This is the first meta-analysis of the pooled prevalence of insomnia in the general population of China. A systematic literature search was conducted via the following databases: PubMed, PsycINFO, ...EMBASE and Chinese databases (China National Knowledge Interne (CNKI), WanFang Data and SinoMed). Statistical analyses were performed using the Comprehensive Meta-Analysis program. A total of 17 studies with 115,988 participants met the inclusion criteria for the analysis. The pooled prevalence of insomnia in China was 15.0% (95% Confidence interval CI: 12.1%-18.5%). No significant difference was found in the prevalence between genders or across time period. The pooled prevalence of insomnia in population with a mean age of 43.7 years and older (11.6%; 95% CI: 7.5%-17.6%) was significantly lower than in those with a mean age younger than 43.7 years (20.4%; 95% CI: 14.2%-28.2%). The prevalence of insomnia was significantly affected by the type of assessment tools (Q = 14.1, P = 0.001). The general population prevalence of insomnia in China is lower than those reported in Western countries but similar to those in Asian countries. Younger Chinese adults appear to suffer from more insomnia than older adults.
CRD 42016043620.
Objective:The authors compared measurement-based care with standard treatment in major depression.Methods:Outpatients with moderate to severe major depression were consecutively randomized to 24 ...weeks of either measurement-based care (guideline- and rating scale-based decisions; N=61), or standard treatment (clinicians’ choice decisions; N=59). Pharmacotherapy was restricted to paroxetine (20–60 mg/day) or mirtazapine (15–45 mg/day) in both groups. Depressive symptoms were measured with the Hamilton Depression Rating Scale (HAM-D) and the Quick Inventory of Depressive Symptomatology–Self-Report (QIDS-SR). Time to response (a decrease of at least 50% in HAM-D score) and remission (a HAM-D score of 7 or less) were the primary endpoints. Outcomes were evaluated by raters blind to study protocol and treatment.Results:Significantly more patients in the measurement-based care group than in the standard treatment group achieved response (86.9% compared with 62.7%) and remission (73.8% compared with 28.8%). Similarly, time to response and remission were significantly shorter with measurement-based care (for response, 5.6 weeks compared with 11.6 weeks, and for remission, 10.2 weeks compared with 19.2 weeks). HAM-D scores decreased significantly in both groups, but the reduction was significantly larger for the measurement-based care group (−17.8 compared with −13.6). The measurement-based care group had significantly more treatment adjustments (44 compared with 23) and higher antidepressant dosages from week 2 to week 24. Rates of study discontinuation, adverse effects, and concomitant medications did not differ between groups.Conclusions:The results demonstrate the feasibility and effectiveness of measurement-based care for outpatients with moderate to severe major depression, suggesting that this approach can be incorporated in the clinical care of patients with major depression.
Global literature has suggested a negative impact of acculturative stress on both physical and mental health among international migrants. In China, approximately 20 percent of its population is ...rural-to-urban migrant workers and there are significant cultural differences between rural and urban societies, but no data are available regarding the acculturative stress of Chinese migrant workers. This study aimed to explore the forms and contexts of acculturative stress among Chinese migrant workers.
Qualitative data were collected from four focus group discussions with 17 Chinese rural-to-urban migrant workers and three individual interviews with three medical professionals who provided mental health services for factory-workers in Shenzhen, China.
The data in the current study showed that rural-to-urban migrant workers in China had experienced various forms of acculturative stress including difficulties in adapting to the environment, work-related stress, family-related stress, financial hardship, and lack of sense of belonging to cities.
Rural-to-urban migration in China is a challenging transition with significant acculturative stress and demands for major adjustments among migrant workers. The assessment and management of acculturative stress is a necessary first step in providing mental health services to migrant workers.
Abstract Background The number of older adults (OAs) is growing rapidly and the elderly suicide rate (ESR) is highest among all age-groups in China. Examining the epidemiology of elderly suicide (ES) ...may facilitate population-specific suicide prevention efforts, however, little is known about the patterns of ES in China. Objective To describe the rates and characteristics of ES in China during 2013-14. Methods Suicide mortality data by gender, quinquennial age-group, residence (urban/rural) and geographic location (east/central/west) were obtained from China's Integrated National Mortality Surveillance System for 2013-14. Crude ESRs of OAs aged 65 years or above were standardized to the 2010 China’s Census population and adjusted for under-reporting. Results While OAs comprised 8.9% of the Chinese population, they represented 38.2% of suicide deaths. The average annual ESR in China was 34.5 per 100000 in 2013-14. ESRs varied widely across OA subgroups, with the highest rates in central rural men (67.1) and women (53.1), and the lowest rate in eastern urban women (13.6). Male gender (incident rate ratio IRR=1.47), every five-year increase in age (IRR=1.33), rural residence (IRR=1.83), and geographic location of central China (IRR=1.93) were significantly associated with increased number of ESs. Limitations Information on means of ES are lacking in the data source. Conclusions ESs disproportionately account for a large portion of China's current total suicides, and ESR, particularly in central rural OAs, is very high in China. Prevention of ES should be given priority as an important public health issue in China. Central rural OAs are key target population for current ES prevention.
IMPORTANCE: Associations between late-life participation in intellectual activities and decreased odds of developing dementia have been reported. However, reverse causality and confounding effects ...due to other health behaviors or problems have not been adequately addressed. OBJECTIVE: To examine whether late-life participation in intellectual activities is associated with a lower risk of incident dementia years later, independent of other lifestyle and health-related factors. DESIGN, SETTING, AND PARTICIPANTS: A longitudinal observational study was conducted at all Elderly Health Centres of the Department of Health of the Government of Hong Kong among 15 582 community-living Chinese individuals age 65 years or older at baseline who were free of dementia, with baseline evaluations performed January 1 to June 30, 2005, and follow-up assessments performed from January 1, 2006, to December 31, 2012. Statistical analysis was performed from January 1, 2015, to December 31, 2016. MAIN OUTCOMES AND MEASURES: The main outcome was incident dementia as diagnosed by geriatric psychiatrists in accordance with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, or a Clinical Dementia Rating of 1 to 3. At baseline and follow-up interviews, self-reported information on participation in intellectual activities within 1 month before assessment was collected. Examples of intellectual activities, which were described by a local validated classification system, were reading books, newspapers, or magazines; playing board games, Mahjong, or card games; and betting on horse racing. Other important variables including demographics (age, sex, and educational level), physical and psychiatric comorbidities (cardiovascular risks, depression, visual and hearing impairments, and poor mobility), and lifestyle factors (physical exercise, adequate fruit and vegetable intake, smoking, and recreational and social activities) were also assessed. RESULTS: Of the 15 582 individuals in the study, 9950 (63.9%) were women, and the median age at baseline was 74 years (interquartile range, 71-77 years). A total of 1349 individuals (8.7%) developed dementia during a median follow-up period of 5.0 years. Multivariable logistic regression analysis showed that the estimated odds ratio for incident dementia was 0.71 (95% CI, 0.60-0.84; P < .001) for those with intellectual activities at baseline, after excluding those who developed dementia within 3 years after baseline and adjusting for health behaviors, physical and psychiatric comorbidities, and sociodemographic factors. CONCLUSIONS AND RELEVANCE: Active participation in intellectual activities, even in late life, might help delay or prevent dementia in older adults.
We had previously identified visual impairment increasing risk of incident dementia. While a bi-directional vision-cognition association has subsequently been proposed, no study has specifically ...examined the longitudinal association between dementia and incidence of clinically defined visual impairment. In this territory-wide community cohort study of 10,806 visually unimpaired older adults, we examined their visual acuity annually for 6 years and tested if dementia at baseline was independently associated with higher risk of incident visual impairment (LogMAR ≥ 0.50 in the better eye despite best correction, which is equivalent to moderate visual impairment according to the World Health Organization definition). By the end of Year 6, a total of 3151 (29.2%) participants developed visual impairment. However, we did not find baseline dementia associating with higher risk of incident visual impairment, after controlling for baseline visual acuity, cataract, glaucoma, diabetes, hypertension, hypercholesterolemia, heart diseases, stroke, Parkinson's disease, depression, hearing and physical impairments, physical, intellectual and social activities, diet, smoking, age, sex, educational level, and socioeconomic status. Among different covariables, baseline visual acuity appears to be more important than dementia in contributing to the development of visual impairment. Our present findings highlight the need for re-evaluating whether dementia is indeed a risk factor for visual impairment.
Objective
Although poor mental health is associated with significant personal and societal burden, it is rarely reported in older Chinese populations. This study examined the mental health status of ...a large representative sample of Chinese elderly in relation to socio-demographic characteristics, lifestyle, and chronic diseases.
Methods
Multistage stratified cluster sampling was used in this cross-sectional study. A total of 4115 people aged between 60 and 79 years were selected and interviewed with standardized assessment tools. The 12-item General Health Questionnaire (GHQ-12) was used to measure general mental health with the total score of ≥4 as the threshold for poor mental health status.
Results
The adjusted percentage of poor mental health status in the whole sample was 23.8 %; 18.5 % in men and 28.9 % in women. Multivariate logistic regression analysis revealed that female gender, widowed/separated marital status, rural abode, low income, poor diet, lack of physical exercise, and multi-morbidity were independently associated with poor mental health. The percentage of poor mental health status was significantly higher in patients with anemia, diabetes, hyperlipidemia, cataract/glaucoma, ischemic heart disease, cerebrovascular diseases, nasopharyngitis, chronic gastroenteritis/peptic ulcer, liver diseases, cholecystitis/gallstone, arthritis, or chronic low back pain.
Conclusion
Given the high rate of poor mental health status among older Chinese population, policy makers and health professionals in China should address the mental health burden of its aging population.
The outbreak of severe acute respiratory syndrome (SARS) posed an unprecedented threat and a great challenge to health professionals in Hong Kong. The study reported here aimed at investigating the ...origin of stress and psychological morbidity among frontline healthcare workers in response to this catastrophe.
Self-administered questionnaires were sent to frontline healthcare workers in three hospitals. The General Health Questionnaire was used to identify psychological distress. Socio-demographic and stress variables were entered into a logistic regression analysis to find out the variables associated with psychological morbidity.
The response rate was 40 %. Sixty-eight per cent of participants reported a high level of stress. About 57 % were found to have experienced psychological distress. The healthcare workers' psychological morbidity was best understood by the perceptions of personal vulnerability, stress and support in the workplace.
These findings shed light on the need for hospital administrators to be aware of the extent and sources of stress and psychological distress among frontline healthcare workers during disease outbreak.
Contributions: The Chinese University of Hong Kong (CUHK)-Jockey Club AI for the Future Project (AI4Future) co-created the first pretertiary AI curriculum at the secondary school level for Hong Kong ...and evaluated its efficacy. This study added to the AI education community by introducing a new AI curriculum framework. The preposttest multifactors evaluation about students' perceptions of AI learning confirmed that the curriculum is effective in promoting AI learning. The teachers also confirmed the co-creation process enhanced their capacity to implement AI education. Background: AI4Future is a cross-sector project that engages five major partners-CUHK's Faculty of Engineering and Faculty of Education, secondary schools, Hong Kong government, and AI industry. A team of 14 professors collaborated with 17 principals and teachers from six secondary schools to co-create the curriculum. Research Questions: Would the curriculum significantly improve the student perceived competence, attitude, and motivation toward AI learning? How does the co-creation process benefit the implementation of the curriculum? Methodology: The participants were 335 students and eight teachers from the secondary schools. This study adopted a mix-method with quantitative data measures at pre- and post-questionnaires and qualitative data emphasizes teachers' perspectives on the co-creation process. Paired <inline-formula> <tex-math notation="LaTeX">{t} </tex-math></inline-formula>-tests and ANCOVAs, and thematic analysis were used to analyze the data. Findings: 1) students perceived greater competence and developed a more positive attitude to learn AI and 2) the co-creation process enhanced teachers' knowledge in AI, as well as fostered teachers' autonomy in bringing the subject matter into their classrooms.
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