[Effect of Family Function on Suicide-Related Behaviors of Junior Middle School Students: The Mediating Effect of Depression].

Objective: To examine the prevalence of suicide-related behaviors among junior middle school students, and to explore the mediating role of depression in the relationship between suicide-related behaviors and family function. Methods: A total of 2572 junior middle school students from three middle schools in Chengdu were interviewed face-to-face by using suicide-related items from Youth Risk Behavior Surveillance System (YRBSS), Chinese Family Assessment Instrument (C-FAI), and Center for Epidemiologic Studies Depression Scale for Children (CES-DC). The mediating role of depression was analyzed with structural equation model. Results: The prevalence of suicide-related behaviors was 26.01% among the respondents. The prevalence of suicide ideation, suicide plan and suicide attempt were 24.38%, 13.49% and 10.77%, respectively. Depression played a partial mediating role in how family function impacted on suicide-related behaviors, presenting a direct effect value of 0.170 (95% CI: 0.117-0.218, P<0.001) and an indirect effect value of 0.205 (95% CI: 0.176-0.234, P<0.001), with the mediating effect accounting for 54.67% of the total effect. Conclusion: Poor family function may increase the risk of suicide-related behaviors, and this effect is produced mostly through the impact on children's mental health. Improving family function will not only improve children's psychological status, but also reduce suicide-related behaviors.

[Analysis of Nursery Services for Children under 3 in Sichuan Province Based on the Theory of Supply and Demand Adaptability].

Objective: To analyze the supply and demand adaptation of nursery care services for children under 3 in Sichuan Province and to provide strategic suggestions for optimizing nursery care services in Sichuan Province. Methods: Data on the supply and demand of nursery school services in all 21 cities (prefectures) of Sichuan Province were collected with questionnaires for nursery care institutions and family needs questionnaires. Applying the theory of supply and demand adaptability, we analyzed the adaptability of nursery care services in Sichuan Province in four dimensions, including relevance, adaptability, accessibility and quality. Results: A total of 6883 valid institutional questionnaires and 41081 valid family questionnaires were collected. The analysis of the adaptability of supply and demand showed that there was insufficient adaptability in all four dimensions of relevance, adaptability, accessibility, and quality of nursery care services for children under 3 in Sichuan Province, which was characterized by the coexistence of insufficient supply and underutilization of services, the mismatch between the structure of services provided and the needs of families with children under 3, low economic accessibility for the general population, and low quality of services. Conclusion: There is insufficient adaptability in the supply and demand of nursery care services for children under 3 in Sichuan Province. Demand-oriented supply-side reforms should be implemented to promote the construction of a system of government-subsidized affordable nursery care services, reinforced support for the care of infants and toddlers for families, standardized management of infant and toddler care institutions, and the implementation of various supportive policies so as to comprehensively meet the diversified needs of infant and toddler care and promote their healthy growth.

Factors influencing parents' willingness to vaccinate their preschool children against COVID-19: Results from the mixed-method study in China.

During the COVID-19 pandemic, little is known about parental hesitancy to receive the COVID-19 vaccine for preschool children who are the potential vaccinated population in the future. The purpose of this mixed-method study was to explore the factors influencing Chinese parents' decision to vaccinate their children aged 3-6 years old against COVID-19. In July 2021, we conducted semi-structured interviews (n = 19) and a cross-sectional survey (n = 2605) with parents of kindergarten children in an urban-rural combination pilot area in China. According to the qualitative study, most parents were hesitant to vaccinate their children with the COVID-19 vaccine. In the quantitative study, we found that three-fifths of 2605 participants were unwilling to vaccinate their children against COVID-19. Furthermore, the main predictors of parents' intention to vaccinate their children were fathers, lower level of education, and positive attitudes toward vaccination. Based on our findings, targeted health education techniques may be able to boost childhood COVID-19 immunization rates.

A network meta-analysis of secondary attack rates of COVID-19 in different contact environments.

As the corona virus disease 2019 (COVID-19) pandemic continues around the world, understanding the transmission characteristics of COVID-19 is vital for prevention and control. We conducted the first study aiming to estimate and compare the relative risk of secondary attack rates (SARs) of COVID-19 in different contact environments. Until 26 July 2021, epidemiological studies and cluster epidemic reports of COVID-19 were retrieved from SCI, Embase, PubMed, CNKI, Wanfang and CBM in English and Chinese, respectively. Relative risks (RRs) were estimated in pairwise comparisons of SARs between different contact environments using the frequentist NMA framework, and the ranking of risks in these environments was calculated using the surface under the cumulative ranking curve (SUCRA). Subgroup analysis was performed by regions. Thirty-two studies with 68 260 participants were identified. Compared with meal or gathering, transportation (RR 10.55, 95% confidence interval (CI) 1.43-77.85), medical care (RR 11.68, 95% CI 1.58-86.61) and work or study places (RR 10.15, 95% CI 1.40-73.38) had lower risk ratios for SARs. Overall, the SUCRA rankings from the highest to the lowest were household (95.3%), meal or gathering (81.4%), public places (58.9%), daily conversation (50.1%), transportation (30.8%), medical care (18.2%) and work or study places (15.3%). Household SARs were significantly higher than other environments in the subgroup of mainland China and sensitive analysis without small sample studies (<100). In light of the risks, stratified personal protection and public health measures need to be in place accordingly, so as close contacts categorising and management.

Associations of Exposure to Air Pollution with Insulin Resistance: A Systematic Review and Meta-Analysis.

In this article, we review the available evidence and explore the association between air pollution and insulin resistance (IR) using meta-analytic techniques. Cohort studies published before January 2018 were selected through English-language literature searches in nine databases. Six cohort studies were included in our sample, which assessed air pollutants including PM2.5 (particulate matter with an aerodynamic diameter less than or equal to 2.5 µm), NO2(nitrogen dioxide), and PM10 (particulate matter with an aerodynamic diameter less than 10 µm). Percentage change in insulin or insulin resistance associated with air pollutants with corresponding 95% confidence interval (CI) was used to evaluate the risk. A pooled effect (percentage change) was observed, with a 1 µg/m³ increase in NO2 associated with a significant 1.25% change (95% CI: 0.67, 1.84; I² = 0.00%, p = 0.07) in the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and a 0.60% change (95% CI: 0.17, 1.03; I² = 30.94%, p = 0.27) in insulin. Similar to the analysis of NO2, a 1 µg/m³ increase in PM10 was associated with a significant 2.77% change (95% CI: 0.67, 4.87; I² = 94.98%, p < 0.0001) in HOMA-IR and a 2.75% change in insulin (95% CI: 0.45, 5.04; I² = 58.66%, p = 0.057). No significant associations were found between PM2.5 and insulin resistance biomarkers. We conclude that increased exposure to air pollution can lead to insulin resistance, further leading to diabetes and cardiometabolic diseases. Clinicians should consider the environmental exposure of patients when making screening and treatment decisions for them.

The Effect of Vitamin A on Fracture Risk: A Meta-Analysis of Cohort Studies.

This meta-analysis evaluated the influence of dietary intake and blood level of vitamin A (total vitamin A, retinol or ß-carotene) on total and hip fracture risk. Cohort studies published before July 2017 were selected through English-language literature searches in several databases. Relative risk (RR) with corresponding 95% confidence interval (CI) was used to evaluate the risk. Heterogeneity was checked by Chi-square and I² test. Sensitivity analysis and publication bias were also performed. For the association between retinol intake and total fracture risk, we performed subgroup analysis by sex, region, case ascertainment, education level, age at menopause and vitamin D intake. R software was used to complete all statistical analyses. A total of 319,077 participants over the age of 20 years were included. Higher dietary intake of retinol and total vitamin A may slightly decrease total fracture risk (RR with 95% CI: 0.95 (0.91, 1.00) and 0.94 (0.88, 0.99), respectively), and increase hip fracture risk (RR with 95% CI: 1.40 (1.02, 1.91) and 1.29 (1.06, 1.57), respectively). Lower blood level of retinol may slightly increase total fracture risk (RR with 95% CI: 1.11 (0.94, 1.30)) and hip fracture risk (RR with 95% CI: 1.27 (1.05, 1.53)). In addition, higher ß-carotene intake was weakly associated with the increased risk of total fracture (RR with 95% CI: 1.07 (0.97, 1.17)). Our data suggest that vitamin A intake and level may differentially influence the risks of total and hip fractures. Clinical trials are warranted to confirm these results and assess the clinical applicability.