Association Between Diabetes and Personality Traits Among the Elderly in China: A Latent Class Analysis.

BACKGROUND: The present study aimed to identify individuals with different personalities using latent class analysis and further distinguish those with a high risk of diabetes among different clusters. METHODS: Data were utilized from a large-scale, cross-sectional epidemiological survey conducted in 2018 across 23 provinces in China, employing a multi-stage, stratified sampling technique. Latent class cluster analysis was performed to identify distinct personality clusters based on a series of variables concerning life attitudes. Logistic regression was used to calculate adjusted odds ratios (AORs) after controlling for potential confounding variables, including age, gender, body mass index, smoking status, alcohol consumption, hypertension, and physical activity levels, to determine the association between these groups and diabetes. RESULTS: Four distinct personality clusters were identified, namely the energy-poor (2.0%), self-domination (61.3%), optimistic (21.3%), and irritable (15.4%) groups. The prevalence of diabetes in these groups was 14.6%, 9.7%, 9.3%, and 11.6%, respectively. After adjusting for potential confounders, the "energy-poor group" exhibited more odds of having diabetes as compared to the "optimistic group" (AOR 1.683, 95%CI: 1.052-2.693; P=0.030). CONCLUSION: This study identified an energy-poor group of individuals with a high risk of diabetes. Targeted interventions should consider the emotional and personality characteristics of the elderly.

Generalized anxiety disorder among rural primary and middle school students during the outbreak of COVID-19: a multicenter study in three southern Chinese cities.

BACKGROUND: The major public health crisis caused by the rapid spread of the coronavirus disease 2019 (COVID-19) and the large-scale public health measures such as social isolation and school closures enforced by some countries have severely affected on the physical and mental wellbeing of children and adolescents globally. This study aimed to estimate the prevalence of the psychological impact and investigate the similarities and differences in the influential factors for generalized anxiety disorder among rural adolescents as a relatively lesser noticed population the outbreak of COVID-19. METHODS: From May 11 to 22, 2020, a total of 1,179 adolescents, including Grade 5-6 in primary school and Grade 7-8 in middle school, were selected by multistage sampling in three Southern Chinese cities (Shantou, Guangdong Province; Hezhou, Guangxi Province; Nanchong, Sichuan Province), and completed the questionnaires including sociodemographic, generalized anxiety disorder, academic stress, coronaphobia, knowledge of COVID-19, and precautionary measures. ANOVA, Chi-square test, Kruskalwallis H test and multivariate linear regression were performed in the statistical analysis. RESULTS: The average scores of generalized anxiety disorder during the past two weeks were 3.43 (SD 4.46), 4.47 (SD 5.15), and 4.10 (SD 4.94) in Shantou, Hezhou and Nanchong, respectively. For the pooled data, academic stress (P < 0.001), coronaphobia (P < 0.001), and precautionary measures (P = 0.002) contributed to the prediction of anxiety scores. Academic stress was significantly associated to anxiety symptoms in all cities (P all < 0.001). Coronaphobia was also significantly associated to anxiety symptoms in all cities (P all < 0.001). CONCLUSION: This study highlights the urgent need for researchers and policymakers to focus on the mental health of rural children and adolescents during the COVID-19 epidemic. The adolescents with academic stress and coronaphobia, the greater the risk that adolescents will suffer from anxiety, suggesting mental health counseling and professional family support are needed.

Approaching autonomous driving with cautious optimism: analysis of road traffic injuries involving autonomous vehicles based on field test data.

OBJECTIVES: To examine the patterns and associated factors of road traffic injuries (RTIs) involving autonomous vehicles (AVs) and to discuss the public health implications and challenges of autonomous driving. METHODS: Data were extracted from the reports of traffic crashes involving AVs. All the reports were submitted to the California Department of Motor Vehicles by manufacturers with permission to operate AV test on public roads. Descriptive analysis and χ2 analysis or Fisher's exact test was conducted to describe the injury patterns and to examine the influencing factors of injury outcomes, respectively. Binary logistic regression using the Wald test was employed to calculate the OR, adjusted OR (AOR) and 95% CIs. A two-tailed probability (p<0.05) was adopted to indicate statistical significance. RESULTS: 133 reports documented 24 individuals injured in 19 crashes involving AVs, with the overestimated incidence rate of 18.05 per 100 crashes. 70.83% of the injured were AV occupants, replacing vulnerable road users as the leading victims. Head and neck were the most commonly injured locations. Driving in poor lighting was at greater risk of RTIs (AOR 6.37, 95% CI 1.47 to 27.54). Collisions with vulnerable road users or incidents happening during commute periods led to a greater number of victims (p<0.05). Autonomous mode cannot perform better than conventional mode in road traffic safety to date (p=0.468). CONCLUSIONS: Poor lighting improvement and the regulation of commute-period traffic and vulnerable road users should be strengthened for AV-related road safety. So far AVs have not demonstrated the potential to dramatically reduce RTIs. Cautious optimism about AVs is more advisable, and multifaceted efforts, including legislation, smarter roads, and knowledge dissemination campaigns, are fairly required to accelerate the development and acceptance.

Prevalence of child passenger restraint use in Shantou, China from 2012 to 2017.

BACKGROUND: Child passenger safety is an important public health problem in China. This study aimed to examine the prevalence of child passenger restraint use while riding in a car in the city of Shantou in China from 2012 to 2017. METHODS: Three large-scale cross-sectional observational studies were conducted in 2012, 2015 and 2017, respectively. The observation sites included randomly selected hospitals, kindergartens, and primary and secondary schools. The outcome measures included the changes in percentages of seating position (e.g., front vs. rear), whether sitting on lap, and use of child restraint systems (CRS) or seat belts by year and by age group. Descriptive statistics, Chi-square tests and logistic regression were used to address the study aims. RESULTS: A total of 9858 commuting children aged 17 and younger were observed in passenger cars in Shantou, China during the study. The proportion of children aged 0-5 sitting on adult's lap decreased from 26.6% in 2012 to 24.6% in 2017, while the proportion of CRS use among the children sitting in the rear row increased among children aged 0-5 (from 0.7% in 2012 to 14.2% in 2017) and children aged 6-11 (from 0.7% in 2012 to 2.4% in 2017). Comparing children aged 0-11 in 2012, children in the same ages were less likely to sit in the front row in 2015 (OR = 0.42, 95%CI = 0.37, 0.48) and in 2017 (OR = 0.27, 95%CI = 0.23, 0.31). Children aged 0-11 were more likely to sit in the rear row with CRS use in 2015 (OR = 8.50, 95%CI = 5.44, 13.28) and in 2017 (OR = 10.95, 95%CI = 7.02, 17.08) comparing with children in the same ages in 2012. As for children aged 12-17, they were more likely to use seat belt in 2017 (OR = 1.40, 95%CI = 1.06, 1.85) compared with those children in 2012. CONCLUSIONS: While child passenger safety behaviors improved from 2012 to 2017 in Shantou, China, more efforts are needed to protect child passengers from injuries.

Assessing an App-Based Child Restraint System Use Intervention in China: An RCT.

INTRODUCTION: While child restraint systems are effective in protecting children from crash-related injuries and deaths, their use in China is extremely low. This study assessed the effectiveness of child restraint system education with and without behavioral skills training on improved use and explored participants' views regarding content and delivery of an onsite intervention and online (WeChat) boosters. STUDY DESIGN: A randomized trial was conducted in 6 kindergartens from May 2017 to January 2018 in Shantou and Chaozhou, China. Selected kindergartens were randomly assigned to 3 groups: (1) control, (2) child restraint system education‒only, and (3) child restraint system education plus behavioral skills training. Analysis was conducted in May 2018. SETTING/PARTICIPANTS: Participants were parents from the selected kindergartens. INTERVENTION: Both intervention groups received child restraint system education that included one-time onsite education and biweekly online boosters for 3 months using an app to deliver education messages. MAIN OUTCOME MEASURES: Survey questions included parent knowledge, attitude and behaviors of child restraint system use, and opinions related to the content and delivery of the onsite intervention and online boosters. RESULTS: Child restraint system use in both intervention groups was higher than that of the control group post-intervention (27.3% and 31.7%, respectively). Compared with the control group, the intervention groups had a higher percentage of correct answers to all 9 items, except Item 7 measuring the parents' knowledge, attitude, and behaviors of child passenger safety after the intervention. Lower parent's level of education (OR=7.00, 95% CI=2.62, 18.70) and older child age (4 years: OR=3.92, 95% CI=1.08, 5.28; 5 years: OR=2.08, 95% CI=1.52, 5.31) were associated with lower rates of child restraint system use. Most parents (92.3%) preferred the online over the onsite intervention component. CONCLUSIONS: An education intervention was effective in improving parents' knowledge, attitude, and practice of child restraint system use. A social media intervention booster (WeChat) may provide a new channel to help promote child passenger safety in China.

Characteristics and factors associated with post-exposure prophylaxis (PEP) treatment of dog and cat bites among left-behind children: a cross-sectional study in two cities of China.

OBJECTIVE: Animal injury is a significant cause of morbidity and mortality worldwide. Dog bites account for tens of millions of injuries annually and the highest risk is among children. However, children may not receive postexposure prophylaxis (PEP) treatment timely and appropriately after rabies exposure. This study aimed to investigate the characteristics and factors associated with PEP treatment of dog and cat bites among left-behind children. DESIGN: A cross-sectional study using questionnaire was conducted in primary and high schools. SETTING: Shenzhen and Shantou cities, Guangdong Province, China. PARTICIPANTS: A total of 9380 participants were included and 2236 of them were with a history of dog and cat bites. RESULTS: 1188 (53.1%) boys and 1048 (46.9%) girls suffered from animal bites. Bitten in holidays was less likely to receive PEP treatment (OR 0.512, 95% CI 0.377 to 0.695) than those bitten in school days. Bitten while being with family (OR 1.418, 95% CI 1.040 to 1.934) and bitten at roadside (OR 1.842, 95% CI 1.297 to 2.171), bitten by unvaccinated animals (OR 1.745, 95% CI 1.246 to 2.443) tended to receive PEP treatment. Compared with unbroken skin, bleeding (OR 1.789, 95% CI 1.165 to 2.745) and laceration (OR 3.834, 95% CI 2.310 to 6.366) were showed as treatment prompting factors. CONCLUSIONS: Bitten in holidays was found as a risk factor of receiving PEP treatment of animal bites. Certain measures should be taken to raise left-behind children's awareness of receiving PEP treatment timely and appropriately after dog and cat bites.