and presenting blindness from 1.35% to 1.77%. With best-corrected VA, the prevalence of visual impairment was 3.66% (the age-standardized rate was 3.38%), and 1.33% for blindness (the age-standardized rate was 1.24%). The ranges across the 4 counties were 2.63% to 4.38% for visual impairment and 1.06%-1.54% for blindness. The prevalence of visual impairment with presenting VA was higher than that with best-corrected VA (2 = 201.262, P = 0.000). There was no significant difference between the prevalence of blindness with presenting VA and that with best-corrected VA (Chi2 = 0.117, P = 0.732). Based on both presenting and best-corrected VA, visual impairment and blindness were associated with older age, female gender, lack of education, and county (P < or = 0.05). CONCLUSIONS: Visual impairment and blindness are important public health problems in rural older adults aged > or = 50 years in Shandong Province. Un-corrected refractive error is one of the main causes of visual impairment.

[Prevalence of trachoma in rural primary school children in Tengzhou City of Shandong Province in China].

OBJECTIVE: To investigate the prevalence of trachoma and its risk factors in rural primary school children in Tengzhou City of Shandong Province. METHODS: In this cross-sectional population-based study, children aged 5 to 14 years old in primary school were randomly selected by a cluster sampling in which school shift was the sampling unit. Out of 2742 students, 2676 were eligible. The examination rate was 97.60%. All selected students were assessed for trachoma using the simplified grading scheme proposed by the World Health Organization (WHO). Statistical significance was calculated using Chi-square tests. RESULTS: Out of 2676 eligible children, 593 cases of active trachoma were found, the prevalence of trachoma was 22.16% (95% CI:20.59%-23.73%). In 1606 boys, the prevalence of active trachoma was 19.74%, compared with 25.79% for girls. Girls were affected by active trachoma higher than boys (25.79% versus 19.74%, P=0.000). There was no significant difference among different age groups in term of the prevalence of trachoma (P=0.052). The prevalence of trachomatous follicle (TF), trachomatous inflammation (TI), and trachomatous scarring (TS) was 5.68% (152/2676), 19.21% (514/2676), 0.56% (15/2676), respectively. TI was more prevalent in girls than in boys (22.90% versus 16.75%, P=0.000). CONCLUSIONS: Trachoma is still endemic in children of primary schools in Tengzhou rural areas. Some interventions including mass treatment with antibiotics, improvement of hygienic conditions, and improvement of primary eye care are needed.

Genetic variants in three genes and smoking show strong associations with susceptibility to exudative age-related macular degeneration in a Chinese population.

BACKGROUND: The present study was undertaken to replicate the associations of representative polymorphisms in three genes (complement factor H (CFH), complement factor B (BF) and HtrA serine peptidase 1 (HTRA1)) with exudative age-related macular degeneration (AMD) in a Han Chinese population, and to test if the modifiable environmental factors affect AMD susceptibility associated with different type of genotype in these genes. METHODS: An age, gender and ethnicity matched case-control study was conducted to genotype the representative single neucleotide polymorphisms (SNPs) loci including rs1061170 and rs1410996 in CFH, rs641153 and rs4151667 in BF and rs11200638 in HTRA1 gene in 144 exudative AMD patients and 126 normal controls using PCR-RFLP and direct resequencing. The demographic characteristics and behavioral risk factors were also recorded. Allelic and genotypic associations for individual SNP and joint associations with two loci were performed. The gene-gene and gene-environment interactions were analyzed using multivariate non-conditional Logistic regression analysis. RESULTS: The C risk allele frequencies for CFH Y402H (rs1061170) in cases and controls were 12.5% and 5.4% respectively, which were much lower than those in Caucasians (P < 0.001). Compared with TT homozygous genotype, the CT heterozygous genotype was positively associated with AMD with odds ratio (OR) of 3.23 (1.36 - 5.07). However, the population attributable risk (PAR) of C allele was only 3.3% (1.4% - 4.3%). rs1410996 was also associated with AMD independent of Y402H. The ORs of exudative AMD for individuals carrying one copy risk allele and two copy risk alleles were 2.57 (1.21 - 5.45) and 4.76 (2.15 - 10.55) respectively, with correspondent PARs of 28.3% (2.0% - 40.5%) and 38.2% (21.8% - 45.4%). rs11200638 in HTRA1 was another susceptible locus for AMD and the risk homozygotes were significantly susceptible for exudutive AMD (OR = 3.98, 1.88 - 8.43) with PAR of 38.9% (24.3% - 45.8%). Education status and cigarette smoking were also related to exudative AMD. After controlling for environmental risk factors, CFH and HTRA1 SNPs were independently associated with exudative AMD, with OR of 3.50 (1.45 - 8.45) for CT genotype in Y402H, 3.34 (1.33 - 8.36) for GG genotype in rs1410996 and 3.85 (1.58 - 9.42) for AA genotype in rs11200638 respectively. The interaction analysis between gene and environmental factors showed that smoking synergistically increased susceptibility of AMD for heterozygotes of rs1410996, with OR(interaction) of 7.33 (P(interaction) = 0.029). CONCLUSIONS: In a Han Chinese population, CFH and HTRA1 polymorphisms appear to be independently and possibly additively hereditary contributors to exudative AMD. Y402H polymorphism conferred a significant but relatively lower contribution in Chinese than in Caucasians with a low frequency of risk allele. The gene-environment interaction may be a best way to encourage those with a high genetic risk to prevent AMD by avoiding modifiable factors until there is effective treatment for AMD.