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Objective: The original 24-item School Refusal Assessment Scale-Revised (SRAS-R) assesses four functions/conditions regarding school refusal behavior (SRB), bridging assessments, and treatments of SRB. No validated Chinese versions are available. Methods: To validate the Chinese version of the SRAS-R, an anonymous cross-sectional survey was conducted from February to March 2022 among 1108 secondary school students in Taizhou, China. Results: Confirmatory factor analysis (CFA) did not support the original 4-factor model. Three items were thus removed in the exploratory factor analysis performed in the first half-spilt subsample, yielding a 5-factor model which was confirmed by CFA in the second subsample. The resulting 21-item scale/subscales of the Chinese SRAS-R generally demonstrated measurement invariance across sex and student types and satisfactory internal consistency, absence of ceiling effect and floor effect, and concurrent validity with the two external variables of preference of not going to school and depressive symptoms. Significant sex and student type differences in subscale scores were found. Conclusions: The 21-item and 5-factor Chinese version of the SRAS-R showed satisfactory psychometric properties and can be applied to research on SRB among Chinese adolescents. Future studies should validate it in other countries.

Background and aims: Internet gaming disorder (IGD) has been mainly studied among adolescents, and no research to date has examined its prevalence in general Chinese adult populations. This study estimated the prevalence of probable IGD in community-dwelling adults in Macao, China. Associations between IGD and psychological distress (i.e., depression and anxiety) as well as IGD and character strength (i.e., psychological resilience and purpose in life) were also tested. Methods: A random, representative sample of 1,000 Chinese residents (44% males; mean age = 40.0) was surveyed using a telephone poll design from October to November 2016. Results: The estimated prevalence of probable IGD was 2.0% of the overall sample and 4.3% among the recent gamers (n = 473), with no statistically significant sex and age effects observed (p > .05). The two most prevalent IGD symptoms were mood modification and continued engagement, despite negative consequences. Probable IGD respondents were more vulnerable to psychological distress (25.0% and 45.0% for moderate or above levels of depression and anxiety, respectively) than their non-IGD counterparts. They also reported a lower level of psychological resilience than non-IGD respondents. No significant buffering effect of the two character strength variables on the distress-IGD relationship was found. Discussion and conclusions: These results provide empirical evidence that IGD is a mental health threat not only to adolescents but also to adults. IGD was significantly associated with psychological distress, which should be addressed in conjunction with IGD symptoms in interventions. Inclusion of gamers of both sexes and different age groups in future prevention programs is also recommended. [ABSTRACT FROM AUTHOR]

Background Little is known about the clinical features and treatment of Chinese patients with Parkinson disease (PD). Methods A large cross-sectional survey of clinical features, medication use, and motor complications was conducted in 901 consecutive PD patients, from 42 randomly selected university affiliated hospitals in four urban economic regions of China, between December 2006 and May 2007. Results The 901 PD patients had age range 30 to 88, and median disease duration 50 months. Most (737, 81.8%) used L-dopa (median 375 mg/day), and often added low doses of other antiparkinsonian agents. Among L-dopa-treated patients, the prevalence of motor complications was low (dyskinesias: 8.5%; motor fluctuations: 18.6%), even among patients with disease duration ⩾11 years (dyskinesias: 18.1%; motor fluctuations: 42.2%). Higher Ldopa use was associated with higher occurrence of dyskinesias (OR 2.44; 95% CI 1.20-5.13) and motor fluctuations (OR 2.48; 95% CI 1.49-4.14). Initiating PD treatment with L-dopa alone (OR 0.46; 95% CI 0.22-0.95) or in combination with other medications (OR 0.41; 95% CI 0.19-0.87) was associated with less dyskinesia than treatment initiated with non-L-dopa medication. Conclusions Many Chinese PD patients are treated with low-dose L-dopa and added low-dose antiparkinsonian agents, with a low prevalence of motor complications, which might be influenced by Chinese culture. [ABSTRACT FROM AUTHOR]

Abstract: This paper employs a simultaneous equation model based on the model of Huang and Labys(2003) to describle the interactions among a set of variables such as economic growth, foreign trade, FDI and environmental pollution. An empirical test is made by using Chinese regional panel data in 1993-2007. The results indicate that export-oriented economy is good for local environments on the whole, and Environment Kuznets Curve holds true in China while Pollution Haven Hypothesis does not. © 2011 Published by Elsevier Ltd. Selection and peer-review under responsibility of RIUDS [Copyright &y& Elsevier]

• Changes in academic pressure at T1 positively linked to adolescent social anxiety at T3. • Classmate support at T2 and PSU at T2 as chain mediators. • Chain mediator model vary by changes in leisure time. • Classmate support at T2 → PSU at T2 was stronger in increased leisure time group. • Changes in academic pressure at T1 → PSU at T2 was weaker in increased group. In response to concerns surrounding excessive homework and off-campus tutoring for students undergoing compulsory education in China, the government implemented the "double reduction" policy to alleviate these burdens. This study aims to examine the mechanisms that underlie the longitudinal relationship between changes in academic pressure and social anxiety among Chinese adolescents under the background of this policy. A total of 2,202 valid questionnaires were obtained, and the sample consisted of 1,234 students who reported having a smartphone (age: M = 14.60, SD = 1.57). They were recruited to complete the changes in leisure time and academic pressure at Time 1, classmate support at Time 1 and Time 2, problematic smartphone use at Time 1 and Time 2, and social anxiety at Time 1, Time 2, and Time 3. The findings indicate that classmate support and problematic smartphone use at Time 2 significantly mediated the association between changes in academic pressure at Time 1 and social anxiety at Time 3. Changes in leisure time at Time 1 also affected these relationships. Specifically, compared to those with decreased leisure time, the relationship between classmate support at Time 2 and problematic smartphone use at Time 2 was stronger among adolescents with increased leisure time, while the relationship between changes in academic pressure at Time 1 and problematic smartphone use at Time 2 was weaker among adolescents with increased leisure time. These results highlight the importance of promoting effective stress coping strategies and peer interactions for adolescents, and also the importance of promoting active parental participation in leisure time management and guidance towards positive coping styles. [ABSTRACT FROM AUTHOR]

Background: Exposure to ambient particulate matter (PM) is associated with a number of adverse health outcomes, but potential mechanisms are largely unknown. Metabolomics represents a powerful approach to study global metabolic changes in response to environmental exposures. We therefore conducted this study to investigate changes in serum metabolites in response to the reduction of PM exposure among healthy college students.Methods: We conducted a randomized, double-blind crossover trial in 55 healthy college students in Shanghai, China. Real and sham air purifiers were placed in participants' dormitories in random order for 9 days with a 12-day washout period. Serum metabolites were quantified by using gas chromatography-mass spectrometry and ultrahigh performance liquid chromatography-mass spectrometry. Between-treatment differences in metabolites were examined using orthogonal partial least square-discriminant analysis and mixed-effect models. Secondary outcomes include blood pressure, corticotropin-releasing hormone, adrenocorticotropic hormone, insulin resistance, and biomarkers of oxidative stress and inflammation.Results: The average personal exposure to PMs with aerodynamic diameters ≤2.5 μm was 24.3 μg/m3 during the real purification and 53.1 μg/m3 during the sham purification. Metabolomics analysis showed that higher exposure to PMs with aerodynamic diameters ≤2.5 μm led to significant increases in cortisol, cortisone, epinephrine, and norepinephrine. Between-treatment differences were also observed for glucose, amino acids, fatty acids, and lipids. We found significantly higher blood pressure, hormones, insulin resistance, and biomarkers of oxidative stress and inflammation among individuals exposed to higher PMs with aerodynamic diameters ≤2.5 μm.Conclusions: This study suggests that higher PM may induce metabolic alterations that are consistent with activations of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes, adding potential mechanistic insights into the adverse health outcomes associated with PM. Furthermore, our study demonstrated short-term reductions in stress hormone following indoor air purification.Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02712333. [ABSTRACT FROM AUTHOR]