Gas transport in landfill cover system: A critical appraisal.

Landfill gas (LFG) emission is gaining more attention from the scientific fraternity and policymakers recently due to its threat to the atmosphere and human health of the populace living in surrounding premises. Though landfill cover (LFC) (viz., daily, intermittent and final cover) is widely used by landfill operators to mitigate or reduce these emissions, their overall performance is still under question. A critical analysis of available literature, primarily pertaining to (i) the composition of the landfill gases and their migration in the LFC system, (ii) experimental and mathematical investigations of the transport mechanism of gas and (iii) the impact of additives to cover soils on transport and fate of gas, has been conducted and presented in this manuscript. Investigation of the efficiency of modified soil was mainly focused on laboratory test. More field tests and application of amended cover soils should be conducted and promoted further. Studies on nitrous oxide and emerging pollutants, including poly-fluoroalkyl substances transport in landfill cover system are limited and need further research. The transport mechanisms of these unconventional contaminants should be considered regarding the selection of LFC materials including geomembrane and geosynthetic clay liners. The existing analytical and numerical models can provide a basic understanding of LFG transport mechanisms and are able to predict the migration behaviour of LFG; however, there are still knowledge gaps concerning the interaction between different species of the gas molecule when modeling multi-component gas transport. Gas transport through fractured cover should also be considered when evaluating LFG emission in the future. Simplified design method for landfill cover system regarding LFG emission based on analytical models should be proposed. Overall, mathematical models combined with experiments can facilitate more visualized and intensive insights, which would be instrumental in devising climate adaptive landfill covers.

The loss and return of self: An interpretative phenomenological analysis of coping and recovery from chronic hepatitis B in China.

Chronic hepatitis B (CHB) is a prevalent disease with various negative consequences. The lived experience of coping and recovery of a patient with Chronic hepatitis B was explored in this study. A semistructured interview was conducted with one participant who had been recovered from Chronic hepatitis B for 10 years. Data were analyzed using interpretative phenomenological analysis. Five superordinate themes emerged, including lingering in the shadow of death anxiety, diminished functioning of the self, adopting a highly disciplined lifestyle, receiving social support, and the return of the self with scars. The findings revealed that the disease is deeply associated with moral standing, which means the diagnosis of Chronic hepatitis B might imply a loss of moral face for Chinese people living with the condition. Our findings point to the need for increasing knowledge about chronic hepatitis B, decoupling the disease from a moral standpoint, and providing a supportive environment.

Who suffered most after deaths due to COVID-19? Prevalence and correlates of prolonged grief disorder in COVID-19 related bereaved adults.

BACKGROUND: Deaths by COVID-19 have left behind nearly 12 million recent bereaved individuals worldwide and researchers have raised concerns that the circumstances of COVID-19 related deaths will lead to a rise prevalence of prolonged grief disorder (PGD) cases. However, to date, no studies have examined the prevalence of PGD among people bereaved due to COVID-19. This study aimed to estimate the prevalence of PGD and investigated demographic and loss-related factors associated with prolonged grief symptoms among Chinese individuals bereaved due to COVID-19. METHODS: This was a cross-sectional online survey conducted between September 1 and October 3, 2020. A total of 422 Chinese participants (55.5% males; 32.73 [9.31] years old) who lost a close person due to COVID-19 participated in the study. Demographic and loss-related information was collected, and self-reported prolonged grief symptoms were measured by a 13-item International Prolonged Grief Disorder Scale (IPGDS: 1-65) and a 17-item Traumatic Grief Inventory Self Report (TGI-SR: 1-85). Multiple linear regression analysis was used to determine the associated factors of levels of grief symptoms. RESULTS: Prevalence of PGD was 37.8% screened by IPGDS and 29.3% by TGI-SR. No difference was found in levels of grief symptoms between participants whose close one died more than 6 months ago and those who experienced the loss less than 6 months ago. More severe prolonged grief symptoms assessed by IPGDS was associated with losing a close person by COVID-19 rather than complications (B: 5.35; 95% CI: 0.54-10.05), losing a partner (B: 7.80; 95% CI: 3.24-12.37), child (B: 8.15; 95% CI: 1.03-15.26), and parent (B: 5.49; 95% CI: 1.49-9.48) rather than losing a relative or a person with other relationship, feeling more traumatic about the loss (B: 1.71; 95% CI: 0.52-2.90), being closer with the deceased (B: 1.60; 95% CI: 0.34-2.86). Moreover, Losing a grandparent (B: 6.62; 95% CI: 0.53-12.71) and having more conflicts with the deceased (B: 1.05; 95% CI: - 0.008-2.11) were related to higher levels of grief symptoms assessed by TGI-SR. CONCLUSIONS: Echoing researchers' concerns, the prevalence of PGD is high among people bereaved due to COVID-19. Individuals with a higher risk of developing PGD should be identified and bereavement support should be offered as early as possible.

Trajectories of depression symptoms in Chinese elderly during widowhood: a secondary analysis.

Objectives: This study aims to identify heterogeneous depressive symptom trajectories among the widowed elderly in China, to explore predictive variables of latent class membership, and to detect between-classes differences in life satisfaction across time.Method: Data of 198 individuals widowed between 2011 and 2013 were drawn from The China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. Latent class growth analysis was employed to identify depressive symptom trajectories across 2011, 2013, and 2015, and a three-step auxiliary approach was applied to detect predictive variables of latent class membership. Mixed Analysis of Variances was followed to make between-class comparisons on life satisfaction across time.Results: Four grieving trajectories were identified: resilient (54.6%), chronic grief (23.7%), depressed-improved (11.6%), and chronic depression (10.1%). Older age, living exclusively with spouse before widowhood, and agricultural Hukou were significant predictors of depressed-improved, chronic grief, and chronic depression patterns, respectively. Life satisfaction in all groups except for the resilient one remained stable across time, and that of the chronic depression group was significantly lower than those of all the remaining groups.Conclusion: Consistent depressive symptom trajectories during late-life widowhood exist across nations while the specific culture, values, and resources in the Chinese context may have contributed to a particularly high proportion of the chronic grief trajectory. More efforts should be made to identify patterns with predictors before support are provided, and interventions need to be tailored to target specific needs in each subgroup of the elderly during their transitions to widowhood.

Can grief be a mental disorder? An online survey on public opinion in mainland China.

This study investigates Chinese people's opinions about the diagnosis of grief and the factors associated with their opinions. Among 1041 participants who completed the online survey, over half (56.5%) agreed that grief could be a mental disorder under certain circumstances, such as harm to self or others, functional impairment, and persistent grief. Primary reasons against the diagnosis were that grief is normal and its intensity decreases over time. A small proportion of opponents also expressed concerns about stigmatization resulting from labeling grief as being pathological. Younger, male, and full-time employed adults tended to support diagnosing grief as a mental disorder.

Predictive factors for differential changes in grief symptoms following group bereavement intervention for Chinese widowed older adults.

This study aimed to delineate changes in the patterns of prolonged grief severity in widowed adults following group bereavement interventions and to identify the predictive factors impacting these patterns. We performed a secondary analysis of data from a randomized trial of 125 Chinese widowed older adults who participated in either LOGBI or DPGBI. Self-ratings of prolonged grief symptoms via Inventory of Complicated Grief (ICG) were subjected to latent class growth analysis to identify subgroups according to symptomatic changes among baseline, post-treatment, and 8-week follow-up. Multinomial regression analysis examined whether participant classification could be predicted by demographics, loss-related characteristics, and the relationship with the deceased and baseline symptom severity. In the results, intervention sample comprised 96 completers with an attendance greater than 60%. A three-class categorization yielded the best model fit for changes in prolonged grief severity for both randomized and intervention samples: improved class (41.6% in the randomized sample, 42.8% in the intervention sample), partial responded class (48.1%/45.5%), and relapse class (10.3%/11.8%). Older widowed adults experiencing a high level of grief at baseline and bereavement following chronic illness had an elevated risk of symptomatic relapse after the completion of intervention. These findings indicated that Chinese widowed adults experienced different changing patterns of prolonged grief severity following group bereavement interventions. Practically, widowed adults with a higher risk of symptomatic relapse might need more intensive or longer term intervention or follow-up support.

Professional caregivers' bereavement after patients' deaths: A scoping review of quantitative studies.

We conducted a scoping review of quantitative studies on professional caregivers' bereavement after patients' deaths following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found 12 studies involving 1317 professional caregivers that met inclusion criteria. Professional caregivers commonly had moderate, and sometimes long-term, bereavement reactions after patients' death. The evidence of factors affecting profession grief is inconclusive. Previous researchers extensively used the framework of understanding familial bereavement for analyzing the professional caregivers' bereavement, which we found to be inadequate. We call for a clear definition of professional bereavement and the development of a specific measurement tool.

Psychometric evaluation of the Chinese version of the Utrecht Grief Rumination Scale.

Given the severe mental health consequences that may ensue after bereavement, it is crucial to better understand malleable cognitive factors that are associated with poorer bereavement outcomes. Grief rumination (i.e., repetitive thinking about the causes and consequences of a loss) is a malleable cognitive process that is concurrently and longitudinally associated with postloss mental health problems. To assess grief rumination, the English and Dutch Utrecht Grief Rumination Scale (UGRS) were recently developed. The current study examined the reliability and validity of a Chinese version of the UGRS. Three hundred and ninety-three Chinese adults (56% women) bereaved on average 16.88 months ago filled out online questionnaires assessing demographic and loss-related characteristics, grief rumination (UGRS), trait rumination, trait mindfulness, and anxiety, depressive, and prolonged grief symptoms. Confirmatory factor analyses showed that a second-order five-factor hierarchical model provided the most optimal factor structure for the Chinese UGRS. UGRS total scale and subscale scores demonstrated acceptable internal consistency. Grief rumination had a moderate positive association with trait rumination and a low negative association with trait mindfulness, providing convergent and discriminant validity evidence. Test-criterion validity evidence was also provided. UGRS scores could distinguish bereaved groups with different relationships with the deceased. Moreover, grief rumination was associated with symptoms of anxiety, depression, and prolonged grief even after controlling for demographic and loss-related variables, trait rumination, and trait mindfulness. The Chinese UGRS appears a valid and reliable instrument to assess grief rumination in Chinese bereaved individuals.

Subjective and objective traumatic death: distinct roles in developing complicated grief and depression among older adults in Hong Kong.

BACKGROUND: Symptoms of complicated grief are associated with a traumatic death. However, the subjective experience of whether or not the death was considered traumatic has not been substantially explored. This study first examined the difference between objective and subjective traumatic death, and then investigated their respective impacts on complicated grief and depressive symptoms following bereavement among older adults in Hong Kong. METHODS: Participants were 187 Hong Kong adults aged 65 years or above who had lost a family member within the past five years. Demographic information, the Inventory of Complicated Grief (ICG), the Geriatric Depression Scale (GDS), and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) were utilized. RESULTS: The subjective traumatic level of the death did not differ between the objective traumatic and non-traumatic death as defined by nature of death (t = -1.554, p = 0.122). Higher subjective traumatic levels and younger age of the deceased, were positively related to complicated grief symptoms, F (10, 161) = 14.222, p < 0.001, R 2 = 0.469. Higher subjective traumatic levels and older age of the bereaved were positively associated with symptoms of depression, F (10, 160) = 2.855, p = 0.003, R 2 = 0.151. However, objective traumatic death was found to have no relation to either complicated grief or depressive symptoms. CONCLUSIONS: Subjective and objective traumatic death may be two distinct concepts, and the subjective experience of the death as a trauma may be a more important factor that contributes to complicated grief and depressive symptoms.

Healing grief - an online self-help intervention programme for bereaved Chinese with prolonged grief: study protocol for a randomised controlled trial.

Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements.Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reappraisal, and meaning reconstruction, and will be delivered via expressive writing. The intervention comprises six modules, with two sessions in each module, and requires participants to complete two sessions per week and complete the intervention in 6 weeks. The primary outcomes include effectiveness, acceptability, and feasibility. The effectiveness will be assessed by measures of prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. Acceptability and feasibility will be evaluated using survey and interview on user experience characteristics. Secondary outcomes include moderators and mediators, such as dual process coping, grief rumination, mindfulness, and continuing bond, to explore the psychological mechanisms of potential improvement. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.Conclusion: The proposed study will determine the effectiveness, acceptability, and feasibility of the newly developed online self-help intervention for bereaved Chinese with prolonged grief and clarify how the intervention helps with symptom improvements. Such an intervention may play an important role in easing the imbalance between the delivery and receipt of bereavement psychological services in China.

In China, mental health services are not widely available for bereaved people.The proposed study will be the first one to develop and evaluate an Internet-based self-help grief intervention for bereaved Chinese with prolonged grief.The proposed study will determine whether and how the intervention helps to improve the mental health of bereaved Chinese with prolonged grief.

[Design and application of artificial multicellular systems for nitrogen removal from wastewater].

Excessive accumulation of nitrogen is a major cause of water eutrophication. Developing an inexpensive and efficient nitrogen removal technology is therefore essential for wastewater purification. The microbial technology for nitrogen removal has been widely used for its low cost, high efficiency, and strong environmental adaptability. Most recently, with the advances in synthetic biotechnology, artificial multicellular systems have been sufficiently developed and exhibited unique definability and controllability. Compared with those in the natural microbial consortia, the nitrogen removal pathways and environmental response mechanisms are easy to be clarified in the artificial multicellular systems, which allow for efficient nitrogen removal under low cellular metabolic loading. Therefore, artificial multicellular systems demonstrate great application potential in the purification of wastewater, including landfill leachate, industrial wastewater, seawater aquaculture wastewater, and domestic sewage. We focused on the design, building, and application of artificial multicellular systems for nitrogen removal from wastewater. Specifically, we summarized the functional microorganisms and their nitrogen removal mechanisms, introduced the design principles and building methods of artificial multicellular systems, illustrated the application of artificial multicellular systems with examples, and prospected the future research trend in nitrogen removal from wastewater. The conclusion is expected to provide new insights and efficient strategies for optimizing the microbial nitrogen removal from wastewater.

Further validation of a Chinese version of the Obsessive-Compulsive Inventory-Revised.

BACKGROUND: There has been an increased effort to understand the nature of obsessive-compulsive disorder (OCD) in non-Western cultures. In particular, growing research has examined OCD in China, but there are no comprehensive instruments that measure both OCD severity and heterogeneity for characterizing samples. AIMS: A validated, comprehensive measure that could be used in China would provide researchers with a useful instrument for evaluating severity and heterogeneity of OCD in a non-Western culture, allowing researchers to better understand the universal and cultural components that play a role in the nature of OCD. METHOD: The current investigation presents data on the reliability and validity of a Mandarin translation of the Obsessive-Compulsive Inventory-Revised (CH-OCI) using both a student (n = 1950) and clinical sample (n = 50 patients with OCD; n = 50 patients with anxiety as a comparison group). RESULTS: Results support the factor structure, convergent and discriminant validity, criterion-related validity, test-retest reliability, and internal consistency of the CH-OCI. CONCLUSIONS: Validation of the instrument permits researchers and clinicians to measure OCD presentation in Mandarin-speaking samples.

A network analysis of posttraumatic stress symptoms and quality of relationship with deceased in COVID-19 bereaved adults.

OBJECTIVE: Network analyses showed that the posttraumatic stress disorder (PTSD) symptom structures may vary across traumatic events and types of survivors. However, the structure of PTSD symptoms in COVID-19 bereavement remains unknown. This study aimed to depict the structure of the PTSD symptom network and illuminate how the quality of the predeath relationship between the bereaved and the deceased links to the PTSD symptom network. METHOD: Using self-reported data from 408 COVID-19 bereaved adults (225 male and 183 female) collected within 9-month postbereavement, we constructed two graphical lasso networks of PTSD symptoms. RESULTS: Symptoms with the highest centrality were exaggerated startle, negative emotional states, and reckless/self-destructive behavior, with exaggerated startle having relatively low predictability. The strongest connections were found between exaggerated starkness and detachment, and between psychological cue response and thoughts of avoidance. Moreover, closeness to and conflict with the deceased were linked to the PTSD symptom network through nightmares and physiological cue reactivity, respectively. CONCLUSIONS: This study extends our understanding of what PTSD is for people who are bereaved due to the COVID-19 pandemic by unveiling the structure of the PTSD symptom network. It also helps to distinguish the symptom-level links between quality of relationship with deceased and PTSD among the bereaved. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Aggressive parenting behavior among grandparents providing childcare for grandchildren: A case study of Shenzhen, China.

BACKGROUND: Grandparents play an essential role in childrearing and fill the parenting gap for dual-earner Chinese families. Many Chinese grandparents engage heavily in childcare, which may increase the risk of child abuse. OBJECTIVE: This study aimed to examine grandparental use of psychological and physical aggression toward children and explore its associated risk factors. PARTICIPANTS AND SETTING: This was a cross-sectional study which involved purposive sampling of 278 grandparents (204 females and 74 males) taking care of at least one grandchild below 18 years old in Shenzhen, China. METHODS: Information on childcare was collected, including grandparents' use of psychological and physical aggression and their involvement in childcare in terms of intensity and activity. RESULTS: An alarming percentage (57.1 %) of grandparents had used psychological aggression, while 26.5 % had used corporal punishment, in the past year. The average use of psychological aggression and corporal punishment was 16.10 times and 10.08 times per year, respectively. Grandparents taking care of two or more grandchildren were more likely to use psychological aggression and corporal punishment compared to those taking care of only one grandchild. Higher mental and physical health summary scores were associated with lower likelihood of psychological and physical aggression of grandparents. CONCLUSIONS: This study advances our understanding of negative grandparenting behavior in childcare. As grandparents play a significant role in childcare, we need to improve their grandparenting skills, provide more formal childcare services to ease their childcare burden, and support their physical and mental well-being to reduce the risk of child abuse.

Hyperthermophilic pretreatment significantly accelerates thermophilic composting humification through improving bacterial communities and promoting microbial cooperation.

Thermophilic composting (TC) can effectively shorten maturity period with satisfactory sanitation. However, the higher energy consumption and lower composts quality limited its widespread application. In this study, hyperthermophilic pretreatment (HP) was introduced as a novel approach within TC, and its effects on humification process and bacterial community during food waste TC was investigated from multiple perspectives. Results showed that a 4-hour pretreatment at 90 °C increased the germination index and humic acid/fulvic acid by 25.52% and 83.08%, respectively. Microbial analysis demonstrated that HP stimulated the potential functional thermophilic microbes, and significantly up-regulated the genes related to amino acid biosynthesis. Further network and correlation analysis suggested that pH was the key factor affecting bacterial communities, and higher HP temperatures help to restore bacterial cooperation and showed higher humification degree. In summary, this study contributed to a better understanding of the mechanism towards the accelerated humification by HP.

Catalytic supercritical water oxidation of o-chloroaniline over Ru/rGO: Reaction variables, conversion pathways and nitrogen distribution.

To ascertain the reaction variables on o-chloroaniline (o-ClA) mineralization, total nitrogen (TN) removal rate, and N-species distribution, o-ClA was subjected to catalytic supercritical water oxidation (CSCWO) in a fused quartz tube reactor (FQTR). The findings demonstrated that when the temperature, reaction time, and excess oxidant were 400 °C, 90 min, and 150%, respectively, the mineralization rate of o-ClA could reach more than 95%. Moreover, potential degradation pathways of o-ClA in supercritical water oxidation (SCWO) was proposed according to the GC-MS results. TN removal rate is significantly impacted by Ru/rGO, despite the fact that its catalytic effect on the mineralization of o-ClA was not particularly noteworthy. Compared with no catalyst, the TN removal rate of o-ClA obviously increased from 44.1% to 90.3% at 400 °C, 10 wt% Ru loading, 90 min and 200% excess oxidant. In addition, N-species distribution in SCWO and CSCWO were also investigated. Results indicated that the Ru/rGO catalyst could accelerate the oxidation of ammonia-N and convert it to nitrate-N, promoting N2 generation. Finally, the possible N transformation pathway in CSCWO of o-ClA was proposed. As a result, this work offers fundamental information about o-ClA catalytic oxidation removal in the SCWO process.

New insights into nitrogen control strategies in sewage sludge pyrolysis toward environmental and economic sustainability.

Sewage sludge (SS) contains a certain amount of nitrogen (N), resulting in various content of N in the pyrolysis products. Investigates on how to control the generation of NH3 and HCN (deleterious gas-N species) or convert it to N2 and maximize transforming N in sewage sludge (SS-N) into potentially valuable N-containing products (such as char-N and/or liquid-N) are of great significance for SS management. Understanding the nitrogen migration and transformation (NMT) mechanisms in SS during the pyrolysis process is essential for investigating the aforementioned issues. Therefore, in this review, the N content and species in SS are summarized, and the influencing factors during the SS pyrolysis process (such as temperature, minerals, atmosphere, and heating rate) that affect NMT in char, gas, and liquid products are analyzed. Furthermore, N control strategies in SS pyrolysis products are proposed toward environmental and economic sustainability. Finally, the state-of-the-art of current research and future prospects are summarized, with a focus on the generation of value-added liquid-N and char-N products, while concurrently reducing NOx emission.

Effects of fungal agents and biochar on odor emissions and microbial community dynamics during in-situ treatment of food waste.

The effects of the co-addition of fungal agents and biochar on physicochemical properties, odor emissions, microbial community structure, and metabolic functions were investigated during the in-situ treatment of food waste. The combined addition of fungal agents and biochar decreased cumulative NH3, H2S, and VOCs emissions by 69.37%, 67.50%, and 52.02%, respectively. The predominant phyla throughout the process were Firmicutes, Actinobacteria, Cyanobacteria, and Proteobacteria. Combined treatment significantly impacted the conversion and release of nitrogen from the perspective of the variation of nitrogen content between different forms. FAPROTAX analysis revealed that the combined application of fungal agents and biochar could effectively inhibit nitrite ammonification and reduce the emission of odorous gases. This work aims to clarify the combined effect of fungal agents and biochar on odor emission and provide a theoretical basis for developing an environmentally friendly in-situ efficient biological deodorization (IEBD) technology.

Relations between parental response to children's negative emotions and suicidal ideation in chinese adolescents: Internalizing problems, emotion regulation, and perceived relationship quality with parents as mediators.

Past work points to the crucial role of parents' responses to children's negative emotions (PRCNE) in adolescents' socioemotional adjustment. The presence of suicidal ideation (SI) is an important sign of significant distress and suicide risk. However, research on the relations between PRCNE and adolescents' SI is lacking. This research aimed to investigate whether parental reactions to children's negative emotions (PRCNE) was related to adolescents' SI and, if so, through which processes. This research utilized data from a sample of Chinese adolescent families (N = 4,574; Parents: 35.81% males, M = 44.07 years old; Adolescents: 55.40% males, M = 16.28 years old), with parents giving their reports on PRCNE and adolescents self-evaluating their psychosocial development (i.e., internalizing problems, emotion regulation, perceived relationship quality with parents) and SI. We examined the relations between six types of PRCNE and adolescents' SI, and analyzed the mediating roles of adolescents' internalizing problems, emotion regulation (i.e., cognitive reappraisal and expressive suppression), and perceived relationship quality with parents. The results showed that emotion-focused response, problem-focused response, and expression encouragement negatively predicted, while punitive response and distress response positively predicted adolescents' SI. However, no statistically significant association emerged between minimization and adolescents' SI. Moreover, adolescents' internalizing problems, usage of expressive suppression, and perceived relationship quality with parents could mediate the relations between PRCNE and adolescents' SI. Contrary to our hypothesis, the results did not support an indirect effect of PRCNE on adolescents' SI through adolescents' cognitive reappraisal. The present research illuminates adolescents' SI by emphasizing the roles of PRCNE. The findings also highlight the importance of paying attention to adolescents' internalizing problems, expressive suppression, and perceived relationship quality with parents in relation to PRCNE in interventions aimed at reducing adolescents' SI.

Prevalence of social anxiety disorder and symptoms among Chinese children, adolescents and young adults: A systematic review and meta-analysis.

The objective of the study is to provide a reliable estimate of the pooled prevalence of social anxiety disorder (SAD) and social anxiety symptoms (SAS) among children, adolescents, and young adults (CAYA) in China. Meta-analysis is used to provide pooled-prevalence rate of SAD and SAS. Literature searches were conducted in both English and Chinese databases from the database's inception to April 2019. Eleven studies were identified for SAD, and 17 were included for SAS. The results revealed a pooled prevalence of SAD of 2.1% (95% CI: 1.2-3.8%) with high between-studies heterogeneity (Q = 1,055.2, I 2 = 99.1%, p < 0.001). The pooled prevalence estimate of SAS was 23.5% (95% CI: 18.6-29.3%), also with significant heterogeneity (Q = 1,019.3, I 2 = 98.4%, p < 0.001). Different diagnostic tools or self-report scales reported significant different prevalence of SAD or SAS. Further analysis stratified by gender, age, sampling methods, economic status, and risk of bias were performed. Limitations include the high level of heterogeneity between studies, inadequate number of the studies, and significant differences in prevalence caused by measurements. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020149591, identifier: PROSPERO CRD42020149591.