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Air pollution is a major public health concern in China. Notwithstanding this, there is limited evidence regarding the impact of short-term exposure to ambient ozone on cardiovascular mortality in the Chinese population. Therefore, we conducted this meta-analysis to address this important question. The random-effects model was applied to pool the results from individual studies. Finally, 32 effect estimates extracted from 19 studies were pooled in this meta-analysis. The pooled relative risk for cardiovascular mortality for each 10 µg/m3 increment in ozone concentration was 1.0068 (95% CI: 1.0049, 1.0086). Ths significant positive association between ozone exposure and cardiovascular mortality was also observed in different two-pollutant models. This meta-analysis revealed that exposure to ozone was associated with an increased risk of cardiovascular mortality in China, and more efforts on controlling the population from ozone are needed to improve cardiovascular health of Chinese population. [ABSTRACT FROM AUTHOR]

This study aimed to explore the association between family function and sleep disturbances in preschool children in rural areas of China. Caregivers of preschool children completed sociodemographic questionnaires, the Children's Sleep Habits Questionnaire (CSHQ), the Self-rating Anxiety Scale (SAS) and the Family APGAR scale. Using sleep disturbances in children as the dependent variable, family function and other related factors as independent variables, binary logistic regression analyses were performed to examine associations between family function and sleep disturbances in children. A total of 3,636 caregivers of preschool children were enrolled in our study, and the prevalence of sleep disturbances among their preschool children was 89.4%. In our study, lower family function was associated with higher risk of sleep disturbances among preschool children. After adjusting for age (years), education level of mother, discipline attitudes of father and mother, only child status and caregivers' anxiety, the associations were statistically significant both in families of which caregivers of children are their parents or other relatives. (AOR for parents = 1.487, 95% CI:1.152–1.919, P = 0.002; AOR for other relatives = 1.963, 95% CI:1.302–2.958, P = 0.001). Our study results indicated that family function was associated with sleep disturbances in preschool children, and future high-quality cohort studies are needed to explore this topic in more detail. [ABSTRACT FROM AUTHOR]

Little is known about the effects of temperature on healthcare-associated infections (HAIs). A distributed lag non-linear model was used to estimate the association between ambient temperature and HAIs in Hefei, China. In total, 9,592 HAIs were included. The effect of low temperature (−0.1°C, 2.5th percentile) was significant on the current day (RR = 1.108, 95%CI:1.003–1.222), and then appeared on the 4th day (RR = 1.045, 95%CI:1.007–1.084) and the 5th day (RR = 1.033, 95%CI:1.006–1.061). The cumulative lag effects of low temperature lasted from the 5th to 10th days (RR = 1.123–1.143), and a long-term cumulative lag effect was observed on the 14th day (RR = 1.157, 95%CI:1.001–1.338). The lag effect of high temperature (31.0°C, 97.5th percentile) was not statistically significant. However, the effects of temperatures on HAIs were not significant among gender or age subgroups. This study suggests that the low temperatures have acute and lag effects on HAIs in Hefei, China. [ABSTRACT FROM AUTHOR]

To evaluate the relationship between resilience and emotion regulation among preschool left-behind children (LBC) in rural China. A total of 620 preschool LBC were enrolled from rural areas in Anhui province, China. Multivariate logistic regression was used to evaluate the associations between resilience and variables. The results showed that 20.2% of LBC had higher resilience. Emotion regulation was correlated with resilience among preschool LBC. Children with higher cognitive reconstruction (adjusted OR (AOR) = 0.349,95%CI:0.249–0.489), passive dealing (AOR = 0.577, 95%CI:0.411–0.810), alternative action (AOR = 0.369, 95%CI:0.267–0.510) and self-comforting (AOR = 0.441, 95%CI:0.315–0.619) would have lower risk of low resilience. Our findings suggest that strengthening emotion regulation could promote psychological resilience and prevent adverse developments in LBC. [ABSTRACT FROM AUTHOR]

The present study attempted to investigate dynamics and predictors of resilience amongst Chinese children using prospective data. Totally 816 children completed the resilience measurement at baseline and one-year follow-up. Multivariate logistic regression was used to examine associations between high resilience and predictor variables. Mean resilience scores increased during the one-year follow-up (t = −2.35, P = 0.019). Although the proportions of high and low resilience were relatively stable, whereas 28% of children had inconsistent resilience level during the follow-up. Multivariable logistic regression analysis showed that participants' parents having secondary school (adjusted OR (aOR) = 1.67, 95%CI = 1.14–2.44) or higher (aOR = 2.53, 95%CI = 1.51–4.24) education level, and high quality of life (aOR = 1.81, 95%CI = 1.20–2.73) were positively associated with high resilience, whereas moderate family function obstacles (aOR = 0.47, 95%CI = 0.34–0.67), abuse experience (aOR = 0.68, 95%CI = 0.50–0.92), and significant depression symptoms (aOR = 0.47, 95%CI = 0.28–0.77) were negatively associated with high resilience. Results highlight that resilience levels were not merely static trait and improved over one year among Chinese children. Findings would deepen understanding of resilience change and provide potential targets of resilience-focused intervention in children. [ABSTRACT FROM AUTHOR]

The road traffic accident is an important public health issue affecting social development and public safety. The purpose of this study is to describe the situation of traffic accidents, and to explore the relationship between fatal traffic accidents and risk factors in Suzhou city of Anhui province in China. The accident data was obtained from the Traffic Police Detachment of the Suzhou Public Security Bureau. Other vehicle, population and road information are derived from Suzhou Statistical Yearbook. Descriptive analysis was used to summarize road traffic accident participants' characteristics. The binary logistic regression model was used to analyze the factors that affected fatal traffic accident. There are 7,795 cases involved 18,774 road traffic participants. By logistic regression, we found that in Suzhou, overloading makes traffic accidents more likely to be the most fatal traffic accidents (adjusted OR = 5.33, 95%CI: 2.60-10.93). Speeding, drive after drinking, fatigue driving and pedestrian reasons might also increase the probability of fatal traffic accidents. These findings would help transportation authorities identify dangerous driving behaviors and take the necessary measures to improve road safety in undeveloped areas. [ABSTRACT FROM AUTHOR]

Purposes: Many studies have indicated that orthostatic hypotension (OH) may be a risk factor for dementia and stroke, but the results have been inconsistent. To further ascertain the links between OH and cognition or stroke, a meta-analysis was performed. Methods: The Chinese Biomedical Database, PubMed, Web of Science, and the Cochrane Library database were searched (up to March 2019) to identify prospective cohort studies that examined the associations between OH and the risks of stroke and dementia among adult populations. Subgroup analyses and meta-regression analyses were conducted to identify sources of heterogeneity. We also performed Begg's test and Egger's test to assess publication bias. Results: A total of 3490 articles were identified, and 18 prospective observational cohort studies were ultimately included. Among these studies, eight prospective studies were about stroke, nine studies were about cognition and one study reported data about both stroke and dementia. Meta-analysis revealed an association between OH and worse cognition (hazard ratio (HR): 1.18, 95% confidence interval (CI): 1.03–1.35, I2 = 69.5%). For dementia, the pooled HR was 1.30, with 95% CI: 1.14–1.48, I2 = 31.0%. In addition, we found that OH was associated with a higher risk of stroke (HR: 1.36, 95% CI = 1.17–1.57, I2 = 67.3%). No publication bias was detected. Conclusion: This meta-analysis provides evidence that OH was associated with worse cognition. OH accounted for a 30% increase in the risk of dementia and a 36% increase in the risk of stroke. [ABSTRACT FROM AUTHOR]

Our study aims to explore child neglect among preschool children in rural China and examine its association with social living ability. Furthermore, another purpose is to examine whether there is a mediated effect of resilience on this association. A cross-sectional survey was conducted among 2397 children aged 6-72 months in rural area of Anhui province. Social living ability, neglect and resilience were measured by Infant-Junior Middle School Student's Ability of Social Life Scale, Child Neglect Evaluation Scales and Devereux Center for Resilient Children (DCRC) Assessment Tools (DECA), respectively. Binary logistic analysis was performed to explore the relationship. The results showed that overall prevalence of child neglect was 59.4% among children aged 6-72 months. Children aged 36-72 months who suffered physical neglect, educational neglect and medical neglect were more likely to express lower social living ability. After adjusting resilience, the association between lower social living ability and child neglect was slightly attenuated but remained significant. In conclusion, neglect would exert the adverse effect on children in 36-72 months group. Children experiencing physical, educational and medical neglect have more chance to express lower social living ability. High resilient subjects may be partly protected against the detrimental effects of child neglect. [ABSTRACT FROM AUTHOR]

Left-behind children (LBC) account for more than one in five Chinese children and more frequently exhibit some personality deviations as a result of being separated from their parents. Therefore, this meta-analysis aimed to systematically review the personality traits of LBC using the Eysenck Personality Questionnaire (EPQ). Relevant studies were identified by searching various electronic databases, and 39 articles that contained 12,494 LBC and 10,381 non-LBC were ultimately included in this meta-analysis. Subgroup analyses by grades and sex were conducted to study the personality deviation rate and personality factor scores in LBC. The results indicated that the personality deviation rates of LBC were higher than those of non-LBC. LBC in middle school had higher personality deviation rates than LBC in elementary school. LBC in elementary school had higher neuroticism scores and psychoticism scores than non-LBC. In addition, the analysis of LBC in elementary school showed that boys had higher neuroticism scores but lower psychoticism scores than girls. In conclusion, this meta-analysis indicates that LBC, particularly those in middle school, exhibit higher rates of personality deviation. Meanwhile, regarding to LBC in elementary school, boys are more likely to exhibit emotional instability whereas girls are more likely to show a tendency toward psychoticism. [ABSTRACT FROM AUTHOR]

Depressive symptoms and empty nest phenomenon of rural elderly people are both important public health issues, which should not be ignored. We aimed to estimate the prevalence of depressive symptoms and related factors of the empty nest elderly in rural China. We recruited 3182 eligible subjects and gathered data by face-to-face interview. Multivariate logistic regression models were used to explore the related factors of depressive symptoms. The present study showed that the prevalence of depressive symptoms significantly differed between empty nest old adults and non-empty nesters (24.1% vs. 19.0%). The elderly living alone had highest OR of depressive symptoms. Depressive symptoms of empty nest elderly was associated with sleep quality, economic status, pain, social support and ADL. While it was associated with gender, economic status, pain and PSMS in non-empty nest group. Number of chronic disease showed significant associations with depressive symptoms in the elderly living alone. Subjective support, support utilization and pain were positively associated with depressive symptoms in the elderly living with spouse. Sleep quality, economic status and ADL were common factors. Depressive symptoms obviously prevail among empty nest elderly than non-empty nesters. It reminded us that complementary social support from family and society is essential. [ABSTRACT FROM AUTHOR]