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Background: High-quality mental health services can improve outcomes for people with mental health problems and abate the burden of mental disorders. We sought to identify the challenges the country's mental health system currently faces and the human resource situation related to psychological services and to provide recommendations on how the mental health workforce situation could be addressed in China. Methods: This study used a cross-sectional survey design. A web-based questionnaire approach and a convenience sampling method were adopted. It was carried out from September 2020 to January 2021 in China, and we finally included 3824 participants in the analysis. Descriptive statistical analysis of the characteristics of the study sample was performed. The risk factors for competence in psychological counseling/psychotherapy were assessed using multiple linear regression analysis. Results: Workforce related to psychotherapy is scarce in China, especially in Western China and community mental health sectors. Psychiatrists (39.1%) and nurses (38.9%) were the main service providers of psychotherapy in psychiatric hospitals, and clinical psychologists (6.9%) and counsellors (5.0%) were seriously scarce in mental health care sectors. A total of 74.2% of respondents had no systematic psychological training, and 68.4 and 69.2% of them had no self-experience and professional supervision, respectively. Compared with clinical psychologists and counselors, psychiatrists and nurses had less training. Systematic psychological training (β = − 0.88), self-experience (β = − 0.59) and professional supervision (β = − 1.26) significantly influenced psychotherapy capacity (P<0.001). Conclusions: Sustained effort will be required to provide a high-quality, equitably distributed psychotherapy workforce in China, despite challenges for community mental health sectors and western China being likely to continue for some time. Because mental illness is implicated in so many burgeoning social ills, addressing this shortfall could have wide-ranging benefits. [ABSTRACT FROM AUTHOR]

Background: The use of reproductive health (RH) services is important to promote RH. However, little is known about RH services in rural areas, especially in low- and middle-income countries. China is the most populous country in the world, and 40.4% of its population is rural. Our study determined the utilization of and factors associated with RH services in rural China. Methods: A cross-sectional study of 978 20- to 39-year-old women was performed in four villages of four cities in Hunan Province. A researcher-created structured questionnaire was used to collect the data. The data were entered into EpiData v3.0 and analysed using SPSS v18.0. Statistical significance was defined as a two-sided P-value of less than 0.05. Descriptive statistics were used to examine the socio-demographic factors and the use of RH services by the sample population. Chi-square tests were used to assess associations between categorical variables. Logistic regression analyses were performed to examine factors that correlated with the use of RH services. Results: The top three services used were antenatal examinations (90.2%), postpartum visits (73.0%) and free folic acid supplements (71.6%). Age, monthly household income, employment, spousal education level, and artificial abortion history were associated with RH service utilization (P < 0.05). The most desired RH service was cervical/breast cancer prevention services (58.9%). The most preferred method participants used to obtain information on RH services was the internet. Conclusions: The utilization rate for RH services in rural China needs improvement. Future efforts should target high-risk populations of women by providing them with RH-related information and cultivating positive attitudes towards RH services. Plain language summary: Reproductive health (RH) services are recognized worldwide as a cost-effective strategy to promote RH. However, little is known about RH services in rural areas, especially in low- and middle-income countries. China is the most populous country in the world, and 40.4% of its population is rural. Due to the implementation of China's universal two-child policy, women between 20 and 39 years old are likely to experience more RH problems related to childbirth. Our study investigated the utilization of and factors associated with RH services in rural China. The top three services used among the 978 participants were antenatal examinations (90.2%), postpartum visits (73.0%) and free folic acid supplements (71.6%). Age, monthly household income, employment, spousal education level, and artificial abortion history were associated with RH service utilization. The participants most desired services pertained to the prevention of cervical/breast cancer, and the most preferred methods used to obtain information related to RH services was the internet. In conclusion, the utilization of RH services requires improvement, and future efforts should target high-risk populations of women by providing them with RH-related information and cultivating positive attitudes towards RH services. [ABSTRACT FROM AUTHOR]

This cross-sectional study identified 2, 585 women aged 50–70 with certain diseases, health behaviors and psychological health problems among a representative and community-conducted sample of women in Hunan Province of China. It disclosed their poor health status: 51.0% had chronic diseases, 49.6% had gynecopathy, 23.6% had mastopathy, 57.1% failed to avoid secondhand smoke, less than 50% completed periodic health examinations, and 3.1% were anxious. Chronic diseases are expected to be serious health problems in the next 10 years, emphasizing the importance of women discussing their health status. Common diseases should be managed via public health service projects, and free screening and treatment of common diseases should be provided. To enhance women's health knowledge and awareness, targeted health education is necessary in accordance with their physiological and psychological characteristics. [ABSTRACT FROM AUTHOR]

Sexuality has an important impact on people's physical and mental health, but current research on the sexual activity of older Chinese women has many limitations and more detailed studies are needed. The objective was to determine the prevalence of sexual activity and related factors in women aged 55 to 85 years in Hunan, China. Based on the data from the Hunan Provincial Women Health Needs Survey in 2018, we conducted a secondary analysis of 2,401 older women aged 55 and above. The dependent variable was sexual activity, and independent variables included sociodemographic characteristics, health behaviors, reproductive and chronic medical history, and psychological characteristics. All statistical analyses were performed using SPSS 26.0. Chi-square test was used to assess the association between categorical variables, and binary logistic regression was used to examine factors related to sexual activity. Sexual activity and related factors. The prevalence of sexual activity among older women was 12.5% (301/2401) in the past month. Having a partner (OR = 1.484; 95% CI, 1.048-2.101; P =.026), jogging (OR = 2.061; 95% CI, 1.391-3.054; P <.001), dancing (OR = 1.477; 95% CI, 1.106-1.974; P =.008), vegetarian-based diet (OR = 2.197; 95% CI, 1.334-3.618; P =.002), meat-based diet (OR = 2.196; 95% CI, 1.144-4.216; P =.018) were positively associated with being sexually active. Whereas, aging (OR = 0.781; 95% CI, 0.647-0.942; P =.010), living in the urban (OR = 0.628; 95% CI, 0.488-0.808; P <.001), hypertension (OR = 0.702; 95% CI, 0.520-0.949; P =.021), and anxiety (OR = 0.680; 95% CI, 0.475-0.972; P =.034) were negatively associated with being sexually active. Health care workers need to be aware that older women still have sexual activity and understand the needs of older women for sex education, take the initiative to discuss safe sex with them, and solve their sexual problems. This is one of the largest studies to determine the prevalence of sexual activity among older women in China and its related factors. In addition, new factors such as exercise types and eating habits related to sexual activity were discovered. The limitation of this study is that it did not use a specific questionnaire to assess the sexual activity and did not consider physical tenderness other than sexual intercourse. Some older women still have had sexual activity in the past month and factors such as lifestyles that can be changed and chronic diseases that can be self-managed were found to predict sexual activity. Li T, LuoY, Meng Y, et al. Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study. J Sex Med 2022;19:302–310. [ABSTRACT FROM AUTHOR]

Background: Leisure time physical activity (LTPA) is beneficial for late-life depression (LLD). The main purpose of this study was to estimate the associations between LTPA parameters (intensity, duration, frequency) and LLD.Methods: Through the 2018 Women Health Needs Survey, data on 1,892 women aged 55-70 in Hunan, China, were studied. Depression was measured by the 9-item Patient Health Questionnaire (PHQ-9). Self-reported LTPA parameters were collected. Binary logistic regression models were used to compute odds ratios (OR) for LTPA for predicting depression. Sensitivity analyses were conducted to examine the effect of missing values.Results: Moderate LTPA volume (OR = 0.582, p = 0.027, 95% CI [0.360-0.941] for 150-299 min/week and OR = 0.392, p = 0.002, 95% CI [0.215-0.714] for ≥300 min/week) was associated with reduced depression, while vigorous LTPA could increase the risk (OR = 2.414, p = 0.029, 95% CI [1.095-5.325] for <75 min/week and OR = 3.824, p = 0.007, 95% CI [1.439-10.158] for ≥75 min/week). Frequent (6-7 days/week), moderate LTPA had a lower risk (OR = 0.570, p = 0.021, 95% CI [0.353-0.918]), while frequent (≥3 days/week), vigorous LTPA increased the risk (OR = 5.103, p = 0.001, 95% CI [1.977-13.172]). The adjusted relationship between the duration and depression was not observed. The results were supported by the sensitivity analysis based on missing value replacement.Limitations: In this cross-sectional study, LTPA data were self-reported and no data on light LTPA were collected.Conclusions: Moderate LTPA, associated with mental health benefits, should be recommended for older women instead of vigorous LTPA. [ABSTRACT FROM AUTHOR]

Background Exposure to metals, including essential and nonessential elements, has been linked to male reproductive health in animals. However, findings from human studies are inconsistent. Objective To examine the associations between metal exposure at environmental levels and semen quality in a Chinese population by performing repeated measurements of urinary metals to estimate individual-level exposure. Methods From March to June 2013, 1052 men seeking semen evaluation were recruited from the Reproductive Center of Tongji Hospital in Wuhan, China. Each man provided one semen sample and two urine sample. Semen quality parameters and urinary levels of 18 metals were determined. Associations between the urinary metal levels and semen quality parameters were assessed using confounder adjusted linear and logistic regressions. Restricted cubic spline analysis was performed to assess dose-response relationships between continuous metal measurements and outcomes. Results Urinary levels of cadmium were significantly inversely associated with progressive sperm motility and total motility (both P < 0.02) based on multivariable linear regression models, consistent with the trends of increased odds ratios for below-reference semen quality parameters observed in the logistic models (both P < 0.05). Additionally, we found significant inverse associations of urinary molybdenum and lead with percentages of normal sperm morphology (both P < 0.05). These associations remained suggestive or significant after adjustment for multiple testing. They were also robust to the simultaneous consideration of multiple metals, and curves of restricted cubic spline showed clear dose-response relationships. Conclusion Our findings suggest that environmental exposure to cadmium, molybdenum and lead may contribute to a decline in human semen quality. [ABSTRACT FROM AUTHOR]

Abstract: Toxicological studies showed that trihalomethanes (THMs), the most abundant classes of disinfection by-products (DBPs) in drinking water, impaired male reproductive health, but epidemiological evidence is limited and inconsistent. This study aimed to examine the associations of baseline blood THMs with semen parameters and serum total testosterone in a Chinese population. We recruited 401 men seeking semen examination from the Reproductive Center of Tongji Hospital in Wuhan, China between April 2011 and May 2012. Baseline blood concentrations of THMs, including chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM) were measured using SPME-GC/ECD method. Semen quality and serum total testosterone were analyzed. Multivariable linear regressions were used to assess the associations of baseline blood THM concentrations with semen parameters and serum total testosterone levels. We found that baseline blood THM concentrations were not associated with decrements in sperm motility, sperm straight-line and curvilinear velocity. However, moderate levels of BDCM (β=−0.13million; 95% CI: −0.22, −0.03) and DBCM (β=−4.74%; 95% CI: −8.07, −1.42) were associated with decreased sperm count and declined sperm linearity compared with low levels, respectively. Suggestive dose–response relationships were also observed between elevated blood TCM or ∑ THMs (sum of TCM, BDCM, DBCM and TBM) concentration and decreased sperm concentration (both p for trend=0.07), and between elevated blood DBCM concentration and decreased serum total testosterone (p for trend=0.07). Our results indicate that elevated THM exposure may lead to decreased sperm concentration and serum total testosterone. However, the effects of THM exposure on male reproductive health still warrant further studies in humans. [Copyright &y& Elsevier]