An outbreak in Wuhan, China in late 2019 of a highly infectious new coronary pneumonia (COVID-19) led to the imposition of countrywide confinement measures from January to March 2020. This is a ...longitudinal study on changes in the mental health status of a college population before and after their COVID-19 confinement for the first two weeks, focusing on states of psychological distress, depression, anxiety and affectivity. The influence of possible stressors on their mental health were investigated, including inadequate supplies and fears of infection. Five hundred and fifty-five undergraduate students were recruited from Hebei Agricultural University in Baoding, China. The participants completed two online surveys-on anxiety and depression, and on positive and negative affect. One survey was conducted before the confinement and the other was conducted 15-17 days after the start of the confinement. Increases in negative affect and symptoms of anxiety and depression (
-values < 0.001) were observed after 2 weeks of confinement. Inadequate supplies of hand sanitizers, a higher year of study, and higher scores on anxiety and depression were common predictors of increased negative affect, anxiety, and depression across the confinement period. The results suggest that healthcare policymakers should carefully consider the appropriate confinement duration, and ensure adequate supplies of basic infection-control materials.
A debate on the decision of women to choose a cesarean section as the mode of birth in uncomplicated pregnancies from the views of relevant stakeholders.
Using five electronic databases, a literature ...search was conducted for studies published from January 2003 to December 2016. Studies on a woman's right to request or to choose a cesarean section as the mode of birth in uncomplicated pregnancies were included. Fifty-five articles were identified (39 research studies and 16 opinion-based articles). Among health professionals, obstetricians were the most supportive of this right. It is argued that although women reported wanting to choose the mode of birth, with the safety of their babies as the priority, they also relied on the advice of their maternity care provider and considered it the responsibility of their obstetrician to make the decision. A higher proportion of the general public in countries with well-developed private healthcare accepted that a woman should have the freedom to choose the mode of birth.
This review provided a debate on the choice of pregnant women in uncomplicated pregnancies on the mode of birth from various stakeholders. Further research is required to explore what the meanings of autonomy of pregnant women to choose the mode of birth, and the process that they go through when making this decision.
Abstract
Background
Ambient environmental factors have been associated with respiratory infections in ecological studies, but few studies have explored the impact of indoor environmental factors in ...detail. The current study aimed to investigate the impact of indoor environment on the risk of acute respiratory illness (ARI) in a subtropical city.
Method
A prospective cohort study was conducted in 285 community-dwelling older adults from December 2016 through May 2019. Individual household indoor environment data and ARI incidence were continuously collected. A time-stratified case-crossover analysis was conducted to estimate the excess risk of ARI associated with per-unit increase of daily mean indoor temperature, relative humidity, and absolute humidity (AH).
Result
In total, 168 episodes of ARI were reported with an average risk of 36.8% per year. We observed a negative association of ARI with indoor AH up to 5 lag days in cool seasons, with a 6-day cumulative excess risk estimate of −9.0% (95% confidence interval, −15.9% to −1.5%). Negative associations between household temperature or relative humidity and ARI were less consistent across warm and cool seasons.
Conclusions
Lower indoor AH in household was associated with a higher risk of ARI in the community-dwelling older adults in Hong Kong during cold seasons.
Indoor absolute humidity was negatively associated with acute respiratory illness in cool seasons. The impacts of indoor temperature and relative humidity were less evident.
: Many parents have difficulty managing childhood asthma. In Hong Kong (HK), while medication is the primary form of treatment, traditional Chinese medicine is another favored option. In addition, HK ...follows a dual-track healthcare system, which may pose unique experiences for Chinese parents in managing childhood asthma. This qualitative descriptive study aimed to explore the experiences of HK Chinese parents in caring for their children with asthma.
: Fourteen HK Chinese mothers of children (aged 3⁻10) suffering from asthma were purposively sampled to participate in individual, semi-structured interviews. A realist approach following conventional content analysis was used to interpret the interviews.
: The mothers expressed feelings of uncertainty, fear of asthma crises, and searched for ways to cope. As long as their child's asthma symptoms recurred, the mothers' distress continued. Their distress was sometimes exacerbated by self-doubt and worries over whether they would receive adequate support from their family and healthcare professionals.
: Helping parents to understand their limits may help them be more open to varied aspects of their caregiving experiences, and thus to cope better. Psychological interventions together with traditional educational training may help to alleviate the psychological difficulties of parents.
Chronic heart failure (CHF) poses a significant burden on both patients and their family caregivers (FCs), as it is associated with psychological distress and impaired quality of life (QOL). ...Acceptance and Commitment Therapy (ACT) supports QOL by focusing on value living and facilitates acceptance of psychological difficulties by cultivating psychological flexibility. A protocol is presented that evaluates the effectiveness of a dyad ACT-based intervention delivered via smartphone on QOL and other related health outcomes compared with CHF education only.
This is a single-center, two-armed, single-blinded (rater), randomized controlled trial (RCT). One hundred and sixty dyads of CHF patients and their primary FCs will be recruited from the Cardiology Department of a hospital in China. The dyads will be stratified block randomized to either the intervention group experiencing the ACT-based intervention or the control group receiving CHF education only. Both groups will meet two hours per week for four consecutive weeks in videoconferencing sessions over smartphone. The primary outcomes are the QOL of patients and their FCs. Secondary outcomes include psychological flexibility, psychological symptoms, self-care behavior, and other related outcomes. All outcomes will be measured by blinded outcome assessors at baseline, immediately post-intervention, and at the three-month follow-up. Multilevel modeling will be conducted to assess the effects of the intervention.
This study is the first to adopt an ACT-based intervention for CHF patient-caregiver dyads delivered in groups via smartphone. If effective and feasible, the intervention strategy and deliverable approach could be incorporated into clinical policies and guidelines to support families with CHF without geographic and time constraints.
ClinicalTrials.gov Identifier: NCT04917159. Registered on 08 June 2021.
COVID-19 has significant impacts on young smokers in their smoking behaviors. This qualitative study summarises the lived experience of young smokers during COVID-19. Moreover, through their lived ...experience, we aim to understand how the COVID-19 pandemic influence tobacco use behaviours in this population. A purposive sampling of 48 smokers aged between 17-25 years old is individually interviewed for 30 to 45 min. All interviews are transcribed in verbatim and analysed by two researchers separately using Colaizzi's method of descriptive phenomenology. The results reveal the following six important themes, which could explain the mixed pattern of smoking behaviour changes in young smokers: (1) perceptions of COVID-19 and its association with smoking, (2) more time at home, (3) taking masks off to smoke, (4) the effects of COVID-19 on smokers' financial status and academic performance, (5) reduced social gatherings, and (6) restricted access to tobacco products. To conclude, this pandemic and the anti-pandemic measures, i.e., mask mandates, stay-at-home and work-from-home orders, and class suspension, result in both new obstacles and new advantages for smoking cessation among young people. More studies should be performed to monitor any transition of tobacco products and the trajectory of use in this population during this pandemic, thus informing public health policy making.
This study explores the association of family process and peer influences with risk behaviors of adolescents. A total of 805 students were recruited from secondary schools. The results showed that ...adolescents who have parents who are "authoritarian" (OR = 1.856) were more likely to smoke. Adolescents who have conflicts with their parents (OR = 1.423) were more likely to drink. Those who have parents who are "permissive" were less likely to drink (OR = 0.885). Having friends who smoked (OR = 5.446) or drank (OR = 1.894), and friends' invitation to smoke (OR = 10.455) or drink (OR = 11.825) were the dominant contributors to adolescent smoking and drinking. Interventions are needed that recognize the strength of the parent-child relationship, as well as strengthen family functioning through improved interpersonal, parenting, and monitoring skills.
Adolescents and young adults mostly drink alcohol because of social activities. However, some drink outside of normative social contexts, exhibiting a behaviour pattern known as solitary drinking. ...Increasing evidence indicates that solitary drinking is strongly associated with problematic drinking in adolescents and young adults. However, it remains unclear why individuals initiate and maintain this drinking habit. To address this gap in the existing literature, the current study explored the factors contributing to solitary drinking in this population. Descriptive phenomenology was used. A convenience sample of 44 solitary drinkers aged between 10 and 24 were invited to undergo individual semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. The data were analysed by two researchers separately using Colaizzi’s method. Using qualitative descriptions, the following factors were identified as explaining the initiation and continuation of solitary drinking among adolescents and young adults: (1) enhancement and coping drinking motives, (2) social discomfort, (3) reduced self-control, (4) automatic mental process, and (5) a desperate response to stressors. Since reduced self-control plays an important role in long-term addiction, future studies should be conducted to determine potential applications of mindfulness-based interventions to improve self-control, which may prevent the progression from solitary drinking to alcohol use disorder.
In Hong Kong, the use of alcohol, tobacco, and other drugs (ATOD) is associated with strong peer influences; frequently absent parents; academic pressures; and a lack of interpersonal skills to cope ...with stress and conflict. It is posited that this social context alters the nature of the adolescent risk of using ATOD. The study aimed to explore how social interactions in their local context shape experiences of adolescents who smoke or use alcohol with their parents and other significant people (e.g., teachers, peers) in their lives.
The participants consistently indicated that the communication of risk was fundamentally influenced by the attachment between the primary parent(s) and the child. In secure attachments, parents could positively discourage ATOD use by instilling fear or expressing regret or disappointment over its use. However, some parents expressed an overly permissive attitude about ATOD use, or stated that they had a limited ability to influence their child, or that the harm arising from their child's use of ATOD would be minimal. Under these conditions, the authors posited that the potential influence of peers to disrupt parental attachments was stronger.
Descriptive phenomenology was adopted in this study and Colaizzi's method was used to analyse the collected data. Focus group interviews were conducted with 45 adolescents, 11 parents, and 22 school teachers and social workers in two districts in Hong Kong. A secure attachment between a parent and a child enhances the child's sense of self-efficacy in avoiding addictive behaviours such as ATOD use. In contrast, insecure parent-child attachments may trigger children to resist social norms, and disrupt their parental attachments. In these instances, parents may inadvertently convey the message that their children do not need protection from the risks of using ATOD. The key findings suggest that reinforcing secure parental attachments, as well as emphasizing how messages of vulnerability to ATOD are conveyed, may counter balance pressures (including peer influence) to use these substances. Further research is needed to uncover mechanisms of communication that add to the vulnerability of adolescents to using ATOD, and to the negative long-term consequences from ATOD use.
The aim of this study was to examine the effectiveness of delivering an individual Acceptance and Commitment Therapy (ACT) for smoking cessation among a Chinese population.
Participants were ...recruited from six primary health care centers. A total of 144 were eligible to take part in the study and agreed to be randomized to the intervention (ACT) group (n = 70) and control group (n = 74), respectively. Both groups received self-help materials on smoking cessation. The ACT group also underwent an initial face-to-face session and two telephone ACT sessions at 1 week and 1 month following the first session. They were re-contacted through telephone follow-ups at 3, 6, and 12 months by research assistants. The primary outcome was self-reported 7-day point-prevalence abstinence at the 12-month follow-up session. Other outcomes included biochemically validated quitting, quitting attempts, the intention to quit, the self-perception of quitting, and psychological flexibility.
There was no significant difference in the self-reported 7-day point prevalence quit rate at the 12-month follow-up between the intervention group (24.3%) and the control group (21.6%) (risk ratio = 1.12; 95%CI = (0.62, 2.05); p = 0.704). Greater improvements in secondary outcomes from baseline to the 12-month follow-up were observed in the ACT group than in the control group, including a forward progression in the participants' readiness to quit smoking (p = 0.014) and increased psychological flexibility (p = 0.022).
This study is the first evidence of a randomized-controlled trial on the adoption of an individual ACT for smoking cessation, delivered initially in primary health care settings and subsequently by telephone within a Chinese population. The present study found that the brief ACT intervention could not produce a significant quit rate but was promising in terms of bringing about cognitive changes, including greater psychological flexibility, and more confidence about quitting, when compared to the use of self-help materials only among the general population.
This trial was registered prospectively with the U.S. National Library of Medicine: ( NCT01652508 ) on 26th July 2012.
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