Exposures to particulate matters and childhood sleep disorders-A large study in three provinces in China.

OBJECTIVES: Evidence on the link between long-term ambient particulate matter (PM) exposures and childhood sleep disorders were scarce. We examined the associations between long-term exposures to PM2.5 and PM1 (PM with an aerodynamic equivalent diameter <2.5 µm and <1 µm, respectively) with sleep disorders in children. METHODS: We performed a population-based cross-sectional survey in 177,263 children aged 6 to 18 years in 14 Chinese cities during 2012-2018. A satellite-based spatiotemporal model was employed to estimate four-year annual average PM2.5 and PM1 exposures at residential and school addresses. Parents or guardians completed a checklist using the Sleep Disturbance Scale for Children. We estimated the associations using generalized linear mixed models with adjustment for characteristics of children, parents, and indoor environments. RESULTS: Long-term PM2.5 and PM1 exposures were positively associated with odds of sleep disorders for almost all domains. For example, increments in PM2.5 and PM1 per 10 µg/m3 were associated with odds ratios of global sleep disorder of 1.24 (95 % confidence interval [CI]: 1.14, 1.35) and 1.31 (95 %CI: 1.18, 1.46), respectively. Similar results were observed for subtypes of sleep disorder. These associations were heterogeneous regionally, with stronger associations among children residing in southeast region than in northeast and northwest regions. Moreover, larger estimates of PM1 were found than that of PM2.5 in southeast region. CONCLUSION: Long-term PM2.5 and PM1 exposures are independently associated with higher risks of childhood sleep disorders, and these associations vary by geographical region.

Altered effective connectivity on rapid automatized naming deficits in Chinese children with developmental dyslexia: An rs-fMRI study with Ganger causality analysis.

Rapid Automatized Naming (RAN) is the core defect of developmental dyslexia (DD), requiring collaboration among brain areas to complete. However, it's still unclear which effective connectivity (EC) among brain areas are crucial for RAN deficits in Chinses children with DD. The current study aims to explore the EC among brain areas related to RAN deficits in Chinese children with DD. We recruited 36 Chinese children with DD and 64 typically developing (TD) children aged 8-12 to complete resting-state functional magnetic resonance imaging (rs-fMRI) scan. Granger causality analysis (GCA) was employed to analysis the EC among brain areas related to RAN, and to calculate the relationship between EC and RAN scores. Compared to TD group, the DD group exhibited significantly decreased EC from left precentral gyrus (PG) to right precuneus, left anterior cingulate and paracingulate gyrus (ACG), left calcarine and right angular, from left middle frontal gyrus (MFG) to left calcarine. Additionally, the DD group showed increased EC from right cuneus to left inferior frontal gyrus triangular part (IFGtri). The EC from left PG to left ACG was positively correlated with letters-RAN score. The results showed Chinese children with DD had both defect and compensatory mechanisms for their RAN deficits. The decreased EC output from left PG may be the core problem of the RAN deficits, which may influence the integration of visual-spatial information, attention, memory retrieval, and speech motor in speech production. The current study has important clinic implications for establishing intervention measures targeted brain.

Positive association between chlorinated paraffins and the risk of allergic diseases in children and adolescents.

Contaminants may induce immune response polarization, leading to immune diseases, such as allergic diseases. Evidence concerning the effects of chlorinated paraffins (CPs), an emerging persistent organic pollutant, on immune system is scarce, particularly for epidemiological evidence. This study explores the association between CPs exposure and allergic diseases (allergic rhinitis, atopic eczema, and allergic conjunctivitis) in children and adolescents in the Pearl River Delta (PRD) in China. Herein, 131,304 children and adolescents from primary and secondary schools in the PRD were included and completed the questionnaire survey. The particulate matter (PM) samples were collected in the PRD and the PM2.5-bound CP concentrations were analyzed. In the multivarious adjustment mixed effect model (MEM), an IQR increase in ∑CPs was significantly associated with allergic diseases (rhinitis, eczema, and conjunctivitis) with the estimated odds ratios (ORs) for 1.11 (95% CI: 1.10, 1.13), 1.17 (95% CI: 1.15, 1.19), and 1.82 (95% CI: 1.76, 1.88), respectively. Interaction analysis indicated that overweight and obese individuals might have greater risk. Similar effect estimates were observed in several sensitivity analyses. This study provided epidemiological evidence on the immunotoxicity of CPs. More studies to confirm our findings and investigate mechanisms are needed.

Association Between Home Renovation and Sleeping Problems Among Children Aged 6-18 Years: A Nationwide Survey in China.

BACKGROUND: Although the indoor environment has been proposed to be associated with childhood sleep health, to our knowledge no study has investigated the association between home renovation and childhood sleep problems. METHODS: The study included 186,470 children aged 6-18 years from the National Chinese Children Health Study (2012-2018). We measured childhood sleeping problems via the Chinese version of the Sleep Disturbance Scale for Children (C-SDSC). Information on home renovation exposure within the recent 2 years was collected via parent report. We estimated associations between home renovation and various sleeping problems, defined using both continuous and categorized (binary) C-SDSC t-scores, using generalized mixed models. We fitted models with city as a random effect variable, and other covariates as fixed effects. RESULTS: Out of the overall participants, 89,732 (48%) were exposed to recent home renovations. Compared to the unexposed group, children exposed to home renovations had higher odds of total sleep disorder (odd ratios [OR] = 1.3; 95% confidence interval [CI] = 1.2, 1.4). Associations varied when we considered different types of home renovation materials. Children exposed to multiple types of home renovation had higher odds of sleeping problems. We observed similar findings when considering continuous C-SDSC t-scores. Additionally, sex and age of children modified the associations of home renovation exposure with some of the sleeping problem subtypes. CONCLUSIONS: We found that home renovation was associated with higher odds of having sleeping problems and that they varied when considering the type of renovation, cumulative exposure, sex, and age differences.

The association between childhood adiposity in northeast China and anthropogenic heat flux: A new insight into the comprehensive impact of human activities.

Anthropogenic heat has been reported to have significant health impacts, but research on its association with childhood adiposity is still lacking. In this study, we matched the 2008-2012 average anthropogenic heat flux, as simulated by a grid estimation model using inventory methods, with questionnaire and measurement data of 49,938 children randomly recruited from seven cities in Northeast China in 2012. After adjusting for social demographic and behavioral factors, we used generalized linear mixed-effect models to assess the association between anthropogenic heat flux and adiposity among children. We also examined the effect modification of various social demographic and behavioral confounders. We found that each 10 W/m2 increase in total anthropogenic heat flux and that from the industry source was associated with an increase of 5.82% (95% CI = 0.84%-11.05%) and 6.62% (95% CI = 0.87%-12.70%) in the odds of childhood adiposity. Similarly, the excess rate of adiposity among children were 5.26% (95% CI = -1.33%-12.29%) and 8.51% (95% CI = 2.24%-15.17%) per 1 W/m2 increase in the anthropogenic heat flux from transportation and buildings, and was 7.94% (95% CI = 2.28%-13.91%) per 0.001 W/m2 increase in the anthropogenic heat flux from human metabolism. We also found generally greater effect estimates among female children and children who were exposed to passive smoking during pregnancy, born by caesarean section, non-breastfed/mixed-fed, or lived within 20 m adjacent to the main road. The potential deleterious effect of anthropogenic heat exposure on adiposity among children may make it a new but major threat to be targeted by future mitigation strategies.

Satisfaction of Hangzhou residents with primary health care servicesand its influencing factors / 预防医学

Objective@#To understand the satisfaction of the residents in Hangzhou with primary health care services and its influencing factors, so as to provide basis for improving the quality of primary health care services.@*Methods@#This study adopted multi-stage stratified random sampling method to recruit the residents aged 14 years or over in Hangzhou from July to September, 2019. A self-designed electronic questionnaire for primary health care services in Hangzhou was used to collect the demographic information, the utilization of primary health care institutions, the scores of the indicators of primary health care services and the satisfaction. The ordinal and multinomial logistic regression model was conducted to analyze the influencing factors for the satisfaction with primary health care services. @*Results@#Totally 1 600 questionnaires were issued, 1 454 valid ones were collected, and the response rate was 90.88%. Five ( 0.34% ) residents were very dissatisfied, 16 ( 1.10% ) residents were dissatisfied, 153 ( 10.52% ) residents were generally satisfied, 780 ( 53.65% ) residents were satisfied, and 500 ( 34.39% ) residents were very satisfied with primary health care services. The ordinal and multinomial logistic regression analysis showed that basic medical insurance for urban employees ( OR=0.514, 95%CI: 0.370-0.714 ) , no health records in primary health institutions ( OR=0.528, 95%CI: 0.331-0.844 ) or unknown ( OR=0.524, 95%CI: 0.331-0.829 ) , the queuing time spent for getting medicines ( OR=0.698, 95%CI: 0.531-0.917 ) , ways of getting medicines (OR=0.639, 95%CI: 0.452-0.903 ) and completeness of testing equipment ( OR=1.315, 95%CI: 1.012-1.710) were influencing factors for the satisfaction with primary health care services.@*Conclusions@#The residents in Hangzhou are generally satisfied with the primary health care services, which are associated with the type of medical insurance, the condition of health records in primary institutions, the queuing time spent for getting medicines, the ways of getting medicines and the completeness of inspection equipment.

Intention and satisfaction of people aged 18 to 25 years to seek medical advice in primary medical institutions in Zhejiang Province / 预防医学

Objective @#To analyze the status and influencing factors of the intention of people aged 18 to 25 years to primary medical institutions and their satisfaction for health services in Zhejiang Province, so as to provide basis for the improvement of health services in primary medical institutions.@*Methods@#During November and December in 2019,the 18-25 year-old people in Zhejiang Province were recruited to investigate the general information, intention to seek medical advice and satisfaction for health services in primary medical institutions through WeChat. Logistic regression was performed to analyze the influencing factors of the intention and the satisfaction. Importance matrix was used to analyze the key drivers of the satisfaction. @*Results@#Among the 620 people surveyed, with a response rate of 93.37%, 142 (22.90%) chose primary medical institutions for advice. Actually 516 (83.23%) people went to primary medical institutions last year, and 384 ( 74.42% ) of them were satisfied with the health services. The results of multivariate logistic regression analysis showed that the people aged 18-25 years who were under the new rural cooperative medical care system ( OR=3.062, 95%CI: 1.745-5.373 ) and who had records in community health centers ( OR=0.547, 95%CI: 0.308-0.970 ) were more likely to go to primary medical institutions for medical advice; the ability of doctors ( OR=1.478, 95%CI:1.168-1.871 ) ,the drug notification by medical staff ( OR=1.308, 95%CI: 1.065-1.606 ) , routine examination items ( OR=1.523, 95%CI: 1.227-1.889 ) , the ways of payment ( OR=1.168, 95%CI: 1.017-1.340 ) , the comfort of environment ( OR=1.785, 95%CI: 1.437-2.219 ) and the bulletin boards of health knowledge ( OR=1.302, 95%CI: 1.086-1.561 ) were associated with the satisfaction. The results of importance matrix analysis showed that the ability of doctors and routine examination items were the priorities to improve, followed by the drug notification by medical staff; the comfort of environment had competitive advantages; the ways of payment and the bulletin boards of health knowledge needed to be further analyzed. @*Conclusions@#The 18-25-year-old people in Zhejiang Province were less intended to seek medical advice in primary medical institutions, which was associated with the type of medical insurance and records in community health centers. They were satisfied with the health services, the ability of doctors and routine examination items were the key drivers.