The Citizen as a Public Health Actor: Complaints as Public Engagement with Aedes Mosquito Control in Singapore, 1965-1985.

In 1986, the World Health Organization heralded Singapore as a model for the control of dengue fever, a viral disease spread by the Aedes aegypti mosquito. Between 1965 and 1985, public health officials successfully employed educational campaigns and mandatory home inspections to convince citizens to guard against mosquito breeding at home. Although this story appears to recapitulate standard narratives of top-down progress in Singapore, this paper argues that the significant role of the public in public health has been overlooked. Citizens complained frequently, sometimes publicly, to public health authorities and often compelled direct responses from them. Through these complaints, citizens modified official anti-mosquito measures and expanded the reach of public health. Public health in Singapore thus appears not simply as the imposition of an autonomous state's vision onto a docile or even resistant citizenry but as a coevolution of the state and the public.

Sense of coherence mediates the relationship between digital health literacy and anxiety about the future in aging population during the COVID-19 pandemic: a path analysis.

Objectives: During the COVID-19 pandemic, older adults experience various challenges, including information uncertainties, financial pressure, and visit restrictions, which may lead to anxiety about the future. As a protective factor, sense of coherence (SOC) may play a role to reduce some psychological discomfort. This study aimed to analyze the relationships of SOC with anxiety, digital health literacy (DHL), information, and financial satisfaction among older adults during the outbreak.Methods: This is part of a large-scale DHL study with a cross-sectional survey across 41 countries. This study extracted data from three Asian countries (China, the Philippines, and Singapore) and included people aged ≥60. Structural equation modeling with path analysis was utilized to examine the relationships of SOC with anxiety about the future and other variables.Results: A total of 266 older adults were included, with 43.2% expressed anxiety about the future. DHL (ß=-0.13, p < 0.05) and SOC (ß=-0.26, p = 0.01) were negatively associated with anxiety, while financial and information satisfaction were not. However, financial satisfaction (ß = 0.34, p < 0.01) and DHL (ß = 0.32, p = 0.01) were positively associated with SOC. Higher SOC further mediated the negative relationships of DHL (ß= -0.11, p = 0.004) and financial satisfaction (ß= -0.12, p = 0.004) on anxiety of older adults.Conclusions: SOC had direct negative effect on anxiety and mediated the relationships between anxiety and DHL/financial satisfaction. Strategies should be developed to enhance SOC and DHL among older adults, as these capacities may help to manage anxiety during the pandemic.

Contextualization of Psychological First Aid: An Integrative Literature Review.

PURPOSE: Contextualization of psychological first aid (PFA) in different cultural, political, and socioeconomic contexts and in different population groups is essential. This review analyzes the efforts that have been made to contextualize PFA in different parts of the world for different disasters and emergencies. DESIGN: Integrative literature review. METHODS: The major databases that were searched for related literature published until August 2019 included JBI, MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), BIOSIS, ISI Web of Knowledge, Scopus, EBSCOhost, and PsycINFO. A total of 17 studies published in peer-reviewed journals were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) model, and the 6W3H tool was applied to synthesize the results. FINDINGS: PFA has been adapted to various disasters and populations in different countries and regions. The organizations that administer PFA range from community level to national level. Professional or "outside helpers" who enter disaster-affected locations include psychologists, fire fighters, social workers, and nurses. "Inside helpers," who live and work in the disaster-affected areas, include HR staff, teachers, and peer emergency personnel. Only a few studies have reported the exact number of first responders who administered PFA. Some studies revised PFA as group based, and a few reported the classification of groups of victims. Notably, all adaptations adhered to the basic principles of PFA, and the time at which PFA was administered ranged from a few days to months after an incident. PFA was conducted on site in all studies. The selection of the location depended on the type of disaster and local situation with due consideration of safety. Only a few studies specified the rationale for revising the PFA. None of these 17 studies reported the cost, cost-benefit, or cost-effectiveness of PFA. CONCLUSIONS: Population-focused, context-specific, and group-based PFA is emerging worldwide. Nurses are actively playing a role in providing PFA. Research gaps exist in differentiating between the roles played by "outside" and "inside" responders, considering vulnerable age groups other than children, incorporating the major PFA concepts such as resilience, and evaluating the cost-effectiveness of PFA. CLINICAL RELEVANCE: It is imperative that nurses and other emergency staff consider the intersection of age, gender, cultural, political, social economic, and spiritual contexts when developing a context appropriate PFA.

Families in the Time of the Pandemic: Breakdown or Breakthrough?

The COVID-19 pandemic has taken a toll on all individuals and their families around the world. Some suffer more adversely than others depending on their unique developmental needs, resources, and resilience. However, instead of breaking down, many families and therapists have hunkered down to cope with this 'wicked' situation as it continues to evolve. This article examines the unique challenges and opportunities of COVID-19 for families at different life developmental stages, as well as the challenges and opportunities for systemic therapists as they venture into unfamiliar territory. Through a case example and by integrating recent literature related to this pandemic, we apply three key and interconnected systemic themes (unsafe uncertainty, family life cycle, and social diversity) to discuss the challenges and opportunities for families and therapists, respectively. We are optimistic that there are many possibilities as families and therapists draw on, and often reinvent, currently available resources to navigate their course in this pandemic. We also find that while the pandemic continues to present unsafe and uncertain situations, there are new ways of being and behaving, especially when families and professionals work together collaboratively. Despite formidable challenges, there are many opportunities, both within families and communities that cut through different social contexts related to family, culture, economics, and even politics. Families and therapists could endure better when they are more cognisant of how and what these contexts may impact and offer them.

Health-related quality of life and post-traumatic stress disorder in inpatients injured in the Ludian earthquake: a longitudinal study.

BACKGROUND: The aim of this longitudinal study was to identify risk factors for posttraumatic stress disorder (PTSD) in inpatients injured in the Ludian earthquake and examine the relationship between PTSD symptoms and health-related quality of life (HRQoL) following the earthquake. METHODS: Three assessments were performed during an 18-month follow-up period. In total, one-hundred forty-seven inpatients of one-hundred seventy-four inpatients (85% of the initial sample) underwent all the assessments. Injured inpatients admitted to the No. 1 People's Hospital of Zhaotong City after a severe earthquake (6.5 on the Richter scale) were enrolled in the study and assessed using the Posttraumatic Stress Disorder Checklist-Civilian Version, Clinician-Administered Posttraumatic Stress Disorder Scale, and Medical Outcomes Study Short Form-36 Scale. RESULTS: At the first, third and eighteenth months after the earthquake, the prevalence rates for PTSD were 23, 14, and 7%, respectively. In a regression model, bereavement, history of major diseases, and severe injury in the earthquake were associated with severe PTSD symptoms. HRQoL was negatively correlated with PTSD symptoms. Compared to that of Chinese norms, participants' HRQoL was significantly lower in all eight HRQoL domains of the Medical Outcomes Study Short Form-36 Scale. CONCLUSIONS: The findings suggest that a substantial proportion of inpatients injured in the earthquake experienced severe PTSD symptoms and poor HRQoL. Therefore, early preventive programs and interventions should be implemented following disasters, to reduce PTSD and improve HRQoL in injured individuals.

Up close: family therapy challenges and innovations around the world.

Family therapists from 10 different countries (China, India, Israel including Palestinian citizens, Japan, Mexico, Peru, Spain, Turkey, Uganda, and the United Kingdom) describe systemic therapy in their contexts and current innovative work and challenges. They highlight the importance of family therapy continuing to cut across disciplines, the power of systems ideas in widely diverse settings and institutions (such as courts, HIV projects, working with people forced into exile), extensive new mental health initiatives (such as in Turkey and India), as well as the range of family therapy journals available (four alone in Spain). Many family therapy groups are collaborating across organizations (especially in Asia) and the article presents other ideas for connections such as a clearing house to inexpensively translate family therapy articles into other languages.

Mushroom body output neurons MBON-a1/a2 define an odor intensity channel that regulates behavioral odor discrimination learning in larval Drosophila.

The sensitivity of animals to sensory input must be regulated to ensure that signals are detected and also discriminable. However, how circuits regulate the dynamic range of sensitivity to sensory stimuli is not well understood. A given odor is represented in the insect mushroom bodies (MBs) by sparse combinatorial coding by Kenyon cells (KCs), forming an odor quality representation. To address how intensity of sensory stimuli is processed at the level of the MB input region, the calyx, we characterized a set of novel mushroom body output neurons that respond preferentially to high odor concentrations. We show that a pair of MB calyx output neurons, MBON-a1/2, are postsynaptic in the MB calyx, where they receive extensive synaptic inputs from KC dendrites, the inhibitory feedback neuron APL, and octopaminergic sVUM1 neurons, but relatively few inputs from projection neurons. This pattern is broadly consistent in the third-instar larva as well as in the first instar connectome. MBON-a1/a2 presynaptic terminals innervate a region immediately surrounding the MB medial lobe output region in the ipsilateral and contralateral brain hemispheres. By monitoring calcium activity using jRCamP1b, we find that MBON-a1/a2 responses are odor-concentration dependent, responding only to ethyl acetate (EA) concentrations higher than a 200-fold dilution, in contrast to MB neurons which are more concentration-invariant and respond to EA dilutions as low as 10-4. Optogenetic activation of the calyx-innervating sVUM1 modulatory neurons originating in the SEZ (Subesophageal zone), did not show a detectable effect on MBON-a1/a2 odor responses. Optogenetic activation of MBON-a1/a2 using CsChrimson impaired odor discrimination learning compared to controls. We propose that MBON-a1/a2 form an output channel of the calyx, summing convergent sensory and modulatory input, firing preferentially to high odor concentration, and might affect the activity of downstream MB targets.

Safe uncertainty: Reflecting on the pandemic responses of two Asian cities.

This reflection focuses on the salient racial, cultural and political processes in the response to COVID-19, particularly in Hong Kong and Singapore, using a framework that examines safety and certainty or the lack of it. It begins by examining the awful racism internationally toward Chinese and the unique Chinese culinary practices that has become a contentious focus in this pandemic. It will then reflect on the meaning and impact of political contexts, with reference to the use surgical masks in Hong Kong and Singapore. Next, it will discuss the disruptions and discoveries for social work teaching and learning and practice during this turbulent time. The reflection will end by looking at the silver linings, and re-thinking about safety and certainty for individuals and social work development, as the pandemic continues to evolve.

Individual Disaster Preparedness in Drought-and-Flood-Prone Villages in Northwest China: Impact of Place, Out-Migration and Community.

Rural communities are generally more vulnerable to natural hazards when compared to urban communities. Moreover, rural communities are diverse and unique in their place, population, agricultural production and culture, which make it challenging for different rural settings to prepare for disasters. There is a little comparison made about the individual disaster preparedness among rural communities with different geographic landforms. In this study, we examined the individual disaster preparedness of rural residents in three drought-and-flood-prone villages with different landforms (plains, loess plateau and mountains) via a cross-sectional self-report structured questionnaire survey conducted in Northwest China. We also adopted an ecological framework to examine the determinants of villagers' individual disaster preparedness across different dimensions: place, individual sociodemographic factors, family socioeconomic status, hazard adaptations, community and neighbourhood influences. We found that place was a significant factor for disaster preparedness when controlling individual sociodemographic and family socioeconomic factors. The level of preparedness in the plains was higher than both mountains and plateau. Moreover, the villagers who had out-migrated to work reported a higher level of disaster preparedness than did local villagers. In addition, the community and neighbourhood played an important role in determining individual disaster preparedness. This research highlights the needs for tailored community-based disaster risk reduction programs to improve villagers' knowledge and skills of disaster preparedness.

Psychosocial Well-Being of School-Aged Children Born to Bereaved (Shidu) Families: Associations with Mothers' Quality of Life and Involvement Behaviors.

Parents who lost their only child in the 12 May 2018 Wenchuan earthquake came to be known as the "shidu" (loss of an only child) parents. After the earthquake, they were beneficiaries of free reproductive health services, and most had another child. This study focuses on the psychosocial well-being of those children born to the shidu parents, and explores factors associated with mothers' quality of life (QoL) and their involvement with their children. A cross-sectional survey was conducted in two primary schools in Wenchuan County. A sample of 192 families was analyzed (147 non-shidu and 45 shidu). The statistical analyses indicated that the children of shidu families had poorer peer relationships than children of non-shidu families. Moreover, shidu mothers' expectations of their children's achievements were significantly lower than for non-shidu mothers, but there was no statistically significant difference in the QoL between them. Additionally, a higher home-based involvement of mothers was found to be moderately associated with peer relationship problems of children in shidu families. Therefore, we suggest a future research focus on developing joint activities for parents and children that help to increase emotional communication for the psychosocial development of children in shidu families after disasters in China.

Health-Promoting Lifestyles Among Health Care Workers in a Postdisaster Area: A Cross-sectional Study.

OBJECTIVE: Health care workers performing rescue tasks in large-scale disaster areas are usually challenged in terms of physical and mental endurance, which can affect their lifestyles. Nevertheless, data on whether health care workers tend to adopt healthy lifestyles after disasters are limited. This paper compares the adoption of healthy lifestyle behaviors among health care workers with that among non-health care workers in a postdisaster area. METHODS: This cross-sectional observational study was conducted in August 2016. The Health-Promoting Lifestyle Profile II questionnaire was used to interview 261 health care workers and 848 non-health care workers. RESULTS: Results of the multivariable linear models showed that health care workers had lower physical activity levels (ß=-1.363, P<.0001), worse stress management (ß=-1.282, P<.0001), slower spiritual growth (ß=-1.228, P=.002), and poorer interpersonal relationships (ß=-0.814, P=.019) than non-health care workers. However, no significant differences were found in either nutrition (ß=-0.362, P=.319) or health responsibility (ß=-0.421, P=.283). CONCLUSIONS: Health care workers had less healthy lifestyle behaviors, including physical activity, stress management, spiritual growth, and interpersonal relationships. Further studies are needed to develop health-improving interventions for health care workers in postdisaster areas. (Disaster Med Public Health Preparedness. 2019;13:230-235).

Impulsivity, self-regulation,and pathological video gaming among youth: testing a mediation model.

Given the potential negative mental health consequences of pathological video gaming, understanding its etiology may lead to useful treatment developments. The purpose of the study was to examine the influence of impulsive and regulatory processes on pathological video gaming. Study 1 involved 2154 students from 6 primary and 4 secondary schools in Singapore. Study 2 involved 191 students from 2 secondary schools. The results of study 1 and study 2 supported the hypothesis that self-regulation is a mediator between impulsivity and pathological video gaming. Specifically, higher levels of impulsivity was related to lower levels of self-regulation, which in turn was related to higher levels of pathological video gaming. The use of impulsivity and self-regulation in predicting pathological video gaming supports the dual-system model of incorporating both impulsive and reflective systems in the prediction of self-control outcomes. The study highlights the development of self-regulatory resources as a possible avenue for future prevention and treatment research.

Pathological video game use among youths: a two-year longitudinal study.

OBJECTIVES: We aimed to measure the prevalence and length of the problem of pathological video gaming or Internet use, to identify risk and protective factors, to determine whether pathological gaming is a primary or secondary problem, and to identify outcomes for individuals who become or stop being pathological gamers. METHODS: A 2-year, longitudinal, panel study was performed with a general elementary and secondary school population in Singapore, including 3034 children in grades 3 (N = 743), 4 (N = 711), 7 (N = 916), and 8 (N = 664). Several hypothesized risk and protective factors for developing or overcoming pathological gaming were measured, including weekly amount of game play, impulsivity, social competence, depression, social phobia, anxiety, and school performance. RESULTS: The prevalence of pathological gaming was similar to that in other countries (∼9%). Greater amounts of gaming, lower social competence, and greater impulsivity seemed to act as risk factors for becoming pathological gamers, whereas depression, anxiety, social phobias, and lower school performance seemed to act as outcomes of pathological gaming. CONCLUSION: This study adds important information to the discussion about whether video game "addiction" is similar to other addictive behaviors, demonstrating that it can last for years and is not solely a symptom of comorbid disorders.

Pathological video-gaming among Singaporean youth.

INTRODUCTION: Increase in internet use and video-gaming contributes to public concern on pathological or obsessive play of video games among children and adolescents worldwide. Nevertheless, little is known about the prevalence of pathological symptoms in video-gaming among Singaporean youth and the psychometric properties of instruments measuring pathological symptoms in video-gaming. MATERIALS AND METHODS: A total of 2998 children and adolescents from 6 primary and 6 secondary schools in Singapore responded to a comprehensive survey questionnaire on sociodemographic characteristics, video-gaming habits, school performance, somatic symptoms, various psychological traits, social functioning and pathological symptoms of video-gaming. After weighting, the survey data were analysed to determine the prevalence of pathological video-gaming among Singaporean youth and gender differences in the prevalence. The construct validity of instrument used to measure pathological symptoms of video-gaming was tested. RESULTS: Of all the study participants, 8.7% were classified as pathological players with more boys reporting more pathological symptoms than girls. All variables, including impulse control problem, social competence, hostility, academic performance, and damages to social functioning, tested for construct validity, were significantly associated with pathological status, providing good evidence for the construct validity of the instrument used. CONCLUSION: The prevalence rate of pathological video-gaming among Singaporean youth is comparable with that from other countries studied thus far, and gender differences are also consistent with the findings of prior research. The positive evidence of construct validity supports the potential use of the instrument for future research and clinical screening on Singapore children and adolescents' pathological video-gaming.

Family therapy in the Forbidden City: a review of Chinese journals from 1978 to 2006.

This article provides a glimpse into the development of family therapy in China, by reviewing family therapy articles written in Chinese and published in journals in China that are not, therefore, readily accessible to the international community. A content analysis of journals published between 1978 and 2006 revealed 199 family therapy articles in 109 Chinese journals. Most of the studies were conducted by psychiatry or medical professionals, and were based on general systems theory or a systemic family therapy model. The articles focused on the promotion of family therapy theories and interventions in China, but did not specify the application of theory to specific clientele or symptoms. After the year 2000, a threefold increase in the number of family therapy publications was noted. These papers included the introduction of additional theories, but did not include critical assessment of the applicability of Western family therapy models to Chinese families. The researchers noted an absence of articles that identified Chinese approaches to family therapy, and a paucity of papers on gender, professional reflection, and the therapy process. The article concludes that there is room for improvement in the quality of family therapy publications in China, and that gains may be made by interdisciplinary collaboration among academics and practitioners.