Reliability and Validity of the Defeat Scale among Internal Migrant Workers in China: Decadence and Low Sense of Achievement.

INTRODUCTION: Internal migrant workers have a great chance to experience defeat due to their low social status and economic situation. It has been reported that defeat might play a prospective role in predicting depression and anxiety; however, defeat is rarely explored among internal migrant workers due to the lack of appropriate measurement scales. The defeat scale (DS) can measure the feeling of defeat, social hierarchy reduction, and loss in social struggle. But its reliability and validity among internal migrant workers have not been reported. This study aimed to verify the content validity and structural validity of the DS among internal migrant workers in China and to explore its correlations with anxiety and depression. METHODS: 1805 internal migrant workers (IMWs) were recruited by stratified multistage sampling from 16 factories in Shenzhen, China. The content validity index (CVI) was used to assess content validity. Cronbach's coefficient alpha of each factor and the total scale were calculated to assess the reliability of DS. The scree test was used to determine the number of factors. Convergent validity and discriminant validity were estimated by calculating the average variance extracted and composite reliability. Logistic regression was performed to explore the effects of DS scores on anxiety and depression. RESULTS: Mean score of DS among IMWs was 18.42 ± 9.40. There were 606 (33.6%) IMWs who were considered to have depression symptoms, and 524 (29.0%) IMWs were considered to have anxiety symptoms. A two-factor model was obtained and fitted well (CFI = 0.956, GFI = 0.932, IFI = 0.956, RMSEA = 0.068, SRMR = 0.052). Cronbach's alpha reliability coefficient for the DS was 0.92. Logistic regression showed that DS scores were positively associated with anxiety and depression among IMWs. CONCLUSIONS: DS performed well among IMWs on content validity and structural validity, and it was suitable as a measurement instrument to assess defeat among this population. Defeat was positively associated with anxiety and depression and might play an important role in the mental health of IMWs.

Prediction Model for COVID-19 Vaccination Intention among the Mobile Population in China: Validation and Stability.

Since China's launch of the COVID-19 vaccination, the situation of the public, especially the mobile population, has not been optimistic. We investigated 782 factory workers for whether they would get a COVID-19 vaccine within the next 6 months. The participants were divided into a training set and a testing set for external validation conformed to a ratio of 3:1 with R software. The variables were screened by the Lead Absolute Shrinkage and Selection Operator (LASSO) regression analysis. Then, the prediction model, including important variables, used a multivariate logistic regression analysis and presented as a nomogram. The Receiver Operating Characteristic (ROC) curve, Kolmogorov-Smirnov (K-S) test, Lift test and Population Stability Index (PSI) were performed to test the validity and stability of the model and summarize the validation results. Only 45.54% of the participants had vaccination intentions, while 339 (43.35%) were unsure. Four of the 16 screened variables-self-efficacy, risk perception, perceived support and capability-were included in the prediction model. The results indicated that the model has a high predictive power and is highly stable. The government should be in the leading position, and the whole society should be mobilized and also make full use of peer education during vaccination initiatives.

Phase-adjusted estimation of the number of Coronavirus Disease 2019 cases in Wuhan, China.

An outbreak of clusters of viral pneumonia due to a novel coronavirus (2019-nCoV/SARS-CoV-2) happened in Wuhan, Hubei Province in China in December 2019. Since the outbreak, several groups reported estimated R0 of Coronavirus Disease 2019 (COVID-19) and generated valuable prediction for the early phase of this outbreak. After implementation of strict prevention and control measures in China, new estimation is needed. An infectious disease dynamics SEIR (Susceptible, Exposed, Infectious, and Removed) model was applied to estimate the epidemic trend in Wuhan, China under two assumptions of Rt . In the first assumption, Rt was assumed to maintain over 1. The estimated number of infections would continue to increase throughout February without any indication of dropping with Rt = 1.9, 2.6, or 3.1. The number of infections would reach 11,044, 70,258, and 227,989, respectively, by 29 February 2020. In the second assumption, Rt was assumed to gradually decrease at different phases from high level of transmission (Rt = 3.1, 2.6, and 1.9) to below 1 (Rt = 0.9 or 0.5) owing to increasingly implemented public health intervention. Several phases were divided by the dates when various levels of prevention and control measures were taken in effect in Wuhan. The estimated number of infections would reach the peak in late February, which is 58,077-84,520 or 55,869-81,393. Whether or not the peak of the number of infections would occur in February 2020 may be an important index for evaluating the sufficiency of the current measures taken in China. Regardless of the occurrence of the peak, the currently strict measures in Wuhan should be continuously implemented and necessary strict public health measures should be applied in other locations in China with high number of COVID-19 cases, in order to reduce Rt to an ideal level and control the infection.

How involuntary subordination and social support influence the association between self-esteem and depression: a moderated mediation model.

BACKGROUND: In China, young migrants are at elevated risk of mental health problems, such as depression. The influence of self-esteem on depression is well acknowledged. We examined correlates of depression and their mediating and moderating role in the association between self-esteem and depression to promote a better understanding of depression prevention among young migrants. METHODS: We conducted a cross-sectional study among young Chinese migrants. A moderated mediation model was used to test the combined effect of involuntary subordination and social support on the association between self-esteem and depression. The Johnson-Neyman method was used to identify the range of scores for which social support acted as a moderator. RESULTS: A total of 572 participants completed questionnaires. The median depression score was 19 (interquartile range: 14). Self-esteem had a negative effect on involuntary subordination (ß = - 2.1440, p < 0.001). Involuntary subordination (ß = 0.2406, p < 0.001), self-esteem (ß = - 0.3870, p < 0.01), and social support (ß = - 0.1221, p < 0.01) all had significant effects on depression. The effect of involuntary subordination on depression was moderated by social support (ß = - 0.0041, p < 0.05), and the effect decreased as social support scores increased. CONCLUSIONS: Our results indicated a mediating role of involuntary subordination and a moderating role of social support in the association between self-esteem and depression among young Chinese migrants. Future intervention strategies should focus on these factors to reduce depressive symptoms.

Understanding condom use among unmarried female migrants: a psychological and personality factors modified information-motivation-behavioral skills model.

BACKGROUND: In China, unmarried female migrants are vulnerable to sexual and reproductive health risks. One effective protection strategy is promoting consistent condom use (CCU). METHODS: We conducted a cross-sectional study to apply the information-motivation-behavioral skills (IMB) model and modified it by addition of psychological and personal factors to examine the related factors of CCU and provide suggestions for intervention among unmarried female migrants. RESULTS: Of all 903 eligible participants, only 13.8% of participants reported CCU in the past six months. Both the IMB model and the modified IMB model provided acceptable fit to the data. In both models, information had no direct or indirect influence on CCU (p > 0.05). However, behavioral skills had a positive effect on CCU (ß = 0.344, p < 0.001 and ß = 0.330, p < 0.001). Moreover, motivation contributed to CCU indirectly by affecting behavioral skills (ß = 0.800, p < 0.001) and had no direct influence (p > 0.05). In the modified model, psychological and personality factors influenced CCU directly (ß = - 0.100, p = 0.005). CONCLUSIONS: Our results highlight the importance of conducting CCU promotion among unmarried female migrants. Future intervention strategies should focus on both the traditional IMB model constructs and the added psychological and personality factors.

Sexual and reproductive health among unmarried rural-urban female migrants in Shanghai China: a comparative analysis.

We compared sexual and reproductive health (SRH)-related knowledge, attitude and behavior among unmarried rural-urban female migrants in Shanghai coming from different regions of China. A total of 944 unmarried rural-urban female migrants were recruited from three districts of Shanghai. We used an interviewer-administered structured questionnaire to collect information from each participant and a multivariate logistic regression to examine the association between premarital sex and risk factors. We found the rates of premarital sex, pregnancy and abortion among unmarried rural-urban female migrants were 28.2%, 5.2% and 5.0%, respectively. Participants from the east of China were more likely to engage in premarital sex than those from the mid-west (p < 0.001). The analysis showed premarital sex was associated with age, hometown, education, current residential type, knowledge of sexual physiology and safe sex, attitude to SRH and safe sex, and permissive attitude to sex. Unmarried rural-urban female migrants lack SRH related knowledge and the data suggests high levels of occurrence of premarital sex. The results indicate that programs to promote safe sex, especially to those migrants coming from eastern China, should be a priority.

Effects of Lung Support Formula on respiratory symptoms among older adults: results of a three-month follow-up study in Shanghai, China.

BACKGROUND: With the acceleration of industrialization in low or middle-income nations, the prevalence of respiratory symptoms among older adults is even more significant now in China. Contemporary treatments using Western medicine, such as anti-inflammatory regimens, may be effective in relieving the symptoms, but may have unexpected side effects. Some natural products may be effective in improving respiratory functions, yet their efficacies remain to be examined in randomized, placebo-controlled studies. To evaluate the effects of Lung Support Formula, a nutritional supplement which contains naturally derived Chinese herbal medicines, we conducted a clinical study among older adults in Shanghai, China. METHODS: A total of 100 patients over 50 years old were recruited and blindly randomized into the treatment or control group. The subjects took either 1 Lung Support Formula capsule or a placebo capsule twice a day for 12 weeks. All subjects were followed-up every 4 weeks to perform investigative and clinical examinations. Repeated measure of analysis of variance was employed to compare the trend of respiratory symptoms scores between the 2 groups during 12 weeks of follow-up. RESULTS: Fifty patients from the treatment group and 49 patients in the control group completed the 3-month follow-up. No adverse events were reported in the treatment duration. The percentage of patients reported to have chronic cough, chronic expectoration and chronic bronchitis were significantly decreased in the treatment group when compared with baseline after a 3-month intervention (P < 0.05). The respiratory symptoms scores declined gradually with the lapse of time (P < 0.05) in the treatment group and there were no significant changes in the control group by repeated measure of analysis of variance (P > 0.05). CONCLUSIONS: The clinical research shows that use of Lung Support Formula shows significant improvements of respiratory symptoms and is well-tolerated in short-term use among older adults. An additional study involving more subjects and longer-term follow-up would be needed to provide convincing evidence of the improvement of respiratory symptoms in the treatment group.

Social, psychological, and environmental-structural factors determine consistent condom use among rural-to-urban migrant female sex workers in Shanghai China.

BACKGROUND: To determine potential social, psychological, and environmental-structural factors that may result in motivating female sex workers (FSWs), who are rural-to-urban migrants, and their paying partners in Shanghai, China to promote consistent condom use (CCU). METHODS: A cross-sectional study was conducted in five districts of Shanghai, including three suburbs and two downtown locales. We adopted a cluster randomized sampling method to obtain 20 geographic sites, which consisted of 1 or more communities/villages proximal to a location where FSWs were accessible. Five hundred four FSWs from 132 Xitou Fang (shampoo wash rooms), massage parlors, and hair salons who explicitly provided sexual services were enrolled in the study. Each participant completed a questionnaire survey and interview aimed to collect information on the perceptions and behaviors of individuals associated with a risk for human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS),self-efficacy at negotiating safe sex,and the physical, social, and policy environment of the establishments where they worked. RESULTS: The percentage of FSWs who reported consistent condom use with their paying partners was 63.3%. Controlling for socio-demographic characteristics in multivariate analyses, environmental-structural support (OR, 3.96; CI, 2.52-6.22) for condom use was the most significant positive predictor of CCU among FSWs and their regular paying partners. A high perception of susceptibility and risk of HIV/AIDS (OR, 1.96; CI, 1.25-3.01), a high perception of benefits on condom use to protect themselves (OR, 2.06; CI, 1.32-3.22), and high safe sex self-efficacy (OR, 2.52; CI, 1.64-3.85) also play important roles on CCU based on multivariate analyses. CONCLUSIONS: Environmental-structural factor support for condom use, in addition to social, psychological, and individual cognitive factors are significant predictors of CCU among FSWs, which should be assessed and addressed in research and interventions related to HIV/AIDS prevention among FSWs in China.

A study of HIV/AIDS related knowledge, attitude and behaviors among female sex workers in Shanghai China.

BACKGROUND: China is currently facing a rapid and widespread increase in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). The activities of female sex workers (FSWs) have contributed to the mounting epidemic of HIV/AIDS and other sexually transmitted diseases (STDs). Therefore, this study aimed to assess the HIV/AIDS-related knowledge, attitude and risk behaviors among FSWs operating in Shanghai China. METHODS: A cross-sectional study was conducted in five districts of Shanghai, including three suburbs and two downtown locales. We adopted a cluster randomized sampling method to obtain ten geographic sites which consisted of one or more communities/villages proximal to a location where FSWs were accessible. A total of 324 FSWs from 109 Xitou Fang, massage parlors and hair salons who explicitly provided sexual services were enrolled in the study. Each participant completed a questionnaire survey and interview aimed to collect information on the individual's knowledge, attitude, and behaviors associated with risk for HIV/AIDs. RESULTS: The overall correct answer rate of HIV/AIDS-related knowledge was 60.8%, and the knowledge of FSWs from downtown areas was significantly higher than those from suburban areas (P < 0.05). The percentage of FSWs who reported having experiences in commercial sexual services without the use of condoms was 33.6%. Condom slippage or breakage was reported as having occurred at least once by 51.2% of the FSWs. FSWs from suburban areas were found to more often engage in high-risk behaviors, including oral and anal sex, than those from downtown areas (P < 0.001). Many of the FSWs (65.7%) reported having non-client sexual partners (most were identified as boyfriends or husbands); however, condom usage with these partners were lower (34.3%). CONCLUSIONS: Based on the findings from our survey, we advise that promotion of HIV/AIDS-related knowledge be targeted towards FSWs in Shanghai, especially those operating in the suburbs. HIV prevention efforts, such as urging constant condom usage with both clients and steady partners, should be sustained and reinforced among the female sex workers population.