Objectives: This study aimed to assess the trends of healthy aging and investigate its determinants in the middle-aged population. Study design: This was a longitudinal study. Methods: The sample comprised 3043 participants aged 45-59 years from the China Longitudinal Study of Health and Retirement 2011-2018. We plotted the prevalence across four waves and used ordered logistic models to investigate the determinants of cumulative times of healthy aging. Results: We enrolled 3043 middle-aged people in our study. The prevalence of healthy aging is 28.2% at baseline but subsequently decreased to 19.72% at wave 4. Active socializing consistently ranked the lowest among the five dimensions. Participants with older age (odds ratio [OR] = 0.95, 95% con fidence interval [CI] = 0.94-0.97), low monthly income (OR = 0.82, 95% CI: 0.69-0.97) or lived in urban (OR = 0.81, 95% CI: 0.70-0.94) were less likely to have per time increase in healthy aging. Participants with more than primary school degree (OR = 1.79, 95% CI: 1.31-2.46), high life satisfaction (OR = 2.38, 95% CI: 1.86-3.06), and good self -report health (OR = 1.97, 95% CI: 1.66-2.34) were more likely to have healthy aging. Conclusion: The number of middle-aged individuals in China who achieved healthy aging is declining and eventually less than one in five, which was far from ideal. Particular attention should be paid to older, women, urban dwellers, individuals with low income, low life satisfaction or poor self -report health. It is urgent to develop public health policies to improve the health and well-being of the middle-aged population . (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4. 0/).

Aging populations, along with low fertility rates, have become a pervasive world-wide problem. To address this challenge, China issued a universal 3-child policy on May 31, 2021. However, little is known regarding the intentions of childbearing-aged Chinese for a third child. The purpose of this study was to assess the fertility intentions of the Chinese as related to this third-child policy and identify risk factors for third-child refusal. In this cross-sectional study, a total of 2129 Chinese childbearing-aged participants were recruited nationwide from June 15 to July 22, 2021. Each participant was interviewed using questionnaires to establish their sociodemographic variables, psychosocial factors as related to third-child intentions, and reasons for third-child refusal. Finally, 2115 responses (866 men and 1249 women) were analyzed. IBM SPSS Statistical Software (version 19) was used for the statistical analyses. Multivariate logistic regression analyses were used to assess independent influences for third-child refusal. Approximately 30% of these participants reported an intention for having a third child. In those expressing a refusal for a third child, women showed a higher prevalence rate (74.1 vs 63.2%, P < .001). Results from multivariate logistic regression analyses revealed that age (P = .033), unemployment (P = .045), and currently raising 2 children (P = .017) were risk factors for third-child refusal among men, while age (P < .001), >15 years of education (P = .017), current smokers (P = .005) and residing in Northern China (P = .035) were risk factors for women. Overall, increased demands upon time and energy (41.5%), as well as economic burdens (41.4%), were the most prevalent reasons for the refusal of a third child, while achieving mutual care among siblings (52.5%) and reducing child educational costs (33.3%) were the most effective persuasions. In response to the 3-child policy, Chinese childbearing-aged adults showed low rates of intention for a third child, with women showing a higher prevalence of third-child refusal. The identification of risk factors and the reasons for third-child refusal as revealed from the results of this study provide a foundation for the development of programs needed to aid in the implementation of this 3-child policy.

BACKGROUND:The ability to understand and make use of object-scene relationships are critical for object and scene recognition.OBJECTIVE:The current study assessed whether patients with mild cognitive impairment (MCI), possibly in the preclinical phase of Alzheimer's disease, exhibited impairment in processing contextual information in scene and object recognition.METHODS:In Experiment 1, subjects viewed images of foreground objects in either semantic consistent or inconsistent scenes under no time pressure, and they verbally reported the names of foreground objects and backgrounds. Experiment 2 replicated Experiment 1, except that subjects were required to name scene first. Experiment 3 examined object and scene recognition accuracy baselines, recognition difficulty, familiarity with objects/scenes, and object-scene consistency judgements.RESULTS:There were contextual consistency effects on scene recognition for MCI and healthy subjects, regardless of response sequence. Scenes were recognized more accurately under the consistent condition than the inconsistent condition. Additionally, MCI patients were more susceptible to incongruent contextual information, possibly due to inhibitory deficits or over-dependence on semantic knowledge. However, no significant differences between MCI and healthy subjects were observed in consistency judgement, recognition accuracy, recognition difficulty and familiarity rating, suggesting no significant impairment in object and scene knowledge among MCI subjects.CONCLUSIONS:The study indicates that MCI patients retain relatively intact contextual processing ability but may exhibit inhibitory deficits or over-reliance on semantic knowledge.

Atherosclerosis (AS) is a chronic inflammatory disease of the arterial intima. As AS represents the most common type of vascular disease, it affects millions of individuals and is a source of high morbidity and mortality rates worldwide. Overwhelming evidence indicates that AS-related inflammation is mediated by proinflammatory cytokines, chemokines, adhesion molecules and inflammatory signaling pathways, with each of these factors being shown to play critical roles during the entire progression of AS. While a number of drugs have been approved for use in the treatment of AS, their benefits are modest, which underscores the urgency for the development of new drug therapies. In part, these deficits in effective drugs can be attributable to the lack of a clear understanding of the molecular mechanisms of AS. In this study, we investigate the capacity for thrombin to trigger inflammation and induce cell proliferation in vascular smooth muscle cells (VSMCs). We then assessed the effects of baicalin and its potential mechanisms on VSMC inflammation as induced by thrombin. Baicalin, which is a natural bioactive compound of S. baicalensis Georgi (SBG), exerted a protective effect against thrombin-induced VSMC inflammation as resulting from the upregulation of PAR-1. This protection as exerted by baicalin appears to reside in its capacity to produce an inhibitory effect on the thrombin-induced activation of the ERK1/2 pathway. These findings suggest that baicalin may be a promising candidate for the treatment of atherosclerosis.

BackgroundWith promotion of COVID-19 vaccinations, there has been a corresponding vaccine hesitancy, of which older adolescents and young adults represent groups of particular concern. In this report, we investigated the prevalence and reasons for vaccine hesitancy, as well as potential risk factors, within older adolescents and young adults in China.MethodsTo assess these issues, an online survey was administered over the period from March 14 to April 15, 2021. Older adolescents (16–17 years old) and young adults (18–21 years old) were recruited nationwide from Wechat groups and results from a total of 2,414 respondents were analyzed. Socio-demographic variables, vaccine hesitancy, psychological distress, abnormal illness behavior, global well-being and social support were analyzed in this report.ResultsCompared to young adults (n = 1,405), older adolescents (n = 1,009) showed higher prevalence rates of COVID-19 vaccine hesitancy (16.5 vs. 7.9%, p < 0.001). History of physical diseases (p = 0.007) and abnormal illness behavior (p = 0.001) were risk factors for vaccine hesitancy among older adolescents, while only a good self-reported health status (p = 0.048) was a risk factor for young adults. Concerns over COVID-19 vaccine side effects (67.1%) and beliefs of invulnerability regarding infection risk (41.9%) were the most prevalent reasons for vaccine hesitancy. Providing evidence on the vaccine reduction of COVID-19 infection risk (67.5%), ensuring vaccine safety (56.7%) and the low risk of side effects (52.7%) were the most effective persuasions for promoting vaccinations.ConclusionIn China, older adolescents showed a higher prevalence for vaccine hesitancy than that of young adults. Abnormal illness behavior and history of physical diseases were risk factors for vaccine hesitancy among these older adolescents, while social support represents an important factor which could help to alleviate this hesitancy.

Introduction: COVID-19, a continuously emerging human-to-human infectious disease, has exerted a significant impact on the mental health of college students. However, little is known regarding the variations in the mental health issues experienced by college students during the peak versus reopening stages of the COVID-19 epidemic in China. Methods: To assess these issues, an online longitudinal survey was conducted via a WeChat applet. Undergraduates (n = 300) were recruited from 26 universities throughout Jinan in February 2020 (T1 – the epidemic peak stage) and in January 2021 (T2 – the society reopening stage). Their mental status was determined using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 item, and the Insomnia Severity Index. Results: Of the original 300 college students recruited for this survey, 294 responses at T1 and 285 at T2 were analyzed. Compared with responses obtained at T1, college students at T2 showed a greater prevalence of depression (65.3 vs. 51.0%; p = 0.001) and anxiety (47.7 vs. 38.1%, p = 0.019), and experienced more severe depression (p < 0.001) and anxiety (p < 0.001). Both males (p = 0.03) and females (p < 0.01) showed higher levels of depression at T2 versus T1, while no differences were obtained with regard to anxiety and insomnia. At T1, Grade 4 students showed greater levels of depression (p = 0.005) and anxiety (p = 0.008) than that of Grade 1 students. While at T2, only greater levels of depression (p = 0.004) were present when compared with that of Grade 1 students. Additionally, Grade 4 college students demonstrated a greater prevalence of depression at T2 versus T1 (p = 0.03), but no statistically differences were present for anxiety and insomnia. No statistically significant differences were obtained among the 4 grades of college students for insomnia at either the T1 or T2. Conclusion: With progression of the COVID-19 epidemic, college students showed increasing levels of depression and anxiety, with Grade 4 college students being most seriously affected. It is imperative that intervention strategies be implemented to mitigate against these mental health issues resulting from the COVID-19 epidemic.

Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a plethora of psychological problems worldwide since its onset in December 2019. In the upheaval period, compared with medical college students, nonmedical students' psychological state deserves additional concern due to their lack of medical knowledge. Although the epidemic in China has been largely controlled for several months, the mental health problems resulting from the COVID-19 epidemic persist to this day. In this study, we assessed the mental health problems and associated risk factors experienced by nonmedical vs. medical college students in universities of Shandong Province during the COVID-19 epidemic recovery period. Methods: An online survey was conducted over the period from 17 to 19 December 2020. A total of 954 Chinese college students (486 nonmedical and 468 medical students) from three universities of Shandong Province participated in the survey. Mental health variables were assessed with use of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI). Results: Compared with medical students, nonmedical college students had higher prevalence rates of depression (53.9 vs. 46.4%; p = 0.020) and insomnia (28.0 vs. 22.4%, p = 0.049), as well as higher total scores on the PHQ-9 (p = 0.03) and ISI (p < 0.01). Among nonmedical college students, being female and native of non-Shandong were risk factors for anxiety and depression (p < 0.01), while only native of non-Shandong for insomnia (p < 0.01). Among medical students, age (p < 0.01) and living in rural areas (p = 0.04) were risk factors for depression, while only age (p < 0.05) was a risk factor for anxiety and insomnia. Conclusion: Nonmedical college students in the universities of Shandong Province had more mental health problems and more risk factors for developing them during the COVID-19 epidemic recovery period than medical students. These nonmedical students require additional attention and recovery programs to alleviate the increased incidence of psychological problems related to COVID-19.

Introduction: With the approval of COVID-19 vaccinations for children and adolescents in China, parental vaccine hesitancy will emerge as a new challenge with regard to the administration of these vaccines. However, little is known regarding this hesitancy as well as regional differences that may exist between parents from Shandong vs. Zhejiang. Methods: To assess these issues, an online survey was conducted via a Wenjuanxing platform over the period from July 22 to August 14, 2021. Parents from Shandong and Zhejiang were recruited from Wechat groups and results from a total of 917 subjects were analyzed. Factors evaluated in this survey included socio-demographic variables, parental vaccine hesitancy, Parental Attitudes toward Childhood Vaccines (PACV) domains (behavior, safety and efficacy, general attitudes) and social support. Results: Compared with those from Shandong (N = 443), parents from Zhejiang (N = 474) showed significantly higher prevalence rates of COVID-19 vaccine hesitancy (19.4 vs. 11.7%, p = 0.001). Multivariate logistic regression showed that yearly household incomes of ≥120,000 RMB (p = 0.041), medical workers (p = 0.022) and general attitudes of PACV (p = 0.004) were risk factors for vaccine hesitancy among parents from Shandong, while behavior (p = 0.004), safety and efficacy (p < 0.001) and general attitudes of PACV (p = 0.002) were risk factors for parents from Zhejiang. Among parents with vaccine hesitancy (N = 144), concerns over side effects (91.0%) and unknown effects (84.0%) of the COVID-19 vaccine were the most prevalent reasons for hesitancy. Evidence providing proof of vaccine safety (67.4%) and assurance of a low risk of being infected by COVID-19 (60.4%) were the two most effective persuasive factors. Conclusion: Parents from Zhejiang showed a higher prevalence of COVID-19 vaccine hesitancy as compared with those from Shandong. Behavior, safety and efficacy, and general attitudes of PACV were the risk factors associated with this hesitancy in these parents from Zhejiang. Given the identification of the various reasons for parental vaccine hesitancy, different strategies as well as regional adjustments in these strategies will be required for an effective and convincing protocol for childhood vaccinations.

Background: As the fight against the COVID-19 epidemic continues, medical workers may have allostatic load. Objective: During the reopening of society, medical and nonmedical workers were compared in terms of allostatic load. Methods: An online study was performed; 3,590 Chinese subjects were analyzed. Socio-demographic variables, allostatic load, stress, abnormal illness behavior, global well-being, mental status, and social support were assessed. Results: There was no difference in allostatic load in medical workers compared to nonmedical workers (15.8 vs. 17.8%; p = 0.22). Multivariate conditional logistic regression revealed that anxiety (OR = 1.24; 95% CI 1.18–1.31; p < 0.01), depression (OR = 1.23; 95% CI 1.17–1.29; p < 0.01), somatization (OR = 1.20; 95% CI 1.14–1.25; p < 0.01), hostility (OR = 1.24; 95% CI 1.18–1.30; p < 0.01), and abnormal illness behavior (OR = 1.49; 95% CI 1.34–1.66; p < 0.01) were positively associated with allostatic load, while objective support (OR = 0.84; 95% CI 0.78–0.89; p < 0.01), subjective support (OR = 0.84; 95% CI 0.80–0.88; p < 0.01), utilization of support (OR = 0.80; 95% CI 0.72–0.88; p < 0.01), social support (OR = 0.90; 95% CI 0.87–0.93; p < 0.01), and global well-being (OR = 0.30; 95% CI 0.22–0.41; p < 0.01) were negatively associated. Conclusions: In the post-COVID-19 epidemic time, medical and nonmedical workers had similar allostatic load. Psychological distress and abnormal illness behavior were risk factors for it, while social support could relieve it.

Senior nurses can suffer from high job stress and burnout, which can lead to negative patient outcomes and higher turnover rates; however, few studies have examined this topic. We recruited 224 head and senior nurses from September to December 2015 using convenience and cluster sampling, to compare job stress and burnout levels between the two groups. The Nurse Job Stressors Inventory and Maslach Burnout Inventory scales were used to evaluate job stress and burnout, respectively. Results indicated that job stress scores significantly differed between head and senior nurses. The highest scoring subscales in both groups were time allocation and workload problems. Scores for the three burnout dimensions also significantly differed between the groups. Positive correlations between job stress and burnout were stronger among senior nurses than head nurses. Burnout may be higher among senior nurses given head nurses' potential for greater perceived job control. Our findings suggest that measures need to be taken to reduce burnout and turnover rates among senior nurses.