Introduction: Student Experiences of COVID-19 Around the Globe: Insights from the Pandemic Journaling Project.

The COVID-19 crisis has taken a significant toll on the mental health of many students around the globe. In addition to the traumatic effects of loss of life and livelihood within students' families, students have faced other challenges, including disruptions to learning and work; decreased access to health care services; emotional struggles associated with loneliness and social isolation; and difficulties exercising essential rights, such as rights to civic engagement, housing, and protection from violence. Such disruptions negatively impact students' developmental, emotional, and behavioral health and wellbeing and also become overlaid upon existing inequities to generate intersectional effects. With these findings in mind, this special issue investigates how COVID-19 has affected the mental health and wellbeing of high school and college students in diverse locations around the world, including the United States, Mexico, Brazil, China, and South Africa. The contributions collected here analyze data collected through the Pandemic Journaling Project, a combined research study and online journaling platform that ran on a weekly basis from May 2020 through May 2022, along with complementary projects and using additional research methods, such as semi-structured interviews and autobiographical writing by students. The collection offers a nuanced, comparative window onto the diverse struggles that students and educators experienced at the height of the pandemic and considers potential solutions for addressing the long-term impacts of COVID-19. It also suggests a potential role for journaling in promoting mental wellbeing among youth, particularly in the Global South.

Seesaw Precarity: Journaling Anxious Hope on a Chinese University Campus During Covid-19.

In this article, we examine the Covid-19 experiences of a group of Chinese university students studying in the city of Guangzhou. We draw on journal entries that Chinese students submitted to the Pandemic Journaling Project between March and May 2022, along with follow-up responses in July and December 2022, to argue that these students spent most of their undergraduate years living in a state of "seesaw precarity." We define seesaw precarity as a protracted period during which many Chinese were unable to predict from one day to the next whether they would be free to engage in the quotidian activities of everyday life. We trace student reactions and adaptations as they struggled to attend class, buy food, and see friends and family in the midst of unpredictable swings between openness and closedness. The seesaw nature of restrictions spurred considerable anxiety among the students we followed, but also produced an optimistic mindset we refer to as "anxious hope." Participants accepted the necessity of Covid controls and felt it was incumbent upon them as individuals to adjust to this reality. They saw themselves as responsible for actively cultivating a positive mindset. Our findings suggest that the promotion of emotional self-care and anxious hope during the pandemic may have supported the viability of long-term controls as well as the acceptability of their sudden abandonment, while muting the possibility of resistance.

"You would think she would hug me": Micropractices of Care Between First-Generation College Students and Their Parents During Covid-19.

The Covid-19 pandemic has greatly disrupted the education of first-generation college students (first-gens)-those whose parents did not complete a college degree. With campuses closed, activities canceled, and support services curtailed, many first-gens have increasingly relied on their parents for mental, emotional, and logistical support. At the same time, their parents face compounding stresses and challenges stemming from the prolonged effects of the Covid pandemic. We examined the role that relational dynamics between first-gens and their parents played in how they weathered the first 2 years of the Covid pandemic together. We draw upon journals submitted by self-identified first-gens and parents of first-gens to the Pandemic Journaling Project between October 2021 and May 2022 as part of a pilot study of first-gen family experiences of Covid-19, along with a series of interviews conducted with three student-parent dyads. We argue that what we term the micropractices of care-the "little things," like a kind word, small gift, or car ride, that were regularly exchanged between parents and students-played a key role in mental wellness and educational persistence. We find that when there is synchrony between practices offered by one dyad member and their reception by the other, mental wellbeing is preserved. When there is asynchrony, mental health is destabilized. These findings reflect the strategies on which first-gen families have creatively relied to maintain shared mental wellness and student success during a time of crisis. We show how everyday mental wellness is forged in the intersubjective space between two people engaged in achieving shared life goals.

Blenders, Hammers, and Knives: Postpartum Intrusive Thoughts and Unthinkable Motherhood.

"Intrusive thoughts" are common symptoms of perinatal mood and anxiety disorders such as postpartum obsessive-compulsive disorder. These thoughts can include horrific flashes of violence involving one's baby and frequently lead to shame and fear on the mother's part, but rarely result in real-world violence. Clinicians tend to downplay the importance of these images' content and calm women by reminding them that they will not act on their impulses. This article leans into the dark nature of intrusive thoughts. I intersperse theoretical and ethnographic reflections with vivid fragments of narratives about intrusive thoughts collected from several years of ethnographic research conducted with postpartum women in the United States. I explore the fear, rage, and repulsion that characterize the thoughts themselves and the racism, classism, and sexism involved in clinical, institutional, and interpersonal responses to them. I suggest that dwelling on the "unthinkable" images contained within intrusive thoughts may be important for understanding and accepting the realities of mother love.

Why they willingly complied: Ordinary people, the big environment, and the control of COVID-19 in China.

During the first two years of the COVID-19 pandemic, the Chinese public consistently demonstrated a high level of compliance with some of the most restrictive infection control measures in the world. As a result, as of early 2022 China achieved remarkable control of a virus that had devastating effects in other parts of the world. In this article we take seriously the complexities of a simple question: Why did most urban Chinese citizens so willingly comply with the state's COVID-19 control measures for so long? Based on two years of ethnographic research conducted primarily in Shanghai, China between June 2020 and May 2022, we argue that the strong support the Chinese government enjoyed among China's self-described laobaixing ("ordinary people") in implementing its COVID-19 control measures emerged from a combination of self-interest, nationalistic pride, and "conscious indifference to transparency," rooted in ongoing critical evaluations of governmental competence. With these evaluations changing in the wake of new outbreaks in 2022, the future of China's zero-COVID policy is in jeopardy.

New life, new feelings of loss: Journaling new motherhood during Covid-19.

In this article we analyze the longitudinal journals of 32 Pandemic Journaling Project (PJP) participants who were pregnant, planned a pregnancy, or gave birth between January 2020 and July 2021. Employing a grounded theory approach, we coded journals in NVivo for emerging themes related to the influence of the Covid-19 pandemic on perinatal experiences in North America and Europe. In the paper we first provide some brief background on perinatal mental health and on the particular conditions for pregnancy and birth during Covid-19, before introducing major themes that emerged from the data, along with three in-depth case studies. We argue that the new mothers and prospective mothers in our sample associated new life with new feelings of loss during Covid-19. New motherhood during Covid-19 has meant for PJP participants a loss of seemingly irretrievable opportunities and moments that they see as necessary for establishing themselves as mothers and integrating their babies into their families through a process of "kinning" (Howell, 2003). Feelings of loss associated with disruptions to kinning may be partially responsible for the increase in perinatal mental distress observed during the pandemic.

Introduction: Journaling and Mental Health during COVID-19: Insights from the Pandemic Journaling Project.

In this article, we introduce the SSM-MH Special Issue "Journaling and Mental Health during COVID-19: Insights from the Pandemic Journaling Project," which presents findings from the Pandemic Journaling Project (PJP). PJP is an online journaling platform and mixed-methods research study created in May 2020 to provide ordinary people around the world an opportunity to chronicle the impact of the COVID-19 pandemic in their lives-for themselves and for posterity. The essays in this collection demonstrate how journaling via an online platform can help illuminate experiences of mental wellbeing and distress, with important implications for both research and clinical practice. We begin by introducing the Pandemic Journaling Project and describing our procedures for generating the data subsets analyzed in the papers collected here. We then outline the principal interventions of the special issue as a whole, introduce the papers, and identify a number of cross-cutting themes and broader contributions. Finally, we point toward key questions for future research and therapeutic practice by highlighting the three-fold value of online journaling as a research method, a therapeutic strategy, and a tool for advancing social justice. We focus in particular on how this innovative methodological approach holds promise as both a modality for psychotherapeutic intervention and a form of grassroots collaborative ethnography. We suggest that our methods create new opportunities for confronting the impact of pandemics and other large-scale events that generate radical social change and affect population-level mental health.

A mixed methods study of perinatal sleep and breastfeeding outcomes in women at risk for postpartum depression.

INTRODUCTION: Pregnant and postpartum women experience significant sleep disruption, but the role of perinatal sleep disturbances in breastfeeding is understudied. METHODS: In this observational cohort study, we used mixed methods to examine associations between perinatal sleep and breastfeeding. Forty-eight women (mean age 28.2 ± 4.9 years) who were euthymic at enrollment but had a history of major depression (n = 43) or bipolar disorder (n = 5) had sleep recorded with wrist actigraphy. We determined feeding status through daily diaries and used semi-structured interviews to identify themes regarding participants' experiences, breastfeeding decisions, and behaviors. To examine whether sleep disturbance during pregnancy predicted breastfeeding (BF) rates, we defined "lower sleep efficiency" (LSE) and "higher sleep efficiency" (HSE) groups based on the median split of actigraphic SE at 33 weeks' gestation (cutoff SE = 84.9%) and classified mothers as No-BF, Mixed-BF (BF + formula), and Exclusive-BF at 2 weeks postpartum. RESULTS: Percentages of women who did any breastfeeding were: Week 2 = 72.3%, Week 6 = 62.5%, Week 16 = 50%. LSE mothers were less likely than HSE mothers to initiate breastfeeding (percent No-BF: LSE = 45.8%, HSE = 16.7%, P < .05). Average actigraphic sleep onset, sleep offset, time in bed, sleep duration, and SE did not differ based on breastfeeding status at any time point. Qualitative themes included insufficient preparation for the demands of breastfeeding, interrupted and nonrestorative sleep, and unrelenting daytime tiredness. CONCLUSIONS: In our sample, preserved actigraphic SE during pregnancy was associated with initiation and continuation of breastfeeding. Future work should examine whether improving sleep in pregnancy improves mothers' feeding experiences.

Epidemiologizing Culture: Scaling Chineseness through Narratives of Stigma in New York City.

Drawing on 18 months of participation on an epidemiological research team and close analysis of in-depth interviews the team conducted with 30 Chinese immigrants to New York City, this article traces a process I call epidemiologizing culture. In producing qualitative interview data from Chinese immigrants at risk for HIV, team members smoothed over individual variation to extract elements thought to be relevant to population-level experiences of "Chinese culture." Relevance was determined based on how closely the experiences of participants mirrored the behavior of a Chinese ideal type. Interviewer and interviewee collaborated in articulating and reproducing homophobic and HIV-phobic discourses associated with Chinese culture while erasing details of lived experience, and conflating race and culture. I conclude that differing epistemic virtues make an epidemiological embrace of contemporary anthropological understandings of culture difficult. A model of "parallel play" may be an alternative approach to interdisciplinary synthesis.

How Do You Build a "Culture of Health"? A Critical Analysis of Challenges and Opportunities from Medical Anthropology.

The Robert Wood Johnson Foundation's Culture of Health Action Framework aims to "make health a shared value" and improve population health equity through widespread culture change. The authors draw upon their expertise as anthropologists to identify 3 challenges that they believe must be addressed in order to effectively achieve the health equity and population health improvement goals of the Culture of Health initiative: clarifying and demystifying the concept of "culture," contextualizing "community" within networks of power and inequality, and confronting the crises of trust and solidarity in the contemporary United States. The authors suggest that those who seek to build a "Culture of Health" refine their understanding of how "culture" is experienced, advocate for policies and practices that break down unhealthy consolidations of power, and innovate solutions to building consensus in a divided nation.

When the Ghosts Live in the Nursery: Postpartum Depression and the Grandmother-Mother-Baby Triad in Luzhou, China.

In Luzhou, China, where grandmothers often serve as primary caregivers for infants, the past and the future haunt new mothers suffering from postpartum depression. In this article, I draw upon longitudinal interviews conducted with ten families in Luzhou as part of a larger multi-sited ethnography of postpartum depression and anxiety. I argue that the grandmother-mother-baby triad model of infant care in interior urban China accentuates the pain of depressed postpartum mothers by making it difficult for them to rid their homes of the ghosts of past trauma and lost futures. Mothers resent and fear grandmothers even as they rely on them to care for their babies. Memories of trauma, perceived displacement by the grandmother as the mother figure for their babies, and lack of control over their households and children characterize postpartum mothers' experiences. Mothers primarily blame their mothers-in-law for their unhappiness even as they depend on themselves to "self-adjust."

Chrono-Socialism with Chinese Characteristics: Temporal Balancing and Moralities of Time in Contemporary Urban China.

This article addresses the management and control of time in contemporary urban China. It traces how competing claims to, and experiences of, time as a limited resource shape the terms of moral engagement among middle-class women, their families, their employers, and their friends. Drawing upon two distinct periods of fieldwork among middle-class families in urban China between 2007 and 2017, I show how Chinese subjects balance private, public, and interpersonal claims on time, creating hybrid approaches to time management that I refer to as chrono-socialism with Chinese characteristics. This balancing act is gendered: women, and especially mothers, are charged with protecting the moral status of their families and their children through effective temporal balancing. Paying attention to moments of discordant expectations, in the form of expressions of impatience, can illuminate the logics of temporal balancing in the domains of work, play, and rest. [time, morality, impatience, socialism with Chinese characteristics, China].

Este artículo aborda el manejo y control del tiempo en la China urbana contemporánea. Traza cómo demandas que compiten por, y experiencias del, tiempo como recurso limitado le dan forma a los términos de compromiso moral entre mujeres de clase media, sus familias, sus empleadores y sus amigos. Basada en dos períodos distintos de trabajo de campo entre familias de clase media en la China urbana entre 2007 y 2017, muestro cómo sujetos chinos balancean demandas privadas, públicas e interpersonales sobre su tiempo, creando aproximaciones híbridas al manejo del tiempo que refiero como crono-socialismo con características chinas. Este acto de equilibrio está basado en género: mujeres y especialmente madres, son encargadas de proteger el estatus moral de sus familias y sus hijos a través del equilibrio temporal afectivo. Prestando atención a los momentos de expectativas discordantes, en la forma de expresiones de impaciencia, pueden iluminar las lógicas de balanceo temporal en los dominios del trabajo, recreación y descanso. [tiempo, moralidad, impaciencia, socialismo con características chinas, China].

Quantitative care: Caring for the aggregate in US academic population health sciences.

Academic quantitative population health scientists (AQPHS) in the US care for populations with an ostensibly apolitical set of quantitative methods. This quantitative care has three interconnected components: AQPHS care about populations, they care for their data sets and models, and they care with these models' outputs. In the process their ideals of objectivity compete with, and enable, a moral ideal of political advocacy. Slipping between knowledge and intervention, the "real" and the imagined, and individuals and populations, AQPHS produce knowledge that they hope will change public narratives about marginalized populations. In doing so they draw on ideal types, converting quantitative findings about populations into speculation about individual behavior. AQPHS' ideal types both precede and tautologically reemerge from their science.

H1N1 Is Not a Chinese Virus: the Racialization of People and Viruses in Post-SARS China.

In this article, I trace how the race-making of people, viruses, and the places they share became a powerful means by which Chinese public health professionals made sense of two major infectious outbreaks that threatened to stall or interrupt China's development: the SARS outbreak of 2003 and the H1N1 influenza pandemic of 2009. By inscribing geographical stability onto infected bodies in motion through the languages of race and genetics, Chinese public health professionals sought to constrain the mobility of infection and, in doing so, to contain the symbolic and material threats to China's modernity and development that flu-like infections, and the people who carried and spread them, had come to represent. While SARS in this imaginary became a "Chinese" or "Cantonese" disease, H1N1 became a EuroAmerican disease that, when it reached inside China, adhered more easily to those Chinese who did not quite belong. In constructing this imaginary, public health professionals' racialization of certain groups thought to be infectious joined with the racialization of the infections themselves. H1N1 could not easily infect most Chinese because both the virus and its hosts were racially alien.

A tailed primers protocol to identify the association of eNOS gene variable number of tandem repeats polymorphism with ischemic stroke in Chinese Han population by capillary electrophoresis.

Endothelial nitric oxide synthase (eNOS) plays an important role in mediating endothelium-dependent vasodilatation and antithrombotic action and is thus involved in the development of ischemic stroke (IS). Controversial results regarding the association of eNOS gene variable number of tandem repeats (VNTR) polymorphism with IS have been reported by conventional PCR-polyacrylamide gel electrophoresis methods. We aimed to identify any common association of eNOS gene VNTR polymorphism with IS in Chinese Han population by capillary electrophoresis (CE). The VNTR polymorphism of 27 bp within the eNOS intron-4 was determined by CE with specially designed tailed primers in Chinese Han patients with IS (n=457) and matched elderly controls without IS (n=457). Significant differences in BMI, WHR, hypertension, diabetes, smoking, TG, HDL, LDL, LDL, and FBG were observed between cases and controls. The distributions of eNOS VNTR polymorphism were not significantly associated with IS after adjustment for cardiovascular risk factors (OR=1.18, 95% CI: 0.82-1.69). This finding was consistent with the further meta-analysis in Asians. The meta-analysis in Americans demonstrated that 4a/4b+4a/4a genotype was significantly associated with IS risk with an OR of 1.54 (95% CI, 1.09-2.17) compared with the 4b/4b genotype. Our data suggests that BMI, WHR, hypertension, diabetes, smoking, TG, LDL, and FBG may increase the risk of IS. However, eNOS VNTR polymorphism may be not an independent major contributor for IS in Chinese Han population. The VNTR polymorphism might be associated with IS in Americans based on meta-analysis.

Lack of association between two key SNPs on chromosome 12p13 and ischemic stroke in Chinese Uyghur population.

Recent genome-wide association studies (GWAS) have identified two key SNPs (rs11833579 and rs12425791) on chromosome 12p13 that were significantly associated with stroke in Caucasians. However, the validity of the association has remained controversial. We performed genetic association analyses in a very unique population which has 60% European ancestry and 40% East Asian ancestry. No significant association between these two SNPs and ischemic stroke was detected in this Chinese Uyghur population.

Mobile migrants, mobile germs: migration, contagion, and boundary-building in Shenzhen, China after SARS.

Shenzhen, a city located on the border between Mainland China and Hong Kong, is populated primarily by internal Chinese migrants. After the 2003 SARS epidemic, the pressure in Shenzhen to contain infectious disease has been considerable. By engaging with issues of global biosecurity, migration and citizenship, and intersubjectivity in medicine, I argue that in their attempts to prevent another SARS and protect their own subject positions as modern, urban citizens, Shenzhen's public health professionals worked to maintain precarious boundaries between themselves and their city's majority migrant population. However, by establishing the migrants as dangerous, biological noncitizens, by denying connections between the migrants' experiences and their own experiences of migration, by failing to engage with the migrants as subjects, and by defending structures that institutionalized these exclusions, they undermined both the health of the migrants and the stability of the city they were trying to protect.

A comparison of HIV infection and related risks among male sex workers in different venues in Shenzhen, China.

Different risks of HIV infection have been reported among different types of male sex workers (MSW). In order to compare the prevalence of HIV infection and related risk behaviors of MSW in different venues in Shenzhen, China, a time-location sampling survey was conducted in 2008. 5.1% of the 394 MSWs were tested positive for HIV, with 6.9% in those working in parks (PMSW), 11.3% in small family clubs (FMSW) and 1.7% in entertainment venues. PMSWs and FMSWs reported a higher proportion of self-identified homosexual/gay. Moreover, FMSWs reported a lower coverage of HIV-related education and services and were more likely to self-report coming from provinces with higher HIV prevalence. The results indicated that MSWs in small venues and parks were comparatively at higher risk of being infected and suggested that current HIV preventive intervention needs to be expanded to the small venues in Shenzhen.

The role of functional polymorphisms of the TNF-alpha gene promoter in the risk of ischemic stroke in Chinese Han and Uyghur populations: Two case-control studies.

BACKGROUND: Increasing evidences for the role of tumor necrosis factor-alpha (TNF-alpha) in the occurrence of ischemic stroke (IS) have shown that it belongs to pro-inflammatory cytokines and carries functional polymorphisms (TNF-alpha -238G/A and TNF-alpha -308G/A) in its promoter region, which affect their transcription rate and plasma cytokine level. We determined the association between these polymorphisms and the occurrence of IS in the Chinese Han and Uyghur populations. METHODS: The TNF-alpha -238G/A and TNF-alpha -308G/A polymorphisms were determined by TaqMan SNP Genotyping assays in cases (n=748) and controls (n=748). Multivariate logistic regression analysis was used to show the association between the TNF-alpha genotypes and the IS events. RESULTS: No significant difference was found in the association between TNF-alpha -238G/A and IS in both ethnic populations. The result showed that carriage of the TNF-alpha -308GA was a decreased risk of IS in both Han and Uyghur populations (OR:0.453, 0.213). In addition, the significant difference in GA frequency in TNF-alpha was found between the two ethnic controls (P=0.000). CONCLUSIONS: TNF-alpha -308 GA heterozygous may be an independent protective factor for IS in the Chinese Han and Uyghur populations.