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Influenza is prevalent globally, leading to severe morbidity and mortality. During the pandemic, knowledge, attitude, and practice (KAP) towards influenza virus and vaccination were less investigated among southern Chinese older adults. A cross-sectional study was conducted through the structured questionnaire among community healthcare centers in selected districts in Shenzhen, southern China from September to October 2021. KAP towards influenza virus and vaccination were analyzed. A multivariable logistic regression model was used to identify associated factors. Among 975 participants, 55.6% were reported to have received influenza vaccination ever, and 46.6% had taken influenza vaccination in 2020 during the pandemic. Only one-fifth of participants knew severe comorbidities happen among severe influenza cases. A total of 88.3% thought older adults should have influenza vaccination. COVID-19 vaccination history was associated with receiving influenza vaccination (OR 1.92, 95% CI 1.32–2.80). People with a high-level income had better KAP towards influenza virus and vaccination. COVID-19 vaccination history was associated with the positive actions of influenza vaccination during the pandemic. Efforts should be made to promote the free influenza vaccination program widely and launch health education events on influenza and its vaccination regularly to improve KAP among older adults. [ABSTRACT FROM AUTHOR]

Background: To promote influenza vaccination coverage, a Chinese megacity, Shenzhen provides free influenza vaccination to its residents aged 60 years and above through community health centres (CHCs) since October 2016. A community health centre-based experiment was conducted by asking primary care physicians (PCPs) working in the intervention health centres to proactively recommend influenza vaccination to their patients aged 60 and above during their patients' visits. Methods: This study used an experimental design and a survey design. The experimental design evaluated the effect of PCP recommendation on influenza vaccination. A total of 24 CHCs were randomly selected as the intervention (involving 3814 participants) and control (3072 participants) group evenly. The intervention study period was during the 2017–2018 flu season. The 2016–2017 flu season was considered as the baseline comparison. The survey design examined changes in knowledge, attitude, and practice of influenza vaccination among older participants before and after the free influenza vaccination implementation. We randomly invited 1200 participants aged 60 and above during their visits to CHCs in October 2016 and followed them up until October 2017; among them, 958 participants completed the follow-up survey using the same questionnaire. Results: In the 2017–2018 flu season, 1,100 more patients got vaccinated in the intervention group under PCP recommendation compared with the 2016–2017 flu season. Among the 958 older adults in the post-implementation period, 77.5% had heard about the influenza vaccine, which was 24.7% higher than in the pre-implementation period; 84.8% of participants were aware where to take influenza vaccines, with the most improvement of 37.2% among all knowledge related questions; 62.5% of them agreed that patients with chronic diseases should have influenza vaccine, which was 19.1% higher than those being surveyed before the implementation period. About 83.6% of participants agreed older adults should have influenza vaccine, but there were still 58.4% who considered themselves too healthy to get vaccinated. Conclusion: PCP recommendation improved influenza vaccine uptake and knowledge, attitude, and practice levels regarding influenza vaccination among older adults. More health policies and health education should be made to raise vaccination willingness and improve vaccination coverage among older adults. [ABSTRACT FROM AUTHOR]

The prevalence of trace elements from industrial and traffic activities poses potential health risks through inhalation exposure. Prior studies have focused on trace elements in water, food, and dust, and less attention has been paid to their occurrence in fine particulate matter (PM 2.5 ). In this study, 1424 air samples were collected from three districts (Nanshan, Longgang, and Yantian) in Shenzhen from 2016 to 2021, and we analyzed the concentrations, temporal trends, and spatial distributions of PM 2.5 and associated trace elements. Both PM 2.5 and trace elements exhibited decreasing trends and similar seasonal variations, with high levels in cold seasons and low levels in warm seasons. In terms of spatial distributions, the concentrations of PM 2.5 and trace elements in Nanshan and Longgang were significantly higher than those in Yantian, likely due to the industrial structure and traffic activities. It is worth noting that PM 2.5 was identified as a potential mediator of the effect of meteorological parameters on trace element levels. Besides, the values of estimated daily intake (EDI) and uptake (EDU) suggested that infants and young children experienced an elevated risk of exposure to trace elements. While the annual average excess hazard indexes (R) were below the safety threshold (10 -6 ), carcinogenic trace elements like arsenic (As) and chromium (Cr) posed a greater potential threat to human health compared to non-carcinogenic trace elements., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The precise associations between temperature-related indices and mental and behavioral disorders (MBDs) have yet to be fully elucidated. Our study aims to ascertain the most effective temperature-related index and assess its immediate impact on emergency ambulance dispatches (EADs) due to MBDs in Shenzhen, China., Methods: EADs data and meteorological data from January 1, 2013, to December 31, 2020, in Shenzhen were collected. Distributed lag non-linear models (DLNMs) were utilized to examine the non-linear and lagged effects of temperature-related indices on EADs due to MBDs. The Quasi Akaike Information criterion (QAIC) was used to determine the optimal index after standardizing temperature-related indices. After adjusting for confounding factors in the model, we estimated the immediate and cumulative effects of temperature on EADs due to MBDs., Results: The analysis of short-term temperature effects on EADs due to MBDs revealed Humidex as the most suitable index. Referring to the optimal Humidex (3.2 th percentile, 12.00°C), we observed a significant effect of Humidex over the threshold (34.6 th percentile, 26.80°C) on EADs due to MBDs at lag 0-5. The cumulative relative risks for high temperature (90 th percentile, 41.90°C) and extreme high temperature (99 th percentile, 44.20°C) at lag 0-5 were 1.318 (95% CI: 1.159-1.499) and 1.338 (95% CI: 1.153-1.553), respectively. No significant cold effect was observed on EADs due to MBDs., Conclusion: High Humidex was associated with more EADs due to MBDs in subtropical regions. Health authorities should implement effective measures to raise public awareness of risks related to high temperature and protect vulnerable populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yin, Jingesi, Yin, Chen, Huang, Cheng, Li, Liu, Wang, Yin and Jiang.)

Evidence is limited on the actual uptake of the coronavirus disease 2019 (COVID-19) vaccine among older adults, especially those with chronic diseases, during the pandemic. To examine COVID-19 vaccine uptake, reasons, and associated factor among older adults, a cross-sectional survey was conducted between September 24 and October 20, 2021 among older adults aged 60 and above in Shenzhen, China. Logistic regression analysis was used to examine associations of COVID-19 vaccine uptake with sociodemographic characteristics, pneumonia vaccination history, and participation in health education activities among older adults and among those with chronic diseases. Of the 951 participants, 82.8% reported being vaccinated against COVID-19 during the study period, but this proportion was relatively lower among adults aged 80 and above (62.7%) and those with chronic diseases (77.9%). The top-rated reasons for not being vaccinated included doctors not recommending it due to underlying diseases (34.1%), not being ready for it (18.3%), and failure to make an appointment (9.1%). General older adults who were aged below 70, had a high school and above education, were permanent residents of Shenzhen, were with good health and had pneumonia vaccination history were more likely to take the COVID-19 vaccination. Yet, among older adults with chronic diseases, other than age and permanent residency status, health status was the only significant indicator of COVID-19 vaccine uptake. Our study added to evidence that health condition is the critical barrier to the actual uptake of the COVID-19 vaccine among Chinese older adults, especially those aged 80 and above and those with chronic diseases.

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous contaminants in the atmosphere that have drawn intense attention due to their carcinogenicity and mutagenicity. In this work, 1424 air samples were collected between January 2016 and December 2021 in three areas of Shenzhen, China to determine the concentrations of PM 2.5 and PAHs and their spatiotemporal variation. Human health risks due to the daily intake and uptake of PAHs and the resulting incremental lifetime cancer risk (ILCR) were also evaluated. PAHs were detected frequently in the samples at concentrations between 0.28 and 32.7 ng/m 3 (median: 1.04 ng/m 3 ). PM 2.5 and PAH concentrations decreased from 2016 to 2021, and the Yantian area had lower median concentrations of PM 2.5 (23.0 μg/m 3 ) and PAHs (0.02 ng/m 3 ) than the Longgang and Nanshan areas. The concentrations of PM 2.5 and PAHs were significantly higher in winter than in summer. Analysis of diagnostic ratios indicated that petroleum combustion was the dominant source of airborne PAHs in Shenzhen. The estimated daily intake (EDI) and uptake (EDU) of PAHs by local residents decreased gradually with increasing age, indicating that infants are at particular risk of PAH exposure. However, the incremental lifetime cancer risks (ILCRs) were below the threshold value of 10 -6 , indicating that inhalation exposure to PAHs posed a negligible carcinogenic risk to Shenzhen residents. While promising, these results may underestimate actual PAH exposure levels, so further analysis of health risks due to PAHs in Shenzhen is needed., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The study was to understand Angiostrongylus cantonensis infection status in host animals and populations in Shenzhen. In 2016-2017, 10 different ecological environments were selected, and intermediate and definitive hosts collected at the sites were examined using the enzyme digestion and dissection method to determine their infection status. Meanwhile, serum was collected from outpatients and healthy people. The enzyme-linked immunosorbent assay test was performed to detect serum IgG-specific antibodies to A. cantonensis , and serological characteristics of the populations were analyzed. A total of 300 Achatina fulica samples had an A. cantonensis infection rate of 10.67% (32/300) and an average infection intensity of 68.7 per snail, whereas 302 Pomacea canaliculata samples had an infection rate of 6.29% (19/302) and an average infection intensity of 31.4 per snail. Although both infection rate and infection intensity were lower in P. canaliculata than in A. fulica , infection intensity was significantly different ( p  < 0.001). Among 238 definitive-host rodents, 22 were infected with A. cantonensis . The infection rate in Rattus norvegicus was 14.68% (16/109), significantly higher than that in Rattus flavipectus ( p  < 0.05). The seroprevalence of A. cantonensis in the 900 outpatients and 1500 healthy people was 7.11% (64/900) and 1.87% (28/1500), respectively. Thus, the infection rate was significantly higher in outpatients than in healthy people in Shenzhen ( p  < 0.001). This study revealed a wide distribution and the prevalence of A. cantonensis in host animals and populations in Shenzhen, therefore, it is necessary to strengthen the current monitoring of the disease to prevent a potential outbreak.